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The Debate as to the Health Benefits of Wine Continues in 2011 Part 2



Cardiovascular Disease

The ability of wine to reduce cardiovascular disease is thought to be the result of many beneficial effects. Roberto Iermoll, Professor of Internal Medicine at ‘Universidad de Buenos Aires’ in Argentina spoke to this subject at the 2011 Vinandino seminar held in Mendoza, Argentina in September 2011. He noted that resveratrol in red wines increases nitric oxide levels, keeping potassium channels open in the mitochondria of the heart cells and protecting them from oxygen deficiency consequences. This mechanism causes fewer cells to die and reduces cell mortality to 50% after a heart attack. Also, alcohol stimulates good cholesterol production (HDL) that removes bad cholesterol (LDL) from arteries and veins where it can form plaques. Alcohol helps lessen the stickiness or coagulation of red blood cells, which can cause an embolism and block the blood flow in an artery resulting in a heart attack or stroke. In addition, he pointed out that alcohol has an anti-inflammatory effect that reduces the development of atherosclerosis. Summary: Wine has the capacity to reduce cardiovascular disease through several proposed physiological mechanisms.

Probably the most important paper published in 2011 appeared in the British Medical Journal (Feb 22, 2011): “Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies.” Two reviewers independently selected peer-reviewed studies that examined adults without known cardiovascular disease and that compared fasting levels of specific biological markers associated with coronary artery disease after alcohol use with those after a period of no alcohol use (controls). 4690 articles from 1950 to 2009 were screened for eligibility and 63 relevant articles were selected. Favorable changes in several cardiovascular biomarkers (higher levels of high density lipoprotein cholesterol - HDL - and adiponectin and apolipoprotein A1, and significantly lower levels of fibrinogen) provided indirect pathophysiological support for a protective effect of moderate alcohol use on coronary heart disease. The authors of the study also determined that different types of alcoholic beverage had similar effects on biomarkers, but inferences on beverage type should be cautiously considered since most of the studies used wine as the alcohol intervention. Many of the reviewed studies used comparisons with a non-red wine alcohol intervention or with de-alcoholized red wine and it was concluded that the effect observed was most likely due to alcohol rather than to the other components of red wine. The study did have some caveats since potential confounders such as smoking, physical inactivity, body weight and diet could have affected the findings. Summary: The results strengthen the case for a casual link between alcohol intake and reduced risk of coronary heart disease.

Alcohol was linked to better survival after heart attack in women in a U.S. study published in the American Journal of Cardiology(January 2012). Women who drank anywhere from a few alcoholic drinks a month to more than three a week in the year leading up to a heart attack ended up living longer than women who never drank alcohol. The results of the study indicated a 35 percent lower chance of dying during the ten year follow up period for women who drank, compared to those who didn’t. No differences were seen among different beverage types. Summary: Adults may not need to stop drinking in moderation once they develop heart disease. One drink a day is a really good target.

A study published in the Journal of the American Dietetic Association pooled the results from nine clinical trials and found that grape seed extract reduced systolic blood pressure by about 1.5 points and slowed the user’s heart rate by an average of 1.4 beats per minute compared with a placebo pill. These results seem insignificant except that past studies have estimated that a blood pressure reduction of just 3 points can reduce the risk of death among people who have heart disease or have suffered a stroke. There was no effect on cholesterol levels or diastolic blood pressure. Diet changes such as reducing sodium and eating plenty of fruit, vegetables, whole grains and lean protein have shown to have more effect on blood pressure numbers. Summary: Grape seed extract is thought to be safe and it is inexpensive but it does have side effects and safety of long-term use is unknown. It does not reduce the risk of heart attacks or strokes. Diet changes such as reducing sodium and eating plenty of fruit, vegetables, whole grains and lean protein have shown to have more favorable effect on blood pressure numbers.

A report in the Journal of the American College of Cardiology(February 2011) looked at alcohol consumption and the risk of the cardiac arrhythmia known as atrial fibrillation. A systematic search of Medline from 1966 to 2009 databases was conducted and 14 eligible studies were included in this meta-analysis. The results indicated that even moderate drinking can lead to atrial fibrillation. Summary: Results suggest that not consuming alcohol is most favorable for atrial fibrillation risk reduction. The relationship between daily alcohol consumption with the risk of atrial fibrillation is linear and independent of sex. (Most previous studies have found that heavy drinking may increase the risk of atrial fibrillation, but the risk with light to moderate alcohol intake seems unlikely).



