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Does Wine Deserve Its Health Buzz?

by Berkeley Wellness

Since the “French paradox” was first reported about 25 years ago, wine (particularly red wine) has gained an aura of healthfulness that distinguishes it from beer and hard liquor. Some people drink it instead of other alcoholic (or nonalcoholic) beverages because they’ve heard that it’s good for the heart, as if it were a medicine or tonic. How true is this common belief? Here are answers to this and other questions about wine.

Is wine more healthful than beer and liquor?

There are reasons to think that wine is the healthiest choice, but this has been hard to prove. Some population studies, notably those from countries with high wine consumption like France and Spain, suggest that wine (usually red) is most cardio-protective, especially when people consume it every day with meals.

But many other studies have found that a moderate intake of any kind of alcoholic beverage reduces the risk of heart attacks, as well as certain other disorders, including ischemic strokes, type 2 diabetes, gallstones, and cognitive impairment. This, plus laboratory research, suggests that the benefits come primarily from the alcohol itself, which helps reduce blood clotting (similar to aspirin) and raises HDL, the so-called “good” cholesterol.

(What’s a moderate intake? No more than one drink a day for women, two for men. People over 65 should drink less than that because they are affected more by alcohol. A standard drink is 5 ounces of wine, 12 ounces of beer, or a relatively modest 1.5 ounces of 80-proof liquor, which all average about 14 grams of pure alcohol.)

Wine, especially red wine, does contain many polyphenolic compounds—such as flavonols, catechins, and anthocyanins—that have antioxidant and anti-inflammatory properties and that may work together to protect blood vessels and promote health in general.

For a while it was thought that the key polyphenol in wine was resveratrol (found in the skin of red grapes as well as in peanuts and chocolate), but some recent research has called this into doubt. For instance, an Italian study in JAMA Internal Medicine in July 2014 found no link between dietary intake of resveratrol and cardiovascular disease or longevity.

Nonalcoholic wine and grape juice also supply healthful polyphenols. Beer and liquors contain an array of potentially beneficial compounds as well. But so do virtually all foods derived from plants. Thus, wine is not essential for a healthy diet—nor is alcohol from any source, of course, which is fortunate, since many people don’t want to or shouldn’t drink. Even moderate drinking can have adverse effects—impairing coordination, for instance, and modestly increasing the risk of breast cancer and some other cancers.

What about white wine?

White wine also has potential health benefits, though red wine contains much higher levels of polyphenols (rosé lies in between, but closer to white).

These compounds are concentrated in the grape skin and seeds, which are separated from the grape juice immediately after the grapes are crushed when making white wine. With red wine, the skin and seeds are removed after fermentation is complete so the polyphenols have time to leach into the liquid.

Nevertheless, some lab studies have found that the flesh and skin of the grapes have equal antioxidant abilities. Keep in mind that the types and concentration of polyphenols in wine depend on many factors, including the grape variety, environmental factors, processing techniques, and vintage.

But is it the wine or the drinker?

Looking beyond the chemistry of various types of alcoholic beverages, there’s a bigger question: Could differences among wine sippers, beer drinkers, and liquor imbibers account for the different health effects of these beverages as seen in some observational studies?

There’s good evidence that wine drinkers generally have healthier habits than beer or cocktail consumers. For instance, they usually have better diets and are less likely to smoke or be obese than other drinkers. They also tend to be more educated and more affluent, at least in the U.S.

Wine also tends to be consumed with meals, which is preferable, since food slows the absorption of alcohol. Moreover, people who drink at meals are more likely to drink moderately.

When researchers control for such factors, the observed superiority of wine over other alcoholic beverages in terms of health benefits weakens or even disappears.

What about wine’s role in the French paradox?

It’s questionable. The paradox is that the French eat relatively large amounts of animal fat but have lower rates of heart disease than Americans. This has been explained in part by French consumption of red wine. But the entire paradox now seems less paradoxical than it did back in 1991 when 60 Minutes aired its famous segment on it. For one thing, the French tend to consume fewer calories and be more active than Americans. And while life expectancy is two years longer in France than in the U.S., the Japanese and Swedes live even longer but drink less wine. Even in France, wine consumption has been falling for decades, and only one in five French adults now drinks wine on a daily basis, compared to half in 1980.

Nowadays researchers are focusing on the diet of the entire Mediterranean region, which includes southern France and also features wine. But it’s impossible to say whether wine (or indeed any other single component) plays an essential role in the benefits of the Mediterranean diet, as opposed to the diet as a whole.

Is wine a “natural,” unprocessed beverage?

It may have been in ancient times, but in recent centuries winemaking has become a complex process, often involving dozens of chemical additives and processing aids besides the yeast added for fermentation. Here are just a few: Sulfites are used to preserve wine; eggs whites or albumin are used for clarification and stabilization; calcium carbonate reduces high acid levels; and copper sulfate removes undesirable odors. Other compounds can be used to affect fermentation; remove cloudiness, undesirable flavors, and particles; or otherwise change the flavor, color, acidity, sugar or tannin levels, and mouth-feel of the wine. Depending on how wines are clarified, stabilized, and processed in other ways, only traces of most additives end up in the finished products. Federal regulations limit the levels of many additives in wine.

Additives don’t have to be listed on the labels, except for sulfites (if more than 10 parts per million), which can cause dangerous reactions, especially in people with asthma. If there were long lists of ingredients on the labels, many consumers might be confused or put off, even though there is no evidence that these other additives in wine pose health risks.

Then there are the inadvertent chemicals in wine—notably pesticide and fungicide residues from the grapes. In 2008, the European Pesticide Action Network found pesticides in nearly all the wines it tested. And in 2013, a French consumer organization tested 92 French wines and found that all had pesticide traces, albeit well below EU toxicity thresholds for wine grapes. There’s no evidence that such tiny residues pose a risk to wine drinkers. As with other conventionally grown crops, the clear concern about these pesticides is for vineyard workers and the environment—which is what makes organic wine an attractive option.

What Is a 'Wine Product'?

The bottle looks like wine, and the label may even have the name of a chateau on it, leading many people to be fooled by this impostor—until they taste it.

Dionysus goes organic

According to the USDA’s National Organic Program, wine labeled or sold as “organic” must contain grapes that have been certified organic, can contain only naturally occurring sulfites, and may contain up to 5 percent non-organic ingredients that are on the National List of Allowed Substances for organic foods.

Like all certified organic produce, organic grapes cannot be treated with most synthetic pesticides, fungicides, or fertilizers.

Wines labeled “100 percent organic” contain only certified organically grown ingredients and no added sulfites. Those labeled “made with organic grapes” must contain at least 70 percent organic ingredients. Other countries have different standards for organic wines, but those imported to the U.S. are supposed to meet USDA organic requirements.

Does wine, like juice, count as part of your daily fruit intake?

No. However healthful it is, wine doesn’t count as produce. The USDA doesn’t include it in its MyPlate program (formerly the Food Pyramid), nor do other groups that recommend targets for daily produce consumption. Wine contains no fiber and almost no vitamins or minerals.

By the way, many experts think that fruit juice also shouldn’t count toward your daily fruit goal, since a serving contains much less fiber and a lot more calories—almost all from sugar—than whole fruit.