Wine and Health

178362592Should you quaff red wine and consume other sources of resveratrol, one of the compounds that's purported to impart health benefits found in this beverage as well as chocolate, berries, grapes and some roots?  Not according to a study Rick and I discuss on PodMed this week, and as reported in JAMA Internal Medicine by our colleague Richard Semba.  Here's what they did: almost 800 residents of the Chianti region of Italy 65 years and older were enrolled in this study, called Invecchiare in Chianti (InCHIANTI) Study (“Aging in the Chianti Region”).  Got to love the Italian! Roughly equal numbers of men and women were enrolled.

Study participants were followed for 9 years, during which time just over 34% of them died. Urinary metabolites of resveratrol were measured at baseline from 24 hour urine samples. Blood tests for inflammatory markers, glucose, and cholesterol and triglycerides were performed. Data on alcohol consumption, smoking status, and physical activity were also collected by self-report. Nutritional supplements were used by less than 1% of the study population.

The dataset was divided into quartiles based on resveratrol metabolites.  Interestingly, the highest quartile also had the greatest number of men, current smokers, and those who both consumed more alcohol and exercised more, and had the least degree of cognitive impairment as assessed with the Mini-Mental State Examination (MMSE).  Those in the lowest quartile experienced more diabetes and coronary artery disease.

Based on the previous findings, it might seem predictable that other factors would also vary according, but as is stated in the study, "There were no significant differences across the quartiles of total urinary resveratrol metabolite concentrations by age, education, BMI, CRP, IL-6, IL-1β, TNF, mean arterial blood pressure, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, or by prevalence of hypertension, heart failure, peripheral artery disease, stroke, cancer, and chronic kidney disease."  Finally, regarding the hard endpoint of death: "Total urinary resveratrol metabolites concentration was not significantly associated with mortality in models adjusting for age, sex, BMI, serum levels of lipids, chronic diseases, and other variables."  Additional analyses and adjustments were made and the lack of any positive association with a reduced death risk persisted.

This certainly is disappointing for those of us who've bolstered our consumption of red wine with the comforting supposition that it's good for us! Yet as both the author of the study and Rick intone, we should simply drink good wine, and not worry about whether it will prolong life since it clearly helps in enjoying life more.  Additionally, we do know that modest alcohol consumption, a glass for women and a couple of glasses for men each day, does reduce cardiovascular events.  What about supplementation with higher doses of resveratrol?  This study can provide no data on that practice since these were dietary levels presumably achieved with wine consumption, but based on the lack of any hint of a benefit in this study, sure seems like this is one more supplement for the slag heap.

Other topics this week include complications of male circumcision with age in JAMA Pediatrics, football, concussion and change in the volume of the hippocampus in JAMA, and a novel treatment for metastatic cancer in Science.  Until next week, y'all live well.

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