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 STORY
In 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.