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Red Wine: Heart-Healthy?

Moderate alcohol consumption (compared to no alcohol consumption) has been associated with a lower incidence of coronary heart disease in a large number of observational studies.1 This only applies to moderate drinking—about one drink or less per day for women, and two drinks or less for men. In the early 1990s, some researchers proposed that red wine could mitigate the harmful effects of a rich, fatty diet and smoking, as an explanation of the “French paradox”—the lower rates of heart disease deaths in France compared to the U.S. (note that heart disease death rates do not remain lower in France today).

Is moderate alcohol consumption truly “heart-healthy?”

The link between alcohol and reduced risk of heart disease is thought to be due primarily not to a beneficial effect on the cardiovascular system, but to the fact that alcohol interferes with blood clotting.2 This effect is valuable only in a person or population consuming a dangerous, heart-disease-promoting diet. For someone who follows a healthful eating style rich in unrefined plant foods, will not have the increased risk of clots forming and there will already be a high level of protection against heart disease, so thinning the blood further would not add protection. In fact, thinning the blood with alcohol may present considerable risk, including increased risk of hemorrhagic stroke.3

Also, alcohol consumption leads to mild withdrawal sensations the next day that are commonly mistaken for hunger and quelled by overeating. Of course, heavy drinking (3 or more alcoholic drinks daily) is exceedingly dangerous, associated with harmful effects on the cardiovascular system, such as cardiomyopathy, hypertension, and potentially life-threatening arrhythmias.1,4

Since the body metabolizes alcohol into acetaldehyde, a carcinogenic compound, light drinking (less than 1 drink/day) and even alcohol-containing mouthwashes may be risky.5-7 Women in the range of 3-6 alcoholic drinks weekly were found to have a 15% increase in breast cancer risk compared to non-drinkers, and 3-4 drinks per week is also associated with higher rates of breast cancer recurrence after diagnosis.8-10 Increased cancer risk due to light alcohol intake is not limited to breast cancer. A 2014 report by the International Agency for Research on Cancer has concluded that there is no safe amount of alcohol when it comes to cancer risk. Alcohol is considered a cause of cancers of the mouth, pharynx, larynx, esophagus, colorectum and liver.11,12 A meta-analysis of studies on the relationship between light drinking and cancer risk estimated that light alcohol drinking is responsible for 5000 deaths from oral and pharynx cancers, 24000 deaths from esophageal squamous cell carcinoma, and 5000 deaths from breast cancer worldwide each year.13 It is best to minimize or eliminate alcohol consumption to reduce these risks.

Red wine contains a widely studied beneficial compound from grape skins called resveratrol. Resveratrol has been shown to have several anti-inflammatory and antioxidant effects that may contribute to cardiovascular disease protection.14 However, at this point in time it is unknown whether resveratrol in red wine contributes additional protection beyond the blood-thinning effects of alcohol.2 Of course, grapes, raisins, blueberries, cranberries, peanuts, and other plant foods also contain resveratrol. It is not necessary to drink wine to obtain any benefits resveratrol may have.

Overall, it is safer to eat a diet that will not permit heart disease rather than to rely on alcohol to decrease the potential of blood to clot. The potential heart healthy effects of resveratrol are not exclusive to red wine—in the context of a nutrient-dense eating style, the resveratrol in the occasional glass of red wine will be only a drop in the bucket of beneficial phytochemicals.


References
1. Klatsky AL: Alcohol and cardiovascular health. Physiol Behav 2010;100:76-81.
2. Saremi A, Arora R: The cardiovascular implications of alcohol and red wine. Am J Ther 2008;15:265-277.
3. Daniel S, Bereczki D: Alcohol as a risk factor for hemorrhagic stroke. Ideggyogy Sz 2004;57:247-256.
4. George A, Figueredo VM: Alcohol and arrhythmias: a comprehensive review. J Cardiovasc Med (Hagerstown) 2010;11:221-228.
5. Brooks PJ, Theruvathu JA: DNA adducts from acetaldehyde: implications for alcohol-related carcinogenesis. Alcohol 2005;35:187-193.
6. Lachenmeier DW, Gumbel-Mako S, Sohnius EM, et al: Salivary acetaldehyde increase due to alcohol-containing mouthwash use: a risk factor for oral cancer. Int J Cancer 2009;125:730-735.
7. Lachenmeier DW, Kanteres F, Rehm J: Carcinogenicity of acetaldehyde in alcoholic beverages: risk assessment outside ethanol metabolism. Addiction 2009;104:533-550.
8. Boyle P, Boffetta P: Alcohol consumption and breast cancer risk. Breast Cancer Res 2009;11 Suppl 3:S3.
9. Kwan ML, Kushi LH, Weltzien E, et al: Alcohol consumption and breast cancer recurrence and survival among women with early-stage breast cancer: the life after cancer epidemiology study. J Clin Oncol 2010;28:4410-4416.
10. Chen WY, Rosner B, Hankinson SE, et al: Moderate alcohol consumption during adult life, drinking patterns, and breast cancer risk. JAMA 2011;306:1884-1890.
11. Stokowski LA: No Amount of Alcohol is Safe. 2014. Medscape Cardiology. http://www.medscape.com/viewarticle/824237_1. Accessed June 2, 2014.
12. Baan R, Straif K, Grosse Y, et al: Carcinogenicity of alcoholic beverages. Lancet Oncol 2007;8:292-293.
13. Bagnardi V, Rota M, Botteri E, et al: Light alcohol drinking and cancer: a meta-analysis. Ann Oncol 2013;24:301-308.
14. Higdon J: Resveratrol. In An Evidence-Based Approach to Dietary Phytochemicals. 2006

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