Wine and Health

Table of contents

1. Enjoy wine sensibly: drink in moderation 2. Drinking wine responsibly 3. How the human body breaks down alcohol 4. About the healthy substances in wine 5. Drinking wine regularly: the advantages 6. Disadvantages of a regular modest consumption of alcohol 7. No alcohol is sometimes the best for your health 8. Further reading material Colophon

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Drinking wine regularly but moderately is good for your health. Excessive use of alcohol is counterproductive and harms the human body.

1. Enjoy wine sensibly: drink in moderation

A glass of chilled ros on a sunny summer evening. A sparking glass of red wine after a long autumn walk. What an enjoyment wine can be. And what a good and even healthy feeling wine can give. But is wine really good for your health or not? How much is OK? When have you drunk too much? And when is it unwise to drink alcohol? The answers to these questions can be found in this brochure. Drinking too much is bad for your health, there is nothing new in this. But if you drink moderately every day, without peaking, alcohol has positive effects. Drinking regularly but moderately is a good way of life. This brochure includes an overview of the current scientific insights, especially into moderate consumption of wine. Do you want to know more about this? Then you should refer to the studies and other sources mentioned on page 25. Enjoy a good glass of wine by drinking responsibly!

Product Board Wine / Wine Information Centre

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Listen carefully to your own body An average woman can take less alcohol than an average man. Alcohol spreads through the body via the blood and women have a relatively smaller amount of blood because they have more body fat. Therefore the same glass of wine results in a higher alcohol level in the blood in women. Incidentally, the same goes for fat men. In addition to the fat percentage, the height and the body weight also have an influence on the effect of alcohol. A person who is 1.55 m tall gets more alcohol into his blood from a glass of wine than a person who stands 1.90 m. And a person who weighs 60 kg gets more alcohol into his blood than a person whose weight is 97 kilo. Moreover, the liver enzymes which break down the alcohol from the blood do not work equally fast in all persons. The recommendation for a moderate and responsible consumption of alcohol are based on the average consumer, but who is average? Always listen carefully to the signals emitted by your own body. Drinking wine goes well within a healthy way of life if you drink regularly but moderately. But what is drinking responsibly? And also: how do you do that, drinking responsibly? Enjoy sensibly, drink moderately Drinking wine is enjoyable and may also have a positive effect on your health. Drinking moderately means one or two glasses per day at the most for an adult woman, and two or three glasses per day at the most for an adult man. In this way you profit optimally from the positive effects of wine and the negative effects are limited to a minimum. However, there are some exceptions where drinking even the smallest amount is not healthy. You can read more about this in Chapter 7.

2. Drinking wine responsibly

Wine at the table !

A good idea, but also serve some water with it. In that case you quench your thirst with water rather than with wine.

Enjoy wine, moderately!

Woman Man 1 or 2 glasses per day 2 or 3 glasses per day

Drink regularly The positive effects of wine on your health are the greatest at a combination of regular and moderate consumption. It is better to drink one or two glasses every day than to drink irregularly. Thus it is not wise to drink a great deal during the weekend and nothing during the week. Even if you stay in this way under the average of 14 to 21 glasses per week. Agencies such as the Netherlands Nutrition Centre recommend abstaining from alcohol one or two days per week, to avoid developing a dependency.

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How much is a glass?

In scientific studies, recommendations and also this brochure, a glass of wine means 100 ml. This is the so-called standard glass of wine which contains the same amount of alcohol as a standard glass of beer or a standard glass of spirits: 10 grams of alcohol to be exact. The alcohol level in wine, beer and spirits differs, but the average alcohol level per standard glass is the same. wine contains circa 12% alcohol beer contains circa 5% alcohol spirits or strong drinks, such as gin, vodka and liqueurs, contain circa 35% alcohol

The standard glasses for each kind of drink have been adjusted to this percentage, so that every drink contains the same amount of alcohol. Therefore a beer glass is larger than a wine glass and a gin glass is much smaller. In order to properly follow the recommendations for moderate consumption, the best thing to do is drink each from its standard glass or, in the event of wine, maintain 100 ml per glass.

Drinking wine regularly but moderately is the best thing for your health
Live healthily If you want to live a healthy life, drinking wine regularly but moderately is obviously not enough. A genetic disposition can not be influenced, but many other factors can. You should, for example, eat healthy food with sufficient vegetables, fruits and fish and few saturated fats. You must also get enough exercise: at least half an hour per day of active movement, such as going for a walk or riding a bicycle.

