Alcohol and the heart
Regular moderate wine consumption has been associated with several health benefits.
J-shaped association between mortality risk and alcohol consumption
Throughout the developed world, cardiovascular disease is the leading cause of death and accounts for up to 50% of all deaths (WHO Fact Sheet, 2007). Consistently, scientific studies are showing that consuming moderate amounts of alcohol reduces mortality from coronary heart disease as well as from other causes by 25-30% in middle-aged individuals, mainly in men aged over 40 years and in post menopausal women (Corrao G et al, 2000; Wannamethee SG et al. 2003; Klatsky a. et al, 2003, Di Castelnuovo A et al., 2002; Klatsky A.L., 2007; Gronbaek M, 2004).
Moderate wine drinkers live longer than those who abstain or drink heavily. This widely accepted association is known as the J-curve (Figure 4). The relative risk of dying is lowest among light to moderate drinkers and greater among abstainers. However, the risk increases dramatically with each drink above moderation. Thus, while one or two glasses can be considered “good for your health”, drinking more than the guidelines will not provide more benefits, only more harm! (Corrao et al, 2000) .
How does it work?
Approximately half of the cardio-protective effects of wine are believed to be due to alcohol itself since it changes the balance of fats in the blood favourably.
Vascular disease occurs when bad cholesterol (LDL) is deposited in artery walls and builds up, eventually rupturing, causing a clot to form which blocks off the artery, and the tissue supplied by that artery of blood dies.
- Alcohol stimulates the production of the "good" high density lipoprotein cholesterol (HDL) which removes the "bad" low density lipoprotein cholesterol (LDL) from arteries and veins where it can form plaques.
- It also reduces the "stickiness" or the clotting together of red blood cells which could form a clot and block the blood flow in an artery (thrombosis) resulting in a heart attack or stroke (Lacoste L et al. 2001).
- Furthermore, alcohol has an overall anti-inflammatory effect that affects the blood vessels positively and thus, delays the development of atherosclerosis (Estruch R et al., 2004).
Wine, in addition, contains phenolic substances which act as antioxidants and inhibit bad cholesterol from being incorporated in the artery wall. These antioxidants also reduce the damage caused by the body's free radicals (toxic waste products) which contribute to causing degenerative diseases in the body such as cancer, Alzheimer's disease, Parkinson's disease and ageing. It should be noted that the antioxidant activity in unfermented grape juice is lower than in the finished wine - antioxidant activity increases during fermentation and maturation. Antioxidant levels will depend on the processing, filtering as well as on the variety, vintage, altitude and soil (Frankel E.N. et al, 2000).
Resveratrol, along with quercetin and epicatechin, is one of the main antioxidants found in wine. These phenolic bioflavonoid compounds give wine its characteristic colour and flavour and are produced by plants in response to fungal infection, ultraviolet light, and various chemical and physical stressors, especially during ripening. Researchers have shown that these antioxidants in wine are five times more potent as antioxidants than the benchmark antioxidant, vitamin E.
These findings support the overwhelming and growing body of scientific research indicating that moderate consumption of alcoholic beverages is associated with lower levels of coronary heart disease as well as with better health and greater longevity.
(Mukamal, KL et al, 2006)
Wine and diabetes mellitus
Evidence from large population studies suggests that light to moderate drinkers of alcoholic beverages have also a lower diabetic risk than abstainers or heavy drinkers. Results of a meta-analysis examining the relationship between moderate alcohol consumption and type 2 diabetes indicate a protective effect for developing diabetes when wine is enjoyed moderately. A 30% reduced risk of diabetes is seen in men as well as in women (Carlsson S. et al., 2005, Koppes L.L. et al, 2005, Wannamethee S.G. et al, 2003; Avogaro, A. et al. 2004; Wei, M. et al. 2000).
Exactly how alcohol reduces the risk of diabetes has not yet been clearly established. Research shows that alcohol may improve the body’s resistance to insulin, a problem of type 2 or adult-onset diabetes. People with type 2 diabetes cannot use glucose effectively because of their resistance to insulin (which is the hormone that permits glucose to be used by the body’s cells).
But not only the risk of developing type 2 diabetes is decreased with moderate alcohol consumption; it may also reduce potential cardiac complications relating to diabetes. This is especially important considering that coronary heart disease is the leading cause of death among people with older-onset or type 2 diabetes, who also have a 4-fold increased risk of having a heart attack or stroke. Research indicates that this risk decreases considerably when they consume wine moderately with the meals.
Considering the world-wide epidemic of type 2 diabetes which is expected to rise even further and is associated with major health care costs, preventing diabetes is a major public health issue. It appears that drinking in moderation could however help reduce type 2 diabetes and thereby contribute significantly to public health (Djousse L. et al, 2007).
In light of such findings, the benefits of moderate wine consumption also need to be adequately recognised. However, the scientific findings regarding the benefits of moderate consumption, whether physical, mental or social should not be an incentive to exceed the guidelines for moderate drinking of alcoholic beverages. Please remember, drinking wine should be for pleasure and enjoyment rather than for any health benefit and drinking more than the recommended amounts will not provide more benefits, only more harm!
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