A study from Spain published in the American Journal of Clinical Nutrition(February 2012) found that ethanol and the nonalcoholic compounds in red wine may cut vascular disease risk. 67 human male volunteers were chosen for study who were considered at high risk for cardiovascular disease on the basis of increased BMI, smoking, diabetes, hypertension, or other risk factors. About half the patients were taking aspirin, statins, oral hypoglycemic drugs and ACE inhibitors. The subjects did not consume any alcohol for a baseline period, then for three one-month periods consumed 30 grams of ethanol per day as red wine or as gin, or an equivalent amount of phenolics from de-alcoholized red wine. The effects of each intervention on a large number of adhesion molecules and chemokines that affect inflammation and relate to cardiovascular disease were evaluated. Both ethanol and nonalcoholic compounds in red wine appeared to have potentially protective effects that may reduce the risk of vascular disease. Summary: Both ethanol and polyphenols of red wine may modulate soluble inflammatory mediators and the phenolic content of red wine may modulate leukocyte adhesion molecules in patients at high risk of cardiovascular disease.

Many studies have shown that the effect of alcohol on heart disease is largely attributable to an increase in HDL. A prospective, observational study reported in Circulation (October 2011) found that alcohol drinking was associated with a significant decrease in risk of death from coronary artery disease. This well-done analysis suggested that very little of the lower risk of heart disease was due to an increase in HDL from alcohol consumption. Summary: This study refutes the results of most other similar studies that shown an increase in HDL is largely responsible for the effect of alcohol on risk of heart disease.

Mice have a similar physiological response to alcohol as humans and have been the subjects of many studies. Research published in Atherosclerosis (August 2011) found that mice that drank regularly and moderately (equivalent of two drinks a day) had dramatically better blood lipids, less atherosclerosis (hardening of the arteries), and less inflammation in their arteries than teetotaler mice and weekend binge-drinking mice. Summary: Daily moderate alcohol consumption in mice reduces atherosclerotic plaque development.

Researchers in Brazil studied the effect of moderate red wine consumption and physical activity on the cardiovascular system of rats with preexisting high blood pressure. The research was published in Arquivos Brasileiros de Cardiologia in 2011. The study found that there was a decrease in cardiovascular disease risk factors for the wine only group and the exercise only group but there was a more significant reduction in systolic blood pressure compared to the control group of the wine only and exercise only groups alone. Good cholesterol (HDL) levels in the wine and exercise group were significantly higher than the exercise alone and control group and only slightly higher in the wine only group. Summary: Wine and exercise are more beneficial than either wine or exercise alone in rats suggesting red wine and exercise in combination may decrease risk factors for cardiovascular disease.



Neurodegenerative Diseases & Brain

A Swedish paper to be published in the Journal of Alcoholism: Clinical and Experimental Research studied men and women over a several years who drank heavily (about 12 bottles of wine a week). Women suffered a 50% decrease in serotonin function in the brain after 4 years and men had the same decrease after 12 years. The damage to serotonin function was equal in the two sexes, but occurred much faster in women. Serotonin is a brain neurotransmitter that is related to the development and treatment of depression and chronic anxiety and is involved in the regulation of impulse control and our ability to fall asleep and stay awake. Heavy drinkers suffered damage to the part of the brain that controls moods, impulses and sleep. Summary: Chronic alcohol dependency leads to significantly lower serotonin functions. Women are more vulnerable to the effects of heavy drinking on certain brain functions.

The University of Missouri College of Arts and Sciences published a study in the Journal of Abnormal Psychology (May 2011) that found that people exhibit drunken behavior not because they are not aware of what they are doing, but because they just don’t care as much and are not as bothered by the implications of such behavior. Summary: Young people (aged 21-35) were less likely to notice mistakes when under the influence of alcohol while performing challenging computer tasks and were less likely to care. More research is needed to understand how alcohol affects the brain.

