Does wine really prevent heart problems?
Michael Apstein, Special to The Chronicle
Sunday, August 23, 2009
Does wine really prevent heart problems? Photo illustration for story on wine and health in San Fr...
When people discover that I'm a liver doctor and a wine writer, they invariably ask, "How much can I drink without developing liver disease?" They never ask, "How much should I drink to stay healthy?"
People know that alcohol - and wine - can cause liver disease. But since the headline-making "60 Minutes" segment in 1991 popularizing the seductively simple French Paradox (the French eat a high-fat diet but have less heart disease because they drink red wine), people have embraced the concept that drinking wine, especially red wine, prevents heart disease. Despite the absence of an ironclad linkage, it's what everyone wants to believe: Alcohol, a forbidden fruit, is actually good for you.
As a physician, I am skeptical of the health claims made for wine - or any single food, for that matter. Such medical skepticism hasn't stopped some in the wine industry from promoting wine as a health drink. Wineries boast about the amount of resveratrol - a modern-day fountain of youth - in their wines. And yes, red wines are filled with antioxidants.
But how strong is the evidence that wine prevents heart disease? At this point, not strong enough.
How we got here
The possibility that wine might reduce heart disease came from the same type of study that suggested alcohol could be responsible for liver disease. In separate studies, World Health Organization researchers and others in the United States and Europe in 1970s compared the amount of alcohol that countries consumed in total with the country's rate of liver or heart disease. The countries with the highest alcohol consumption - France, Italy and Spain - had the highest rates of liver disease, but also had low rates of heart disease.
These kinds of studies, called observational studies, can never determine cause and effect. They only highlight associations - possibilities. But they're important because they direct future research. Is alcohol causing liver disease - or preventing heart disease - or is something else the real cause?
Advertisers trumpet associations, hoping to dupe consumers into thinking that their product causes the desired effect. To promote sales of prepared dinner entrees on its Web site, Stouffer's touts research that "teens who have frequent family dinners are likelier to say they get mostly A's and B's in school." The clear implication is that eating together causes students to excel in school. A more plausible explanation is that families who eat together have higher incomes and support their children's education. Eating together doesn't cause better grades; it's associated with behavior that results in good grades.
We liver doctors debated for years whether it was alcohol or poor nutrition common among alcoholics that caused liver disease. Dr. Charles Lieber at the VA Medical Center in the Bronx, N.Y., settled the debate in 1974 when he fed baboons alcohol and a nutritionally complete diet. The animals developed every stage of human alcoholic liver disease.
Without proof, how has it become conventional wisdom that that wine prevents heart disease?
Observational studies around the world have shown the same association: People who drink moderately - one to two drinks daily - have less heart disease than those who don't drink at all or who drink heavily. Although they don't show cause and effect, the results are compelling.
Researchers also proposed several ways alcohol might be beneficial. Consumption, up to two drinks a day, increases blood levels of HDL cholesterol, so-called "good" cholesterol, which unclogs arteries. Cardiologists believe that raising HDL levels, as occurs with exercise, reduces the chance of heart disease.
Like aspirin, alcohol inhibits blood clotting; it "thins the blood." Aspirin decreases the chance of a heart attack in some people. Similarly, alcohol's anti-clotting effect potentially could reduce the chance of a heart attack. Does it definitively? That's unknown.
Wine isn't necessarily like other drinks. In July at the 32nd World Congress of Vine and Wine in Zagreb, Croatia, Serge Hochar of Lebanon's Chateau Musar, one of the wine world's most compelling and controversial figures, rightly chided people for lumping wine with other alcohol because wine contains additional components that have important health impacts - at least in the test tube.
Nonalcoholic benefits
Even with the alcohol removed, wine raises blood levels of polyphenols and antioxidants such as resveratrol and has dramatic effects on blood vessels. Because the oxidation of cholesterol is thought to play a role in the development of atherosclerosis - the narrowing of arteries - and heart disease, perhaps it's the nonalcohol component of red wine that's beneficial. And there is other evidence for the benefits of white wine, which has a different chemical makeup, that further complicate the picture.
With the barrage of commercials, and even some wineries, raving about the benefit of antioxidants, you could be forgiven for believing that polyphenols are what make wine so healthy.