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It takes the liver approximately an hour to an hour and a half to break down the alcohol from one glass of wine.
Still, the speed at which the liver breaks down alcohol varies per person. That mainly has to do with the activity of the liver enzymes which in turn depends on genetic factors, among others. For example, there are relatively many Asiatic persons whose liver enzymes break down the alcohol very slowly.

3. How the human body breaks down alcohol

The breaking down of alcohol is a complex bodily process. After you have drunk a glass of wine, the alcohol enters into the bloodstream via the stomach and the intestines. The alcohol reaches the brain and the liver approx 10 minutes later. The liver plays an important part in many metabolic processes. For example, it breaks down the harmful substances in the blood. Liver enzymes also break down alcohol into a harmless substance which is used by the body as a source of energy. On average the human body breaks down seven grams of alcohol per hour. One standard glass of alcoholic drink contains ten grams of alcohol. So it takes the body an hour to an hour and a half to break down this amount of alcohol. If a person drinks more than the liver can cope with, then the excess amount of alcohol stays in the blood. In a manner of speaking, this alcohol is queuing at the liver until the liver is capable of breaking it down. If too much alcohol is used for a long period of time, then the liver gets overloaded and serious illnesses may develop, such as fattening of the liver, fibrosis of the liver and cirrhosis of the liver.

True or not true?

Coffee breaks down alcohol. Not true! The breaking down of alcohol in the body is done by liver enzymes only. This process can not be accelerated by mints, fresh air or coffee!

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Wine contains a large amount of antioxidants Antioxidants are substances which help protect the body cells against free radicals. Free radicals are aggressive molecules which are formed as a by-product by the combustion of food in the body. They also enter into the body by inhalation of polluted air, excessive exposure to sunlight and by viruses and bacteria. The free radicals can damage proteins in cells and enter into reactions with the DNA in body cells. This may result in deregulation of the cell division and in the growth of tumours. The antioxidants which are contained in wine, but also in vegetables and fruits, can render these free radicals harmless. Moreover, wine contains a large number of other bioactive substances. Research into the beneficial effects of these substances on health is still in full swing.

4. About healthy substances in wine

Old scientific studies seemed to indicate that wine is healthier than other alcoholic beverages. There is doubt, however, about whether this conclusion is justified. The wine drinkers in these studies differed not only in their preference for drinks. Most of them lived and ate in a healthy way and took more exercise. The effect of that healthier way of life as a whole and the effects on health of wine in particular sometimes interfered with one another in the interpretation of the study results.

It is especially the alcohol in wine which has a positive effect on health

Recent studies indicate for the time being that it is mainly the substance alcohol which has a positive effect on health. It does not matter whether that alcohol comes from wine, beer or spirits. The amount of antioxidants is an aspect in which wine differs from other alcoholic beverages. Wine, and in particular red wine, contains a relatively large amount of these antioxidants.

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It is not quite clear yet which effect a moderate consumption of alcohol has on blood pressure. Some studies show a slight drop in blood pressure, but other studies, on the other hand, show a slight increase. It is a proven fact, however, that an excessive use of alcohol causes the blood pressure to rise.

Alcohol has a protective effect especially among males over 40 with an increased risk of cardiac and vascular diseases.

5. Drinking wine regularly: the advantages

Drinking wine regularly has a positive effect on the condition of the heart and the blood vessels, the brains and the bones. In addition, it helps prevent old age diabetes and kidney stones and gallstones. This requires an explanation. It reduces the risk of cardiac and vascular diseases In our Western society a disorder of the heart and/or the blood vessels is the number one cause of death. In 2007, one third of the deaths in the Netherlands were the result of cardiac or vascular disease. Examples of cardiac and vascular diseases include heart attacks, strokes and thrombosis. Alcohol appears to reduce the risk of these diseases. People who drink wine regularly but moderately stand a 20% to 30% smaller chance of developing cardiac and vascular diseases. The reason is that a moderate use of alcohol increases the good (HDL) cholesterol in the blood and this good cholesterol evacuates the bad ( LDL) cholesterol. Bad cholesterol may stick to the vascular walls so that the veins get clogged and obstruct or even arrest the blood circulation. And this can lead to a heart attack or a stroke. A moderate consumption of alcohol also has advantages for the anti-coagulation mechanism in the blood. The anti-coagulation mechanism plays an important part in preventing thrombosis, among other diseases. An accurate measurement has been made of the amount of alcohol at which the positive effects on the heart and the vessels are the greatest. For men this is two and a half glasses per day and for women one glass per day. Especially in men over 40 and in persons with an increased risk of cardiac and vascular diseases, alcohol has a protective effect. It reduces the risk of gallstones and kidney stones The positive effect of a moderate consumption of alcohol on the good HDL cholesterol and the bad LDL cholesterol also helps prevent gallstones. This is because gallstones consist for the greater part of cholesterol. Moderate drinkers stand a 20% smaller chance of developing gallstones. A large scale study in the United States indicates that moderate wine drinkers even stand a 50% smaller chance of developing kidney stones. It reduces the risk of diabetes In the Netherlands approximately 600,000 persons suffer from diabetes, and 85% of these have type 2 diabetes. The insulin hormone plays an important part in diabetes. Insulin assures the transport of glucose (sugar) from the blood to other parts of the body. A person is a diabetic if his body does not produce enough insulin or the insulin can not do its work properly. In type 2 diabetes the blood sugar level gets unbalanced quickly. Too high peaks and valleys occur in the blood sugar level because the body is less sensitive to the insulin. This insensitivity is caused mainly by overweight and/ or lack of exercise. Persons who regularly drink a moderate amount of wine or other alcoholic drink stand a 30% (approximately) smaller chance of developing type 2 diabetes. The reason for this is not quite clear yet. There are indications that the body

