Is alcohol necessary for wine’s health benefits?

High on the list of controversies about wine and health is the alcohol question, one I get asked about every time I do a seminar on the subject. Why not grape juice, or for that matter wine's goodness in a pill?

New research from the University of Barcelona took the question head on and it's good news for wine drinkers.

There are so many thousands of papers on wine and health now that you can be forgiven for not keeping up (which I am taking care of for you here) but in order to understand the implications of this latest study we need a little background. For one, as I said in the book, wine is not just grape juice without the alcohol; the content of polyphenols antioxidants is much higher in wine for several reasons (for another, grape juice is high in sugar.) There is a great temptation to assume that we could just take the polyphenols from grapes and put them into supplement form, which indeed many have. For non drinkers and occasions where wine consumption is inappropriate, it may not be such a bad idea. But does alcohol make a positive, independent contribution to health?

In terms of cardiovascular health, it is known that alcohol in moderation improves the HDL/LDL cholesterol ratio, and it is tempting to assume that is the end of the story. But atherosclerosis is a much more complex phenomenon than simply sludged up pipes from a high fat diet. Chronic inflammation, at least as biologists use the term, is the important underlying factor. So the scientists in Spain designed a clever clinical study in which volunteers were assigned to three groups: one consumed a standardized amount of red wine daily, another an equivalent amount of de-alcoholized wine, and a third had gin, standardized to the same alcohol amount as the wine group, for 4 weeks. They then measured 25 separate inflammatory biomarker levels. These molecules go by an alphabet soup of names, but the implications of the study were clear: Both alcohol and red wine polyphenols independently improved (“down-regulated”) inflammatory marker levels, and though there was some overlap they generally worked differently.

So is alcohol an anti-inflammatory compound? At least where cardiovascular disease is concerned, it would appear so. That would explain why alcohol from any source appears to offer some benefit, though not as much as when it is in wine. Another important aspect of this study is that it is a randomized prospective clinical trial, meaning we can take very high-level confidence in the results. Not that I had any real doubts.