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Does red wine consumption correlate to better heart health?
October 5, 2009
For those individuals intent on living a long, healthy life, a popular growing health trend is the idea that drinking a glass of red wine daily is correlated to better heart health. While this trend may prove to be correct, it is important to research the evidence behind any health claims and decide whether the evidence can stand up to proper scrutiny. In this case, indeed, there have been studies that demonstrate that people who regularly drink red wine, such as those who live around the Mediterranean, have lower risks of heart disease (http://www.healthcastle.com/redwine-heart.shtml). This belief that a daily glass of red wine positively affects heart health stems from studies that show that red wine contains antioxidants, which have been linked to good cardiovascular health and thus hopefully to longer life. (http://www.nytimes.com/2009/07/21/health/21real.html?_r=1&scp=1&sq=red%20wine%20and%20heart%20health&st=cse). Here are the claims regarding red wine consumption as presented on the internet.
A glass of red wine contains antioxidants, which are nutrients found in food or drink that can slow the process of oxidation in the body (http://www.healthcastle.com/antioxidant.shtml). The antioxidants found in red wine can be broken down into two different groups, flavonoids and non-flavonoids. Flavonoids demonstrate properties that help prevent blood clots and plaque formation in arteries (http://www.healthcastle.com/redwine-heart.shtml). Non-flavonoids appear to be helpful in preventing artery blockages (http://www.mayoclinic.com/health/red-wine/HB00089). The non-flavonoid antioxidant resveratrol has received much attention from researchers because of its supposed healthy promise. Resveratrol also appears to increase HDL (the good cholesterol) levels (http://www.healthcastle.com/redwine-heart.shtml). Resveratrol is found in grape skins and seeds, which is important when considering the actual production of red wine. Red wine is fermented with grape skins longer than white wine, and thus has a higher concentration of resveratrol in it than white wine (http://www.mayoclinic.com/health/red-wine/HB00089). This fosters the idea that red wine is a more heart healthy drink than white wine or other forms of alcohol.
The claim that moderate intake of red wine is correlated to good heart health propagated by the media is indeed based in scientific research, but some of this research may be skewed or not comparable to normal levels of antioxidant intake. According to research studies, the regular consumption of red wine is correlated to a lower risk of coronary heart disease and lower mortality, but the actual mechanism and level of contribution to some of wine’s healthy constituents is as yet unclear and under continued study (Corder et al. 2006). The claim that the antioxidant resveratrol is the key ingredient in red wine for better heart health is also based upon scientific study, but most of these studies were conducted on mice, not people, according to the website (http://www.mayoclinic.com/health/red-wine/HB00089). Though these studies correlated resveratrol to lowered risk of health disease, the dose of resveratrol used in these studies (as indicated on the public websites) was much higher than the normal dosage found in a glass of red wine.
Though red wine contains antioxidants which are correlated with better heart health, alcohol intake should still be done in moderation. The American Heart Association recommends one to two drinks per day for men and one drink per day for women (http://www.healthcastle.com/redwine-heart.shtml). Too much alcohol consumption increases the risk of hypertension, liver damage and obesity, among others effects, thus moderation is key (http://www.mayoclinic.com/health/red-wine/HB00089). In addition, even small amounts of alcohol can cause cardiomyopathy, or weakened heart muscle in some individuals, which will negate any positive effects the antioxidants provide (http://www.mayoclinic.com/health/red-wine/HB00089). The AHA also recommends that individuals who don’t drink already should not start drinking alcohol.
The idea that the consumption of red wine correlates with better heart health is propagated by health websites. These websites range from sites such as WebMD and The Mayo Clinic (http://www.mayoclinic.com/health/red-wine/HB00089) to health sites presented and authored by an RD (http://www.healthcastle.com/redwine-heart.shtml), or registered dietician. Each website is presenting mostly the same information, that red wine contains antioxidants that promote better heart health. How each website backs up its claims is an individual entity. The information on the WebMD and Mayo Clinic websites is backed up by scientific research with controlled studies. The information presented on other websites has no citations from scientific studies, but still presents similar information. Though the information may match the scientific research, without citations and research presented to back up the claims on the websites, the claims aren’t worth much. In addition, some sites mention that resveratrol supplements are actually available for consumers who wish to up their level of antioxidant intake even more, though they did not seem to endorse the antioxidant as something that truly will make a difference in heart health. This may demonstrate that the motive of presenting resveratrol as the correlating factor between red wine and better heart health is for monetary gain, not necessary because the information is correct.