Researchers in Belgium reported in the European Journal of Neurology (November 2011) that patients who had the relapsing form of multiple sclerosis but not progressive onset multiple sclerosis had less progression of disability when they also drank wine, coffee and ate fish. Cigarette smoking was associated with an enhanced risk of disability. The protective effect of wine on symptoms was limited and the mechanism of effect was unclear. Summary: More research is needed as the results could indicate reverse causality (people who had less progression of disability due to multiple sclerosis might have felt more comfortable in drinking alcohol, including wine).

There have been a number of studies that support a decreased risk of dementia and Alzheimer’s disease among moderate drinkers. Researchers at Loyola University Chicago Strich School of Medicine reviewed 365,000 people who were in studies dating back to 1977. Published in the journal Neuropsychiatric Disease and Treatment (August 2011), the paper found that moderate drinkers (2 drinks a day for men and 1 drink a day for women) were 23% less like to develop dementia, Alzheimer’s disease and other “cognitive impairment.” Heavy drinking (more than 3-5 drinks a day) had a higher risk of dementia and cognitive impairment but the results were not statistically significant. Wine appeared to be more beneficial than beer or spirits in both men and women. The results were statistically significant in 14 out of 19 countries including the United States. Summary: The International Scientific Forum on Alcohol Research agreed with the conclusions of the authors that overall, light to moderate drinking did not appear to impair cognition in younger subjects and actually seems to reduce the risk of dementia and cognitive decline in older subjects. Moderate drinking may increase blood flow to the brain and might make brain cells more fit by slightly stressing them. Since there is no randomized clinical study available, the results of this review are only suggestive.

The German Study on Aging, Cognition and Dementia in Primary Care Patients evaluated the association between alcohol consumption and incidence of dementia and Alzheimer’s over three years. The daily consumption of alcohol was found to reduce the risk of dementia by near 30 percent compared to nondrinkers in patients 75 and older. The risk was another 30 percent lower for people who drank one to two servings per day of alcohol. No significant differences were found among the different types of alcoholic beverages consumed. Summary: Moderate drinking is associated with less dementia and Alzheimer’s disease in individuals aged 75 years and older.

Gary Small, M.D., director of UCLA’s Longevity Center and co-author of The Alzheimer’s Prevention Program: Keep Your brain Healthy for the Rest of Your Life,” wrote an update on the relationship between alcohol and Alzheimer’s Disease in Huffpost Healthy Living (January 19, 2012). He reported on a study that showed a nearly 30 percent lower risk for dementia among light drinkers compared to teetotalers or those who overindulged. This was not a double-blind placebo controlled study so it is not proof that moderate drinking protects the brain but there is a possibility. Other studies suggest that one glass of wine or spirits is brain protective for women and two glasses are the healthy brain limit for men. Some experts believe that light to moderate alcohol consumption may lower the risk of Alzheimer’s disease because of associated lifestyle habits and personality. Studies on the effect of wine on experimental lab mice that possess a human Alzheimer’s gene showed that when mice ingested moderate amounts of Cabernet Sauvignon wine (a mouse equivalent of 6 ounces), the animals had better memory ability and less of the protein building blocks that lead to amyloid plaques in the brain of the type seen in Alzheimer’s. Summary: Small amounts of wine, beer and spirits all appear to lower the risk for Alzheimer’s disease. Antioxidant effects of alcohol and polyphenols in wine may protect the brain.

Rats treated with resveratrol showed a reversal in diabetes-associated brain damage in a study published in the American Journal of Physiology (June 10, 2011). Brain tissue in diabetic rats treated with 10 milligrams of resveratrol per kilogram of weight per day ( a very high dose) showed some reversal of damage associated with diabetes. Resveratrol appeared to relax arteries and keep blood flowing in the brain of the treated rats as well as normalizing oxygen levels. The authors of the study speculate that the observed effects of resveratrol may reduce the stress factors that lead to strokes in diabetics and opened the possibility that resveratrol could be a potential agent used to prevent brain dysfunction and reduce stroke risk in diabetics. Summary: Even less resveratrol could be as effective for reversal of diabetes-associated brain damage in rats. Much more study is necessary.

