Red Wine and Heart HealthA Position Paper for Middle-Aged AmericansBy Jennifer QuirkSpring, 2005A Paper for Consumer Reports on Health MagazineFrench researchers Serge Renaud and Michel deLorgeril created quite a worldwide media stir in 1992 when they first published their results of a scientific study that quickly became known as "The French Paradox". In this study the researchers concluded that, although a high-fat diet usually correlates with a high mortality rate from cardiovascular disease, this particular statistic does not generally hold true for the French (Fig. 1). Renaud and deLorgeril went on to suggest that one possible explanation for this surprising finding involves the French consumption of wine. Specifically, the French typically consume large quantities of wine (red wine, in particular) throughout their lifetimes, and the researchers claimed that ingredients in this wine help protect the Frenchfrom the cardiovascular disease risks generally associated with high-fat diets (Renaud and deLorgeril). The possibility that the consumption of red wine may indeed help explain "The French Paradox" has prompted numerous scientific studies to evaluate the effectiveness of red wine in reducing the risk of cardiovascular disease.Dr. Robert Waschler's American research has provided further support for the French researchers' initial findings. His statistics indicate, for example, that the per capitaconsumption of wine in France is sixty liters (about fifteen gallons) per person per year, whereas American adults average only about seven liters per person per year. Waschler's statistics also point out that the French, in spite of a typical diet high in fat, suffer forty percent fewer heart attacks per year than we Americans do (Waschler). Cardiovascular disease is indeed the leading cause of death in the United States for both men and women of all races and ethnic groups. Current statistics indicate that approximately one million (forty-two percent) deaths result each year from some form of cardiovascular disease in this country. Cardiovascular disease is also the leading cause ofdeath for all Americans over the age of thirty-five. One out of every four Americans over2Fig. 1the age of sixty suffers daily from complications of cardiovascular disease (American Heart Association).We Americans, of course, have serious concerns about this high incidence of cardiovascular disease in the United States. It is imperative, therefore, that we all educateourselves about current research and any specific findings that may point to ways we can reduce our risk factors for this deadly disease. Recently, there has been positive news in the various media regarding possible cardiovascular health benefits of moderate red wine consumption. Current research studies provide substantial evidence that there are chemical components present in red wine that specifically reduce the incidence of cardiovascular disease. In order to effectively evaluate the results of these studies, however, it is necessary to first understand the physiology of the development of cardiovascular diseaseand how it may relate to possible benefits from the consumption of red wine. The leadingcause of cardiovascular disease is atherosclerosis, a clogging and narrowing of arteries within the body. Research indicates that this condition is caused by plaque deposits that build up within artery walls as a result of the oxidation of LDL (low-density lipoprotein) cholesterol. Atherosclerosis will eventually block the flow of blood through arteries, resulting in a heart attack or stroke if coronary (heart) or brain arteries are affected (American Heart Association). Current research indicates that the oxidation of LDL (bad) cholesterol within the body is a mechanism that initiates the development of atherosclerosis. Oxidation is a chemical process that occurs anytime a substance comes into contact and combines with oxygen. Oxidation is a natural process that takes place continually within our bodies. As3LDL cholesterol circulates through the arteries and contacts oxygen in the bloodstream, the resulting chemical reaction (oxidation) causes a breakdown of the LDL cholesterol and the formation of unstable, toxic waste products called free radicals (Frankel et al). These unbalanced byproducts of the oxidation of LDL cholesterol are dangerous chemical compounds that attempt to neutralize themselves by combining with other nearby molecules. As a result, they attach to interior artery walls, then penetrate and damage them. This process stimulates the cells that line the interior of smooth artery walls, called endothelial cells, to increase their production of a protein whose role is to fight damage and repair the interior artery walls. The complex interaction between the waste products produced by the oxidation of LDL cholesterol and the release of this excess endothelial protein eventually leads to the buildup of dangerous plaque deposits and atherosclerosis (Frankel et al). If we can take steps to inhibit the oxidation of LDL cholesterol in our bloodstream, then we may be able to stop this dangerous chain of events that results in atherosclerosis. Recent studies indicate that chemical compounds abundant in red wine called polyphenols are powerful antioxidants that can inhibit this oxidation of LDL cholesterol in the blood. The results of two independent human studies led by researchers Frankel and Fuhrman both provide strong evidence that red wine polyphenols can aid in the protection against the oxidation of LDL cholesterol and thereby inhibit the initiation of atherosclerosis. For example, Frankel's research group performed a four-week study of comparisons between LDL cholesterol oxidation rates in blood samples taken from twenty-four healthy human male subjects after daily consumption of high-fat meals with either red wine, white wine, or red wine polyphenols in which the researchers had 4removed the ethanol. They found that red wine consumption reduced LDL cholesterol oxidation rates by forty-six percent, the red wine polyphenols by thirty-eight percent, andthe white wine by only six percent as compared to the control group that received a placebo (Fig. 2) (Frankel et al). The results of their study provide significant support for the claim that specific components of red wine are highly effective antioxidants that can help reduce the rate of LDL cholesterol oxidation in the human bloodstream. Fuhrman's