Scientific Literature Review
A popular growing health trend is the idea that drinking a glass of red wine daily is correlated to better heart health. It is necessary to be able to understand what sort of health improvement claims are facts and which ones are fictional. The claim that red wine increases heart health does appear to stand up to scientific scrutiny. The red wine concept began has the French Paradox, which is based on the fact that the French mortality rate is lower than the British mortality rate, though both countries’ diets are similar in content (Corder et al., 2001). The French Paradox phenomenon has grown into a major health trend, one that has been written up in the New York Times and Nature alike, proving that it is indeed a research-provoking concept that individuals worldwide wish to know more about. Recently, more studies have been conducted to try to pinpoint which substance that is present in red wine is the nutrient responsible for such mortality differences, as well as how much of said nutrient is necessary to make a difference. These questions are important where wine is concerned because certain geographical regions of vineyards will produce wine consisting of more or less of the nutrients in question, purely based upon the quality and quantity of grapes grown in the area. Some relevant questions to be asked regarding the wine research are:
Antioxidants: Flavonoids and Resveratrol
What substances in red wine are responsible for the decreased risk of coronary heart disease? The scientific research points to two substances present in red wine that appear to be the responsible correlating variables, flavonoids and resveratrol (Hertog et al., 1995; Kopp, 1998; Ray et al., 1999). Flavonoids are “polyphenolic antioxidants that occur in foods of vegetable origin” such as red wine (Hertog et al., 1995, page 381). According to Hertog et al. (1998), flavonoids are thought to reduce levels of low-density lipoproteins, or LDLs, which, in lay terms, are the “bad cholesterol.” Thus, it follows that flavonoids may reduce the risk of coronary heart disease. Indeed, Hertog et al. (1998) found that flavonoid intake was actually inversely related to the rate of coronary heart disease mortality.
Resveratrol has antioxidant properties and is a “natural phytoalexin found in a wide variety of plant species including grapes, [and] it is abundantly present in the seeds and skin of grapes and constitutes one of the major components of red wine” (Ray et al., 1999, page 160). According to Ray et al. (1999), resveratrol has cardioprotective effects, specifically protection against myocardial infarction.
Red or White Wine?
Is red wine better than white wine where the concentration of heart healthy nutrients is concerned? According to Kopp (1998), resveratrol is present in much higher levels in red wines than in white wines. Kopp states that this can be “explained by the fact that immediately after the grapes are pressed, the skins are removed in white wine production, while the grape skins are left with the freshly pressed red wine for variable periods of time in order to extract aromatic compounds” (Kopp, 1998, page 619). This follows from the fact that resveratrol is found in grape skins and seeds (Ray et al., 1999). In addition, differences in resveratrol content may be found between grapes in different geographical locations and therefore even red wines from different geographical locations (Wollin and Jones, 2001).
Is there really a difference?
Is there a difference in risk for coronary heart disease between those who drink red wine daily and those who do not? Yes and no. The scientific evidence supports the claim that alcohol consumption in moderation is beneficial for heart health. Rimm (1998) reviewed more than 60 ecological, case control and cohort studies with populations from the world over searching for a correlation between alcohol consumption and decreased risk of coronary heart disease. The evidence indicates that “in general, men and women who consume 1-2 alcoholic drinks per day have the lowest risk of coronary disease” (Rimm, 1998, page 1094). The key for Rimm’s review, however, is that the consumption of alcoholic drinks was not limited to just red wine – his review included wine, beer and liquor. Interestingly, the heart health benefits from alcohol could be greater from wine, beer, or liquor, depending on the geographical cohort studied. Then, it may be possible to state that the differences in heart health from the effects of the three different alcoholic drinks could be based on the lifestyle and environment of the cohort in question.
