An Update on Oenotherapy
– or how wine can help you die young as late as possible

We all want a long, healthy and happy life i.e. we want to stay young as late as possible. The ultimate life expectancy for humans, according to geriatricians is 120 years. To reach that age in a healthy body with an intact and alert mind will require good preventative medicine. One of the major components in this preventative medicine regime will be consuming wine in moderation on a regular daily basis. We should thus think of wine as our daily health drink and not just for special occasions, celebrations or for fancy dinners. We will also have to change our definition of health from the current narrow medical definition of being disease free to a new broader definition of the ability to enjoy life physically, mentally and environmentally because our health is co-dependent on the health of our planet earth. Pollution and the quality of our food, water and wine from the earth are basic to our health and survival.

Besides conforming to the usual preventative health measures such as maintaining a normal weight, cholesterol, blood sugar, blood pressure, not smoking and exercising regularly, we can add drinking wine daily because not consuming wine regularly is now considered another major risk factor in the pathogenesis of vascular disease. Daily consumption is required because wine’s antioxidant and anticoagulant effects are short lived i.e. 24 hrs. only. For the past decade or so researchers have been telling us how wine in moderation protects us against coronary heart disease; but this has now changed. We should be talking about protection against vascular disease throughout the whole body’s vascular tree from the brain (ischaemic strokes or brain attacks and dementia) to the heart (heart attacks) to the kidneys (50% of all renal failure is due to vascular disease) to macular degeneration (a form of blindness) to osteoporosis (thinning of the bones) and to deep vein thrombosis (clot in the leg).

Before discussing the health benefits of drinking wine, we should define moderation and also discuss those who should not consume wine.

Moderation is a maximum of 4 standard drinks per day for a male and 2 for a female, where a standard drink is defined in Australia as a drink which contains 10 gms. of alcohol i.e. 120-150 mls. of wine, depending on the percentage of alcohol contained in the wine. Women can consume only half the amount that men can consume, because they have only half the amount of alcohol dehydrogenase, the enzyme which metabolises or breaks down alcohol.

People should avoid drinking alcohol if they react badly to it or have any significant stomach disease such as gastritis or ulcers; liver disease such as hepatitis or cirrhosis; heart disease such as myocarditis or myocardopathy or nerve disease such as peripheral neuropathy or encephalopathy.

If in doubt, always check with your doctor.

So how does drinking wine in moderation reduce cardiovascular disease?

When too much fat in the form of low density lipoprotein (LDL) or ‘bad cholesterol’ becomes deposited within the blood vessel wall the blood vessel becomes blocked. Eventually this fat, called atheromatous plaque, swells up and forms an obstruction to blood flow. As well, by altering blood flow, this fatty plaque can also cause the blood to form clot.

Or, the fat can swell up to the point where it bursts through the internal lining of the artery wall, causing a clot to form to breach the tear in the wall of the artery.

However, it occurs, when a blood vessel becomes blocked, it causes death to the tissue the blood vessel supplies, resulting in a heart attack or stroke.

Wine acts in five ways to help prevent this happening.

First, it lowers LDL, the ‘bad cholesterol’, so there are less fatty deposits available to form atheromatous plaque.

Second, it raises the high density lipoprotein (HDL) or ‘good cholesterol’. HDL clears away the ‘bad cholesterol’ from the artery wall by taking it back to the liver to be metabolised and reused.

Third, wine contains very strong antioxidants. They are five times stronger than vitamin E, the usual benchmark antioxidant. These strong antioxidants inhibit ‘bad cholesterol’ from being incorporated into the blood vessel wall, thus preventing the formation of atheromatous plaque.

Fourth, wine acts as an anti-coagulant which stops the blood from forming clots.

Fifth, because wine is able to relax you, it also reduces stress.

The potent antioxidants in wine, mainly resveratrol, quercetin and epicatechin, are five times stronger than the usual benchmark antioxidants Vitamin C and Vitamin E and plateau at 100% antioxidant activity after about two glasses of wine whereas the antioxidant activity of Vitamin E will plateau at only 20%, thus allowing a lot of oxidative damage to occur to the body. The body has many biochemical pathways occurring within it all the time and the waste products of this activity are called free radicals which cause biochemical havoc, thus damage to our bodies. Wine’s potent antioxidants can block the activity of these free radicals thus reducing damage to and aging of our body. The antioxidants also reduce neurodegenerative diseases such as dementia and Parkinson’s disease, damage to DNA (Genetic material in cells) leading to less cancer and reduce insulin reistance in our cells thus helping diabetes. A summary of the many medical benefits of wine in moderation follows at the end of this article.

