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Something to Drink To: Red Wine and Heart Health
October 10, 2008
As obesity rates skyrocket in the United States, everyone is looking for a quick fix for the chronic medical conditions associated with this epidemic. Diabetes, high blood pressure, and heart disease can all be treated with medications, diet, and exercise, but alternative treatments are often hotly discussed and utilized by those at risk. One popular and hotly discussed proposed preventative measure is the regular consumption of red wine. Many have heard that a glass a day can have health benefits, particularly for the heart and the circulatory system. This paper will seek to determine what claims internet-based literature makes regarding red wine’s impact on an individual’s susceptibility to heart disease, and compare that to the scientific research published on the same topic.
Will a Glass A Day Keep the Doctor Away?
Most of the popular web articles correlate red wine consumption with reduced rates of heart disease, as well as the incidence of heart attacks and even cancer. For the purposes of this article, red wine’s association with improved heart health will be examined. The claimed benefits, in regards to a healthy circulatory system, are carefully outlined in Karen Pallarito’s article “To Your Health: Benefits of Red Wine” published on the women’s internet community iVillage. Wine contains chemical compounds known as antioxidants that protect and restore the body’s cells, ultimately delaying the onset of chronic disease and aging. The scientific term for these non-alcoholic chemicals are polyphenols. Flavanoids are one type of polyphenols that are of particular interest. They exhibit antioxidant properties by trapping free-radicals in the blood stream that may cause damage to healthy cells. Resveratrol, another polyphenolic compound, is a non-flavanoid that is most concentrated in red wine and has become somewhat of a buzz word in the discussion of this health topic. The Mayo Clinic, a world-renowned research center, published an article specifically on this topic, titled “Red Wine and Resveratrol: Good for Your Heart?” This substance is found in the skin and seeds of grapes and is most popularly touted as the primary ingredient that helps to improve and maintain heart health. In addition to general antioxidant properties discussed, resveratrol helps to elevate levels of high-density lipoprotein (HDL) cholesterol, the “good” cholesterol, in the blood. This keeps platelets, the clotting agents that stick together to form blockages in blood vessels, from aggregating and restricting the flow of blood throughout the body. Often this is referred to as “thinning” the blood. Furthermore, the antioxidants previously discussed prevent plaque from accumulating on the walls of the arteries and veins throughout the body, further counteracting the deterioration of the circulatory system. This topic was covered on the Today Show, and summarized in the article “Raise a Glass! Wine’s Health Benefits” This resource elaborates on this property the naturally-occurring chemicals found in red wine.
Why Red Wine?
Some may be wondering why red wine is preferable to white wine or even grape juice when trying to improve heart health. As you may have noticed, the most commonly mentioned “magic ingredients” in red wine are resveratrol, flavanoids, and antioxidants in general. These are stored in the skins and seeds of the grape. Since red wine ferments longer with the skins intact, the levels of antioxidants in the finished product are significantly higher than in a bottle of white wine. Similarly, grape juice is not processed and produced in such a way that the heart-healthy compounds are allowed to steep in the juice for an extended period of time. This explains why red wine is the drink with proposed health benefits, instead of another type of wine or simply grape juice. (Red Wine and Resveratrol: Good for Your Heart?)
There is some discussion about whether the increased levels of HDL cholesterol associated with red wine consumption can be attributed to the alcohol content in wine. Alcohol is known, in small to moderate amounts, to have a slightly positive effect on the presence of good cholesterol in the blood stream. Even so, other alcoholic beverages do not have the antioxidant properties that red wine does. Since an excess of alcohol leads to intoxication and consumption of empty calories in the short-term and increased risk for cancer in the long-run, no matter what the drink, moderation is strongly encouraged. (The Health Benefits of Drinking Red Wine)
Is This Safe and Effective?
Generally, internet-based literature does not guarantee effectiveness of this proposed heart health initiative, but gives varying degrees of support for adopting a red wine regimen. In fact, many of the websites remind readers that alcohol can be a dangerous substance and warns that excess consumption can have a variety of adverse health effects. For instance, The American Heart Association (AHA) published an article titled “Alcohol, Wine and Cardiovascular Disease” that was extremely hesitant to endorse this behavioral intervention. One might even label this organization’s stance on the treatment as skeptical. They begin by listing all the negative effects and possible complications associated with alcohol consumption before even mentioning the potentially beneficial properties of wine. Even so, they are careful to emphasize the correlation between improved heart health and red wine consumption, as opposed to direct causality. The authors note that such a correlation could be attributed to other confounding variables, such as diets low in saturated fat or increased physical activity. Furthermore, those writing on behalf of the AHA provide suggestions of other anti-oxidant rich foods and beverages from which one could obtain similar health benefits. Ultimately, this internet source encourages more traditional methods of reducing risk for cardiovascular disease, like altering diet and exercise habits. They suggest this in favor of increasing alcohol intake, supposing that this intervention is more of a risky behavior for other complications than it is a preventative or protective measure for heart disease.
Is This a Trustworthy Claim?
