On Thursday, the French will go nuts.
We know this because they go nuts every year on
the third Thursday of November, the day the latest crop of
just-off-the-vine wines hit the market.
Wine-lovers will swarm to those cute little bistros,
swell with Gallic pride, swill a glass of this fairly flimsy red
stuff, and proclaim, "Le Beaujolais Nouveau est arrive!"
(This proves either that the French really do have a
better grip on things than the rest of us, as I suspect, or that
they, too, can be suckered into a clever marketing ploy. Or both.)
But it's not just the French who love wine. In recent
years, American wine sales have been booming, too. Nobody knows why,
but it may be that Americans have come to believe that wine is
actually good for them.And so it is. In the
last quarter century, more than 50 studies from around the world
have shown that people who drink moderately have up to a 40 percent
lower risk of heart disease than those who don't drink. Because
heart disease is such a huge factor in overall mortality in the US,
this translates statistically into a lower death rate in any given
year for moderate drinkers.
But the whole truth -- in vino, veritas -- is a bit
more complicated, so before you pop that cork, some caveats.
By government estimates, 14 million Americans have an
alcohol disorder, which is defined as abuse and dependence (or
uncontrolled drinking), tolerance for high doses, and withdrawal
symptoms when drinking stops.
In excessive amounts, alcohol raises the risk of
heart disease, hypertension, stroke, some cancers, violence, and
suicide. It's also bad for pregnant women because it can cause
defects in the developing fetus. It shouldn't be mixed with certain
medications (check the labels). And it clearly doesn't mix with
driving.For the record, alcohol consumption
can also be tough to study because people sometimes lie about how
much they drink. It's especially tough to sort out the relative
merits of wine, beer, and liquor because people typically drink
different types of alcohol on different occasions.
Beyond that, researchers don't always agree on what
counts as "moderate drinking," though it's usually one drink a day
for women and two for men, with a drink being 5 ounces of wine, 1.5
ounces of spirits or 12 ounces of beer.That
said, compared to most medical research, the data on alcohol and
health are remarkably clear, consistent, and compelling, though
things get murky on the finer points, like whether wine, especially
red wine, is better than other alcohol.
The first hints that alcohol might carry health
benefits came 25 years ago -- as a surprise.
With a colleague, Dr. Arthur Klatsky, now a senior
consultant in cardiology at Kaiser Permanente Medical Center in
Oakland, Calif., was studying factors that predicted heart attacks.
In a 1974 study, Klatsky says, there was no
hypothesis about alcohol, but he asked about drinking anyway and
found that abstainers were actually at higher risk of heart attack
than those who drank moderately. No one knew why.
Now scientists think they do. Alcohol, whether from
wine, beer or spirits, raises HDL, or "good" cholesterol, and lowers
levels of a blood-clotting protein called fibrinogen and reduces the
activity of platelets, which also help form clots. (A recent
Stanford University study showed alcohol may also help reduce the
damage done to tissue during a heart attack -- at least in rats.)
The study that clinched the link between moderate
drinking and overall survival came in 1997. Researchers led by Dr.
Michael J. Thun, who heads epidemiological research for the American
Cancer Society in Atlanta, studied 490,000 people and found that
moderate drinkers had a 20 percent lower risk of death in any given
year than abstainers.This holds true for
women as well as men, Thun says, though he's quick to warn that the
risk-benefit ratio is trickier for women. That's because the risk of
dying from (not just getting) breast cancer is 30 percent higher
among women who have at least one drink a day.
"For breast cancer, not drinking at all would be
optimal," he says. Yet because heart disease kills six times as many
women as breast cancer, the benefits of moderate drinking still
outweigh the risks for many women.Here's
another way of looking at it. A huge, 1998 Harvard study of pooled
data on 322,000 women found that the risk of getting breast cancer
goes up linearly with the amount (though not the type) of alcohol
consumed; one drink a day raises risk about 10 percent. Put another
way, a woman who lives to age 85 has a 12.5 percent chance of
getting breast cancer; adding a drink a day raises this to 13.6
percent. (On the other hand, just to confuse matters, a smaller
study published in January and based on data from the ongoing
Framingham Heart Study showed that women who drink one alcoholic
beverage a day have no increased risk of breast cancer.)
