Since the early 90’s, researchers from the United States and different parts of the world have published preliminary data associating polyphenols, flavonoids and phytochemicals with certain properties that may contribute to improved health outcomes. However, most of these studies have taken place in vitro (in test tubes) or in animals, and it is still not certain that these biological effects translate to humans. At the same time, most of this research has provided some evidence that these phenols reduce the rate of harmful cell oxidation and favorably affect other processes that if unchanged could lead to atherosclerosis, heart disease and cancer. Most recently, some of the cutting edge research is being undertaken by a team of investigators at the University of Alabama at Birmingham (UAB) where new investigative approaches have identified additional mechanisms by which these constituents in the beverages may reduce the risk of certain diseases and especially CHD.

This comprehensive work on beverage-related compounds (i.e. alcohol and polyphenols) and their potential disease-preventing effects is being carried out by a team of world-renowned experts under the leadership of Dr. Francois M. Booyse, who is a Professor of Medicine and Director of the Molecular Cardiology Research Program at UAB. They have established their laboratory as one of the leading research groups to investigate the basic mechanisms that are involved in the cardio-protective effects of moderate alcohol consumption. Their ongoing scientific research has revealed that cardio-protective results may derive not only from individual polyphenolic components, per se, but also from additive or perhaps synergistic effects of alcohol and polyphenol components on a variety of vascular, cellular and haemostatic functions.

Over the past few years Dr. Booyse’s research team has developed new methods and approaches, using live cultured human endothelial cells and animal models, to study alcohol and polyphenol-induced changes on haemostatic function. In particular, they have focused on increased fibrinolysis (clot lysis), which may underlie and partly contribute to the reduced risk for thrombosis and cardiovascular disease and, therefore, may afford cardio-protection. Specifically, their published research has shown that both alcohol and polyphenols are potent stimulators of increased and sustained endothelial cell fibrinolysis, thus promoting clot lysis and reducing thrombotic risk. The investigators, however, have explained that while polyphenols have been established as potent antioxidants, their duration of action is relatively short-lived. Consequently, Dr. Booyse’s research group has shifted their focus from the antioxidant properties of these compounds to their potential ability to alter critical gene expression and function, in particular fibrinolysis that can be sustained for 24 hours or longer. Specifically, they have examined the effects of alcohol and polyphenols on the expression of tissue-type plasminogen activator (t-PA), which is an agent that is administered after a myocardial infarction (heart attack) to facilitate clot lysis. Their results have shown that both alcohol and polyphenols can alter the expression of a number of different fibrinolytic protein genes, resulting in increased fibrinolysis. Their results have been published in a series of papers in the Journal, Alcoholism, Clinical and Experimental Research.

Several other important studies have been published by this research team from UAB, including a comprehensive review article released late last year in Thrombosis and Haemostasis where Dr Booyse and colleagues concluded, "In combination, these multiple alcohol- or red wine component-induced changes will be expected to provide significant overall cardiovascular disease protection by decreasing the early initiation of thrombosis, atherogenesis and the atherothrombotic consequences of myocardial infarction, thus reducing the eventual overall risk for CHD-related mortality."

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) as well as the Alcoholic Beverage Medical Research Foundation (ABMRF) and the Wine Institute have supported the work by Dr. Booyse and his colleagues. Their research continues to identify and define the molecular regulatory mechanisms by which alcohol and polyphenols can increase fibrinolysis, in vitro, in cultured human endothelial cells and, in vivo, in animal models, to provide a well-defined molecular basis by which increased fibrinolysis can contribute, in part, to the overall cardiovascular disease protective mechanisms attributed to moderate alcohol or red wine consumption.

This rapidly emerging new area of cardio-protection research through new and continuing research efforts from groups worldwide should provide significant new insights into our understanding of the multiple divergent mechanisms that underlie and contribute to cardiovascular disease protection. These findings may have long-term public health policy implications as public health groups such as the American Heart Association and others have acknowledged these preliminary research discoveries as well. In the meantime, however, members of the research and policy communities around the world are calling for more comprehensive and focused scientific investigations in this area. Future initiatives also need to address the many unanswered questions related to the nutritional and lifestyle effects of polyphenols so that the public can be given the most sensible advice with respect to the responsible consumption of alcohol as part of a well balanced diet.

Oldways Preservation & Exchange Trust Sponsors Major Phytonutrient / Antioxidant Initiative

Over the last couple of years, Oldways Preservation & Exchange Trust has worked with scientific experts from Harvard School of Public Health, the University of Alabama, and University of California at Davis, Tufts University and many others on a major Phytonutrient Initiative. This program is intended to bring more visibility to the nutritional importance of dietary phenolics in foods and beverages including those found in alcoholic beverages such as wine. The concept is communicated through a "Good Health Puzzle" and alcohol beverages and their phenolic compounds fall under the general healthy lifestyle choice category. This acknowledgement is based on a comprehensive scientific review that was undertaken as part of two major conference programs in April of 2000 and October 2001. In the specialized education efforts Oldways also refers to" PAX rich foods" which stands for naturally occurring phytonutrients and antioxidants from plant-based foods and beverages which scientific research studies have associated with major risk reductions for certain common diseases.

Oldways Preservation & Exchange Trust is a non-profit educational organization based in Boston that promotes specific alternatives to the unhealthy foods that often characterize eating patterns in industrialized countries. These programs are based on the synthesis of current scientific evidence and are part of a major education initiative under which messages on the nutritional importance of phenolic compounds are brought to consumers and public health leaders. As part of the comprehensive healthy eating promotions, Oldways has also acknowledged the option of moderate wine, beer, sake and spirits consumption as a possible staple of several healthy traditional eating concepts in accordance with the regionally dependent cultural norms. Over the last decade, Oldways has released eating concepts and dietary pyramids based on Asian, Latin American, Mediterranean and Vegetarian diets that have been scientifically proven to promote good health over the long term. The newest scientific evidence behind the most well known Mediterranean Diet Pyramid will be revisited at an upcoming conference with the Harvard School of Public Health in Boston in January of 2003. Conference program sessions will feature the latest evidence on alcohol and health as well as dietary phenolics, which could contribute to new evidence based education and public health messages.