Top medical authorities are cautioning the nation's health care professionals to downplay the popular but unproven supposition that drinking red wine can help ward off heart attacks.
An American Heart Association science advisory published in Circulation: Journal of the American Heart Association urges physicians to emphasize heart-protective steps that may be less appealing than sipping a daily glass or two of wine, but which are firmly supported by scientific research.
"We want to make clear that there are other risk-reduction options that are well-documented and free of the potential hazards associated with alcohol consumption," says Ira J. Goldberg, M.D., a member of the association's Nutrition Committee and professor of medicine at Columbia University in New York City.
"Our recommendations in this advisory are directed primarily at members of the health care professions," says Goldberg. "Our advice: If you want to reduce your risk of heart disease, talk to your doctor about lowering your cholesterol and blood pressure, controlling your weight, getting enough exercise and following a healthy diet. There is no scientific proof that drinking wine or any other alcoholic beverage can replace these effective conventional measures."
The hypothesis that drinking wine - particularly red wine - helps counteract the harmful effects of dietary cholesterol and saturated fat grew out of population surveys showing lower rates of heart disease despite high-fat diets in some parts of Europe where wine is consumed regularly. This so-called "French paradox" has created wide interest in the United States.
However, this hypothesis deserves further investigation, says Goldberg. "The pattern of consumption of alcoholic beverages may be a marker for other lifestyle factors related to heart disease risk. A number of dietary factors, such as eating fresh fruits, vegetables and fish, and reduced intake of milk products differ between American and European populations and are associated with reduced heart disease risk."
The advisory notes that more than 60 studies have shown that moderate alcohol consumption can increase blood levels of "good" high-density lipoprotein (HDL) cholesterol. One to two alcoholic drinks per day may increase HDL by about 12 percent on average.
"This increase is similar to that seen with exercise programs and medications," Goldberg says. "Niacin therapy is effective in raising HDL even higher, for about a 20 percent increase."
Another theory attributes the supposed benefits of red wine to antioxidants. Yet there is still no proof that consuming antioxidants actually lowers the risk of heart and artery disease, Goldberg adds. In fact, a number of recent studies have failed to substantiate any protective qualities in antioxidants such as vitamin E.
"Besides, the same antioxidants found in red wine can also be obtained from unfermented grape juice, and without the hazards related to alcohol," he adds. Fresh fruits and vegetables should also have a similar antioxidant action as red wine.
The proposed benefits of alcohol consumption must be weighed against the adverse effects, writes the advisory team. Studies show, for instance, that consuming more than one or two drinks per day can raise blood pressure in some individuals. Other adverse effects of long-term alcohol consumption are fetal alcohol syndrome, cardiomyopathy, stroke, irregular heartbeat and sudden death.
"Alcohol is an addictive substance with many downsides," says Goldberg. "Even moderate drinking can adversely affect some individuals."
Without a large-scale trial that focuses specifically on wine intake and its association with heart disease risk, the American Heart Association urges individuals to talk to their physicians about the benefits and risks of drinking alcoholic beverages.
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Issuing the advisory along with the association's Nutrition Committee, which is part of the newly created Nutrition, Physical Activity and Metabolism Council of the American Heart Association, are the organization's Council on Epidemiology and Prevention and the Council on Cardiovascular Nursing.
Other authors of the advisory include Lori Mosca, M.D., Ph.D., M.P.H.; Mariann R. Piano, R.N., Ph.D.; and Edward A. Fisher, M.D., Ph.D.