red wine
by Jenny Bryan
We can blame the French for the long-running debate over whether red wine is good for us. For years, many non-French doctors insisted that the low levels of heart disease recorded in France were due to the French preference for putting digestive rather than circulatory disorders on their death certificates. But too many studies now point to small amounts of alcohol – one to three drinks a day – being good for the heart for the evidence to be ignored. Still controversial, however, is whether the type of alcohol has to be red wine.
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why is red wine good for you?
In moderation, alcohol appears to be good for the heart. About 10 years ago, researchers calculated that people who had two or three drinks of alcohol per day reduced their risk of heart disease by about 17% compared with teetotallers. Subsequent studies have put the figure between 10% and 40%.
Wine got its reputation for being the tipple of choice because it is so widely consumed in France where heart disease rates are low, despite the high consumption of fatty dairy products. But researchers have been divided over whether we should be drinking wine, specifically red wine, or any type of alcohol to look after our heart.
Red wine contains anti-oxidants and polyphenols which help to prevent arterial damage by reducing the likelihood of fatty lesions and blood clots forming in blood vessels and impairing the blood supply to essential organs, such as the heart (see chocolate).
The latest evidence suggests that polyphenols also reduce the production of a substance called endothelin 1 which makes blood vessels constrict. By reducing levels of endothelin 1, red wine may be relaxing key arteries to the heart and helping to prevent them from becoming blocked. So far, the studies have only been done on arterial cells from cattle, but if they can be repeated on human cells, scientists should be able to calculate just how much wine we should drink to protect our heart. Interestingly, only red wine – not white or rosé – affected endothelin 1 production.
what's the evidence?
Much of the evidence about alcohol and heart disease comes from three types of studies summarised in a large review published in the British Medical Journal in 1996.
Ecological studies relate government data on alcohol sales to national heart disease death rates. The databases are vast and give a good breakdown of beer, wine and spirit drinking, but they only give an average figure for 'per head' consumption and cannot distinguish between people who drink a lot and those who drink a little. Analysis of 12 such studies showed that wine-drinking reduced heart disease deaths, with weaker or non existent protective effects for beers and spirits.
Observational studies (case-control and cohort) check the health and drinking habits of groups of individuals, rather than large anonymous populations. Assuming respondents are honest, they give more accurate and detailed information about their drinking habits than is possible with ecological studies. Case-control studies compare the answers of people with and without different diseases, while cohort studies follow the progress of a group of people with different drinking habits and other health risks to see what diseases they develop.
red wine and heart disease
Two out of three case-control studies included in the review showed that drinking alcohol reduced the risk of heart disease, while the third showed a small trend in the reverse direction. None of the studies picked out wine as being particularly beneficial.
Four out of ten cohort studies showed a definite protective effect for wine, four showed a benefit for beer and four for spirits! Further analysis showed that wine and spirits had slightly stronger data on their side than beer.
This massive review of the evidence therefore concluded that, while moderate alcohol intake seemed to protect against heart disease, the type of alcohol drunk did not seem to matter.
alcohol and strokes
Unfortunately, alcohol seems to be less protective against strokes than heart attacks. Nearly nine out of ten strokes are caused, like heart attacks, by blood clots that block vital arteries. These are called ischaemic strokes and, as with heart attacks, small amounts of alcohol seem to be protective.
But as many as 15% of strokes are caused by burst blood vessels in or around the brain, resulting in a major bleed. Alcohol does not protect against these haemorrhagic strokes and even relatively small amounts of alcohol – 2 or 3 units per day – can double or treble the risk of having a haemorrhagic stroke.
red wine and cancer
Heavy drinkers are more likely to get cancers of the upper digestive system – throat and oesophagus – than non drinkers. But there is some evidence that moderate wine drinkers are at no greater risk than teetotallers.
In a study of nearly 30,000 Danish people, beer and spirit drinkers were three to five times more likely to get cancers of the upper digestive tract than non-drinkers. But those who took at least a third of their drinks as wine had a risk of cancer slightly lower than that of the non-drinkers.
Wine is known to contain several anti-cancer agents which may offset the harmful effects of the alcohol, and one of these, called resveratrol, has been shown to block tumour growth in the laboratory.
what about the drawbacks of alcohol?
The drawbacks of excessive alcohol intake are all too obvious – and red wine is no exception. Heavy drinking raises blood pressure and damages the heart, liver, kidneys and brain. It causes impotence and infertility. In pregnancy, it damages the fetus. People who have been drinking are more likely to have accidents, be involved in violence or have sex when they hadn't intended or didn't want to.
Women are currently advised to drink no more than two or three units of alcohol per day (1 unit = a small glass of wine, half a pint of beer, or one pub measure of spirits) and men are advised against going above three or four units per day). But research shows that a lot of people exceed these recommendations (see the legal drug in the Drugs section).
help and info
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organisations
British Heart Foundation
14 Fitzhardinge Street
London W1H 6DH
Heart Information Line: 08450 70 80 70 (Mon-Fri 9am-5pm)
Website: www.bhf.org.uk
Provides a range of information about the causes, prevention and treatment of heart disease. Website contains a glossary, details of publications, plus practical advice on how to protect yourself from heart disease.
Stroke Association
240 City Road
London EC1V 2PR
Stroke Information Service Helpline: 0845 30 33 100 (Mon-Fri 9am-5pm)
E-mail: info@stroke.org.uk
Website: www.stroke.org.uk
Provides information and support for people affected by stroke and funds research into stroke prevention, diagnosis, treatment, rehabilitation, and care. Also produces a wide range of publications.
Drinkline
PO Box 4000
Glasgow G3 8XX
Helpline: 0800 917 8282 (24 hours, every day)
A free national helpline offering advice and information for people with alcohol problems
or anyone concerned about alcohol misuse. Provide advice on sensible drinking and
information on local support services to help people cut down on their drinking.
websites
Alcohol and Health
www.wineanorak.com/health.htm
An article Can drinking wine really be good for you? and related resources on wine and health from www.wineanorak.com.
Alcohol Concern
www.alcoholconcern.org.uk
A wide range of information and advice including a directory of local alcohol services and downloadable version of Alcohol Concern's latest report on alcohol use and misuse in the UK, The State of the Nation: Britain's True Alcohol Bill.
Is red wine the key to a long life?
www.bupa.co.uk/health_information/html/health_news/010903wine.html
An informative article from BUPA.
Institute of Alcohol Studies
www.ias.org.uk
Information about alcohol and the social and health consequences of its misuse for the public and professionals. Factsheets are available for downloading.
reading
'Endothelin-1 Synthesis Reduced by Red Wine' by R Corder and others in Nature vol 414 (20 December 2001), pages 963-864 |
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'Population Based Cohort Study of the Association Between Alcohol Intake and Cancer of the Upper Digestive Tract' by M Gronbaek and others in the British Medical Journal, volume 317 (26 September 1998), pages 844-848 www.bmj.com |
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'Review of Moderate Alcohol Consumption and Reduced Risk of Coronary Heart Disease: Is the effect due to beer, wine, or spirits?' by EB Rimm and others in the British Medical Journal, vol 312 (23 March 1996), pages 731-736 www.bmj.com |
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Allen Carr's Easy Way to Control Alcohol by Allen Carr (Arcturus Foulsham, 2002) |
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The Effective Way to Stop Drinking by B Colclough (Penguin, 1994) |
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(April 2002, resources updated March 2005)
