Friday, December 30, 2011

Is it all lifestyle or is wine the key to health? New studies considered.

Much has been made of the recent report from a 20-year study from Harvard that apparently found that it is the lifestyle choices made by wine drinkers, not the wine itself, that is responsible for longer and healthier lives. Following more than 800 people over the age of 55, the researchers found that it was the pattern of moderate drinking and associated lifestyle factors that most closely correlated to health and longevity.

Taken at face value, this study would appear to turn the French paradox on its head. But wasn’t the French paradox defined by heart health despite the unhealthy habits of the French? If that is so, then the findings from the Harvard researchers need to be reconsidered in a new light. On the one hand, it is widely known that aside from the French with their Galoises and penchant for fois gras, wine drinkers do tend to have healthier habits; we are better educated, we exercise more, and eat better. On the other hand, the French paradox – which is supported by substantial statistical data – suggests that there must be something special in the wine after all.

Sorting all of this out becomes tricky, because it isn’t simply all one or all the other. Positive lifestyle factors associated with moderate wine drinking do make a contribution, as this latest study suggests. There are numerous problems with these types of studies, such as self-reporting bias (which we have detailed here before), but the clear message to be drawn is that whatever benefits wine contributes to health and longevity aren’t reducible to biochemistry. It demonstrates that wine consumption with meals, on a consistent basis as an integral part of the lifestyle is where the chips begin to stack up. It underscores the role of alcohol, whether due to its salutary effects on cholesterol profiles or its ability to relax and unite around the dinner table.

So again we see that resveratrol isn’t the explanation, supplements aren’t likely to deliver the same benefits as a glass of wine with dinner, and health and happiness derive from a way of living. With that in mind, let’s all resolve as the new year begins to relax, savor the company of good friends and the joys of good wine. Cheers!
A more detailed critique of the research here.

Saturday, December 17, 2011

The biggest myths about wine and health

Just when it seems that people are starting to catch on about the wine and health story, along come the naysayers to muddy the waters with out of date and disproven assumptions. True, a lot of what I am about to cover here is counterintuitive and goes against longstanding beliefs, but it’s a matter of science. Like Lt. Joe Friday used to say in the 50’s TV series Dragnet, it’s “just the facts, ma’am.”

Myth #1.  Alcohol abuse is the biggest cause of liver disease. We all know that alcohol leads to cirrhosis of the liver right? It turns out that by far the largest cause of liver failure in developed countries is Non-Alcoholic Fatty Liver Disease, or NAFLD. What’s more – and here’s the interesting part – wine seems to have a protective effect against NAFLD. The key here if course is amount, so as with all things wine and health, we are talking about a glass or two of red wine with dinner.

Myth #2. Alcohol destroys brain cells. While technically it may be true that alcohol is toxic to neural tissues, the presumption that any level of drinking is bad for the brain is not. In fact, one of the more surprising revelations to come from the research on wine and health is that cognitive function is objectively better in wine drinkers as they age compared to nondrinkers. This has been a remarkably consistent finding. So drinking –wine, at least – is good for the brain.

Myth #3. Any “French Paradox” benefit to heart disease from wine is nullified by alcohol’s contribution to high blood pressure. While not as widely discussed, this one has been a sort of trump card for the anti-alcohol group since it is well known that alcohol consumption contributes to hypertension. However, it has been confirmed that the heart health benefit still holds even among hypertensives – those who already have high blood pressure.

Myth #4. Wine’s benefits are all due to resveratrol, so you are better off taking a pill and skipping the alcohol.  This is an interesting conclusion but widely held even among “experts.” Resveratrol is indeed a remarkable substance, and wine is the best natural dietary source of this potent antioxidant. (That’s why I have a whole chapter on resveratrol in my book.) But while wine has been shown to have a multitude of benefits, there isn’t actually very much resveratrol in wine, at least compared to the amounts used in laboratory studies. So wine’s benefits by definition have to be mostly from something else.

Myth #5. Wine is empty calories and causes weight gain. Not so fast – red wine’s calories are all from alcohol, which is metabolized differently than carbohydrates so it doesn’t cause the spike in blood sugar. Wine drinkers overall have much lower rates of obesity, and while the polyphenol compounds that make wine red may not have calories, they are important components of a healthy diet.

So a toast to your health this Holiday season, and may you have a guilt-free indulgence or two.

Friday, December 2, 2011

Wine and friendship in Spain - a healthy experience

Is there anything more beautiful in life than the joys of breaking bread and sharing wine and food around the table with friends? As I have written here before, there is some scientific evidence of the health benefits of wine with food and companionship, and it helps to explain why wine’s anti-aging properties can’t be reduced to biochemistry and put into a pill. So with that in mind, let me express thanks to some new friends in Spain from my visit to Madrid and the Ribera del Duero.

Rebeca Colina Giralda gave us a wonderful tour of the Abadia Retuerta vineyards and a tasting of their magnificent wines. The juxtaposition of modern winemaking in a thoughtfully restored centuries-old abbey was an inspiring experience, and the wines are wonderful. Running into Rebeca at a tapas bar in Valladolid the next day was like seeing an old friend!

But few have done more to advance winemaking in the Ribera than Alejandro Fernandez, founder of the Tinto Pesquera group. We had the great pleasure of having lunch with one of his daughters, Lucia Fernandez Rivera, and got to know her and the wines (Pesquera, La Granja, Condado de Haza, and El Vinculo.) Their new hotel, another caringly restored old building in the same vein as Abadia, is well worth a visit.

But not all the winemakers in the Duero are adherents to tradition, as in the case of Richard Sanz of Sitios de Bodega. We had a phenomenal dinner with Richard and a small group at the new symphony hall in Valladolid, showcasing modern Spanish cuisine with a range of wines. Bravo!

Thanksgiving dinner (just happened to be that day, not a Spanish holiday) was an experience so unique that I doubt any American has ever done it before. We enjoyed a private tour of the traditional musical instruments museum run by the multitalented Paco Diaz, who then took us to his 400-year old Bodega cave in Cigales and prepared a truly memorable meal. As you might imagine, there was plenty of local wine, singing, and camaraderie. Our companion for the evening was Angel Moreton, director of the new and very sophisticated International School of Culinary Arts. If you have a chance to visit (and I hope you do) look for a copy of my book in their library.

Back in Madrid we had the great privilege of dining at the CafĂ© de Oriente with Alfonso de Salas, of the Spanish newspapers El Mundo and El Economista, and founder of the splendid winery Montecastro. Definitely get your hands on some of this wine, and look for a review of my book in the Spanish press.