The most available articles on this subject are from a variety of sources, but all reference reliable and generally trusted organizations. As previously mentioned, the Mayo Clinic is federally funded and known around the world for scientific knowledge and ground-breaking research. Likewise, the American Heart Association is a very well-respected and easily recognized health care affiliate that most of society would view as credible and knowledgeable about a variety of health topics. On the more pop culture side of the spectrum, sources such as iVillage and the Today Show are trying to reach a specific audience and tailor their information to be both informative and entertaining to these audiences. This bias is important to note, especially when examining the much more favorable tone of these articles in discussing the adoption of a red wine regimen into one’s lifestyle.
What Scientific Evidence is Available?
In recent years, red wine’s potential health benefits have been a hot topic not only in popular culture but in the academic community. There have been numerous studies conducted that attempt to find a connection between red wine and positive health outcomes, if there is a connection to find.
Mukamal and colleagues (2003) designed a study to determine whether alcohol consumption had an impact on the risk of myocardial infarction, a type of cardiovascular disease. They surveyed a sample of over 38,000 male health care professionals about their current health conditions and alcohol consumption habits. They followed up every two years and collected the incidence of cardiovascular complications. The results indicated that those who drank alcohol in moderation 2-3 days a week or 4-5 days a week had a lower risk of myocardial infarction or other cardiac problems. Furthermore, their research showed that type of beverage was not a factor in reducing risk—no type of beverage had a statistically significant difference in effectiveness than any other beverage. This study supports the idea that red wine has health benefits, but it extends these benefits to all types of alcoholic beverages.
Another article written by Reinaud and de Lorgeril (1992) explores what is commonly known as “the French paradox,” a phrase used to describe the relatively low incidence of cardiovascular disease in France, despite similar rates of saturated fat intake in countries like the United States and Canada. One of the possible explanations is that in addition to a Mediterranean-style diet, the French drink a high volume of wine. Reinaud and de Lorgeril’s article confirms several of the points found in online literature on the subject. For instance, they discuss the properties of alcohol that lead to increased levels of HDL cholesterol in the bloodstream and describe in detail how platelet aggregation is reduced. However, they have little conclusive evidence that red wine is the sole explanation for the French paradox or that red wine is more beneficial than other types of alcohol.
In a literature review published in the European Heart Journal, Opie and Lecour (2007) also address the French paradox, which they refer to as the “red wine hypothesis.” They look specifically at the popular notion that red wine is more beneficial than white wine and cite several studies that used non-alcoholic wine to test the benefits discussed in the previous section. The findings of these studies are that red wine does have slight health benefits, most notably from the polyphenols that act as antioxidants. Like some of the websites mentioned, Opie and Lecour attribute many of the positive circulatory benefits to resveratrol and recommend new studies examining and comparing the effects of alcohol, red wine, and resveratrol. This would be an attempt to determine what components of red wine promotes a healthy heart.
Zern and Fernandez (2005) wrote an entire article in regards to the cardioprotective effects of a diet rich in polyphenols like those found in red wine. They begin by acknowledging the plethora of conflicting studies claiming either positive benefits and null effects of red wine’s ability to reduce the production of low-density lipoprotein (bad cholesterol). The rest of the article reviews other studies that have found different benefits of red wine consumption, such as reducing inflammation and aiding triglyceride assembly and secretion. These positive attributes were not mentioned in any of the internet literature reviewed previously in this report, possibly because these mechanisms are highly technical and function on the cellular level. The academic nature of these findings would make it difficult for an individual with no scientific background to fully understand.
Tony Peregrin, writing on behalf of the American Dietetic Association (2005), reiterates many of the claims about the cardioprotective factors of red wine in this selection of literature. A significant portion of his article is dedicated to moderation, as many of the websites also did. He emphasizes the importance of having only one or two glasses of wine to optimize the health benefits and not employ alcohol’s negative effects on the body.
To Drink or Not to Drink?
As one can see, any claim regarding the positive health benefits of regular consumption of red wine can easily be disputed. Web-based research is relatively informative and accurate when compared to the literature on the subject. However, one must also note that an article written about how red wine has no effect on health would be much less attuned to what readers want to hear or read. The single overwhelming consensus across sources is that moderation is essential to obtaining any sort of benefits from a red wine regimen. Since wine is an alcoholic beverage, overindulgence can lead to an elevated risk for a variety of different diseases and conditions. Any of the minor health advantages gained by drinking red wine could quickly be overpowered if an individual’s drinking behavior was excessive in nature. Ultimately, this leaves those looking for a quick fix to their high risk lifestyle to do it the hard way with exercise and a diet of fresh foods that are low-fat and high-fiber. So, to answer the question, “To drink or not to drink?” for a healthy heart: sure, have a drink, maybe even two. But only after you eat your veggies and hit the gym!
Mukamal, K., Conigrave, K., Mittleman, M., et al. (2003). Roles of drinking pattern and type of alcohol consumed in coronary heart disease in men. The New England Journal of Medicine, 348: 109-18.
Opie, L. & Lecour, S. (2007). The red wine hypothesis: from concepts to protective signaling molecules. European Heart Journal, 28: 1683-1693.
Peregrin, T. (2005). Wine—A drink to your health? Journal of the American Dietetic Association, 105: 1053-1054.
Renaud, S., & de Lorgeril, M. (1992). Wine, alcohol, platelets, and the French paradox for coronary heart disease. The Lancet. 339: 1523-1527.
Zern, T. & Fernandez, M. (2005). Cardioprotective effects of dietary polyphenols. The Journal of Nutrition, 135: 2291-2295.
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