A study presented at the American Academy of Neurology’s 63rd Annual Meeting in April, 2011, that was performed at the Harvard School of Public Health in Boston, suggested that the flavonoids in plants and fruits may increase dopamine levels in the brain and possibly prevent Parkinson’s disease. Of the subjects monitored during the study, men who ate more foods containing flavonoids, such as berries, apples and oranges, were 40 percent less likely to develop Parkinson’s disease. In women, there was no relationship between eating general flavonoids and the occurrence of Parkinson’s disease, but the flavonoids such as anthocyanins found in berries were found to protect both men and women against the disease. Summary: A diet high in fruits and vegetables could be protective against Parkinson’s disease risk but the results are still preliminary. Research needs to be done to see what other flavonoid-rich foods such as cacao, and red wine, do for the risk of Parkinson’s and other neurological diseases.

Drinking red wine over a lifetime apparently reduces the risk of essential tremor significantly. In the medical journal Movement Disorders (April 2011), researchers found that over a period ofapproximately 30 years, three glasses of red wine a day led to a 65 percent lower risk of developing tremors and four or five glasses of red wine daily led to an 86 percent lower risk. It was postulated that antioxidants in red wine provide a protective effect. Summary: This case-control study was subject to bias and more research is needed to determine the role of alcohol drinking in the development of essential tremor.

A study published in Alcoholism: Clinical & Experimental Research (November 2011) by Japanese researchers looked at the effect of alcohol on sleep. 10 healthy, male university students were give three different alcohol beverages at three week intervals: 0 alcohol (control), a low dose of alcohol, or a high dose of pure ethanol. A Holter electrocardiogram was attached to each subject for a 24-hour period and the subject was instructed to drink one of the three alcoholic beverages 100 minutes before going to bed. Polysomnography was performed for 8 hours. The team found that alcohol increased the heart rate and interfered with sleep and the more alcohol the participants drank, the greater the effect. The subjects exhibited good sleep quality in the first half of the sleep cycle, but in the second half, the alcohol interfered with sleep quality and the restorative role of sleep. Summary: A “nightcap” before bedtime may actually prevent a good night’s sleep.



Gastrointestinal

A study reported in the American Journal of Clinical Nutrition (October 2011) found that European men, but not women, who drank more than four alcoholic drinks per day had an increased risk of stomach cancer. Men who averaged more than four drinks per day were twice as likely to develop stomach cancer as light drinkers (a half drink a day or less). Beer, rather than wine or liquor, was associated with the stomach cancer risk. The findings were confirmed regardless of smoking habits (smoking is a risk factor for stomach cancer). Summary: one of the metabolic byproducts of alcohol, acetaldehyde, is a human carcinogen and nitrosamines in beer have been shown to cause cancer in animals. The combination of those two carcinogens may explain why beer drinkers are more at risk for stomach cancer.

An analysis of the relationship between alcohol intake and upper aerodigestive cancers was published in Oral Oncology (September 2011). Smoking is the most important factor in the risk of these cancers but the risk is increased in those who also consume 2 or more drinks per day. Tobacco use alone explain 28.7% of the aerodigestive cancers in Europe, the combination of smoking and drinking 43.9%, and alcohol use alone only 0.4%. In women, the study suggested that wine may play a role in reducing the risk associated with smoking since in women, the risk of these cancers was higher among abstaining smokers than among those who both smoked and drank alcohol. Summary: Aerodigestive cancers are causally related primarily to smoking, with alcohol playing a lesser role. More studies are needed to determine the effects on risk of varying levels of alcohol consumption.

A British study reported in the British Journal of Surgery (August 2011) found that drinking wine and beer excessively did not increase the risk of acute pancreatitis but binge drinking spirits did raise the risk. The number of drinks consumed per occasion affected the risk of pancreatitis. Summary: Spirits drinkers may experience a greater rise in BAC as a result of a faster rate of drinking and this may be an important factor in the higher risk of pancreatitis.