Thinking back on these memorable experiences, I feel healthier already. And send me an email if you want to know where the best undiscovered medieval hill town in central Spain is, or for more recommendations on Spain’s remarkable Tempranillo wines.

Wednesday, November 2, 2011

Why the new study on alcohol and breast cancer got it wrong - again

Big news! The latest study on the association between alcohol and breast cancer found what all the numerous prior studies using the same methods found: even small amounts of consumption increase the risk, regardless of the type of alcoholic beverage, even red wine. But as I point out in my book Age Gets Better with Wine, they are simply repeating the same mistakes and failing to see the big picture. Here’s why:

Self-reporting bias. Studies such as this, which seem to derive power from their large numbers, only magnify the errors if the data isn’t reliable. The nurses in this study were asked to fill out questionnaires on their drinking habits and other lifestyle factors every 6 months. It is widely acknowledged that this retrospective self-reporting is highly unreliable. So having a hundred thousand or even a million participants doesn’t yield stronger data, it just magnifies the error. Statisticians are of course aware of this and attempt to make adjustments according to known behaviors, but in a sense it would be better to use a smaller number of subjects and observe them more closely.

No distinction between different drinking patterns. If we were to design a study that could accurately measure the effects of say red wine vs beer or spirits, it would look like this: one group drinks only red wine, in the same amounts, every day, while the others do the same for their assigned beverage. They would be closely followed for many years. This is clearly not the case with the nurses study, which simply asked people what sort of drinks they prefer. By far the vast majority have mixed drinking patterns, both in amounts, types of drinks, and daily patterns. There is simply no realistic way to infer anything about the different drinks from this. On the other hand, studies from areas where drinking patterns are consistent for wine show a substantial decrease in breast cancer incidence.

Ignoring the big picture: Let’s put the numbers in perspective: the overall lifetime risk of breast cancer is around 9 or 10 percent, so a 10% increase in risk from a couple of drinks a week raises it to around 11%, and a 50% increase from heavy drinking brings it up to 15%. But far and away the leading cause of death in women is heart disease (1 in 3), and regular wine consumption clearly reduces that risk. Breast cancer, at 1 in 36, is a ways down the list. Add in also Alzheimer’s, hip fractures from osteoporosis, and diabetes, all of which are reduced among wine drinkers, and you get a very different picture.

That’s why I tried to portray the bigger picture in my book. There is little question that the net effect of regular wine consumption, especially wine with meals, is positive both in terms of disease incidence, lifespan, and quality of life.

Monday, October 3, 2011

New information on resveratrol’s breast cancer fighting properties

There is hardly a stickier subject than alcohol consumption and breast cancer, except perhaps the wildly exaggerated claims for resveratrol supplements. A new study helps to clarify the picture by looking at resveratrol’s interaction with estrogen receptors on breast cancer cells, though we still have a ways to go before resveratrol can be recommended for duty in the breast cancer battle.

Some historical context will help put things into perspective. Most studies have concluded that breast cancer risk is increased by alcohol consumption, though the effect at moderate drinking levels is a very difficult thing to measure. On the other hand, it is well-documented that moderate regular consumption of wine is associated with longer life and lower rates of diseases such as cancer, diabetes, atherosclerosis, and Alzheimer’s. Though red wine contains a number of antioxidant molecules, resveratrol has emerged as one of the more interesting ones despite that fact that wine doesn’t actually have very much of it. Nevertheless, resveratrol is touted as the explanation for the French paradox and an anti-aging miracle. So more sober-minded scientists can be forgiven a bit of cynicism here.

Resveratrol does do some very interesting things though, at least in laboratory studies. One vein of research follows the observation that wine drinkers tend to have lower rates of osteoporosis. This it turns out is explained by resveratrol’s estrogen-like properties. Tied with an impressive array of specific anti-cancer effects (again, in lab studies not clinical trials) it seems that something must be going on with resveratrol and breast cancer. But since many breast cancers are “estrogen receptor positive” (ER+) meaning that too much estrogen could encourage cancer growth, it is important to know the details.

This recent study helps to sort that out, by looking specifically at ER+ cancer cells. What the researchers found was that resveratrol appeared to turn off the gene that makes estrogen receptors, reducing the number of receptors in the cells and ramping down cell growth. Combined with non-ER-related cancer fighting properties, resveratrol or its derivatives could very well be useful in fighting breast cancer. The road to effective cancer treatments is littered with false starts and dead ends, however, so the smart money will wait for clinical trial data.

Monday, September 19, 2011

Australian policy group statment on alcohol misses the mark

Anti-alcohol activists fired another salvo last week in Australia with the release of a paper by the Alcohol Policy Coalition challenging the view that regular consumption of red wine is good for the heart. They even went so far as to proclaim wine’s health benefits a busted myth. The paper authoritatively bases its interpretation on a review of “all the scientific evidence” and asserts that red wine has “no special, protective qualities when it relates to cardiovascular disease.” I too have reviewed a lot of data on this subject for my book “Age Gets Better with Wine” and came to the exact opposite conclusion. So again I am left to wonder how such this well-meaning group of knowledgeable people can still get it so wrong?

It may be that the Australians are just a bit behind the times on this one, so let’s back it up a few years. Nearly all of what is now gospel about lifestyle factors and heart health comes from the Framingham study, now in its fourth generation. Back in the 1970’s, after the study had already been in progress for some 25 years, a review of the role of alcohol and heart disease was done. By now you know the result – moderate drinkers had lower rates of heart disease – but the data was suppressed for years because it didn’t mesh with what policy makers believed. Flash forward some 40 years and we are right in the same place with the Australian policy. In the meantime however, several hundred studies have reaffirmed the pattern of moderate drinking, particularly red wine, as having a protective effect. (References in my book.)

The same tired and discredited arguments prop up the Alcohol Policy Coalition’s paper. To begin with, they limit the benefits discussion to heart health, while the evidence comprehensively shows that red wine drinkers live longer than nondrinkers, have lower rates of Alzheimer’s and better mental function with age, lower rates of diabetes, osteoporosis, on and on. But the counter-argument presented by the Coalition lists all of the health hazards of heavy drinking.