But we don't know that. Other foods contain antioxidants, including resveratrol, but it is wine that captures the public's attention because it satisfies two desires simultaneously. It's a silver bullet, a simple and easy solution to the complex problem of heart disease. Hard-to-follow advice - exercise and eat reasonably - can be substituted with the more palatable - literally - recommendation to drink without guilt.
On a visceral level and as a wine lover, I hope these claims are true. On an intellectual level, I know there are no magic bullets. And drinking comes with inherent risks. A doctor might precede a recommendation to exercise with a stress test to make sure you're in proper health. But there are no tests to ensure healthy drinking.
So what's the problem?
Scientists do not know the exact relevance of antioxidants in preventing heart disease. If they play only a minor role, increasing them even a thousand-fold would be of no clinical importance. Same with any wine-related factor.
That's why I - like other physicians - am reluctant to recommend drinking for health reasons, despite the plausible health impacts and overwhelming observational evidence.
I am reminded of the certainty with which physicians recommended that women take estrogen supplements to reduce the risk of heart disease after menopause. Ample observational studies suggested a link: Women had less heart disease than men and this discrepancy disappeared after menopause. As with wine, there were plausible scientific explanations as to why.
In the 1990s the National Institutes of Health sponsored the Women's Health Initiative, a cause-and-effect study of 16,000 post-menopausal women; half received supplemental hormones and half did not. Surprise. The women who received hormones had more heart disease, not less.
Why not commission a comparable study of alcohol and heart disease? The ethical considerations of chronically giving alcohol to people is one good reason.
Animal studies, similar to Lieber's, might be possible. We need results that show cause and effect before recommending wine as a way to reduce heart disease. Try finding a government agency to fund that.
Without such studies, we are left with nagging possibilities. Maybe wine drinkers have less heart disease because they are more affluent, eat better, control their blood pressure better, exercise and do other things to take care of themselves. Perhaps we are not smart enough to know what these "other things" are.
To me, wine is not a health beverage. It's to be enjoyed because it tastes good, and makes a meal and life more enjoyable. If moderate consumption turns out to be good for us, so much the better.
If it doesn't, I'll still have some with dinner.
The myths and facts, step by step. K6
How we got here
-- In the 1970s and 1980s, observational studies by Dr. Arthur Klatsky in Oakland, Dr. Eric Rimm in Boston and many others showed that people who drank moderate amounts of alcohol had less heart disease. They raised the question "Is moderate alcohol beneficial?"
-- In the 1990s, mechanisms for alcohol's protective effects emerged. Dr. Michael Graziano in Boston showed that alcohol raised the levels of HDL cholesterol, the "good" cholesterol. Other scientists showed that alcohol inhibited clotting.
-- In 2009, Dr. Kenneth Mukamal in Boston started a six-month experiment giving some people a small amount of alcohol - equivalent to one drink - daily and withholding all alcohol for others. He plans to compare blood lipids and plaque buildup in arteries of the two groups to determine if alcohol slows the cholesterol-clogging arterial disease atherosclerosis.
Does alcohol have magical powers?
Resveratrol, a polyphenol found in wine, has almost magical powers in animals, extending the lifespan of fruit flies and worms and reducing inflammation and protecting against the adverse effects of obesity in mice. These potentially ground-breaking discoveries need to be tempered by the knowledge that very high doses - the equivalent of 100-plus bottles of red wine daily - were given to mice. Importantly, after resveratrol is absorbed into the blood, it is broken down quickly and may have limited effect in humans.
The headline-creating clinical studies purporting to show that moderate wine consumption prevents Alzheimer's disease do not show cause and effect, but are observational studies. A plausible explanation is that the healthy elderly can drink moderately without becoming impaired, but those with early or mild Alzheimer's will be pushed over by even a small amount of alcohol and hence, don't drink. Drinking wine, like driving a car safely, doesn't prevent Alzheimer's, it's just more evidence that you don't have it.
The downside
-- Several large observational studies show an increased risk of breast cancer in women who drank moderate amounts of wine. As with the observational studies showing a reduction of heart disease, cause and effect remains unknown, but the results are worrisome.
