A Wine-y Time of Year (Conclusion)
A wine and health primer, part 3
Posted Nov 04, 2016
While excessive alcohol consumption of any type is unequivocally associated with the development of serious and potentially fatal liver disease, there is good news for moderate consumers. A recent study examined almost 12,000 participants who abstained from alcohol or consumed either 4 ounces of wine, 12 ounces beer, or 1 ounce of liquor per day. The regular consumption of moderate amounts of wine reduced the risk of nonalcoholic fatty liver disease (NAFLD) by approximately 50% compared to those who never drank wine. Those who consumed beer or spirits had twice the risk of developing NAFLD compared to that of the abstainers and four times the risk compared to moderate wine drinkers.
NAFLD is the most common liver disease in the United States, affecting over 40 million adults. Approximately 5% of those afflicted with NAFLD will go on to develop cirrhosis. The risk factors for the development of NAFLD are the same as those seen with many other disabilities and diseases associated with consumption of the modern Western diet. Many people who develop NAFLD also suffer from metabolic syndrome, diabetes, obesity, hypertension and cardiovascular disease. Since moderate red wine consumption is associated with the reduction in many of these pathologies, a beneficial effect on this hepatic malady should not be unexpected. Yet the conventional wisdom that any alcohol consumption is bad for the liver goes to show that such an assumption is often neither conventional nor wise.
Among the pleiotropic effects of quaffing a delightful glass of red wine, are the beneficial effects in insulin sensitivity. Resveratrol, which is found in red wine, has been shown to improve insulin sensitivity. Resistance to insulin is the hallmark of type II diabetes. Multiple studies have shown that moderate alcohol consumption is associated with a decreased risk for developing type II diabetes. In multiple meta-analyses, consumption of 2 to 3 glasses of wine per day is associated with an approximate 20% decrease in the risk of developing diabetes.
The Mediterranean diet, which is been shown to not only prevent some of the complications of diabetes, but is associated with a reduction in the incidence of its development; contains consumption of moderate amounts of wine as one of its dietary pillars. Recent studies have suggested that adherence to a Mediterranean approach can even result in the reversal of disease. The different components of the Mediterranean diet: ethanol consumption, low meat product consumption, high vegetable consumption, high fruit and nut consumption, high monounsaturated to saturated lipid ratio, high legume consumption, high serial consumption, hi fish and seafood consumption, and low dairy consumption were analyzed. The analysis revealed that the predominant healthful effect was due to moderate ethanol (primarily wine) consumption, being responsible for just under 25% of all benefit.
Wine associated health benefits extend as far as the eye can see; and in some cases further. Diabetic retinopathy can cause vision loss in almost 20% of people suffering with diabetes. Age-related macular degeneration is the leading cause of blindness among Americans aged 50 years and older. Both are caused by an abnormality of blood vessels in the eye. Murine experiments demonstrated a potent effect utilizing the resveratrol component found in red wine. Operating through the eukaryotic elongation factor-2 kinase, or eEF2, regulated pathway; resveratrol not only eliminated the abnormal vessels, but prevented new ones from forming.
10. Gut Microbiome
Like the seasons of wine, the story of health benefits comes full circle and ends where it began, with cardiovascular disease. Yet it also ends in a place most unexpected; the gut. The gut microbiome is that collection of bacteria that resides within us; outnumbering our cells by roughly 10 to 1. It is our collection of personal minions that assist us in the everyday tasks of processing the foods we consume. Research continues to reveal it playing an increasingly important role in health and wellness and the development of disease; particularly the disabilities and diseases of modern civilization.
Cardiovascular disease remains the leading cause of death in the United States and most other industrialized societies. It is estimated that 80-90% of Americans over the age of 30 suffer from some degree of atherosclerosis. Cutting edge science has demonstrated that the gut microbiome is intimately involved in the process of gut homeostasis. Depending on a complex set of variables, including genetics and what we eat; our gut microbiome can be a friendly Wal-Mart greeter or an angry soccer mob. Just like a fine wine; each of us has our own internal terroir. And nobody wants the crush harvested from Chernobyl.
It turns out that the unique microbial diversity within different regions around the globe, or appellations, affects the final chemical composition of individual wines. Wine is a living, natural fermented product. A bacterial product produced by the human gut microbiome, trimethylamine (TMA), can make its way to the liver where it is converted to Trimethylamine-N-oxide (TMAO). TMAO is associated with cardiovascular disease, systemic inflammation, diabetes and a host of other modern scourges.
The consumption of wine can favorably alter the human gut microbiome; as many naturally fermented foods appear to do. Murine studies have shown that the components found in wine can remodel the gut microbiota including increasing the Bacteroidetes-to-Firmicutes ratios, significantly inhibiting the growth of Prevotella, and increasing the relative abundance of Bacteroides, Lactobacillus, Bifidobacterium, and Akkermansia. In other words, a glass of wine just might turn that angry mob into choir boys.
There are several caveats which apply here. The first is to realize that the dose matters. With respect to wine consumption, it is about quantity and not averages. Many studies give the results in glasses per day or week. However, the law of averages does not apply here. It is the turtle’s pace of slow, reasonable, moderate consumption that yields benefit and enjoyment. Saving the drinks up during the week to binge over the weekend has been shown to be associated with zero health benefits and is in fact associated with the conditions linked to chronic, heavy alcohol abuse.
This article addresses red wine consumption in terms of moderation. This of course raises the question of exactly what amount that comprises. That, in truth, depends on many factors; weight, age, sex, body stature, other meal components and the like.
Women tend to absorb alcohol more rapidly than men because commonly they have a lower body water content and different levels of stomach enzymes. In general, their body weight also tends to be less. Therefore, moderate wine consumption may be lower for women than for men. In most studies, for women, moderate wine consumption ranged from one-half to two glasses of wine per day. A glass of wine generally being between four and five US ounces. For men the range was generally one to three glasses.
For those with a history of, or at serious risk for, alcohol abuse; any alcohol consumption should be avoided. For those looking for non-alcoholic sources of components like resveratrol, consumption of other naturally occurring comestibles can be found. These include grapes, blueberries, raspberries, bilberries, and peanuts.
Remember, wine is not a panacea for all of Pandora’s ills. As the saying in medicine goes; the poison is in the dose. Excessive consumption and alcohol abuse can lead to depression, mental health problems, heart disease like cardiomyopathy and arrhythmias, stroke, hypertension, liver disease like fatty liver, alcoholic hepatitis, and cirrhosis, several types of cancers (particularly when combined with smoking), pancreatitis and many other chronic diseases.
With that being said, let your next glass of red wine, be literally; “To Your Health!”
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