Moderate alcohol consumption can lead to gastrointestinal symptoms due to bacterial overgrowth in the small intestine. As reported in Teatro Naturale International (November 2011), this study at Dartmouth-Hitchcock Medical Center and the Mayo Clinic, is one of the first to look at the relationship between moderate alcohol consumption and small intestinal bacterial overgrowth (SIBO). Patients in the study who drank a moderate amount of alcohol, sometimes less than 1 drink per day, were at high risk for SIBO. SIBO is a potentially harmful condition that leads to abnormally large numbers of bacteria in the small intestine that consume many of the nutrients that otherwise would be absorbed. Summary: It has been previously shown that alcoholics have high rates of SIBO, but this study indicates that even light to moderate drinking may predispose to SIBO. Alcohol cessation may be a treatment for this condition.

Considering the recent developments in the reported risks of Lap-Band surgery and the requests for Congress to investigate, a study released by Swedish researchers in 2011 is relevant. Two common procedures used for management of obesity are gastric bypass and Lap-Band surgery. Gastric bypass creates a smaller stomach pouch and bypasses part of the intestine. The Lap-Band procedure is performed by placing an inflatable silicon band around the stomach to decrease food intake, but food continues to pass through the intestine. After examining 12,277 patient records, the researchers found a 2.3 times increased risk of developing alcoholism among those who had gastric bypass compared to the group who got Lap-Band surgery. Summary: After gastric bypass surgery, alcohol that normally would be metabolized by stomach enzymes reaches the intestines largely intact. Gastric bypass surgery doubles the risk of developing alcoholism as a result. A prospective observational study published in 2011 found that the LAP-BAND AP system offered a safe and effective therapy to reduce weight in severely obese patients.



Metabolism

The medical journal Nutrition Reviews (August 2011) reported a Spanish study that found that moderate drinkers gain less weight than the general population. A meta-analysis was conducted of numerous studies on alcohol and weight between 1984 and March 2010. Theoretically, alcohol adds additional calories to one’s diet (one gram of alcohol equals 7.1 kilocalories; a standard 5 ounce glass of red wine contains about 106 calories but this varies with alcohol content), and may lead to weight gain by increasing a person’s daily energy intake. Alcohol does contribute to obesity in heavy beer and spirits drinkers. The study found that those who consume 1 to 2 glasses of wine per day, but not those who drink three glasses or more, gain less weight than the general population. Consumption of spirits was positively associated with weight gain. Another study published in Nutrition (July- August 2011) found that moderate wine drinkers compared to beer and spirits drinkers showed less yearly weight gain. Summary: The reasons that moderate wine drinkers have less weight gain than beer or spirits drinkers are not clear. Suggested factors include the dietary patterns of wine drinkers and the possibility that resveratrol in red wine inhibits the conversion of sugars into fat.

In the Annals of Internal Medicine (September 6, 2011), scientists from the National Heart, Lung and Blood Institute and the National Cancer Institute (both part of the National Institutes of Health) reported that moderate alcohol consumption reduces the chances of developing type 2 diabetes (adult onset), especially in women. Moderate drinking reduced the risk by 19 percent in men and 37 percent in women 50 to 71 years of age. The NIH group looked at a health survey of over 500,000 AARP members. The causes for this effect in moderate imbibers, which included wine drinkers, is speculative and includes enhanced insulin sensitivity, anti-inflammatory effects of alcohol, and elevated triglyceride concentration from alcohol. Summary: More research is necessary to elaborate the mechanisms that suggest that moderate alcohol drinking lowers diabetes risk. It is not clear why moderate alcohol consumption was associated with a lower risk for diabetes in women.

Dutch scientists report the first study to show the effects of resveratrol on human metabolism in a paper published in Cell Metabolism (November 2011). Either large doses of resveratrol supplements or a placebo were given to 11 obese men and then the groups were switched after 30 days. The effects were small but did show a similar benefit to a low-calorie diet or endurance training such as reduced levels of liver fat, blood pressure, triglycerides and blood sugar, and less insulin resistance. The result was more optimal lowered metabolism. Resveratrol did not lead to weight loss but appeared to slow down the problems associated with obesity. Summary: This is the first study in humans to show resveratrol effects on human metabolism that might extend lifespan. Moderate wine drinkers cannot expect the same result as the dose of resveratrol needed for a neutraceutic effect, 150 milligrams a day, would be equal to about 10 liters of red wine. However, that amount of resveratrol could conceivably be incorporated into a food supplement or a daily capsule.