-- Women are more susceptible to all effects of alcohol, both potentially beneficial and harmful. They have a higher blood-alcohol level compared with men after drinking the same amount of wine or other form of alcohol because they have less of an enzyme in their stomach that starts to break down alcohol. Keeping the alcohol in the stomach, which occurs with eating, allows more of it to be broken down. Less is absorbed, so the blood alcohol level is lower.
-- The calories in dry wine come entirely from alcohol. A 5-ounce glass of dry red or white wine (at 13 percent alcohol) contains about 110 calories.
Please note: Nothing in these articles should be construed as individual medical advice. For specific recommendations regarding alcohol consumption, consult your physician.
Wine writer Michael Apstein is a gastroenterologist at Beth Israel Deaconess Medical Center in Boston and an assistant professor of medicine at Harvard Medical School.
http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/08/23/FDF2196S5E.DTL
This article appeared on page K - 1 of the San Francisco Chronicle
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* Dr. James Ellingson, jellings(a)me.umn.edu *
* University of Minnesota, mobile : 651/645-0753 *
* Great Lakes Brewing News, 1569 Laurel Ave., St. Paul, MN 55104 *
Greetings,
Just made the reservation for 6:30 Thursday 13 August.
Style is Italian - white and/or red.
Thanks to those who replied:
Dave Turand
Jim, Louise, Kathy,
Russ, Sue
Bill "Hop Along" S,
Alicia A
I've made the reservation for the eight people listed.
Let me know if you're joining us, or if you can't make it.
Arezzo Ristorante
5057 France Ave S,
Minneapolis, 55410
612 285-7444
www.arezzoristorante.org
Cheers,
Jim
----- Forwarded message from "Jim L. Ellingson" <jellings(a)me.umn.edu> -----
Date: Tue, 11 Aug 2009 19:17:01 -0500
From: "Jim L. Ellingson" <jellings(a)me.umn.edu>
To: wine(a)thebarn.com
Subject: [wine] Dave Turandino says Arezzo
Greetings,
Dave T would like to meet at Arezzo this week or next.
I'm available this week.
Louise and Kathy are a maybe.
Please let me know so I can call Dave and Arezzo.
Cheers,
Jim
----- Forwarded message from "Jim L. Ellingson" <jellings(a)me.umn.edu> -----
Date: Tue, 14 Apr 2009 17:22:40 -0500
From: "Jim L. Ellingson" <jellings(a)me.umn.edu>
To: wine(a)thebarn.com
Subject: [wine] Meeting this week? Arezzo?
Greetings,
Russ, Sue, Alicia, Dave T and I are planning to meet this week.
Thursday, 6:30 at Arezzo in Mpls/Edina. I'm bringing wines from Piedmont
or at least in that style.
$6 per person in lieu of corkage.
Cheers,
Jim
* Dr. James Ellingson, jellings(a)me.umn.edu *
* University of Minnesota, mobile : 651/645-0753 *
* Great Lakes Brewing News, 1569 Laurel Ave., St. Paul, MN 55104 *
_______________________________________________
wine mailing list
wine(a)thebarn.com
http://www.thebarn.com/mailman/listinfo/wine
----- End forwarded message -----
--
------------------------------
* Dr. James Ellingson, jellings(a)me.umn.edu *
* University of Minnesota, mobile : 651/645-0753 *
* Great Lakes Brewing News, 1569 Laurel Ave., St. Paul, MN 55104 *
_______________________________________________
wine mailing list
wine(a)thebarn.com
http://www.thebarn.com/mailman/listinfo/wine
----- End forwarded message -----
--
------------------------------
* Dr. James Ellingson, jellings(a)me.umn.edu *
* University of Minnesota, mobile : 651/645-0753 *
* Great Lakes Brewing News, 1569 Laurel Ave., St. Paul, MN 55104 *
Greetings,
Dave T would like to meet at Arezzo this week or next.
I'm available this week.
Louise and Kathy are a maybe.
Please let me know so I can call Dave and Arezzo.
Cheers,
Jim
----- Forwarded message from "Jim L. Ellingson" <jellings(a)me.umn.edu> -----
Date: Tue, 14 Apr 2009 17:22:40 -0500
From: "Jim L. Ellingson" <jellings(a)me.umn.edu>
To: wine(a)thebarn.com
Subject: [wine] Meeting this week? Arezzo?