One-sided statistics further cloud the picture; for example, there is the assertion that several hundred thousand deaths annually are attributable to alcohol consumption. Though arguable, even if true it does not take into account the number of deaths delayed due to the health benefits of moderate drinking. Dr. Curt Ellison, a world-renowned expert on the epidemiology of drinking and health, has convincingly demonstrated that the number of lives saved is a multiple of the number of alcohol-related deaths. Back in 1998 he wrote “ Only stopping smoking would have a larger beneficial effect on heart disease than for a non-drinker to begin having a drink or two each day.”

Mention is also made in the Coalition paper that one in five breast cancers is alcohol-related. This is such a wildly speculative figure that it undermines the credibility of the entire paper. While it is true that heavy drinking does increase the odds of developing some types of breast cancer, evidence shows that the risk is offset by a healthy diet containing folate. The risk of moderate drinking remains a matter of extrapolation.

The authors conclude with a recommendation to limit drinking to no more than 2 drinks per day. That is indeed sensible advice, but even more sensible would be to encourage a glass or 2 (no more) of red wine with dinner.

Monday, August 22, 2011

Resveratrol derivative helps obese lab mice live longer – so what?

Do the new findings about the resveratrol derivative SRT-1720 extending the normally shortened lifespan of obese mice tell us anything new? It’s been a long and ultimately disappointing road with the red wine derivative resveratrol, once touted as the basis for miracle anti-aging drugs and now a fading star. As I have described here before, resveratrol was purported to activate an enzyme system known as sirtuins, which in turn activate anti-aging genes that trigger a unique lifespan extension phenomenon normally associated with severe caloric restriction. Take a pill and skip the starvation diet was the promise, and live up to 40% longer. The idea was so compelling that the biotech company Sirtris was founded to exploit more potent (and patentable) resveratrol derivatives such as SRT-1720.

This latest report showed that giving mice resveratrol after rendering them morbidly obese through an unhealthy diet helped them live longer than they normally would have, by improving insulin sensitivity and otherwise normalizing metabolic parameters thrown out of whack by the diet. But there are problems with the study: firstly, the subject mice still didn’t live as long as mice on a healthy diet. Secondly, there isn’t really anything new here; this has all been reported before.

The real problem is that neither resveratrol nor any of its derivatives has been proven to directly activate sirtuins in the first place. In fact, several labs other than Sirtris have definitely concluded that it doesn’t, that the initial reports were an artifact of the testing method. SRT-1720 may prove to be a useful drug for type 2 diabetes, joining a crowded market. But – and here’s the interesting twist – another diabetes drug, metformin, does extend lifespan in mice on a normal diet.

I have always been a little bit uncomfortable with attributing wine’s well-established health benefits to resveratrol. There isn’t enough resveratrol in wine to explain all of the good things that a glass or two with dinner imparts. There are a lot of things in wine besides resveratrol, including alcohol, and a lot of healthy habits that moderate wine drinkers have. So while I wish the good people at Sirtris all the best of luck, let’s not forget the simple things we can do for a long and healthy life now.

Monday, August 15, 2011

Is organic wine a healthier choice?

Many people accept as gospel that organic food (and wine is a food) is healthier. No chemicals, harmful pesticides, or hormones must mean more nutritional value, right? Maybe, but there is a surprising lack of evidence in the form of dietary intervention studies –that is, actual measures of health parameters comparing organic and regular diets. That isn’t to say that there aren’t any, and recent studies are helping to shed some light on the subject.

Beyond the questions of environmental stewardship and moral/ethical reasons to eat organic, it is important to identify what sorts of nutrients that organic foods might contain in greater abundance and how this translates into better health. Vitamins aren’t the answer; simple enough to take a multivitamin pill and get what you need. A more promising possibility is antioxidants, nutrients such as the polyphenols that make red wine red and in general seem to be more prevalent in brightly colored foods. Antioxidants come in a variety of types, but in general they act as part of self-defense systems against spoilage and a number of environmental challenges. A well-know example is resveratrol from wine; this pluripotent polyphenol is an antiviral, antifungal, all-around good guy that seems to have a wide range of anti-aging properties. And because plants make these in response to environmental stress, they should make more of them when not pampered with sprays, fertilizers, and all manner of unnatural things, they should be more nutritious when left to fend for themselves. (A related concept is “biodynamic” farming.)

So a diet higher in antioxidants is a good thing. The science, however, is a bit trickier, since there are various ways of measuring antioxidant potency, and what works in the lab may not in the diet. Among the various ways to measure antioxidant potency is the ORAC test (Oxygen Radical Absoption Capacity), and it is possible to measure a sort of whole body ORAC with what is called “human plasma total antioxidant capacity.” The aforementioned study started by determining the ORAC levels of organic vs. traditionally farmed foods, including wine, and the scores were higher for the organic foods (with a few exceptions.) In test subjects converted to an organic Mediterranean diet, an increase of 21% in total body antioxidant capacity was seen after 14 days.

Does this mean your wines (and other foods) should be organic? You could make a case for it, but there are plenty of non-organically grown wines that pack a healthy punch. Winemakers already intentionally stress the vines in specific ways because more polyphenols also means more flavorful and distinctive wines. It is just fortunate that good wines tend to be good for you too.

Friday, July 29, 2011

Red wine may protect against breast cancer for some women at increased risk

As we have discussed here before, the question of alcohol consumption and breast cancer is a volatile one, but a new study helps to shed some light on the subject. It becomes especially difficult for a subset of women with a genetic trait that places them at increased risk. Two genes, called BRCA1 and BRCA2, are mutations of genes that normally code for tumor suppression. When one of these mutations is present, the chances of developing breast cancer are substantially increased, and it is now routine to test for them when there is a family history of breast cancer. And given the consensus that alcohol consumption further increases the odds of developing breast cancer, it might make sense that the BRCA gene and drinking would be an especially dangerous mix. But when it comes to red wine, the story takes a different turn.

This new study, from the University of Ottawa in Montreal, looked at a large population of women with breast cancer, and tested them for BRCA. Additionally, drinking habits were determined by questionnaire. Interestingly, women with BRCA1 who were primarily red wine drinkers had about half of the expected incidence, and alcohol had no correlation at all. For BRCA2 positive women, alcohol was independently associated with breast cancer but red wine had no relationship.

So for BRCA-positive women, the effect of red wine really depends on which type; BRCA2 women should probably seriously consider avoiding alcohol of any type (unless they choose to have prophylactic mastectomy with reconstruction) while BRCA1 women might seriously consider cultivating a taste for cabernet. It’s a confused message, since the original purpose of the study was to clarify the magnitude of alcohol as a risk factor for BRCA-positive women, but the unexpected benefit for wine drinkers adds a layer of complexity. It’s not the first crack in the consensus about wine and breast cancer though, since populations where wine is regularly consumed there is a much lower incidence of breast cancer. The difficulty is statistically teasing out the true wine drinkers from the mixed and erratic drinking patterns in most populations.

