wine and health

Winemakers have been in a debate for some years now with the U.S. Department of Treasury's Alcohol, Tax and Trade Bureau (formerly the ATF, for Alcohol, Tobacco, and Firearms--yeah, that made a lot of sense) about ingredient listing for wines, particularly since the healthful properties of wine polyphenols such as resveratrol have been widely publicised. A couple of years back, an Oregon pinot noir producer gained approval for a fairly benign claim: "Pinot noir develops a natural defense against botrytis (mold) in our moist, cool climate - the antioxidant resveratrol." Since resveratrol is indeed produced in the skins of grapes subjected to certain environmental stresses such as mold, and Oregon's climate is certifiably moist, it seems a fairly harmless claim. However, the feds simultaneously disallowed placing the same wording on another vintage from the same producer, citing concern about making therapeutic claims on labels or creating "misleading" associa...

When I was growing up in California, there were periodic droughts that resulted in mandates to cut down on water use, and one of my favorite pieces of advice was to shower with one or more friends. Now it turns out that drinking with friends has measurable health benefits. It seems obvious that drinking alone is not necessarily a good thing, but a new study from Japan provides actual data that social drinking--in moderation--is healthful. (Whether it also leads to communal bathing remains a personal choice.) The data comes from a large prospective public health study in Japan involving more than 19,000 subjects evaluated for the incidence of stroke and heart disease relative to drinking habits. As one would expect, light-to-moderate drinkers had fewer episodes (this has been reported in studies too numerous to list) and heavy drinkers had more. In epidemiology this is known as a J-shaped curve, about which more in my book. What was unique about this study was the use of a measure calle...

The red vs white debate is enough to make me blue. Red wine, with very few exceptions, has much higher levels of the polyphenols to which many but not all of wine's benefits are attributed. In recent weeks, reports came out that it didn't matter whether it was even wine or any other alcoholic drink, breast cancer risk was apparently raised by as little as a glass a day. As I have pointed out in previous posts, there are too many problems with the way the data for these studies is gathered to say anything that definitive, but now a study from the Fred Hutchinson Cancer Research Center here in Seattle weighs in with the red vs white wine question. They were particularly interested because earlier studies from the Hutch (as we call it here) found that red wine drinking correlated to lowered odds of prostate cancer in men, and a large body of research suggests that wine polyphenols are effective at countering breast cancer. The study, funded by the National Cancer Institute, was lo...

Last week the news was that wine is supposedly equal to any other type of alcoholic beverage in encouraging the development of cancer, particularly of the digestive tract, even when consumed in moderate amounts. This week it is the opposite, at least in terms of one especially nasty type of cancer involving the esophagus. Wine drinkers, it turns out, have a lower risk because they tend not to get as much reflux of stomach acid up into the lower esophagus, which causes inflammation. This condition is called Barrett's esophagus and is not only miserable but potentially deadly because it predisposes to cancer. It reminds me of my days as a general surgery resident, when one of the most common conditions leading to surgery was stomach ulcers. (They are prone to bleeding and numerous other unfortunate consequences.) Standard advice regarding ulcers was to avoid spicy foods and alcohol, in the belief that these encouraged the stomach to produce more acid. It was some years later that we ...

Just when we thought the issue was settled, a new large scale study from France's National Cancer Institute finds that even small amounts of regular drinking can increase the risk of cancer. In fact, even as little as one glass of wine per day supposedly ups the odds of cancers of the throat all the way through to the colon and rectum. Problem is, this study is so out of phase with everything we have been hearing about wine and health that it ends up confusing the issue rather than helping. Here's what I think: The first key to putting this in context is to remember that cancer isn't the whole story with wine and health. Benefits in lowered cardiovascular disease risk, Alzheimer's, diabetes, osteoporosis, and many others would vastly outweight the increased cancer risk even if it did exist. Secondly, no single study provides the definitive answer; in order for it to be meaningful, it has to be independently confirmed by other studies. This one is inconsistent with nearl...

One of the hardest notions to shake is that taking antioxidant vitamins (A, C, and E) will reduce the chances of developing what we call "degenerative" diseases: things like cancer, heart disease, and Alzheimer's. We all know that antioxidants are good for us, because the oxidation theory of aging--free radical molecules wreaking havoc on our DNA--is so well accepted. But studies keep throwing cold water on the idea that vitamins are the key. The latest is a study from the Fred Hutchinson cancer center here in Seattle, out this past weekend. This study, called VITAL (VITamins And Lifestyle) looked at not just the traditional vitamin supplements but also lutein and lycopene. Across most categories, cancer risk was actually higher in those using supplements. This is consistent with many previous studies but somehow vitamin sales seem to be unaffected. So what does this have to do with wine? Recall the whole wine and health story started with the identification of what we no...

Researchers have been wrestling with the question of the relationship between drinking and breast cancer for years, and the issue remains far from settled. It is a huge topic and so I plan to post on it from time to time, but today I am interested in the role of resveratrol and cancer. Several recent studies have identified unique ways that resveratrol might be important in both prevention and treatment of breast and other types of cancer. One study in particular, from the University of Nebraska this past summer, helped shed some light on the subject. It is known that estrogen increases the risk of breast cancer, which is one of the reasons why post-menopausal hormone replacement therapy (HRT) is so problematic. What makes it more complicated still is that it isn't the estrogen itself, but one of the compounds formed when it is metabolized (broken down) that is responsible for initiating the cancerous changes in breast cells. Estrogen is metabolized by certain enzymes, of which the...