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

One more reason why wine is good for you, and not just the red stuff

When it comes to health benefits, red wine tends to get most of the credit.

Cardiovascular benefits have been ascribed to alcohol itself (find a reasonably readable and full-text review here, courtesy of the Journal of the American College of Cardiology). But, of late (as in, say, the past decade), resveratrol has attracted the most attention; as a potent antioxidant, it truncates the chain of events involved in endothelial plaque formation (“hardening of the arteries”). Resveratrol is much more concentrated in red wine than in white. But resveratrol is a polyphenol, one of many. And polyphenols in general, and both red and white wine, have circulatory system benefits in lab studies we can ascribe to other causes.

For instance, NO, which is to say nitric oxide. Polyphenols encourage artery-lining cells to produce more NO. We know NO both as laughing gas and as a potent (if short-lived) vasodilator. NO tells the artery muscular to relax, which increases vessel diameter and lowers blood pressure. Arteries that no longer relax properly are a feature of many cardiovascular diseases and part of the cascade of interrelated faults that progressively damage both the heart and organs like the kidneys and eyes that suffer damage from blood pressure that’s consistently too high. NO also helps makes platelets less sticky with the effect of gently working against that damaging plaque formation.

Antioxidants, including polyphenols, increase NO levels indirectly by countering oxidative molecules that can rapidly destroy NO in the bloodstream. Polyphenols also stimulate NO production directly, and arteries benefit by learning to relax and suffering clogs less readily.

A paper just out in PLOSOne (always and ever open access) convincingly adds to evidence that caffeic acid, a polyphenol in which white wines are particularly rich, increases arterial lining NO production. The research team demonstrated that caffeic acid increases NO, but also that it improves arterial cell function and slows kidney disease damage in mice. Translating caffeic acid-dosed mice to white wine-dosed humans is still a leap we’ve not yet made, but it’s a likely one. Doses mice received were along the lines of what a moderately-drinking wine lover might ingest, and these sorts of mouse experiments have worked well to model human arterial disease in the past.

In short, there’s a good argument to be made that white wine is good for your heart. As good as red? That’s going a step too far, and not least of all because individual wines vary so much in their concentrations of resveratrol and caffeic acid and total polyphenols that we’d need to compare individual wines rather than try to stereotype by color. But the next time someone tries to talk you out of a glass of Chablis or riesling in favor of the red option for the sake of your health, don’t let them. You know more than they do.

In other news: three useful-if-not-groundbreaking reviews arose in recent days, on biotech uses for winery waste products, causes of and solutions for protein hazes, and polyphenols found in oak. Details are here.

Arsenic in wine: A news update, but not a scientific one

The news this morning is full of pieces on Kevin Hicks, proprietor of a consumer-oriented wine analysis company called Beverage Grades, and the class action lawsuit he’s bringing against multiple California wineries for selling wine with arsenic concentrations far exceeding what the US Environmental Protection Agency allows in drinking water. Many of the reports are emphasizing the “wine may kill you” side of this story.

Mr. Hicks contacted me by way of an email and a suggested arsenic-in-wine story — for which he advised me I could pay him by check or PayPal — a little over a year ago, which prompted me to write this post on whether wine consumers should be concerned. My admittedly brief scan of the literature suggests that no new scientific research on wine and arsenic has been published in English since then. I’ll stand by what I wrote in 2014. The key points:

  • Arsenic is definitely found in wine. It’s also found in many other foods and beverages. Arsenic is, in fact, naturally present in water and soil, and unless you’re part of a special population, drinking water is your primary source of dietary arsenic.
  • Researchers have found evidence of higher arsenic intake in wine drinkers, but also in people who drink beer and who eat rice, fish, and/or Brussels sprouts. (Exemplar references here and here.)
  • The FDA regulates arsenic levels in apple and pear juice, but not (yet) in wine. Dietary arsenic isn’t well understood, and whether we have good evidence for the current “safe” cut-offs and what those cut-offs should be has been discussed for decades.
  • Our current best evidence indicates that arsenic in wine isn’t a health concern. It’s fair to say that every food and drink we consume brings minor amounts of potentially harmful substances into our bodies. Risk assessments say that the amount of arsenic in wine doesn’t pose a threat to consumers. (Exemplar references here and here)

The wines indicted in Hicks’ lawsuit weren’t a major part of the studies I’ve listed above. His data may show something amiss with these specific wines, but he hasn’t shared either his methods or his data. When I looked at Beverage Grades a year ago, I was disturbed by the complete lack of detail offered to back up awarding specific wines badges like “HealthyPour™.”

I’m uncomfortable with Kevin Hicks and Beverage Grades’ tactics of withholding rather than being transparent with information, damaging at the best of times and ironic in light of his accusations. If third-party labs can back up Hicks’ claims in the course of this lawsuit, we may well have something to talk about: ways to reduce arsenic levels in wine, new regulations, and/or renewed scrutiny of the EPA guidelines. But until then, the healthiest thing to avoid is likely the inflammatory news headlines.