Saturday, July 23, 2011

How wine helps diabetes

If current trends continue, an epidemic of diabetes is looming over the country. Are wine drinkers exempt? There is good evidence that wine drinkers are less likely to develop type 2 (non insulin-dependent) diabetes, and recent research may help explain why: wine derived compounds work in much the same way as popular diabetes medications.

To begin with, type 2 diabetes is typically associated with obesity, a main reason for the upward trend in developed countries. Wine drinkers tend to have healthier lifestyles overall so a certain amount of the benefit relates to healthier eating and exercising regularly. However, there seems to be more to it than that, and now we have biochemical evidence to back us up. One way that diabetes drugs work is to make cells more sensitive to insulin, which in turn helps them take in sugar. (Type 2 diabetics have a problem with insulin sensitivity, not a lack of insulin as in type 1.) Fat cells in particular become resistant to insulin.

Diabetes drugs such as Avandia (rosiglitazone) make cells more responsive to insulin by binding a receptor call PPAR. Red wine contains at least 2 compounds, ellagic acid and epicatechin gallate, that also bind PPAR. On average, a glass of red wine is equivalent (experimentally) to a full dose of Avandia (which by the way cautions against taking it with alcohol.) Other studies have found resveratrol from red wine to have anti-diabetic effects.

Of course anyone on diabetes medication should discuss their alcohol consumption with their doctor, but it helps to be independently informed as well. Alcohol, despite the calories, is metabolized differently from carbohydrates such as sugar; so wine, whose only calories come from alcohol, is less likely to cause problems with blood sugar levels.

Friday, July 8, 2011

Let them drink wine: A Bastille Day toast to healthy drinking

Marie Antoinette may be popularly credited with spurring the French revolution (and losing her head) with her response to the shortage of bread, but a closer look at the events leading up the storming of the Bastille on July 14, 1789 reveals that access to affordable wine was perhaps an even more important factor. In May a national assembly was convened to air grievances of the common people and demand formation of a constitution. A series of poor harvests and widespread food shortages contributed to general unrest, but the Bastille became a target both because “political” prisoners were housed there on arbitrary orders from the king, and also because it was an armory. But it was not the storming of the Bastille that was the first act of civil unrest in the French revolution, it was attacks on the customs houses where duties on wine were collected.

Wine, however, was not in particularly short supply in the 1780’s. The issue was a tax that was collected on wine as it was brought into the city, which had created an opportunity for enterprising publicans who set up shop just outside the Paris city gates. Affordable wine had thereby been generally available without a long journey at the end of a day’s work in the city. As one member of the legislature, Etienne Chevalier put it in 1789: “Wine is the basis of survival for the poor citizens of Paris. When bread, meat, and other foods are too expensive, he turns to wine; he nourishes and consoles himself with it.” But Paris, a walled city at the time, was growing, and as the walls were moved outward it became increasingly difficult for the “poor citizens of Paris” to maintain easy access to this important source of nutrition and comfort. So it was the customs houses at the gates of Paris that were targeted first in the revolution.

Some 300 years later, the French paradox would confirm the health benefits of regular consumption of wine with the evening meal. If there is a lesson in this historical nugget, perhaps it is this: Let them drink wine. A good baguette wouldn’t hurt either.

Friday, July 1, 2011

Space: The next frontier for wine and health?

Spaceflight has a number of deleterious effects on health, but recent evidence suggests that resveratrol – a polyphenol antioxidant from red wine – might help to offset some of these effects. If you ask me, not having access to wine with dinner is bad enough, but there is a long list of physical deteriorations that occur with prolonged zero gravity. These include muscle wasting and decrease in bone density, but there are also physiologic alterations such as insulin resistance and a shift from fat metabolism to carbohydrate utilization. These are issues with a months-long stay in the international space station, but extrapolating to the time required for planetary exploration they become serious problems.

A study on rats suggests how resveratrol may help protect against these changes. While the animals were not launched into space, there is an experimental model that mimics the effects to some degree by “unloading” the hind leg. This results in loss of muscle mass, decrease in bone density, and the associated metabolic changes. With resveratrol added to the diet, these changes were completely prevented, including insulin sensitivity and dietary fat processing.

What this means for us terrestrials may be the more intriguing question. Is wine a subsitute for exercise? Previous studies have suggested that resveratrol enhances athletic performance, and slows age-related muscle loss (again in mice only.) There is some evidence that muscle wasting from cancer may also be slowed with resveratrol supplementation. However, several studies  support the use of another wine polyphenol, quercetin, for boosting athletic performance and endurance, and the optimal combinations and dosages remain to be determined.
It is of course important to recognize that people are not rats (at least metabolically if not behaviorally) and this notion is completely untested in humans. Absorption and the biological availability of resveratrol in people is different than in rats and so we can’t read too much into this. What we do know is that wine drinkers are healthier and live longer on average, and it appears to be related to a number of things besides resveratrol. The real trick of course will be stocking the space cellar.

Thursday, June 16, 2011

Why wine makes food healthier

In my book Age Gets Better with Wine I have a chapter called “Wine is a Food” in which I emphasize the importance of wine as a part of a healthy meal. There is good scientific evidence for why this is the case, and a new study adds to the picture. Wine with food changes the way the fatty components of the meal are handled by the body.

We all know that saturated fats are bad news nutritionally speaking. High cholesterol levels contribute to increases risk of heart disease and other problems, but it isn’t purely a matter of the fat content in the food. When the fats are absorbed and oxidized, they are converted into a particularly malicious form know as cholesterol oxides and lipid peroxides. This recent study, conducted by INRAN, the Italian Institute for Research on food and Nutrition, (a division of the Ministry of Agriculture, Food and Forestry), recruited 12 volunteers who were given a meal with known cholesterol-laden meal consisting of a double cheeseburger. The 6 men and 6 women in the study were not on any vitamins or other supplements so as to not interfere with the measurements. In the first phase, only water was taken, and the predicted spike in oxidized fats in the blood was measured. Two weeks later, the meal was repeated but with a glass of red wine; in this case, the wine suppressed levels of cholesterol oxides and lipid peroxidation products. It was not determined whether the effect was due to alcohol or antioxidant polyphenols in wine.