If there is an increased risk, it's modest and
probably due to the fact that alcohol raises blood levels of
estrogen, at least transiently, and estrogen can drive some breast
cancers.But this increased breast cancer
risk from drinking is less than that from estrogen supplements,
which raise risk about 40 percent in menopausal women who take them
for five years or more. Even adding together the increased risk from
a drink a day to the increased risk from hormone therapy, that's
still only a 50 percent increase in the risk of breast cancer,
fairly modest by statistical standards. This may be a crucial
difference for women with a strong family history of breast cancer,
but for others, the benefits of alcohol may still outweigh the
risks.
And what of the notion that red wine has even more
health benefits than lowlier forms of booze? That gets tricky.
The theory is that many phenolic compounds in the
seeds of grapes and a particular one called resveratrol from grape
skins act as potent anti-oxidants, or disease-fighting chemicals.
Grape seeds and skins are used in making red wine (and purple grape
juice), but not white wine, notes wine chemist Andrew L. Waterhouse
of the University of California, Davis.
In a study published in September, Waterhouse showed
that a phenolic compound called a catechin shows up in the blood
after people drink red wine. Other research has shown that red wine,
but not white, causes changes in the blood that make it harder for
LDL, or "bad" cholesterol, to be oxidized and thereby perhaps to
help form artery-clogging plaques.
Researchers from the University of Wisconsin also reported recently
that in 15 people who drank purple grape juice every day, blood
vessels were more elastic and LDL cholesterol was oxidized more
slowly.
But does this translate into real differences in
disease?Some researchers think so. In 1995,
Danish epidemiologist Morten Gronbaek reported in the Copenhagen
City Heart Study of 13,000 men and women that the risk of dying was
reduced by 50 percent in people who had three to five glasses of
wine a day. He did not find the same benefit for beer or spirits.
But he also found in a 1999 study that people who
drank wine were more likely than those who drank beer or spirits to
eat a healthful diet, with lots of fruits, veggies, fish, and olive
oil.Klatsky, the Kaiser Permanente
cardiologist, has also looked for any special effect of wine and has
concluded that if there is a benefit to wine over other forms of
alcohol, it's probably not the wine but the health habits of the
people who drink it.
Eric Rimm, a nutritional epidemiologist at the
Harvard School of Public Health, puts it this way. About one third
of the 50 worldwide studies on alcohol and health look at wine,
beer, and spirits separately. Taken together, he says, there's no
compelling evidence that red wine has more health benefits than
other types of alcohol.To which the only
decent answer is a raised glass, a Gallic shrug, and a hearty, "C'est
la vie!"
SIDEBAR:
LABELS CAN'T TELL THE STORYIn February, the
government took a long-awaited step toward legitimizing wine
consumption when, at the urging of wine manufacturers, the Bureau of
Alcohol, Tobacco and Firearms approved a voluntary label for wine
bottles that refers consumers who want "to learn the health effects
of wine consumption" to the agriculture department's Web site.
But last month, the agency bowed to political
pressure from Sen. Strom Thurmond (R-S.C.), and announced it was
re-opening the issue for public comment. Last week, John De Luca,
president and CEO of the California-based Wine Institute, an
industry-supported group, said, "Far from fearing this, we welcome
it. It's a terrific new forum to share the scientific findings on
the subject."The new label approved in
February did not replace the required label carrying the US Surgeon
General's warning that pregnant women should not drink alcohol
because of the risk of birth defects and that drinking alcohol
impairs the ability to drive a car or operate machinery and may
cause health problems.
It didn't make outright health claims, either, but
did refer readers to the US Department of Agriculture's statement,
which says that in moderation, alcohol is associated with a lower
risk of coronary heart disease. The USDA defines moderate drinking
as no more than one drink a day for women and no more than two for
men.To read the full USDA statement on the
Web, go to
http://www.usda.gov/fcs/cnpp.htm
For more information on the health effects of wine
and other forms of alcohol, check out the Web site of The Wine
Institute at http://www.wineinstitute.org. It's an industry site,
but has done a decent job of pulling together some scientific
studies.
Judy Foreman’s column runs every other week. Past
columns are available on
www.myhealthsense.com.
Listen to her live
call-in webcast radio show every Wednesday night
from 8:30 to 9:30 EST on
http://www.healthtalk.com.