Greetings,
Russ, Sue, Alicia, Dave T and I are planning to meet this week.
Thursday, 6:30 at Arezzo in Mpls/Edina. I'm bringing wines from Piedmont
or at least in that style.
$6 per person in lieu of corkage.
Cheers,
Jim
* Dr. James Ellingson, jellings(a)me.umn.edu *
* University of Minnesota, mobile : 651/645-0753 *
* Great Lakes Brewing News, 1569 Laurel Ave., St. Paul, MN 55104 *
_______________________________________________
wine mailing list
wine(a)thebarn.com
http://www.thebarn.com/mailman/listinfo/wine
----- End forwarded message -----
--
------------------------------
* Dr. James Ellingson, jellings(a)me.umn.edu *
* University of Minnesota, mobile : 651/645-0753 *
* Great Lakes Brewing News, 1569 Laurel Ave., St. Paul, MN 55104 *
Do your own "Bob" joke.
BTW, I have a free spot for anyone interested in a
tasting by Michael Martini of Ghost Pines and Louis Martini.
Additional or guest spots are just $15 per person.
Contact me at 651 645 0753 if interested. Tasting is at 7 in
Bloomington.
Cheers,
Jim
August 5, 2009
WINES OF THE TIMES
Beaujolais Shows Its Complex Side
By ERIC ASIMOV
FEW wine names are better known around the world than Beaujolais, but no well-known wine is as little understood. The reasons for this are clear.
Perhaps no other wine today is as defined, and as victimized, by its marketing and its history as Beaujolais. In short, Beaujolais is imprisoned by clichés.
Marketing, of course, is what transformed the image of Beaujolais from a light and charming bistro wine to Beaujolais nouveau. The annual roll-out-the-barrels of Beaujolais nouveau took a quaint local harvest celebration and made it a worldwide phenomenon, sadly centered on wines that were largely tutti frutti and banal.
Novelty begat boredom, and in the United States at least, the annual arrival of Beaujolais nouveau has been met with yawns for some time now.
The history issue is a little trickier. For as long as most people remember, Beaujolais was a jolly little wine. The proverbial river of Beaujolais poured forth to Lyon, and eventually to cafes and neighborhood joints in Paris and other parts of France. But as with so much of wine lore, the notion of Beaujolais as a simple quaff needs to be put to sleep.
Sad or not, the fact is that the wine world has changed sharply since Beaujolais perked up the daily lives and meals of so many French families. For one thing, the French don’t drink nearly as much wine as they once did, and when they do drink, they are now more discerning and more price conscious.
As has been well documented, producers of vin ordinaire, whether it comes from Bordeaux, Languedoc or Beaujolais, have been in trouble for some time now.
There are fewer customers and increased competition from the growing number of wine-producing countries around the world.
At the same time, serious artisanal producers in Beaujolais have in the last 20 years done the same as serious artisanal producers everywhere else: they have vastly improved the quality and consistency of their wines, building on a greater understanding of viticulture and winemaking.
Instead of selling cheap wine to a wide market of inexpensive bistros and cafes, top Beaujolais producers now sell to a narrower slice of the market willing to pay more money for wines of higher quality.
The future of good Beaujolais, just as it is for many wines, is a specialty market of knowledgeable consumers with disposable income. Yet in the context of Beaujolais, the top wines are still only $15 to $30 a bottle.
This may seem expensive according to outdated ideas about Beaujolais, yet, as the wine panel discovered in a tasting of 20 cru Beaujolais from the 2007 vintage, they are excellent values given the level of their quality.
For the tasting, Florence Fabricant and I were joined by Chris Goodhart, who oversees wine programs at Keith McNally’s restaurants, and Fred Dexheimer, a sommelier turned consultant.
The cru Beaujolais, made from 10 communes judged to have distinctive terroirs, are generally the best wines of the region. Wines labeled Beaujolais or Beaujolais-Villages tend to be like the simpler wines of yore, though from good producers they can be highly satisfying.
The transformation of wine from everyday grocery to luxury good has induced some winemakers around the world to cynically tailor their methods in a quest for higher ratings and greater profits. But as far as we could tell this has not at all been the case with top Beaujolais producers.
