Over 200 physicians from around the world attended the 3rd International Wine & Heart Health Summit held at the Silverado Country Club & Resort in Napa, California. The Summit was co-sponsored by Desert Heart Foundation and the Wine Spectator.

The two-day symposium brought together an impressive faculty of physicians, scientists and epidemiologists to discuss the health effects of the daily consumption of wine, beer or spirits on improved cardiovascular health.

Tedd M. Goldfinger, DO, FACC Chairman of the International Wine & Heart Health Summit emphasized in his opening remarks that the research delegates from around the globe act as important ambassadors for the promotion of a healthy lifestyle. He reiterated that in light of the emerging science, “It is prudent for physicians to discuss the harmful effects of alcohol with their patients, while at the same time, not discourage a potentially healthy practice of wine in moderation with meals.” In fact, the presentations from many world renowned experts revealed that research often reports more pronounced cardiovascular benefits among wine drinkers. At the same time, however, many investigators increasingly explained that this may be due to wine drinkers’ overall healthier lifestyles.

This article presents some of the key statements made by some of the presenters who concentrated on the subject of wine, alcohol and cardiovascular health.

R. Curtis Ellison, MD from Boston University School of Medicine outlined how wine has been considered the ‘healthiest of beverages’ since ancient times until the 20th century. Through Prohibition in the USA, essentially no research was done on alcohol and health for many decades. In fact, in 1974, the Framingham Heart Study was blocked by the National Institute of Health from publishing findings showing striking reductions in coronary heart disease (CDHD) deaths from moderate drinking. This was triggered by concerns that such information might foster abuse. As the research on moderate wine, beer and spirits consumption and potential coronary heart disease benefits emerged, the scientific, media and policy communities acknowledged the reported lifestyle benefits to the public.

Ellison explained, “The mechanisms of such protection have been extensively studied: they include beneficial effects of alcohol and/ or wine polyphenolic substances on blood lipids, lipid oxidation, coagulation, fibrinolysis, arterial endothelial function, ventricular function, inflammation, and glucose metabolism.” He outlined the recent research developments demonstrating potential benefits for subjects who already have developed CHD by showing fewer recurrent infarcts and repeat percutaneous cardiac interventions, as well as overall lower death rates for moderate drinkers. In addition, Ellison presented an overview on studies that found protection from alcohol on the risk of cognitive decline, on all components of the metabolic syndrome and the possible protection against weight gain. In the closing statement, he emphasized that “For the first time in decades, wine and other alcoholic beverages, in moderation, are now being considered an important part of a ‘healthy lifestyle.” Lending even more scientific support to this trend, Ellison outlined the recent research that has also shown the importance of the pattern of drinking, with the most favorable effects being seen from the daily consumption with meals.

Serge Renaud, PhD from Segalen University in Bordeaux presented an overview of the findings from the Lyon Heart Study. The important findings demonstrate how nutrition and lifestyle habits can lead to better health and increased life expectancy. In fact, according to Renaud the evidence is stronger then ever that a healthy diet that includes wine and specifically red wine is the main protector against coronary heart disease. Specifically, findings from the Lyon Diet Heart Study illustrate the potential: importance of a dietary pattern that emphasizes fruits, vegetables, breads and cereals, and fish, as well as alpha- linolenic acid as found in vegetable oils such as flaxseed and canola oil. Traditionally, the diet also includes moderate amounts of alcohol. Renaud reiterated that “it would be short sighted to not recognize the enormous public health benefit that this diet could confer with adoption by the population-at-large if the findings are confirmed.” He and other experts have long encouraged US public health organizations such as the American Heart Association to take these important findings into account when providing messages to the public.

Arthur Klatsky, MD, Senior Consultant in Cardiology from the Kaiser Permanente Medical Program in Oakland presented findings on beverage choice and coronary heart disease (CHD) risk.

Klatsky explained that in the past decade most relevant reports of beverage choice differences have been cohort or case control studies with data about individuals. He stated, “While not unanimous, these data support the probability that CHD is lower in wine drinkers than in beer and liquor drinkers”. He further added that “several reports from countries with no preponderant beverage choice such as Denmark and the US show that other lifestyle habits such as drinking patterns, socio economic status, diet, and smoking habits are more favorable for wine drinkers.” Klatsky explained that this is a fact often used to challenge a causal hypothesis with respect to observed beverage choice differences in CHD risk and added that it can not be ignored that “numerous reports of non-alcoholic compounds in wine, especially red, with hypothetically beneficial actions against athereo-thrombotic disease offer biological plausibility to additional benefit of wine.”

