Are Wine Drinkers Different?

It seems as though not a week goes by without a story that links a health benefit to wine. Whether it’s stronger bones, a lower risk for dementia or fewer heart attacks, one lingering question remains: Is the benefit in the beverage or the wine drinkers’ lifestyle?

Wine drinkers, it turns out, are different. Regardless of country of origin, wine drinkers stand apart from those who prefer to imbibe beer, spirits or not at all in many ways.

A 2001 Danish study of nearly 700 moderate drinkers between 29 and 34 years of age found that wine drinkers in that group had higher IQ scores and enjoyed better socioeconomic status compared to beer drinkers. The study also looked at measures that indicated personality and other social traits, and ranked wine drinkers’ scores as optimal and beer-drinking groups as subpar.

Not yet convinced? The following year, a study looked in on 4,435 men and women enrolled in the University of North Carolina’s Alumni Heart Study. This older group reported alcohol and food intake, further sorted by fruit, vegetable and red or fried meat consumption. Participants were asked about saturated fat, fiber and cholesterol intake as well as dietary supplement, smoking or tobacco use, exercise, body-mass index (BMI) and socioeconomic markers such as income and education.

Responders who named wine as their alcoholic beverage of choice reported healthier habits than spirits and beer drinkers. Wine drinkers ate better diets that were richer in fruits, vegetables and fiber. They also got more exercise and were less likely to smoke. Compared to other types of drinkers, those who chose wine consumed less saturated fat, cholesterol and drank less total alcohol.

So does protection from disease track back to wine or healthier habits? A 2012 study from the University of Texas and Stanford University attempted to answer that question. They followed a group of 802 adults over 20 years, all of whom were 55-65 years of age when the study began. Only abstainers or moderate drinkers were considered. Drinkers ranked their alcoholic preference as high or low in wine.

Compared to abstainers, moderate drinkers in both wine categories fared far better in terms of overall survival over the two-decade period. However, once results were controlled for other lifestyle factors such as diet, tobacco use and exercise, no such advantage emerged. The authors concluded that, at least for older adults who were moderate alcohol drinkers, wine drinkers’ apparent longevity benefit appeared rooted in other health-promoting lifestyle factors, as opposed to wine drinking itself.

The Centers for Disease Control may have summed it up best in a 2011 report that drew little fanfare. Their study identified four healthy behaviors associated with living a longer, healthier life:

• Keep alcohol intake in check – no more than one drink per day for women and two for men

• Lay off tobacco in all forms, and if you currently smoke, get help quitting

• Eat a healthier diet rich in fruits, vegetables, whole grains, low-fat dairy and seafood, and limit intake of salty, high-cholesterol and high-fat foods, added sugars and refined grains

• Stay physically active – aim for a mix of aerobic and strengthening activities every week 

Future studies will continue to weigh the role of wine, alcohol itself and other factors to healthier living. For now, it seems fair to say that wine drinkers are indeed different, and those differences themselves may provide the lift for wine drinkers’ health and survival benefits. But before you pat yourself on the back with a vive la différence, dig deep into all the other health-promoting behaviors that might spare you from the burden of chronic disease, and help you to live a longer, more robust life. 

Remembering Serge Renaud

The wine world lost a force provocateur with the passing of Serge Renaud late last month. The Bordeaux-based scientist caused a disruptive moment with his 1991 appearance on the CBS program 60 Minutes, an episode credited with embedding the term French Paradox in the American lexicon. In the segment, Renaud described studies that linked lower rates of heart disease among the French to their consumption of healthy fats and custom of washing down fat- and cheese-laden meals with wine. When asked to explain why even the northern French, whose diet contains very little olive oil, had lower rates of heart disease than Americans, Renaud said, "My explanation is, of course, the consumption of alcohol."

By up-ending the prevailing view at the time that only considered alcohol's potential for harm, televised comments by Dr. Renaud and epidemiologist R. Curtis Ellison, MD created an ensuing buzz that helped propel funding and research activity to delve deeper into the paradox and, by extension, the nature and prevention of cardiovascular and other inflammatory diseases. The segment, which provided enough fodder to prompt 60 Minutes to revisit the story in 1995 and again in 2009, also caused Americans to rethink wine. What followed into the 1990s was a dramatic upswing in American wine consumption, and a new taste for reds. 