A study in Food & Function (January 2011) from Vienna tested the chemical composition of two white wines and 10 red wines from Austria. 100 millimeters of a 2003 Blaufränkisch contained four times the recommended daily dose of rosiglitazone, a drug used to treat type 2 diabetes manufactured by GlaxoSmithKline and marketed as Avandia. The researchers also found that red wines contained large amounts of ligands which are molecules that prevent blood clots, reduce inflammation, and promote beneficial cholesterol metabolism. The ligands contain polyunsaturated fatty acids that bind to cholesterol and transport it to the liver for removal. Of the wines studied, not all had equal amounts of the chemicals and white wines had very low measurable amounts. Summary: Red wine cannot be considered a treatment for type 2 diabetes, but grape skin or other plant extracts show potential as therapeutic agents.

An article in the Journal of Nutrition & Metabolism (August 2010) examined the benefits of grape pomace on type 2 diabetes. Pomace from red grapes (Cabernet Franc) and white grape pomace (Chardonnay) was compared to an extract of red apple pomace as a control. Red grape pomace extract suppressed postprandial hyperglycemia in ST2-induced diabetic mice with a 35% reduction compared to control, while red apple pomace had no effect. Summary: this is the first report that grape pomace extract inhibits intestinal aglucosidase and suppresses postprandial hyperglycemia in diabetic mice. The results suggest a potential for using grape pomace-derived bioactive compounds in the management of diabetes.



Skeletal System

Researchers from the University of East Anglia and King’s College London reported in the American Journal of Clinical Nutrition(September 2011) that moderate amounts of wine may strengthen bones and reduce the risk of osteoporosis. Other alcoholic drinks such as beer and spirits did not have the same effect. The study assessed more than 1,000 pairs of female twins in their mid-50s by looking at the relationship between diet and risk of bone fracture. Moderate intake of alcohol from wine led to a higher bone mineral density while a diet high in fruit and vegetables had little benefit and a traditional English diet of fish and chips, baked beans, meat pies and cooked meats had damaging effects on bone strength. Summary: The study suggests that moderate consumption of wine can improve bone mineral density, supporting a number of previous studies that suggested alcohol might have a protective effect. It is uncertain how wine builds bone strength but previous studies suggest it is polyphenols rather than alcohol that are responsible. Heavy drinking is a major risk factor for osteoporosis.



Skin

Researchers at the University of Barcelona reported in the Journal of Agriculture & Food Chemistry (May 2011) that flavonoids in grapes are able to stop the chemical reaction that causes skin cells exposed to UV rays from the skin to die and therefore prevent skin damage. This in vitro study on human keratinocytes showed a protective effect of grape fractions rich in procyanidin oligomers and gallate esters (polyphenols) against UVinduced cell damage and death. Summary: Plant-derived polyphenolic extracts may prove valuable as agents for skin photoprotection.

Recent research published in the journal BMC Complementary and Alternative Medicine (December 21, 2011) reported that grape seed proanthocyanidins (GSPs) in vitro inhibit the spread of squamous cell skin cancer by preventing cancerous cells from invading healthy cells. The study findings suggest that GSPs could be developed as an alternative medicine for the prevention of invasion and metastases of head and neck squamous cell carcinoma. Summary: GSPs are non-toxic agents that may have therapeutic value in inhibiting the metastatic spread of potentially fatal squamous cell carcinomas of the skin.



Teeth

Italian scientists reported in Molecules (February 11, 2011) that plant polyphenols can help ward off dental caries. An analysis of the literature supported the anti-bacterial role of polyphenols on cariogenic streptococci. Research in which bacteria typically found in the mouth exposed to small amounts of red wine with the alcohol removed indicated that bacteria could not cling to the teeth or saliva once they were exposed to red wine. Summary: A daily glass of red wine could keep teeth healthy but more studies are needed to establish conclusively that polyphenols can prevent dental caries. White wine, which often has a higher acid content, can erode teeth enamel and lead to tooth decay.