So there is now a good case to be made to let non drinkers and occasional drinkers know the potential health benefits that they are missing out on because they are not consuming wine on a regular daily basis. Abraham Lincoln once said "Tell the people the truth and the country will be free". As a doctor I feel it is my duty to let people know the good news about wine and then leave it up to them to decide whether or not they want to drink wine. I do not agree with the arrogant "Granny State" mentality which has prevailed where censorship of medical research findings about wine in moderation has occurred to ‘protect’ the public for fear they will all abuse alcohol. It amazes me that governments and society allows adults to vote, drive cars, marry, raise children and work – all of which are very responsible activities, yet denies them the good news about wine because they may not handle it properly!!

Now the anti alcohol lobby is saying that the health benefits are not apparent and statistically significant in most studies until after the age of 40 so we should restrict consuming alcohol before then. During the Vietnam War, when autopsies were carried out on fit young soldiers of 18 or 20, fatty streaking was shown in their arteries. Fatty streaking is the first visible sign of atheroma formation, hence beginnings of vascular disease. So vascular disease does not start on ones 40th birthday (happy birth and have a nice heart attack) but much, much earlier, so we should be educating young adults, once they are old enough to legally consume alcohol, to consume wine daily in moderation to prevent what is going to kill half of them in their 40’s and later.

Researchers in alcohol related studies always use death as their end point because they can refer to the death certificates for cause of death and because it is a standard end point – once you are dead you are dead, there are no grades of death. So what we should also be looking at, besides mortality, is morbity i.e. the statistics of the diseases that do not lead to immediate death such as the people who survive a heart attack but are left with severe heart failure or angina hence cannot function properly or people who survive a stroke but are left paralysed hence cannot function or people in renal failure or people with dementia. These people do not show up in the research statistics. If they did it would show things to be much, much worse hence reinforces even more the need for prevention with wine.

So the new things to consider in wine and health are the whole vascular tree and not just the heart benefit, diabetics benefit from reduced insulin resistance, wine should be consumed in moderation daily, plus non drinkers and occasional drinkers should be encouraged to consume wine in moderation.

Education for all and harm reduction for abusers is the way forward, not prohibition and increased taxation (because the Ledermann Theory is invalid).

"Unless there is a contraindication consuming wine in moderation daily is the best preventative health measure one can do except stopping smoking".

This list is to show that there are many other health benefits from consuming wine in moderation besides those relating to the circulatory system.

1. Reduction of Vascular Disease (due to greatly improved blood flow) resulting in:
   • Reduced Coronary Heart Disease
   • Reduced Ischaemic Stroke
   • Reduced Deep Vein Thrombosis
   • Reduced Osteoporosis
   • Increased Intellect in the Elderly
   • Reduced Macular Degeneration (a common cause of blindness)
   • Reduced Renal Failure (50% of renal failure is due to vascular disease)
2. Tonic – wine contains many substances including most vitamins, minerals and trace elements
3. Fat and cholesterol free source of carbohydrate
4. Reduced cancer
5. Reduced blood pressure
6. Antiseptic due to alcohol and more importantly polyphenols
7. Increases morale and appetite – nursing home and hospital patients
8. Wine contains Quercetin, Resveratrol and Epicatechin which are potent anti-oxidants and also act as anti-carcinogens
9. Reduction in colds
   
10. Diabetes – dry wine only alcoholic drink that is allowed with diabetes as all the sugar has been converted to alcohol and reduced insulin resistance
    
11. Reduced gallstones
    
12. Reduced kidney stones
    
13. Reduced Alzheimer’s disease
    
14. Reduced Parkinson’s disease
    
15. Improved digestion
    
16. Reduced H. Pylori infection of the stomach and duodenum leading to reduced ulcers
    
17. Improved physical condition of the elderly
    
18. Reduced Hepatitis A
    
19. Reduced stress and depression
20. Reduced essential tremor
21. Reduced tooth decay
22. Reduced cancer of the prostate by up to 50%

Dr Philip NORRIE
MBBS,MA,MSc,MSocSc[Hons],PhD,MD, currently doing M.Phil