While not all of Dr. Renaud's theories gained traction, the University of Bordeaux professor offered the scientific community a new lens with which to study heart disease and diet. Specifically, Dr. Renaud's work shed light on alcohol's anti-clumping effects on platelets and how this action appeared to prevent the formation of blood clots that set the stage for heart attacks or strokes. His groundbreaking papers in the 1960s and 1970s challenged conventional wisdom regarding cholesterol and saturated fat through experiments that linked atherosclerosis and fatal clots with effects of dietary fats on platelet function and biochemical changes to blood vessel walls.

Perhaps his most far-reaching findings involved studies published during the 1980s and 1990s on effects of dietary change on health, specifically, the heart-protective Cretan or Mediterranean diet. A 1995 study by Renaud published in the American Journal of Clinical Nutrition criticized the so-called prudent diet, which the American Heart Association championed for heart patients at the time. Renaud's paper showed the prudent diet was clinically inferior to the Cretan Mediterranean diet of the 1960s, with more than a 70% reduction in cardiovascular events, heart attacks and overall death rates in heart patients who followed a Mediterreanean diet that gave less emphasis to meat and was richer in olive and canola oils, grains, fish, legumes – and red wine.

Cardiologist Tedd M. Goldfinger, Chairman of the Renaud Society, an association of medical professionals with an interest in the wine-health connection to which this author belongs, called the Society's patriarch "a champion of health through nutrition," whose many contributions included scientific insights into fatty acid metabolism and the range of benefits associated with a Mediterranean diet on cardiovascular health.

With Serge Renaud, Ph.D., (right) and R. Curtis Ellison, MD, Walla Walla, Wash. 2009

Looking back at his prolific career for an article in the Lancet published on the first day of the new millennium, Renaud reflected to author Bruno Simini, “If I hadn’t lived with my grandparents and great-grandparents on a vineyard near Bordeaux, perhaps this idea wouldn’t have occurred to me. When you see people reach the age of 80 or 90 years, who have been drinking small amounts of wine every day, you don’t believe wine in low doses is harmful.”

Renaud passed away within sight of his seaside home in Carcans Maubuisson in the Médoc, a few weeks shy of 85^th birthday. We are grateful for his contributions, and thankful to have shared in his gentle presence.

Wine, Women & Health: Medicine or Myth?

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!

The French Paradox, 20 Years Later

Call it preaching to the choir if you want, but a few days of scientific presentations earlier this month at the 6^th International Wine and Heart Health Summit confirmed the belief that there are many health benefits associated with a glass of wine at dinner, at least for this attendee.

Dubbed the French Paradox two decades ago by Serge Renaud, famed researcher at the University of Bordeaux, the phrase refers to the strikingly decreased rate of heart attacks and deaths due to heart disease among the French, despite a diet rich in saturated fats, cheeses and assorted high-calorie treats.

CBS correspondent Morley Safer concluded a 60 Minutes broadcast on November 17, 1991 that investigated what might account for the paradox by posing a question: Could the answer be found in the propensity of the French to wash down fat-laden meals with a glass of red wine? The broadcast sent shock waves through the research community as well as the lay public, causing red wine sales in the United States to jump by nearly 40%, and ushering in an era of increased red wine consumption among Americans.

This year's Wine Summit brought together some of the most prominent researchers in this active field. Held at the magnificent Allison Inn & Spa in Willamette Valley, Oregon, the panelists included Arthur Klatsky, MD, and Curtis Ellison, MD (featured in the original 1991 broadcast), as well as young researchers currently investigating other ways in which wine may enhance our ability to combat or stem other diseases from periodontal disorders to dementia. Ralph Brindis, MD, President of the American College of Cardiology also examined historical and political issues surrounding alcohol use and abuse.

Presentations covered a lot of ground. Winemaker David Adelsheim traced the brief, yet red-hot trajectory of Oregon winemaking while Wine Spectator and Oregonian columnist Matt Kramer shared his take on finding wine values. Event host Donald Olson, MD of Torii Mor Winery moderated a spirited panel discussion among Oregon winemakers that included founders from Bergstrom, Ken Wright Cellars (with single-vineyard soil specialist Ken Wright himself), and Jim Bernau of Willamette Valley Vineyards. Bernau told an intriguing story about how he was about to get the US Alcohol and Tobacco Trade and Tax Bureau (TTB) to allow WVV to include resveratrol content of Pinot Noir on their wine labels.