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continues to be sensitive to insulin by a moderate use of alcohol. An excessive consumption of alcohol has a counterproductive effect. A person who drinks too much runs a greater risk of developing diabetes. It has an effect on the brain Anyone who has drunk an alcoholic drink knows that alcohol has an effect on the brain. A glass of wine has a relaxing effect, calms down a person and can reduce feelings of stress and anxiety. In a sense it is mind-expanding, so that one becomes more open and sometimes also more creative. It also increases a persons selfconfidence so that social contacts are established more smoothly. This is because alcohol has an effect on the stimulating and inhibiting systems in the brain. This pleasant and positive effect works only at a very moderate use. Even after drinking just one to three glasses the brain clearly functions less well and the ability to react decreases. Too much alcohol results in border-crossing, reckless, risky and often obnoxious behaviour. This in turn may lead to disrupted social contacts and physical accidents and, in the longer term, concentration problems and even permanent brain damage.

It may reinforce the bones Bone fractures occur relatively frequently in women after menopause. Because of the changed hormone housekeeping, decalcification of the bones (osteoporosis) occurs to a more or less serious degree. If osteoporosis occurs, the bone density decreases, the bones become less strong and therefore break more easily. Women who drink wine moderately turn out to have stronger bones than women who do not drink (moderately!). The scientists are not quite convinced yet of these outcomes, for there are studies in which the positive effect of a moderate alcohol consumption on the health of the bones has not been found. The provisional conclusion is that drinking alcoholic beverages moderately is not harmful and may protect the condition of the bones. Again, it is certain that the positive effect disappears when too much alcohol is consumed.

Weight in balance
Make sure you have the right weight, also when you drink alcohol regularly and moderately. Take this into account in your daily menu. One glass of wine contains about 82 calories (kcal). Per day an adult woman needs 2000 kcal and an adult man 2500 kcal on average.

Drinking wine moderately helps relax and reduces anxiety. It also increases creativity and self-condence.
This is how the body burns alcohol Just like fat, proteins and carbohydrates from the food, the alcohol in wine supplies energy. The substance alcohol supplies 7 kcal per gram. The conversion and combustion of alcohol is given priority in the body over the combustion of fat, carbohydrates and proteins. The body can not store the energy from alcohol and uses its right away. Energy from other food products which is not used immediately, is stored by the body in the form of fat. An alcoholic aperitif works as an appetiser. This is in fact what its purpose. It makes you hungry, but this does not prove that drinking moderately instigates more eating thereby increasing the risk of overweight. After all, alcohol itself supplies energy which partly satisfies the appetite. Again, striking the right balance is the principal message here.

It reduces the risk of dementia Drinking wine moderately has still another positive effect on the brain. Studies have demonstrated that alcohol may protect against dementia, such as Alzheimers disease. This is a disease in which the memory no longer works or no longer works properly. Persons who regularly drink wine moderately stand a 40% smaller chance of developing dementia. But once again: too much alcohol is not good. At an intake of four or more glasses per day the risk of dementia actually increases.