Indeed, not only our top wines but also almost all the bottles we tried seemed to be sincere efforts at making the best possible wines without resorting to crowd-pleasing measures like layering on oaky or overtly fruity flavors.
Instead, our favorites were indisputably serious wines that combine density of flavor with lightness of body, and beautiful aromas of fruit, flowers, minerals and spice with freshness and structure.
While these wines belie the patronizing cliché that Beaujolais is a simple though charming wine, the best of these wines nonetheless retain the innate joyousness at the heart of the gamay grape. Our favorite, the Côte-de-Brouilly from Jean-Paul Brun, was simultaneously serious and exuberant, delicious yet with enough complexity and precision to give you something to think about.
Similarly, our No. 2 wine, the Juliénas from Michel Tête, had densely layered aromas and flavors yet was light and elegant. At $16 it was our best value, though it had competition from the Brun, which was only $2 more.
The wines at the top of the list, from Côte-de-Brouilly, Juliénas, Chiroubles and Brouilly, tended to be a little more open and accessible than the rest of the wines in our top 10, which, with one exception, came from Morgon, Moulin-à-Vent and Fleurie, which generally give denser, more structured wines.
Domaine Diochon’s Moulin-à-Vent was particularly rich and chewy, while Daniel Bouland’s Vieilles Vignes was a classically rugged Morgon, though with an underlying beauty that will emerge with another year or two of aging. Also among this group was the spicy, juicy Régnié Vallières from Jean-Marc Burgaud.
Our No. 10 wine was a Moulin-à-Vent from Georges Duboeuf, who largely personifies Beaujolais around the world. While some wines issued under the Duboeuf name can be very good, I have often found his inexpensive flower label wines have an unappealing candied quality. Not this one. It had all the density and complexity one could wish for in a Moulin-à-Vent.
Aside from our top 10 wines, some other producers are well worth seeking out. Marcel Lapierre makes beautifully balanced Morgons, while Louis-Claude Desvignes’s Morgons are more sturdy and structured. I’m also a big fan of the Fleuries of Clos de la Roilette and the Moulin-à-Vents from Louis Jadot’s Château des Jacques.
While the received wisdom continues to dismiss Beaujolais as a simple little wine, these wines speak far differently.
Tasting Report: Flavorful Yet Light
Jean-Paul Brun Terres Dorées Côte-de-Brouilly 2007 $18 *** 1/2 (Three and a Half Stars)
Joyous, with precise aromas and flavors of flowers, berries, anise and minerals. (Importer: Louis/Dressner Selections, New York)
BEST VALUE
Michel Tête Domaine du Clos du Fief Juliénas 2007 $16 *** 1/2 (Three and a Half Stars)
Dense yet elegant with lovely aromas and flavors of fruit, iron and granite. (Louis/Dressner Selections)
Georges Descombes Chiroubles 2007 $28 *** (Three Stars)
Light-bodied, with lingering flavors of fruit, flowers and minerals. (Louis/Dressner Selections)
Pierre-Marie Chermette Domaine du Vissoux Brouilly Pierreux 2007 $26 *** (Three Stars)
Juicy, balanced and delicious with flavors of blackberries and earth. (Weygandt-Metzler Importing, Unionville, Pa.)
Domaine Diochon Moulin-à-Vent Vieilles Vignes 2007 $19 ** 1/2 (Two and a Half Stars)
Dense with deep flavors of dark fruit, earth and granite. (Kermit Lynch Wine Merchant, Berkeley, Calif.)