The American Heart Association appears to stand firm on their recommendations for proper consumption level. While the afore-mentioned scientific studies contend that a higher intake of antioxidants correlates with a decreased risk of coronary heart disease, alcohol drinkers must remember that the antioxidants in question appear in alcohol. According to the AHA, too much alcohol consumption can lead to higher levels of triglycerides, hypertension, heart failure and high calorie intake (Alcohol, 2009). Other health issues, such as cardiomyopathy, cardio arrhythmia, and sudden cardiac death can also occur with higher levels of alcohol consumption (Alcohol, 2009). Thus, the AHA recommends that alcohol consumption should be done in moderation, which means “an average of one to two drinks per day for men and one drink per day for women” (Alcohol, 2009).
This literature review finds that moderate red wine consumption does correlate to better heart health. For individuals who wish to maintain a healthy lifestyle, the current scientific research demonstrates that in moderation, red wine, in addition to alcohol in general, decreases the risk of coronary heart disease and therefore correlates to better heart health in individuals. Depending on where this information is presented, whether on a layperson’s health website or in a scientific electronic journal, the findings will be seen as either more or less reputable. In this instance, the findings on both ends of the reputability spectrum were similar, but the scientific journals will be more highly regarded and believed by more individuals because of the evidence to back it up. Layperson’s health websites often do not have any sort of scientific citations and the reader is left to wonder whether the information presented on the website is true or whether it is a ploy for earning a profit. In the case of red wine consumption, the scientific literature has found correlations to better heart health in response to moderate alcohol consumption, but there is much left to be considered and studied on the subject. Because of the ever-changing scientific research being conducted, and because of the ease with which it is possible to present an invalid claim on the web as true, it is important to always consider the validity of a health claim before following its recommendations.
American Heart Association. (2009). Alcohol, Wine and Cardiovascular Disease. Retrieved October 4, 2009 from http://www.americanheart.org/presenter.jhtml?identifier=4422
Corder, R., Douthwaite, J. A., Lees, D. M., Khan, N. Q., Viseu dos Santos, A. C., Wood, E. G., et al. (2001). Endothelin–1 synthesis reduced by red wine. Nature, 414, 863-864.
Corder, R., Mullen, W., Khan, N. Q., Marks, S. C., Wood, E. G., Carrier, M. J., et al. (2006). Oenology – red wine procyanidins and vascular health. Nature, 444, 566.
Hertog, M. G. L., Kromhout, D., Aravanis, C., Blackburn, H., Buzina, R., Fidanza, F., et al. (1995). Flavonoid intake and long-term risk of coronary heart disease and cancer in the seven countries study. Arch Internal Medicine, 1995, 381-386.
Knekt, P., Jarvinen, R., Reunanen, A., and Maatela J. (1996). Flavonoid intake and coronary mortality in Finland: a cohort study. British Medical Journal, 312, 478-481.
Kopp, P. (1998). Resveratrol, a phytoestrogen found in red wine. A possible explanation for the conundrum of the ‘French Paradox’? European Journal of Endocrinology, 138, 619-620.
Ray, P., Maulik, G., Cordis, G. A., Bertelli, A. A. E., Bertelli, A., and Das, D. K. (1999). The red wine antioxidant resveratrol protects isolated rat hearts from ischemia reperfusion injury. Free Radical Biology and Medicine, 27(1), 160-169.
Rimm, E. B. (1996). Alcohol consumption and coronary heart disease: good habits may be more important than just good wine. American Journal of Epidemiology, 143(11), 1094-1097.
Rimm, E. B., Katan, M. B., Ascherio, A., Stampfer, and Willet, W. C. (1996). Relation between intake of flavonoids and risk for coronary heart disease in male health professionals. Annals of Internal Medicine, 125(5), 384-389.
Wollin, S. D. and Jones, P. J. H. (2001). Alcohol, red wine and cardiovascular disease. Journal of Nutrition, 131, 1401-1404.
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