In a 2011 Wine Spectator online Q&A report debunks the myth that white wine is healthier for and less likely to stain your teeth. White wine can still stain teeth as badly as red wine when it is consumed with foods and beverages that are high in pigment. A study done by the New York University College of Dentistry looked at cow teeth soaked in black tea alone, and in white wine followed by black tea, and the teeth soaked first in the wine picked up much of the dark tea pigment, while the teeth soaked only in black tea were unstained. Summary: Wine erodes enamel, leaving it exposed to staining pigments in food and beverages. To avoid long-term tooth stains and tooth decay, brushing should be performed about an hour after drinking a glass of wine. This enables the saliva to neutralize the layer of acid left on the teeth and prevent damage that can occur if brushing is done in a highly acidic mouth. Gargling with baking soda after drinking wine may have the same effect.



Eyes

A study reported in Free Radical Biology and Medicine (December 2011) and funded by the National Eye Institute of the National Institutes of Health and the California Table Grape Commission suggests that eating grapes might slow or help prevent the onset of age related macular degeneration which is thought to be at least partly due to oxidative stress. The study compared the impact of an antioxidant-rich diet on vision using mice prone to developing retinal damage in old age in much the same fashion as humans do. Mice either received a grape-enriched diet, a diet with added lutein, or a normal diet. The grape-enriched diet protected against oxidative damage of the retina and prevented blindness in the mice consuming grapes. Lutein was effective also but less so. Summary: The authors suggest that a lifelong diet enriched in natural antioxidants, such as those in grapes, are directly beneficial for retinal health. The three year study showed that eating antioxidant- rich foods should begin before the onset of advanced age, preferably in youth or young adulthood. Mice who receive a grape and lutein-rich diet after the age of the human equivalent of 60 showed little or no improved retinal function. Age related macular degeneration does not seem to be reversible with the institution of a diet rich in antioxidants.



Longevity

One of the most significant studies to appear in 2011 was titled, “Alcohol consumption at midlife and successful aging in women; a prospective cohort analysis in the Nurses’ Health Study.” It was published in PLOS Med (September 2011). Alcohol consumption at midlife was assessed using a questionnaire administered to 13,894 white registered nurse participants in the Nurses’ Health Study who lived to the age of 70 or older and were free of eleven major chronic diseases and had no major cognitive, physical impairment or mental health limitations. The Nurses’ Study began in 1976. The study found that light to moderate alcohol consumption at midlife (late 50s) was associated with modestly increased odds of successful aging. Those who drank regularly during the week had better odds of successful aging than those who drank occasionally. Compared to nondrinkers, women who drank less than or equal to 1 drink a day had about a 20% higher chance of successful aging, women who drank 5-7 drinks per week had a 50% greater chance of successful aging, and women who drank 1-2 drinks per week had a similar likelihood of successful aging as nondrinkers. Summary: Light to moderate alcohol consumption at midlife led to modestly increased odds of successful aging in women. This supports earlier studies that indicate successful aging and survival are favorably affected by moderate consumption of alcohol on a regular basis. It also supports the notion that the benefits of moderate drinking outweigh the risks. The results cannot be applied to men or other ethnic groups (most of those in this study were of European ancestry). An important disclaimer is that there may be other lifestyle factors responsible in women who regularly drink a small amount such as an active social life, a healthy appetite, and generally good health.

New research reported in the journal Nature (September 2011) calls into question the mechanism by which wine is said to extend life. Studies that began ten years ago suggested that natural proteins called sirtuins could help living things live longer and resveratrol could increase sirtuin production. A team headed by geneticist David Gems at the University College London attempted to replicate earlier experiments with worms and fruit flies but found that they did not live longer. Researchers found that resveratrol did not activate sirtuins. Genetic changes in some of the animals in earlier studies may explain the previous life-extending findings, although researchers on the science advisory board of Sirtris Pharmaceuticals said they repeated the experiments after removing the strain with genetic changes and found situins still produced a life-extending effect, but it was not as impressive as originally reported. Summary: The role of resveratrol and sirtuins in prolonging life in humans is in doubt, although sirtuin drugs do show promise in preventing diseases associated with aging like diabetes and heart disease and thereby helping humans to live longer. Sitris Pharmaceuticals is still working on adapting sirtuins to drugs that could prolong life.