Jean-Marc Burgaud Régnié Vallières 2007 $22 ** 1/2 (Two and a Half Stars)
Fresh and bright with lovely aromas of violets, cinnamon and plums. (Langdon Shiverick, Cleveland)
Jean Foillard Morgon Côte du Py 2007 $30 ** 1/2 (Two and a Half Stars)
Earthy, with silky texture and flavors of black cherries and spices. (Kermit Lynch Wine Merchant)
Daniel Bouland Morgon Vieilles Vignes 2007 $20 ** 1/2 (Two and a Half Stars)
Dense and rugged with flavors of black cherries and earth. (Weygandt-Metzler Importing)
Château du Chatelard Fleurie Cuvée Tradition 2007 $24 ** 1/2 (Two and a Half Stars)
Serious with balanced flavors of fruit, spice, minerals and flowers. (Wineberry America, New York)
Georges Duboeuf Moulin-à-Vent Flower Label 2007 $12 ** 1/2 (Two and a Half Stars)
Juicy, smoky and silky; aromas of fruit, flowers and minerals. (W. J. Deutsch & Sons, White Plains)
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* Dr. James Ellingson, jellings(a)me.umn.edu *
* University of Minnesota, mobile : 651/645-0753 *
* Great Lakes Brewing News, 1569 Laurel Ave., St. Paul, MN 55104 *
Sad, sad news team.
Our friend Craig Schutte has suffered theterrible loss
of his brother Brad. Recall Brad and Craig ran the 510
Restaurant, one of our favorite destinations.
Below is the article from the Strib.
More info here: http://kstp.com/news/stories/s1061143.shtml
I don't have an address for Craig, but would be
interested in sending a card and/or flowers.
Best,
Jim
Man drowned in hot tub owned bar
The man friends called "Sutterbug" owned and operated Stasiu’s Place in Northeast Minneapolis.
By ABBY SIMONS, Star Tribune
Last update: August 1, 2009 - 10:21 PM
A man discovered drowned in a Robbinsdale hot tub Friday afternoon was a former chef and the owner of a popular Northeast Minneapolis bar, said grieving friends Saturday as they reminisced about the buddy they called “Sutterbug”.
Brad Schutte, 39, who lived in Minneapolis, owned and operated Stasiu’s Place, a neighborhood bar at the corner of University and Lowry avenues NE that frequently books live, local music acts that often played for free.
Schutte was found dead after Robbinsdale police and Hennepin County Sheriff’s deputies were called to a house in the 3800 block of Toledo Avenue at 1:30 p.m. Friday. He appeared to have drowned, said Inspector Tracey Martin of the sheriff’s office.
A search of the home turned up drugs, and a 32-year-old woman and 30 year-old man were booked into the Hennepin County Jail for probable cause drug possession and weapons violations. They have not yet been formally charged.
Schutte’s brother, Craig Schutte, said he was too overwhelmed Saturday to talk about his brother. He said he is still in constant communication with law enforcement as they wait for relatives to arrive to Minnesota.
“We’ve just got a lot to deal with,” he said
On Saturday, Martin released no new details of the investigation, and would not discuss whether authorities suspect foul play. Martin did not know the two were also booked for possible weapon violations.
The bar remained closed Saturday, and no vigil was planned, though friends flooded Schutte’s facebook page with tributes from bar regulars and longtime friends who posted photos, reminisced and shared their shock and heartbreak.
Among them was Johnny Myhers, who met Schutte when he took over Stasiu’s in 2005 after working as chef and owner of the now-closed 510 restaurant, located near the Walker Art Center. In addition to supporting local bands, Schutte was known for taking the stage to strum out a tune by local music heroes such as The Replacements or Soul Asylum. Myhers and Schutte quickly became close friends, and Schutte dubbed himself “The Love Doctor” after helping Myhers make up with his girlfriend, Cindy Hatch, following a spat at a wedding there weeks ago.
“His place was one where you could go to the bar by yourself, but you’d never be alone,” Myhers said. “He always wanted to have a good time. Stasiu’s itself has its own niche of close friend and family, and he was like our leader.”
Myhers and Hatch don’t know what happened Friday afternoon, but they suspect what happened to Schutte was nothing more than a horrible accident. Their friend sometimes lived “a bit on the wild side.” Myhers said, but also would literally give the shirt off his back to others, and was an adoring father to his girls, ages 7 and 9.
“He wasn’t just a bartender. He wasn’t just a friend, he wasn’t just a father,” Hatch said. “He was a chef, a confidante, a text-messaging buddy. He was more than just what they say.”
Abby Simons • 612-673-4921
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* Dr. James Ellingson, jellings(a)me.umn.edu *
* University of Minnesota, mobile : 651/645-0753 *
* Great Lakes Brewing News, 1569 Laurel Ave., St. Paul, MN 55104 *
