Does wine help protect against heart disease? That, in a
nutshell, was the focus of my presentation last week at Tasty Topics, the
monthly educational series put on by the desert's Go Red For Women campaign of
the American Heart Association.
Wine, Women and Health provided an update
of recent developments and controversies linking wine with health. After a historical
review of wine-health associations, the talk centered on the investigative flurry
that followed the now-famous Mediterranean
dietary studies begun in the late 1950s with Ancel Keys' Seven Countries Study.
But it wasn't white-coated scientists and medical reports
that turned Americans' attention to wine. Rather, it was a 60 Minutes
television broadcast in 1991 that caused red wine sales to soar. In its French
Paradox segment, correspondent Morley Safer asked if the French proclivity for
a glass of wine alongside rich, high-fat cuisine could explain that country's paradoxical
lower rate of heart disease. Ten years later, the American Heart Association
issued a science advisory that noted more than 60 published studies in support of
a heart-protective role for alcohol. Groups who drank in moderation, that is,
one to two alcohol-containing drinks a day, had significantly lower death rates
and lower rates of cardiovascular disease such as heart attacks, strokes and
heart failure.
In 2005, a state-of-the-science summary written specifically
for heart patients was published in Circulation, the journal of the American
Heart Association. The paper cited a risk reduction of about 30%, or about
one-third fewer deaths and heart attacks among men and women who drank alcohol
in moderation a few times a week.
To answer the question of whether red wine is better than
other forms of alcohol, the Circulation paper cited the Copenhagen Heart Study
of more than 13,285 men and women who were followed for 12 years. That study
found an even greater drop-off in deaths and cardiovascular events among
moderate wine drinkers, who were half as likely to die of heart attacks or
cardiovascular disease as people who did not drink at all. On another hand, the
paper also cited studies in which red wine drinkers did not fare as well,
without a clear heart-protective benefit over those who drank beer or spirits.
Studies in test tubes, animals and human studies have
pointed to pathways and precise mechanisms that seem to account for the
beneficial effects of moderate alcohol consumption on cardiovascular health. For
example, one or two drinks daily boost HDL, or good cholesterol. Alcohol also
inhibits blood clotting, similar to the way aspirin is used in heart patients
to decrease blood platelet stickiness, and thus their ability to clump together
to form a blood clot. Compounds in red wine such as resveratrol also appear to
help blood vessels relax and maintain healthy tone. These compounds also interfere
with wayward processes that churn out protein molecules that damage blood
vessel walls.
Given the many known dangers of overindulgent alcohol use –
or any use at all by at-risk populations such as pregnant women, youth and
those with a family history of alcohol use disorders – no scientific society
endorses alcohol use to reduce risk of heart disease. Instead, the AHA and
other medical societies advise patients to discuss alcohol on a one-on-one
basis with their doctor. With barely enough time to talk about active health
problems, medications, tests, etc., some patients may be reluctant to bring up drinking,
or ask about health risks and benefits associated with wine. Further, some
doctor-patient discussions may be waylaid by physicians who are unaware,
dismissive or who disagree with the AHA advisory.
What about recent reports that have linked drinking any
amount of alcohol to an increased risk for cancer, specifically cancer of the
breast? This is clearly a situation that warrants discussion between patient and
physician, with the expectation that oncologists may be more likely to
discourage taking on any perceived increase in cancer risk. It's worth
remembering, however, that cardiovascular disease kills four of ten American women,
more than all types of female cancers, and nearly more than the next five
leading causes of female deaths combined. Look for more on this touchy subject
in another post.
If you missed the presentation at Bellatrix at The Classic
Club, get on the mailing list for future Tasty Topics or send a gmail to arrange a presentation for your corporate or community. Meanwhile, give a toast
to spreading awareness about women and heart disease. Get a read on your own
lifestyle and risks here. Learn more about what we can all do every day to live
healthier lives by getting involved with Go Red For Women. Salute!