These results are in line with earlier studies, and more research is planned in order to further elucidate what mediates the effect. But what is clear is that wine makes the food healthier. Another effect, not evaluated in this study, is that wine consumption with a meal also slows down alcohol absorption. This further explains why those who drink wine with meals have better health and longevity, because it is inconsistent with alcohol abuse. I like to think of it as drinking wine for aesthetic enjoyment rather than for its anesthetic effects.

Whatever your reason, consider opening a bottle of something red with your next summer BBQ. You’ll be happier and healthier for it.

Saturday, May 28, 2011

Cholesterol drug Niaspan disappoints; better to just have a glass of wine?

This week it was announced that a clinical trial on the use of Niaspan (a sustained release formulation of the vitamin niacin) to raise levels of HDL or “good” cholesterol, was suspended because of disappointing results. While it is well-established that higher levels of HDL (high-density lipoprotein) relative to LDL (its low-density counterpart) are associated with reduced risk of heart attack and stroke, the addition of Niaspan to the cholesterol-lowering statin drugs (for example Lipitor) has failed to deliver the same benefit seen in people who naturally have a high HDL/LDL ratio. In this recent trial, there was even a trend to an increased stroke incidence. Sales of Abbott’s Niaspan totaled nearly $1 billion last year, but development of several cholesterol drugs has been suspended recently due to lack of efficacy in preclinical trials.

It seems appropriate then to take a few steps back and see what we know about what does work. Not smoking, along with exercise and a healthy diet are unquestionably the first steps in reducing the risk of cardiovascular disease. But how is a healthy diet defined? Regular consumption of red wine has long been identified as a significant element in a heart-healthy diet, though randomized prospective clinical trials such as those used in drug development are few. Nevertheless, a positive pattern emerges for wine consumption especially with meals.

Wine consumption is known to affect cardiovascular disease risk factors in several ways: First, alcohol in moderate amounts also raises the HDL/LDL ratio, though in light of the Niaspan study the benefit of this effect seems debatable. Alcohol also helps prevent thrombosis, or clotting in the arteries which is the critical event in heart attack. A 2008 prospective clinical trial from the Netherlands pointed to additional benefits from alcohol, observing that the addition of white wine but not grape juice to the diet of postmenopausal women improved insulin sensitivity—a good thing for cardiovascular risk—while raising HDL and lowering LDL along with triglycerides, another bad actor. At a more fundamental level, tissue levels of a substance called adiponectin were increased, providing a possible explanation for less weight gain observed among middle-aged wine drinkers. A similar trial in men, looking a a broader range of alcoholic beverages, found positive effects on blood pressure and various markers of inflammation in the blood after red wine or beer consumption but not whiskey or white wine.

As anti-alcohol activists point out, alcohol also has deleterious effects on blood pressure, but intervention studies find that the threshold for this is at about 4 drinks per day. So alcohol seems to be at least acceptable if not beneficial in moderate amounts, and when combined with the long list of properties associated with the antioxidant polyphenols in wine, it seems clear that a glass or two of wine with dinner should be a central part of a heart-healthy diet.

Sunday, May 15, 2011

The French Paradox at 20

This year will mark twenty years since the CBS television show 60 Minutes christened the term “French paradox” and ushered in the modern era of research on wine and health. It was a provocative idea at the time, attributing the French custom of regular imbibing to health and well-being, and it still has its naysayers; at the other extreme, there are those who reduce the idea to a simple question of nutritional biochemistry and proclaim that all of wine’s health benefits can be put into a pill, conveniently and properly skipping the alcohol. Is there still a useful truth underlying the paradox?

As with many questions in the realm of lifestyle and health, the answers are often nuanced and conditional. Though challenged by government authorities in both America and Europe, the authors of the idea – Serge Renaud in Bordeaux and Curt Ellison in Boston – provided a rigorous defense of the notion. The French paradox is invoked regularly as an excuse for having a few, to the point that it has become a clichĂ© and its real lessons lost. Despite all of the advances in understanding the components of wine and how they contribute to health, at its heart the paradox is a reflection of a lifestyle. Wine is a food, squarely affixed in the daily rituals of the Mediterranean diet.

The science that grew from the seed planted by the French paradox idea has grown far beyond what any of the early researchers could have predicted though. Antioxidant polyphenols from the skins of wine grapes (not so much from juice or table grapes) have emerged as vitally important elements of an anti-aging diet. Among the best known is resveratrol, about which there were 2 articles in the scientific literature in the year of the original broadcast of the story, whereas there a more than 2 every day now. Resveratrol and other wine polyphenols provide a handy explanation for why wine drinkers have lower odds of developing Alzheimer’s, diabetes, osteoporosis, and pretty much all of the disease of aging. They help break up the protein plaques in the brain associated with Alzheimer’s, prevent cholesterol from aggregating into concretions in the arteries, kill cancer cells (while protecting normal ones), even improve insulin sensitivity. Resveratrol appears at first glance to be a miracle molecule, as I dubbed it in my book Age Gets Better with Wine.

But there remains a problem with giving resveratrol all the credit: there isn’t very much of it in wine. Data clearly supports the benefits of regular wine consumption, but is lacking when it comes to the use of resveratrol in supplement form. This brings us back to the role of wine as a lifestyle factor. Wine drinkers tend to do a lot of health things besides having a daily tipple with dinner, and wine contains a lot more than the pittance of resveratrol. It is the synergies of these various things that unleash the true benefits of wine.

Monday, May 2, 2011

New Heart Association Survey on wine: Why are Americans confused about healthy drinking?

The American Heart Association recently released the results of a survey of Americans on their knowledge of healthy drinking and consumption of sea salt. No surprise, they concluded that we have it all wrong. On the plus side, two thirds agreed with the statement that wine is good for the heart, but less than one third know the AHA’s recommended limits of a daily glass or two for men and no more than one for women. The survey showed that “we need to do a better job of educating people about the heart-health risks of overconsumption of wine” according to a spokesperson.

I say bless their hearts but their paternalistic message only adds to the confusion. For starters, they don’t even have their definitions right, which is a 5-ounce pour as the standard on which research and policymakers have long agreed, but the AHA cuts it back to 4. Granted, they have come a long way since the mid 1990’s when the official policy grudgingly acknowledged that a glass or two a day “might be considered safe” while hastening to add a disclaimer about all of the social ills attributed to alcohol consumption. But these problems are associated with excess and problem drinking, not a glass or two or even three with a leisurely dinner. What statistics consistently show is that wine with dinner is among the most powerful contributors to health.