The level of wine consumption and total mortality in 802 adults age 55-65 at baseline was studied with controls for key co-founders. The research appeared in the Journal of Studies on Alcohol and Drugs (January 2012). Both high-wine-consumption and low-wine-consumption drinkers showed reduced mortality compared with abstainers but the apparent unique effects of wine on longevity could be explained by confounding factors correlated with wine consumption (see page 5). Summary: Wine does not confer longevity over other types of alcoholic drinks when the results are controlled for all co-variates. The study did confirm a lower mortality risk for alcohol consumers than for non drinkers.

Further entertaining reading on this subject and in particular resveratrol: The Youth Pill: Scientists at Brink of an Anti-Aging Revolution, David Stipp (2010).

An article in the Journal of the American Geriatric Society (2011) reported a study in which 477 people who were at least 95 years old were identified and completed a survey on their lifestyle habits. The information was compared with surveys from 3,164 people from the general population who were born around the same time but were no longer alive. Overall, there were no significant differences as each group had similar average body mass index, had about the same daily alcohol consumption and had about the same amount of daily exercise. One difference that was noted was the over-95 group were less likely to be obese. Summary: The key to longevity may lie in genetics.



Pregnancy

The health risks of moderate drinking in women are extremely low. However, one of the conundrums for women is drinking during pregnancy. Public health officials, the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics and the Surgeon General recommend that pregnant women avoid alcohol entirely. In some countries wine is considered part of a healthy lifestyle even during pregnancy and women feel that an occasional drink is safe. A number of studies have indicated that pregnant women can safely drink a glass or two of wine per week and their children often perform better three years after birth when compared to children of women who abstained. Women who decide to have wine during pregnancy should avoid the first trimester and consume minimal amounts, sipping it slowly with food to avoid a rapid rise in blood alcohol levels. One of the problems with drinking during pregnancy is that women may get pregnant without planning or knowledge and drink both during conception and shortly thereafter.

Findings published in the Journal of Alcoholism: Clinical and Experimental Research (January 16, 2012) indicated that any drinking during pregnancy increases the odds of fetal alcohol syndrome (FAS). FAS includes low birth weight, developmental delay, growth deficiencies, abnormal facial features and learning and behavioral problems). It has been the belief that FAS only afflicted children of mothers who were heavy drinkers and not those who had an occasional drink (1 to 2 drinks a week) during pregnancy. This study reported that for every one drink per day increase in alcohol intake during the second half of the first trimester, a woman’s baby had a 25 percent increased chance of an abnormally shaped lip, a 12 percent increased risk of a smaller-than-normal head, and a 16 percent increase chance of low birth weight, all of which are signs of FAS. The risk to the fetus was highest if a pregnant woman drank during the second half of the first trimester of pregnancy. An average number of drinks during the third trimester only affected the baby’s length at birth. The total number of drinks a woman had while pregnant was most predictive of a baby’s risk of FAS. Summary: There is no low threshold level below which drinking alcohol doesn’t raise the risk of FAS, supporting the Surgeon General’s recommendation that drinking be avoided entirely. There are other factors that come into play since not every woman who drinks during pregnancy will have a baby with FAS. These factors include diet, genetic differences, body fat levels and exposure to environmental toxins. Women who are planning a pregnancy, have the potential to become pregnant, or who become pregnant, should not consume alcohol.

A new study has been launched in Australia by the Murdoch Children’s Research Institute in Melbourne to determine whether low to moderate levels of alcohol are harmful or not to a fetus. They are recruiting 2,000 pregnant women who will be quizzed throughout their pregnancy about their drinking habits, general health and diets. Their babies will undergo extensive medical examinations at age one and two years to see if there is any developmental or behavioral affects of alcohol in those women who drank during pregnancy. A study by the University of Newcastle published in 2010 indicated that 80 per cent of Australian women drank during pregnancy.



Reproduction

A study published in Alcohol (June 2011) studied the effects of ethanol consumption on chromatin condensation and DNA integrity of epididymal spermatozoa in rats. This experimental study showed for the first time that ethanol consumption disturbs sperm motility and DNA integrity of spermatozoa in rats. Summary: Ethanol abuse results in the production of spermatozoa with less condensed chromatin, and this may be one possible cause of infertility following ethanol consumption.

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