Is red wine really good for your heart and your brain?

An excerpt from Beautiful Brain, Beautiful You.  Published by Hyperion. Copyright(c)2011.

by Marie Pasinski, MD

Although much has been written about how red wine in moderation can be good for your heart and your brain, I would like you to reconsider. It’s important to understand that the studies supporting this claim are “observational.” This means they were conducted through self-reported questionnaires inquiring into the drinking habits of a large group of people, then correlated with their heart and brain health. Let’s look at why these types of studies may be severely flawed and why the opposite conclusion—that moderate drinking is unhealthy—may, in fact, be true.

In recent years we have seen that the results of similar “observational” studies were disproved when subjected to a “randomized controlled trial”—the standard bearer of scientific proof. A good example of this is female hormone replacement. For decades it was believed that female hormone replacement was beneficial. But a randomized controlled trial, called the Women’s Health Initiative, demonstrated that the exact opposite was true. The study was stopped in 2002 because women taking the study pills of estrogen plus progestin were developing heart disease and breast cancer at increased rates compared to those taking the placebo or inactive pills.

Unfortunately, randomized control trials have not been done on alcohol, nor are they likely to be done in the near future. And there is reason to believe that the observational studies out there are flawed. An important study by Dr. Tim Naimi looked at the characteristics between moderate drinkers and teetotalers. He found that moderate drinkers were wealthier, healthier, better educated, and received better health care than those who abstained from alcohol. In other words, there are many other reasons why moderate drinkers are healthier that may have nothing to do with alcohol.

Additionally, in his editorial for the New England Journal of Medicine, Dr. Ira Goldberg wrote: “One wonders if the alcohol consuming group also drank more tea, ate more nuts or consumed more fish.” So we would be wise to think twice before toasting to the health of our brains with alcohol.

There have also been news stories about the incredible antioxidant benefits of resveratrol, which is found in red wine. This has been used by spirits’ fans and distributors as yet another reason to fill our goblets. Although studies did show mice that were given hefty doses of resveratrol were healthier and lived longer, an article in the New York Times pointed out that the average 150-pound person would need to drink 750 to 1,500 bottles of red wine a day in order to get the equivalent beneficial dose!

One thing that is not in dispute, however, is the fact that alcohol is a neurotoxin. Excess alcohol causes widespread damage throughout the nervous system, and in particular, it kills off cells in important memory areas. When intake is not curbed, alcoholic dementia ensues. A 2004 study by Changhai Ding and colleagues using MRI imaging showed that moderate alcohol intake is associated with brain atrophy. Even more brain damage may occur in teenagers who binge drink, because their brains are not yet fully developed.

It is also important for women to take into account the fact that even low to moderate alcohol consumption is associated with an increased risk of cancer. Although previous studies have shown a link between alcohol consumption and breast cancer, the Million Women Study in the UK shows that women who drink as little as one alcoholic beverage per day, be it wine, beer, or hard liquor, have an increased risk of cancer. The risk increased with increasing alcohol consumption, especially for cancers of the breast, liver, mouth, throat, and esophagus. After reviewing this study for the Journal of the National Cancer Institute, Michael Lauer, M.D., and Paul Sorlie, Ph.D., of the National Heart, Lung and Blood Institute in Bethesda, Maryland, concluded: “From a standpoint of cancer risk, the message of this report could not be clearer. There is no level of alcohol consumption that can be considered safe.”

Although the above study is also observational, taking all this information into account, as well as the dire consequences of alcohol abuse and addiction, as far as I’m concerned the conclusion is clear: Alcohol is not good for us, even in small amounts. So if you can’t give up that glass of wine with dinner, a Smart Diet would include reducing the amount of alcohol you drink. If you need even more incentive for a last call, remember that alcohol contains empty calories that slow the body’s ability to burn fat for energy, and some studies support the notion that binge drinking can promote abdominal fat. They don’t call it a beer belly for nothing!

Marie Pasinski is a neurologist at Massachusetts General Hospital and author of Beautiful Brain, Beautiful You.

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  • http://myheartsisters.org Carolyn Thomas

    This is intriguing – yet why am I still confused?

    As a woman and a heart attack survivor, I was happy to learn (at the Mayo Women’s Heart Clinic in Rochester) that a glass of wine per day (max) may actually be good for my heart health. (Almost as happy as I was to hear the same about dark chocolate!)

    But when the U.K. study was released in February ’09 on this alcohol/breast cancer link, I went directly to the National Coalition For Women With Heart Disease and their Scientific Advisory Board of world-class cardiologists for their take on the study. Here is their response to me:

    “First, the U.K. study was an observational study that re-confirmed the already known association between alcohol intake and certain cancers (notably breast and liver). But this is the first study to show risk at such low levels of alcohol consumption (just one serving per day for women) and must be replicated before firm conclusions can be made.

    “Women should discuss their individual risks with their doctors. Meanwhile, there are several studies showing that moderate alcohol intake may reduce the risk of coronary artery disease.

    “There are, however, many other ways to reduce this risk (diet, exercise, not smoking, or taking medications to control cholesterol, diabetes, high blood pressure). If women do drink – no more than one drink per day is recommended (two per day for men).

