It is well-known that wine is a good dietary source of flavonoids, those critical nutrients from fruits and vegetables, but how this translates into wine’s role in a healthy diet is another question. Newly reported findings from two long term studies have confirmed that wine can actually be an important daily nutrient. This is welcome news because wine’s impact on health has been subject to renewed controversy of late. One reason for this is the challenges in proving the case with large enough prospective studies reflecting real-world wine consumption. There are several short-term trials on what happens to biomarkers of health in abstainers who begin drinking a defined amount of wine, and they show positive results. (1) The opposite, looking at what happens to drinkers who quit, is also valuable (see last post re: “sick quitters.”) But if you want to determine long-term outcomes, you need a different strategy. Fortunately, there are studies that have been underway for decades that have just the sort of intel we need, and this new evidence lands squarely in the plus column for wine.
A massive project called the Nurses Health Study has been prospectively tracking its participants (mostly women) since 1976, and the Health Professionals Follow-up Study (mostly men) has been ongoing since 1986, with nearly 200,000 subjects between the two. What is of interest for our purposes here at Age Gets Better with Wine is the opportunity this provides to look at how changes in drinking behavior, diet, and other modifiable risk factors affect health and longevity over many years. The research group overseeing the project, which includes Harvard professor of epidemiology Walter Willett, recently published an update using a tool they dubbed the flavodiet score. (2) The upshot? If you want to live longer and healthier, you need to boost your intake of red wine, peppers, and blueberries; an increase of 3.5 servings per week of any of these yielded a 4-5% drop in mortality. A similar benefit was seen for tea, though less pronounced.
Wine is a food
The flavodiet score derives from a composite tally of flavonoids including antioxidants such as resveratrol, quercetin, anthocyanins, and many others. A strength of this approach is the potential to capture synergies between wine and other flavonoid-rich foods as part of a healthy way of living. Wine as a food? Of course. As we have said before, wine as a part of a meal is where the benefits align.
These results also help to set a new tone in the discussion of wine and health. For a long time, articles in the medical literature in which a health benefit to wine was found would conclude with a paternalistic statement along the lines of “While we found a clear association between wine and better health, we don’t recommend that nondrinkers start drinking.” (3,4) Then why publish the findings, why even do the study? If we are to put this information to good use, the question of what happens when these midcourse corrections based on lifestyle and dietary occur is important. People do change their habits, sometimes out of concern for health, sometimes for other reasons. If the evidence says that adding a glass of wine with dinner is healthful, it deserves consideration.
At the same time, good biomedical research always acknowledges the weaknesses of the study methods and relevant disclaimers, and these authors do mention the potential for reverse causation and the need for further studies. To their credit, they close with the conclusion that “increasing intakes of specific flavonoid-rich foods, namely tea, blueberries, red wine and peppers, even in middle age, may reduce mortality risk.” That’s about as close as we are going to get to a medical recommendation to drink wine. Perhaps studies like this one, placing wine in the context of other dietary choices, will make this advice easier to swallow for those who remain unpersuaded. In the meantime, I’m planning on reserving “flavodiet score” as my rapper stage name.
- Lombardo M, Feraco A, Camajani E, Caprio M, Armani A. Health Effects of Red Wine Consumption: A Narrative Review of an Issue That Still Deserves Debate. Nutrients. 2023 Apr 16;15(8):1921. doi: 10.3390/nu15081921. PMID: 37111141; PMCID: PMC10146095.
- Bondonno NP, Liu YL, Zheng Y, Ivey K, Willett WC, Stampfer MJ, Rimm EB, Cassidy A. Change in habitual intakes of flavonoid-rich foods and mortality in US males and females. BMC Med. 2023 May 12;21(1):181. doi: 10.1186/s12916-023-02873-z. PMID: 37173745; PMCID: PMC10182674.
- “The beneficial effects of low and moderate doses of alcohol on the occurrence of cardiovascular diseases have been shown in many population studies and meta-analyses in which the effect of U-shaped or J-shaped curves relating alcohol intake to cardiovascular mortality was observed, especially in ischemic heart disease. However, due to the fact that alcohol consumption is associated with many health hazards, it is not recommended to consume it as a preventive action of cardiovascular diseases.” – Chudzińska M, Wołowiec Ł, Banach J, Rogowicz D, Grześk G. Alcohol and Cardiovascular Diseases-Do the Consumption Pattern and Dose Make the Difference? J Cardiovasc Dev Dis. 2022 Sep 22;9(10):317. doi: 10.3390/jcdd9100317. PMID: 36286269; PMCID: PMC9603956.
- “… daily low- to moderate-dose alcohol intake, ideally red wine before or during the evening meal, is associated with the strongest reduction in adverse cardiovascular outcomes. Health care professionals should not recommend alcohol to nondrinkers …” – O’Keefe JH, Bhatti SK, Bajwa A, DiNicolantonio JJ, Lavie CJ. Alcohol and cardiovascular health: the dose makes the poison…or the remedy. Mayo Clin Proc. 2014 Mar;89(3):382-93. doi: 10.1016/j.mayocp.2013.11.005. PMID: 24582196.
Age Gets Better With Wine 