Part of the problem is the narrow focus on heart health, which we can forgive to some degree for the AHA but it leads to an incomplete picture of the broader benefits of healthy drinking. When consumed with meals, up to 3 glasses for a man and about half that for a woman is associated with the greatest reduction in health problems across the board leading to longer lifespan and a higher quality of life, especially in old age.

Just as interesting to me is the comments that follow the various news postings about the study. It would seem that we are even more confused about wine and health now as ever, judging from remarks suggesting that red grape juice has the same benefits as wine without the alcohol.

Friday, April 22, 2011

Should diabetics drink wine?

An epidemic of type 2 diabetes looms over the western world, with some estimates predicting that as many as a third of all Americans will have the condition within a decade or two. Obesity is the culprit, a complicated issue to be sure but the role of wine in the diet of diabetics is even more so. A recent study finding that low-dose supplements of the wine-derived polyphenol resveratrol improve glucose tolerance and other parameters in humans provides some guidance in sorting it all out.

It has long been known that wine drinkers, especially those who consume red wine in moderation with dinner on a daily basis, are less likely to gain weight and hence less prone to type 2 diabetes. There are a number of potential explanations, including the fact that wine drinking is linked to a range of healthy lifestyle factors including diet and exercise, but the science of wine polyphenols – including the antioxidant resveratrol – provides some intriguing evidence of a biochemical mechanism at work. Studies in mice have been very promising but this new randomized prospective double-blind study, on 19 human subjects, documents that it can be useful clinically if the results can be verified. Importantly the study used a low dose of 10 milligrams daily, consistent with what you might get in wine.

The question of whether it would be better to take the supplements and avoid the calories from wine remains a subject of debate. Clearly, wine drinkers do better in terms of developing type 2 diabetes, and resveratrol may have little to do with it. But calories from alcohol are metabolized differently that from carbohydrates and other food components, so that the spike in blood sugar is minimized.

All of this brings us back to the role of wine as a food. In the case of diabetics, it may actually be a functional food, by avoiding the types of calories that make the problem worse while providing natural ingredients that could actually improve the condition on a biomolecular level. In order for it to work, however, it all has to be integrated into a healthy lifestyle.

Thursday, April 7, 2011

A charitable view of wine and health

As most of you know I am on the board for the Washington Wines Festival, which raises awareness of Washington’s wonderful wines and funds for worthy charities such as Camp Korey. The wine business has a long and laudable history of charity, dating at least as far back as the famous Hospices de Beaune in Burgundy. Dating to 1443, the hospice was a hospital for the poor and needy, supported by funds raised from the local wine producers. To this day an important wine auction is held every November at the Hospice, maintaining a centuries-long tradition.

Health care continues to be a popular beneficiary of charity wine auctions, and there are some interesting parallels to the circumstances that prevail today with the conditions at the time of the founding of the Hospices de Beaune. The Hundred Years War had just ended, but the long conflict had been financially ruinous. Marauders roamed the countryside, pillaging and plundering, and much of the population was destitute. The Hospice became a refuge for the sick, the disabled, orphans, expectant mothers, and the destitute, all supported by the wine industry. Every year here in the Seattle area, the Auction of Washington Wines raises money for the Uncompensated Care fund at Children’s Hospital, and the Washington Wines Festival supports Camp Korey, one of Paul Newman’s “Hole in the Wall” camps for seriously ill children. Down the road in Oregon a similar event benefits health care for farm workers, a group traditionally excluded from access to health care services. And there is of course the Napa Valley Wine Auction, which includes health care for the needy among its worthy causes. These are only a few of a large number of charitable activities around the country, especially important in a time of economic upheaval. Worldwide, the impact is in the high millions of dollars at the very least. And given that wine is not only a health food but contributes to the enjoyment of life, it is the ultimate win-win.

Thursday, March 31, 2011

German study confirms benefits of drinking in elderly

One of the hardest ideas to wrap one’s head around is the idea that alcohol consumption (in moderation) actually improves mental function and lowers the risk of developing Alzheimer’s disease as we age. But a recent study from Germany adds to the already considerable evidence, and to the ongoing controversy. The study enrolled more than 3200 subjects aged 75 or more from primary care practices, and gathered detailed information about drinking and lifestyle patterns. Additionally, they were tested comprehensively for signs of declining mental function, and specifically Alzheimer’s dementia. The average age in the group was more than 80 years, and after 1.5 and 3 years of follow-up a clear benefit to the moderate drinking cohort was found. Drinkers were 30% less likely to experience mental decline, and 40% less likely to have Alzheimer’s.

The controversy relates to the question of moderate drinking as a lifestyle “marker” for a range of healthy behaviors. In other words, people in this group –as opposed to heavy drinkers or nondrinkers – tend to exercise more, be better integrated socially, less likely to be depressed, and have a higher level of education. If this is the case, so goes the reasoning, the alcohol has little to do with the health benefits. But the pattern held up even after these other factors, known as confounding variables, were accounted for in the statistical analysis.

In any case, what is clear is that moderate drinking in old age is associated with both measureable reduction in the odds of mental decline and the healthy lifestyle factors that are likely to also contribute. Independent data from other studies verifies that wine drinkers enjoy a higher quality of life in old age. My take on it is that there are synergies between living the good life and moderate drinking, much as the polyphenol molecules in wine seem to have the best effects in combination and with alcohol.

What is confounding to me is why we are still so conflicted on the question. It’s not like we are talking about keggers at the nursing home, just a glass or two of wine with dinner.
 More info at AIM.

Tuesday, March 22, 2011

Healthy wine drinking is a family value

There are few more controversial subjects than the topic of underage drinking, so let me just say at the outset that I am not encouraging it. But with many such questions, things aren’t always so black and white, as a recent study on teenage drinking demonstrated. In a nutshell, the study evaluated beverage preferences among high school students who display risky drinking patterns, concluding that hard liquor and beer are preferred over wine. The study, called the Youth Risk Behavior Survey, questioned nearly 8000 adolescent drinkers, and the correlation between preference for liquor and/or beer was strongest among those who exhibited the riskiest behaviors (binge drinking, drinking and driving.)