In the two decades since the broadcast, studies have pointed to a range of health benefits associated with not only moderate amounts of wine but also moderate intake of other alcoholic beverages. In case you were wondering, moderate consumption, as defined by the USDA 2010 dietary guidelines for people who choose to drink, means one 5-ounce glass of wine at 12% alcohol daily for women (or two 5-ounce glasses for men) or 12 ounces of regular beer or 1.5 ounces of 80-proof distilled spirits.

While this story is still being written, we're placing bets on a healthy lifestyle that includes wine to come out on top. You don’t just have to take our word for it. Here's a look at FAQs from the Centers for Disease Control that answer a few more questions you may have. This link will take you to a recent CDC report that notes how certain low-risk behaviors – never having smoked, following a healthy diet, getting enough physical activity and moderate consumption of alcohol – can help you live a longer, healthier life. Salute!

Super Bowl Wines

We have pigskin picks to vinify your Super Sunday, but first a few food facts. Just two days after Go Red For Women, the American Heart Association's campaign to raise awareness about women and heart disease comes XLV, the super-snackdown day of the year. 

1,200

Incredibly, the amount of food Americans will tackle this Super Bowl Sunday may gut-bust Thanksgiving Day, the defending pig-out champion. The average fan is set to scarf 1,200 calories and 50 grams of fat from game day snacking alone – and that doesn't include any regular meals. Unless you plan to walk around a football field for three hours, no amount of fist-pumping and jump-up cheering is going to burn off those calories. Backfield in motion, baby, and bring out the tape. Or, as comedienne Elaine Boosler would say, why not just rub all that stuff right into your thighs?

Worse perhaps is that so many bowl day foods are close to awful. Can we get a holding foul here? Burgers, fried funkitude and chip-dip combos that scream out for an aspirin-nitro-statin garnish hardly seem worth the angina – or agita either, for the Italians out there. I mean, if you're gonna Hail Mary, doesn't a nice plate of lasagna or a juicy rib-eye off the grill sound more appealing than something that stinks of cilantro or singes your palate? Yuck.   

Bottom line is that many Super Bowl food flavors + wine = false start. Chili, thick dips and weighty or fried foods are hard hits for lighter reds and oaked Chardonnays. In the red zone, Cabernet tannins come across as too harsh when combined with super salty foods. Even bigger or bolder reds such as Syrah or Zinfandel can get crushed in the pileup by four-alarm barbecue sauces or hotly spiced wings. 

Unfortunately, there aren't many takers for the alt idea of super Sunday: flip on the crockpot in the morning and uncork a favorite bottle over a real meal during halftime break. No worries about delay of game or missing the halftime show – odds are it'll be as lame as ever. Bah humbug. So with a shrug to mega-snacking as the official play of the day, here are wine picks sure to score big with the gang:

Riesling

Riesling racks up huge yardage for how well it goes with a wide range of foods, especially spicy dishes, sausage, salads and smoked fish. Many Rieslings are low-alcohol too, to help keep guests safe and under-the-limit. Costco has a German Riesling now that's only 7.5%. Look for Dr L by Loosen Brothers in the tall, teal screw-cap bottle, around $10 at Dan's Wine Shop and Trader Joe's.

Box Wines

The space-saving eco-packaging by Octavin Home Wine Bar holds three liters, equal to four bottles of wine. With a convenient pour spout, these tasty, good quality wines will douse a couch-full of thirsty fans. Find them at Albertsons and Ralphs grocers, better still when they're on sale. Silver Birch Sauvignon Blanc is refreshing and balanced, without too much grassiness for game day foods. Kickoff reds worth a runback are the low-tannin Monthaven Cabernet Sauvignon (find the 2007 if you can) or Big House Red, sometimes also at Costco.

Rosé

If you think real men don't drink pink, food-friendly rosé will rock your manly man's playbook. Go with New World rosés made from heartier red grapes instead of more delicate French and Provençal rosé styles. Give it a good chill and watch for conversions. Try screw-capped Tapiz Rosé of Malbec from Argentina (BevMo!), Barnard Griffin Rosé of Sangiovese from Oregon or Mulderbosch Rosé of Cabernet Sauvignon from South Africa (World Market Cost Plus).

Finally, if your heart beats for healthier Super Bowl recipes, score with the roasted red pepper dip and others here, more recipes and substitution ideas here and funny but real food safety tips from Uncle Sam here.

Coming soon: Not-so-grouchy picks for a romantic Valentine's Day