Most significantly, Klatsky presented data from the world renowned Kaiser Permanente study, outlining that data collected in 1978-1985 among 129,000 persons supplied information about total alcohol intake and frequency of drinking beverage types. Recent studies include all beverage choice data as frequency variable in analyses with results indicating the independent relationships of the beverage types. Data collected in 1997 showed lower risk of CHD hospitalization for both beer and wine frequency than liquor, and a 2003 report robustly showed lower risk related to frequency of wine drinking for total mortality and CHD death. New data about heart failure risk also reveal wine frequency to be associated with reduced risk. Klatsky further added that in none of these studies was there a difference for drinkers of red and white wine. In his closing statements, Klatsky explained, “It is now clear that frequent wine drinkers have lower risks than beer or liquor drinkers. However, it remains unresolved whether this is due to non-alcoholic wine ingredients, drinking pattern or traits associated with wine drinking.”

These findings from the Kaiser Permanente study have also been echoed through ongoing results from the Copenhagen Centre for prospective Population Studies such as the Copenhagen City Heart Study. Morton Gronbaek, MD, PhD from the Danish National Institute of Public Health, spoke on the subject of alcohol and cancer and specifically breast cancer, colon and rectal cancer which are of increasing concern in populations around the globe. He presented data on alcohol intake, drinking patterns and risk of postmenopausal breast cancer “showing a monotonic increase in the risk of breast cancer among postmenopausal women with increasing average daily intake of alcohol, and this relationship with alcohol intake did not depend on drinking frequency.” Furthermore, Gronbaek addressed the relations between amount and type of alcohol and colon and rectal cancer. He explained that their study provides evidence of a causal relationship between alcohol and rectal cancer. However, he outlined the exact data demonstrating that “The carcinogenic effect of alcohol on rectal cancer appears to be reduced when wine is included in alcohol intake.” According to Gronbaek and his colleagues, “This suggests an anticarcinogenic effect of wine, consistent with the findings of experimental studies.”

Francois Booyse, MD from the University of Alabama at Birmingham provided an overview of his ongoing research addressing the molecular basis for the health benefits of wine. He and his team of experts have found that wine components—alcohol and individual principal polyphenols—can exert a diverse array of biological effects on systemic circulatory components and myocardial function. Specifically, his team has conducted ongoing studies with cell culture/ animal models combined with state-of-the art methods such as microarray gene analysis that are used to delineate the molecular basis and mechanisms by which individual wine components activate endothelial cells tag the cellular, molecular and gene levels to increase and sustain their clot dissolving potential. Booyse explained, “The combined ability of wine components to simultaneously increase systemic fibrinolysis, in conjunction with the described suppression of the coagulation system and platelet function, will be expected to provide substantial cardio protection by reducing the overall risk for early initiation of thrombosis and atherogenesis, as well as the later CAD-related atherothrombotic consequences of myocardial infarction, stroke and CAD-related mortality.”

This cutting-edge research will be of major significance over the years to come as it is a fundamental cornerstone for lending more evidence to the potential health advantages of moderate drinking. Last year, AIM developed a major website section on this ongoing research and you can learn more about it by visiting www. aim-digest.com

There were several other presentations by media, industry and other experts which provided other interesting aspects on wines from around the world. The last discussion featuring the ‘Physicians in Wine Panel- A Blend of Medical Practice & Wine Culture’ underscored the importance of the ongoing research findings on moderate wine, alcohol consumption and health. Overall, it was emphasized that messages on the moderate and responsible enjoyment of wine and alcohol should be maintained as an important educational component.

Towards this end, Tedd Goldfinger outlined how the Desert Heart Foundation launched The Renaud Society. He explained how the Society has been named for the ‘iconic pioneer in the field of wine and health’ and hopes to expand its ‘network of physicians interested in the pleasures of wine and a healthy way of life’. The Renaud Society will offer a regular newsletter, annual special events, as well as trips and tours to wine regions around the world. To learn more about the different activities of the Society, please write to membership@renaudsociety.com .