    “At this recommended level, there may be a SLIGHT INCREASE in the risk for certain cancers, and a SLIGHT REDUCTION in the risk for heart disease.”

    More on this at: “Is Alcohol Unsafe For All Women?” at HEART SISTERS:
    http://myheartsisters.org/2009/06/14/alcohol-unsafe/

  • doc99

    I suggest you look no further than the “French Paradox.”

  • Dr. Kene Mezue

    I’ve always suspected that the evidence of benefit of alcohol in heart disease has been spurious…why hasn’t an RCT been done on this common topic yet? Especially given the increasing relevance of alcohol in public health in Europe…

  • Donna Carrillo Lopez

    Well, there are lots of anecdotes…I went to visit a cardiology friend at his home and he excused himself after a while and told us he was off for his 5 mile run. He poured himself 2 ounces of organic red wine and assured me that he did this before every run each day for his “myocardial health”.

    Chinese medicine uses small amounts of alcohol to warm the meridians (‘jiu’) and here’s a great recipe for those cold winter days that is a great example: http://www.chinesericewine.com/blogs/traditional-chinese-medicine-tcm-blog/

    RCTs are actually quite hard to do well and they are an imperfect standard of practice…however they are all we have in evidence based medicine at least in this era.

  • Alan

    This is an extremely confusing area of inquiry. I seem to recall that LPI (Linus Pauling Institute), the Harvard Health Letter editors, and even health letter editors at U.C. Berkeley and Tufts indicate that moderate drinking of any form of ETOH is beneficial for the heart. The longevity researcher Aubrey de Grey makes it a point to consume a few beers each day. On the other hand, the former head of British public health David Nutt has campaigned strongly against alcohol consumption, largely due to the dangers of its overuse and the horrendous damage caused by binge drinking. Maybe they are all correct, within measure. That ETOH is a neuro-toxin is not in a dispute, but the question should be whether the “moderate” dosages are, on balance, beneficial for cardiovascular health. The most straightforward summary out there may come from Edzard Ernst, M.D., who wrote to the effect, “drink a little bit, live a little longer.” That the basic issue of whether moderate consumption of alcohol confers any benefits is still in dispute is somewhat depressing, though. Science moves in fits and starts, in non-linear fashion, but one has to wonder about the quality of the questions being asked and the research conducted to have reached such a muddled understanding of a what probably should be a basic issue.

  • gioacchino aj patuto, MD

    have to diagree 100% with dr pasinski’s take on red wine or any kind of wine.
    wine has been a staple on people’s table for thousands of years. many wealthy go out to eat–not very healthy.
    too much of anything can hurt you.
    if you sit in the sun, then, the vitamin D is ok. if you bake in the sun , then, your skin changes and burns and can cause disastrous effects! this is observational diagnosis, right?
    obviously this doctor can not handle a good wine , nor make an intelligent conclusion.
    her estrogen comparison is totally off the wall. we are talking messing with hormones and a natural food byproduct.
    i’d rather stick to old tradition and enjoy the moment,than, worry if my brain cells will burn out in 80 years.
    please doctor—-get a life and loosen up.
    a retired dr. without borders, marine, trauma surgeon. i teach medicine and allied health, i speak 4 languages, i play 9 instruments and i still make homemade wine after 25 years.
    here is to your health!!!!!!

  • Dr. Kene Mezue

    @Dr. Patuto…I don’t agree totally with your analogy. Most things in life have a gradient. People have been eating meat for years but only recently are we realizing that red meat is harmful and may cause cancer (EPIC studies). Also, there is growing evidence that vegetarians live longer. Alcohol in moderate quantities may not be very harmful, but saying that those who don’t drink alcohol have lower life expectancies may be harder to believe.

    • gioacchino aj patuto, MD

      i respect your opinion. i did not say that people who do not drink , have a lower life expectancy. please read again.
      and, you forget that red meat 50 years ago did not have all the injections that it has today.
      maybe you should go to italy and try their food for a change, instead of reading ur info from journals.
      you must be a younger person than myself.
      i will continue to teach this in the medical schools and go on experience—thank you all.

  • gioacchino aj patuto, MD

    dr. mezue,
    you have brought vegetarians into this dialogue. it has nothing to do with the topic.
    however, i am a dr. without borders (25years). and, if you see what i do and people are starving—-then, it doesn’t matter anymore what food you eat. hunger is a brutal enemy!!!
    have a glass of wine and relax—it comes from fruit…

  • Donna Carrillo Lopez

    Well human life is all too brief but it seems that the presence of good friends, good food and good wine (in moderation) are a perfect recipe for reducing stress and maximizing the quality of these all too brief years. I applaud Dr. Patuto’s service to those who he serves..when I worked in County hospital I was certain that it was these monolingual, profoundly “impoverished” patients (who struggled just to survive) who seemed to possess the most joy and compassion. They humbled me.

  • gzuckier

    well, there’s no doubt that fruit, particularly berries, are good for you; apparently even after fermentation. (the resveratrol is in the grapes to begin with). as for the alcohol, the evidence is just too determined not to go away that a trifling bit of alcohol a day may provide a trifling benefit. perhaps a side effect inhibits cholesterol production by the liver, much as a side effect of niacin overdosing does.

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