Does drinking red wine protectagainst heart disease ? By Brian Eccleston

INTRODUCTIONEver since the discovery that red wine could help in the reduction of Coronary Heart Disease, CHD the controversy surrounding its effects has not stop. Currently there is a wealth of evidence to suggest the benefits but there are some detractors who believe there other reasons such as food and exercise is best.

Key DatesAs early as 1819 was the connection between

wine and health detected ( ‘French Paradox’).

1980- Honolulu Heart study showed

moderate alcohol consumption reduced CHD.

The subject did not re-merged until the early

1990s after the screening of the ‘60minutes’

documentary in the USA on this subject.

1992 -British Medical Journal *reports drinking up to two glasses of wine lowers CHD in women.

Key Dates 2

Doll studied 12 321 British doctors,publishing

in 1994. The lowest risk of death occurred

with one to two drinks per day. CHD deaths

were reduced in all.

Gaziano et al, publishing in 2000, studied

89299 US male physicians. Up to one drink

per day conferred a lower overall mortality.

There was no benefit from drinking more than

two drinks per day.

So what’s all the fuss about ?The ‘fuss’ is about red wine being cardio-

protective against heart disease. Majority

of evidence has come from epidemiological

studies in USA,UK and France.The focus of

the studies has been on the antioxidant

properties of wine’s phenolic compounds and

flavanoids which appear to reduce risk of

atherosclerosis and heart attacks.

The EvidenceAs early as 1992 in the The New England

Journal of Medicine researchers* have

concluded mild to moderate drinking of

alcohol particularly red wine is beneficial for

reducing coronary heart disease. Other

evidence* points to alcohol suppressing

cancer growth, platelet aggregation and

increasing antioxidant activity. The focus

being on red wine and its properties

Chemical compounds in wine The Main ones:

Resveratrol-first studied by E H Siemann

and Leroy Creasy in 1992 at Cornell

University who first described it in wine

(see structure) It is the main phenolic

compound in wine. Results show resveratol could: 1.) Inhibit the oxidation of low density lipoproteins (LDL).

2.) Inhibit platelet aggregation by blocking the production of eicosanoid synthesis.

Other compounds in wine-FlavonoidsMore abundant than reserveratol >100mg/l.There are four major classes:the anthocyanin,the catechins (theflavanols),and oligomers(also called procyanidins).There is anothergroup of called polymers of catechins (tanins )Main facts: 1) Wine flavanoids inhibit platelet aggregation by blocking the oxygenaseenzymes. 2) the catechins are a powerfulantioxidant especially epicatechin (see structure)

Catechins, are a special group of flavanoids are believed to be protective against both coronary heart disease and certain types of cancer. They can also be found in fresh fruit, vegetables and Tea. In terms of potency for antioxidants epicatechin and quercetin (see structure) are the most potent while resveratrol is less potent.

The flavanoids are also thought to improve immune function.

What is the 'French paradox'In essence, the 'French paradox' is the observation that although the French don't eat a particularly healthy diet, they show much reduced rates of coronary heart disease when compared with northern European nations such as the UK and Germany. Why might this so? The most popular explanation has been that the relatively high consumption of alcohol, and in particular red wine, by the French, which in some way acts to protect them from heart disease.

Main points: About red wine and CHDStudies about red wine and heart diseasemainly based on epidemiological studiesdone on Northern Europeans. Red winecontains more flavanoids than red orpurple grape juice because the process ofwine making extracts more from theseeds and skins..

The J-shaped curve ?

ConclusionThe combination of epidemiological,clinical and mechanistic studies strongly suggests that wine phenolics are beneficial nutrients that can reduce CHD mortality and their effects.

These phenolics must absorbed into the blood stream to have any direct effect on coronary diseases.

SummaryHeart Disease may be reduced by taking:

2 glasses red wine or purple grape juice.

Green or black tea can also be taken.

Nearly all researchers have reported that more than two glasses of red wine tends to have a negative effect on heart disease. Some detractors have said that other causes such as exercise, low fat diets,not smoking and treating hypertension as well as taking low-dose aspirin.should be included. as contributing factors

Thank you for watching. Cheers !