Why writing about wine and health is a dead-end

My August article for Palate Press is a brief update on some new research about wine and cancer. It’s a tricky subject. Trying to determine the relationship between two highly variable things is always tricky, and cancer and drinking are highly variable. Cancer comes in a lot of different forms – all breast cancers or colon cancers aren’t the same – and affects a lot of different kinds of people, and we don’t even know about all of the different factors that influence when and how it progresses. Meanwhile, people’s drinking habits are a lot more complex than those abstinence-light-moderate-heavy drinker scales make it seem. Do you drink wine, beer, spirits, or a combination? What kinds? Do you drink with meals, or alone? If you drink with food, what are you eating? Do you have a drink a day all week, or seven drinks all in one setting, and is your “drink” anything like my “drink?” Are you happy while you’re drinking, or sad?

The wine-and-health story, or the wine-and-cancer story, consequently has to be a lot more complicated than “drinking good” or “drinking bad.” As I point out in the Palate Press article, this is a good thing. We’re understanding enough about disease and lifestyle to stop doing the lifestyle modification equivalent of treating all ailments with leeches, recommending that everyone stop drinking because drinking is bad, and to start asking why and when drinking might be a bad idea.

Here’s my problem. Every time I write about wine and health, I find myself wanting to shorten the entire 1200-ish word article to one sentence: “Drink moderately, especially with food; don’t go overboard, and don’t worry too much about the whole thing.” Continue reading

And the winner for strangest wine experiment of the year goes to…

Research about the effect of wine on cancer is pretty common. Witness the slew of attention resveratrol has received for being, among other things — like the fountain of eternal youth or your key to firm skin with no injections — an anti-cancer agent. We also see plenty of epidemiological research: the population studies that say things like “moderate red wine drinkers are less likely to develop lung cancer.

How these studies work is easy to understand. Cancer-like cells grown in dishes are bathed in resveratrol-containing solutions and observed afterwards (in vitro = “in glass;” the dishes are more likely plastic these days, but the Romans didn’t have a word for plastic, gosh darn-it). Or whole organisms — mice, worms, humans — are fed resveratrol and observed afterwards (in vivo = “in the living”).

In the “I haven’t seen this before” file is an article released in preliminary form at Cancer Cell International a week or two ago that did things a bit differently. They bathed in vitro lung cancer cells in wine. Picture where your lungs are and where wine goes when you drink it. See the problem?

Wine per se never gets past your stomach. Just about everything we eat is broken down into component parts before being pulled out of the digestive tract and into the blood, with the indigestibles — things that can’t be broken down and transported into the blood, like the cellulose in plants — being left to exit the other end. Where and how a compound makes the move from digestion to blood depends on the compound. Polyphenols, the class of chemical which includes tannins and anthocyanins that give wine astringency and color, respectively, are mostly absorbed in the small intestines. Resveratrol** and alcohol are both fairly unusual in being absorbed directly across the mucous membranes in the mouth and pulled into the bloodstream, which explains why we get drunk so fast as well as why it makes sense to treat cancer cells directly with resveratrol.

Bathing cancer cells in wine is therefore a thing that will never, ever happen in your body. I suppose that cancer patients could be given red wine via an IV, putting it directly into the bloodstream where it would have direct access to cancer cells. Intuitively this seems like a bad idea, though I couldn’t say precisely why. I also don’t know if that’s what these scientists were getting at, or if this was just a “wonder what will happen if we try this” experiment.

It is interesting that very dilute red wine solutions — less than 1% — had specific anti-cancer effects. White wine was only effective at much higher doses – 2-5%. The effect (on specific signal transduction pathways; too complex to explain here) wasn’t the product just of resveratrol or alcohol; the authors haven’t yet figured out what specific wine components are responsible.

French hospitals include wine as part of patients’ regular diets, which I’ve always thought was a much more sensible attitude to nourishing recovery than the insipid and very non-alcoholic slop served up in most American hospitals. Sipping slowly on a glass of red is likely to do you more good than using it to tint your IV drip pink, though who knows? Maybe that is indeed the next thing.


**Because resveratrol is absorbed in the mouth, drinking wine is an excellent way to get it into your bloodstream: sipping gives it time to be absorbed. Swallowing a concentrated pill is a terrible mode of delivery. When it’s fast-tracked to the stomach — the pill bypasses those mouth membranes — very little resveratrol makes it out to where it can do any good. For a fantastic, if highly technical run-down of what we currently know about resveratrol, check out the micronutrient pages at the Linus Pauling Institute at Oregon State.