No surprises there you say, we all know that liquor is quicker where the beverage is merely a vehicle for alcohol consumption as a drug. We don’t expect teenagers to be wine connoisseurs, even if it were legal. But there is the well-known European tradition of starting children on watered-down wine with meals and special occasions, in the context of wine as part of a meal. Growing up with such a view of wine as food probably contributes to lifelong healthy drinking habits, and it does begin in the teenage years. On the other hand, a typical American household views alcohol as a drug no matter what the form it takes, holding it out as a special reward of adulthood (placing it in the same category as pornography.)

And beer, for all its potential list of positives, tends to be portrayed in TV commercials in the context of parties and recreational events, virtually never as a nutritional part of the evening meal. Simply put, it is marketed as a drug, a message only reinforced by the admonishment to “drink responsibly.”

So is there a way to bring some balance to the message? I say make drinking a family value: wine with dinner means drinking at home, setting a positive example as an alternative to kegger parties and binging on weekends; drinking for aesthetic reasons, not anesthetic ones. In so doing we take away some of the mystique of the forbidden fruit. This of course presumes that we adults set the right example.

Monday, March 14, 2011

Which types of wine are the healthiest?

I am often asked after lecturing on the healthful properties of wine which type is best to drink. Since much of the discussion has to do with the polyphenol antioxidants from the skins and seeds of the grape, red wine is the first criterion since it is fermented with the whole grape rather than the pressed juice. This allows for extraction and concentration of these compounds, familiar ones being resveratrol and tannins. But beyond that, which varietals have the highest concentrations?

According to the Roman philosopher Pliny the Elder, “The best kind of wine is that which is pleasant to him that drinks it” but modern science expects more specifics. (The point of course is that if you have a wine that you enjoy you are more likely to drink regularly and therefore reap the benefits.) But there are several difficulties in singling out certain wines for their healthful properties. Which compounds to measure? Are we talking about heart health or the whole gamut? Is it the varietal of the grape or the viticultural method that is most important? For all of these reasons there are different answers.

Let’s begin with the well-known anti-oxidant capacity of wine. Anti-oxidants of course play a role in reducing the risk of a range of diseases and wine polyphenols are among the most potent ones. One would therefore think that there would be plenty of published resource material but in fact there is surprisingly little. One study from France evaluated comparative antioxidant capacity and found the highest readings for grenache and pinot noir based wines, followed by syrah, cabernet sauvignon, and merlot. Interestingly, they also found significant year to year variation, indicating the importance of growing conditions. These factors in concert with region-specific viticultural techniques probably contribute as much or more to polyphenol content as varietal. Given that grapes express these compounds in response to stress it makes sense.

But looking specifically at the heart health question, it appears likely that the primary benefit comes from compounds called oligomeric proanthocyanidins (let’s agree to call them OPC’s) which are associated primarily with the seeds of the tannat grape. Malbecs from Argentina are reported to have respectable amounts of OPC's, as do wines from Spain and southern Italy. These compounds may impart a more bitter flavor, and so often the wines with high levels are more “rustic.” Australian reds, big and lovely though they are, often lack in this category.

One thing is sure, the health benefits of wine are not reducible to a list of chemicals anyway. It is all of them working together, with alcohol, with food, as part of a healthy lifestyle. Pliny had it right all along.

Monday, March 7, 2011

Is any amount of alcohol good? Resolving the conflict

Sometimes it happens that opposing views on a controversial subject juxtapose. Such is the case this week, with a new large study published on the role of alcohol and health, another outlining the reasons for it, and an opinion piece questioning whether any amount at all is beneficial. In brief, the argument goes something like this: Anti-tobacco activists point out that any amount of tobacco is harmful, and since alcohol in excess has many hazards it must be bad in small doses too, if less so. On the other hand, if moderate wine consumption is a good thing for health, as I affirm in my book Age Gets Better with Wine, then we must account for a positive role of alcohol in the health equation.

The case against alcohol is made by one Professor David Nutt, professor of neuropsychopharmacology at Imperial College in London. Professor Nutt outlines his reasons why he belives that it is a myth that small amounts of alcohol are not harmful: First, alcohol is a toxin, and amounts only 4 times as high as those required to reach legally defined intoxication levels can be fatal. True enough, but there is a long list of things that if consumed in 4 times a sensible amount would also be very bad news; for example, a radio station recently held a water drinking challenge that resulted in a fatality from drinking too much water! The professor then mentions that while most people are not likely to become abusers of alcohol, some do, and so that apparently is reason enough why the rest of us should abstain. The professor’s final argument is that the evidence for alcohol’s benefits is weak, which brings us to the just-released studies both in the British Medical Journal.

These two papers are particularly helpful because they are based on a review of all published studies on the question of alcohol and health, a major challenge. The focus of these reports was purely on heart disease, and the conclusion was “Light to moderate alcohol consumption is associated with a reduced risk of multiple cardiovascular outcomes.” The reasons for this are also well-defined, relating to improved levels of HDL cholesterol (the good kind), as well as apolipoprotein A1, adiponectin, and lowered levels of fibrinogen, all good things for cardiovascular risk. One questions whether professor Nutt actually read any of the literature on the subject before dismissing it.

Anti-alcohol activists are quick to point out the hazards of alcohol consumption, which are also well-known and itemized by the professor. The assumption is that these hazards would disappear if alcohol were to be banned or somehow eliminated. The opposite is more likely to be the case, as deaths from cardiovascular diseases would outnumber the decrease in alcohol abuse-related deaths by a substantial multiple. With hundreds of studies out now, questioning the health benefits of moderate drinking is just nutty.

Tuesday, March 1, 2011

Red wine compound resveratrol supports anti-cancer therapy

Resveratrol, for all appearances the miracle molecule from red wine, has disappointed on several research fronts but don’t count it out just yet. In the right amounts it may be an important part of an anti-cancer diet, but the story now is synergy: compounds working together in ways that enhance their effectiveness. Evidence has been slowly coming to light in recent years that the compounds in red wine amplify each other’s health benefits, explaining why studies continue to support the benefits of moderate drinking but supplements often fail in clinical tests. New research demonstrating how resveratrol supports the anti-cancer drug rapamycin provides another example of synergy.

Rapamycin , derived from a bacterium first found in the soil on Easter Island (hence the name, from Rapa Nui, the original name of the island), is clinically used as an anti-immune drug for organ transplantation. Its anti-cancer capabilities are being explored, in particular for breast cancer. But as with other therapies, drug resistance can develop, and here’s where resveratrol comes in. Resveratrol appears to prevent this resistance from developing when given along with rapamycin, at least in the lab. This points to one of the more interesting properties of resveratrol, which pulls off this feat with a range of other drugs and tumor types, rendering them more sensitive and preventing resistance from emerging. All this is preliminary of course, pending long-term clinical trials.

