Cutting through the Clutter about Heart Health
The following outline formed a webinar that NCADD presented in August 2015 as part of Cigna’s Alcohol and Drug Awareness Series. The presentation focused on the impacts of wine as it relates to cancer and cardiac health, weighing out the benefits and the risks of drinking wine. Concrete suggestions were offered for making better overall health decisions.
Presenters were:
- Julia M. Dostal, PhD
Executive Director, LEAF Council on Alcoholism & Addictions and NCADD-National Board Member - Robert Pezzolesi, MPH
Founding Director, New York Alcohol Policy Alliance
Wine and heart health
Studies have shown that moderate consumption of wine may have cardiac benefits.
- Raises HDL cholesterol (the “good” cholesterol)
- Reduces the formation of blood clots
- Helps prevent artery damage caused by LDL cholesterol (the “bad” cholesterol)
- Produces changes in blood pressure
There are some important limitations to consider:
- Health benefits do not seem to apply to African Americans and some other racial/ethnic groups
- No health benefits for people under 40 years of age
- Drinking pattern is important – cardio-protective effect disappears when light to moderate drinking is mixed with irregular, binge-drinking occasions
- Heavy drinking can lead to serious cardiac problems, including cardiomyopathy
Resveratrol Claims
- The key ingredient in wine research is resveratrol, a unique plant nutrient (also known as a phytonutrient)
- Resveratrol acts as a plant estrogen in the body (much like soy products)
Acts as an antioxidant in the body — reported to have anti-inflammatory properties and improve circulation
Resveratrol Research is now Questioned
- Conducted on mice & rats
- Studied at doses 100 to 1000 times more than in a serving of wine.
- Non-alcoholic red wine appears to have as much resveratrol as its alcohol-containing counterpart
- Does not have to be in a fermented beverage to act as an antioxidant
- Some key resveratrol research was shown to be fraudulent
Sources of Resveratrol
- Grapes
- Grape Juice
- Peanut Butter
- Blueberries
- Dark Chocolate
- Cranberries
The wine drinker’s conundrum: what is “moderation?”
Moderation for Health
- Two drinks or less per day for men – 10 ounces of wine
- One drink or less per day for women – 5 ounces of wine
The greatest cardiovascular benefit of drinking wine for women appears to occur at:
- 1/3 of a serving of wine (about 1.6 oz) per day
- Many liver specialists are recommending “days off” from drinking – even at light/moderate levels
Wine: not an “equal opportunity” beverage
- All alcohol (ethanol) impacts women differently than men
- Not just a body mass issue
- Hormone issue
- Body fat issue
A woman’s increased risk of alcohol-related issues occurs at anything above one drink
Balancing the Risks for Women
- Alcohol has a strong link to breast cancer and some other cancers
- There are 20,000 alcohol-related cancer deaths in the US per year
- 60% of alcohol-related cancer deaths for women are breast cancer deaths (about 6,000)*
- 30% of alcohol-related breast cancers occurred in women drinking less than 1.5 servings
per day* **
* Harvard School of Public Health, 2013
** “Saving up” all of your drinks for a special event increases risk
Why the Impact on Women?
- Ethanol blocks the absorption of folate. Folate is protective against breast cancer.
- Ethanol is a teratogen, but only in women.
- Finally, ethanol is a Group A carcinogen – and because women tend to absorb alcohol more slowly, it stays in the body longer.
“Per glass of wine, ethanol is more than 100,000 times more potent than resveratrol”
Wine Consumption Recommendations for Women
5 oz of wine (or less) per day is considered low-risk if you:
- Are not pregnant (or do not plan to become pregnant)
- Don’t have an addiction or a family history of addiction
- Are at very low risk for cancers of the breast, head/neck, liver, and colorectum
- Have not had a gastric bypass
- Do not have any other conflicting health conditions or take any conflicting medications
- Currently drink alcohol
Any amount of wine would considered high-risk if you:
- Are pregnant or of child-bearing age (and sexually active)
- Have an addiction or are in recovery
- Have a family history of addiction
- Have risk factors for – or a family history of – cancers of the breast, head/neck, liver, and colorectum
- Have a gastric bypass
- Have other conflicting health conditions or take any conflicting medications
Wine Consumption & Men’s Health
While men have a greater capacity for alcohol metabolism, there are some special risks:
- Some effects on male reproductive system, especially at heavier drinking levels
- “Accumulating” (but not definitive) evidence that alcohol may be risk factor for prostate cancer
- Risk for cirrhosis of the liver with daily drinking
- Greater risks for alcohol-related suicide
As with women, drinking is riskier if you:
- Have an addiction or are in recovery or have a family history of addiction
- Have risk factors for – or a family history of – cancers of the breast, head/neck, liver, and colorectum
- Have a gastric bypass
- Have other conflicting health conditions or take any conflicting medications
All drinking confers some risk For Women & Men – “Less is Better” Recommended daily limits should NOT be interpreted as a “safe” baseline from which to range upward
The best advice from our friends at WHO/Europe and the Association of European Caner Leagues: “Less is Better”
The key may not be in the wine at all
Research shows that most people who drink in true moderation have other protective health indicators (“confounders”):
- More likely to be active regularly
- More likely to eat a healthier diet
- More likely to have established social networks
- More likely to engage in preventive healthcare
Thus, many epidemiologists are beginning to question the unqualified assertion that wine and other alcohol consumption is “heart healthy.” And… of course: If you do not currently drink alcohol, there is no health benefit to starting.
Heart-healthy foods (with and without resveratrol) are your friends
- grapes
- peanuts
- blueberries
- cranberries
- mulberries
- grape juice
- peanut butter
- dark chocolate
- pistachios
- muscadines
Heart-healthy activities are your friends:
- healthy weight
- exercise
- regular checkups
- healthy diet