But rapamycin is emerging as an interesting player in the anti-aging arena too. Because of its anti-immune properties and general toxicity, it is not practical as an anti-aging intervention, but its actions at the molecular level reveal a pathway that could lead to practical therapies. Recall that resveratrol was thought to be able to activate the same enzymes (sirtuins) responsible for a longevity effect, but was unable to do so in mammals (like we humans.) But rapamycin does extend life in lab rats, via a more direct pathway.

So don’t give up on resveratrol just yet, despite the many questions about its future. Given its propensity for working well with others, the smart money is on whole wine for anti-aging and combination therapy for cancer.

Thursday, February 17, 2011

An end to wine headaches at last

Thank food biotechnologist Hennie van Vuuren at the University of British Columbia for finding the solution to one of the most vexing problems for would-be wine lovers: the headache that so often accompanies wine drinking for up to 30% of the population. These unfortunate folks are sensitive to compounds known as biogenic amines such as histamine, which can also impart off-putting flavors to wines. (It isn't the sulfites.) I have long thought that there was a huge opportunity for someone to crack this particularly hard nut and figure out how to make low-amine wines.

van Vuuren apparently had the same idea, and over the past several years he has been developing a strain of yeast for wine fermentation that produces low levels of amines. The yeast, known as Malolactic ML101, has already been approved by Health Canada and the US Food and Drug Administration. According to the developers of the new yeast, Lesaffre Yeast Corporation, there is a good chance you have had wine produced with ML101 without knowing it, since it doesn’t require any special labeling. If you ask me though, they are missing an opportunity to spread the good news to the millions who have been avoiding wine for fear of triggering a migraine.

There is of course a catch in that the FDA and other regulatory agencies in the U.S. take a dim view of winemakers claiming any health benefits about wine, despite the massive amount of supportive data on the subject across a wide range of conditions. That leaves it up to independent wine and health experts (such as yours truly) to spread the word. So winemakers, if you are using ML101 let us know, and consumers, let’s talk it up especially to our friends who have been unable to enjoy wine. (The only winery to confirm that they are using ML101 is Sandhill Winery in British Columbia, though several American wineries do as well.)

Saturday, January 29, 2011

Notch up a victory for alcohol and heart health

OK, we all know that wine is good for the heart; French paradox, old news. And if you are at all interested in anti-aging, you will have heard that wine’s benefits are attributed to the polyphenol antioxidants from the skins, including resveratrol, quercetin, and a menagerie of other exotic molecules. But the role of alcohol has long been questioned. Even though the epidemiologic evidence points to a contributory part for alcohol, the exact mechanisms by which it might accomplish this have not been well understood, other than favorably shifting the high density/low density cholesterol ratio. New findings implicate a signaling molecule called Notch, another one of those exotic breeds that seem to be involved in a lot of things once we get to know them.

     Vessel thickening is reduced in the carotid arteries of mice fed the equivalent of two drinks, compared to no-alcohol controls. (Credit: Image courtesy of University of Rochester Medical Center)

Notch does seem to be a multitasker. One important position it occupies is signaling immune system cells called helper T-cells to differentiate into specific subtypes. Research on notch may lead to new therapies for a range of immune system diseases and certain types of infection that require targeted immune responses. But notch, a receptor protein in cell walls, influences many types of cells on their differentiation pathways. This potentially involves notch in several types of cancer too, and the inflammatory processes that lead to the formation of plaques in the walls of arteries. This is where alcohol comes into the picture.

Atherosclerosis is not a passive buildup of sludge in the arteries, but a dynamic condition that includes thickening and proliferation of the muscle cells in the artery wall (it is relaxation or contraction of these muscles that sets blood pressure.) The more thickening that occurs, the stiffer the artery and the more likelihood of a clot and a heart attack. These specialized muscle cells are triggered to grow by notch signaling, a process inhibited by alcohol.

It’s probably fair to say that recognizing the undercurrent of chronic inflammation as one of the most important causes of cardiovascular disease was a major breakthrough. Your aspirin a day is effective not because it protects against a clot forming but because of its anti-inflammatory actions. Now we know that inhibition of notch may be another important pathway for reducing heart disease risk, at least according to a paper from the University of Rochester Medical School. Using muscle cell cultures from human arteries and intact arteries from mice, the researchers identified notch as a sort of relay signal for the cells to divide and grow. Alcohol was identified as a notch inhibitor, and therefore in the right amounts a positive factor in helping to maintain supple arteries. I say cheers to that.

Morrow D, Cullen JP, Liu W, Cahill PA, Redmond EM. Alcohol inhibits smooth muscle cell proliferation via regulation of the Notch signaling pathway. Arterio Scler Thromb Vasc Biol 2010 Dec; 30(12):2597-603.

Thursday, January 13, 2011

Aging in oak barrels may improve wine’s healthful properties

No one knows for sure when the oak barrel was invented, but it probably dates to the 13th century. Wine and oak have had a long and happy marriage, despite occasional excesses and changes of taste, and it is as hard to imagine a big red without oak as it is beer without hops. Vanillins and other compounds improve the wine if managed carefully, but the question of how these molecules may affect the health benefits of wine has just recently begun to be explored.

Collectively these compounds are called lignin-derived polyphenols, which bear a relationship to polyphenols from grape skin and seeds. These molecules are often aromatic, vanilla being a good example. And the prolonged time that red wines often spend in barrels can result in a high degree of extraction into the wine, though levels may still be small in comparison. Nevertheless, their contribution to wine’s effects on health may be as important as their input to flavor and structure, according to recent research.

A study from the University of Alabama found impressive antioxidant capabilities of lignin polyphenols, with free radical scavenging potency in the same range as wine phenolics. Of particular interest is that these compounds bind many of the same proteins as resveratrol, indicating they may send similar metabolic signals. The authors of the study concluded that oak phenolics may contribute to cancer prevention and heart disease prevention to a significant degree.

Traditional methods of winemaking are on the decline though, and the effects of newer techniques such as micro-oxygenation instead of prolonged barrel aging may change the composition of the final product. Oak chips are being substituted for the barrel, which may or may not impart similar compounds. To be sure, barrels are one of the more costly aspects of winemaking, but I guess I am a traditionalist. I am willing to let the angels have their share (the evaporative loss from aging in oak) in return for something I know is good.