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Wine and calories

Dry white wine contains fewer calories than dry red wine. Dry wine contains less energy than sweet wine. Dry white: 67 kcal per 100 ml (= standard glass) Dry ros: 66 kcal per 100 ml Dry red: 82 kcal per 100 ml Sweet wine: 96 kcal per 100 ml Sweet, strengthened wine such as port: 150 kcal per 100 ml

6. Disadvantages of a regular and moderate use of alcohol

Generally speaking, a regular moderate consumption of alcohol is good for ones health. But all advantages have their downside, and this saying applies to alcohol as well. Some adverse effects of a moderate use of alcohol are known. An increased risk of breast cancer and cancer in the mouth, throat and oesophagus is the most important of these effects. An increased risk of breast cancer Breast cancer is the most frequently occurring form of cancer among women in the Netherlands. A moderate consumption of alcohol increases the risk of breast cancer in women. The risk that a Dutch woman develops breast cancer before the age of 75 is 8.8%. If one glass of alcoholic drink is used every day, the risk of breast cancer increases by 8%, so that the total risk of developing breast cancer becomes 9.5%. And if more alcohol is drunk, the risk increases accordingly. It is not clear (yet) why alcohol increases the risk of breast cancer. The risk of cancer in the mouth and throat increases A moderate consumption of alcohol also increases the risk of cancer in the mouth cavity, the throat and the oesophagus. Fortunately these forms of cancer which occur are relatively rare. In most cases a combination of alcohol and smoking is involved. If a person drinks moderately but smokes a lot, he or she has a 50% greater chance of cancer of the mouth, throat and oesophagus than a moderate drinker who does not smoke.

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No relationship has been demonstrated between a moderate consumption of alcohol and other forms of cancer. Drinking excessive amounts of alcoholic drinks is simply bad for ones health and may result in an increased risk of cancer.

Alcoholism is a disease with serious physical and social consequences. The bad thing about an addictive substance such as alcohol is that the body gets used to it and needs an ever increasing amount to become satisfied. When alcoholics do not drink, they develop withdrawal symptoms such as sweating, trembling and anxiety attacks. It is difficult to kick an alcohol addiction. And as alcoholism is such a personal thing, there is no standard method to stop drinking. Expert help is usually needed. Exhibit-alcoholics continue to be sensitive, for example because of their character, to the attraction of alcohol, they rarely succeed in limiting themselves to drinking moderately. Therefore it is usually recommended that they do not drink alcohol at all. Do you want to know more about this? Then visit www.alcoholinfo.nl.

Beware of the hangover

Drinking too many alcoholic drinks is bad for your health and for your well-being in general. The hangover is an example of a direct unpleasant and unhealthy consequence of drinking too much. The body clearly indicates that it can not process the alcohol consumed.

Alcoholism: a disease with serious consequences Drinking too much for too long may result in alcoholism and alcohol addiction. But what do too much and too long mean? Too much is more than five or six glasses of alcoholic drink per day and too long is when you do this for a number of years in a row. The causes and the occurrence of alcohol addiction are complex. Character, personality disorders and education play a part. The development of an alcohol addiction seems to depend to an important degree on hereditary factors. One out of three alcoholics has at least one parent who is also an alcoholic. Research is being conducted into the genetic explanation for this. The environment, often in combination with other factors, may stimulate the use of too much alcohol. One may think, for example, of friends who often drink too much and of problems, tension and stress.

Alcoholism is a serious disease in which hereditary factors play a major part

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Alcohol has a retarding and permanent harmful effect on a body which is still growing
No alcohol when you are or want to get pregnant For women who are or want to get pregnant the advice is: do not drink alcohol around the time of conception and during the entire pregnancy. Even the consumption of one glass of alcoholic drink per day increases the risk of complications during the pregnancy. It may also have adverse consequences for the later psychomotoric development of the child. Researchers can nor determine a safe lower limit. Therefore the advice to pregnant women is not to touch alcohol at all. No alcohol when you are breastfeeding Also during the breastfeeding period it is better not to drink alcohol at all. Alcohol finds its way into the mothers milk via the blood. There is still alcohol in the mothers milk until three hours after she has drunk one glass of alcoholic drink. Still feel like a glass of wine occasionally? Then do so immediately after having breastfed the baby. And then wait at least three hours again before you breastfeed your baby again.

7. No alcohol at all is sometimes the best thing for your health

So you should drink regularly but moderately. That is the best for most people, but not for everyone. Some people ought not to drink any alcohol and therefore no wine either, at all. For example when your brain is not fully grown yet or when you are or want to get pregnant. And of course alcohol is irresponsible when your brain has to function optimally and must be alert, such as in traffic, at work and when you are practising a sport. No alcohol under the age of 16 Alcohol has a retarding and harmful effect on the growth of the brain and the body as a whole. Alcohol during the growth period may permanently damage certain parts of the brain. Even a small amount of alcohol is unhealthy when you are still in the growth phase. In addition, the impact of alcohol is greater on a young, not yet full-grown body. This is because young bodies are smaller and lighter than those of adults. Moreover, young people still have fewer liver enzymes which break down the alcohol. Therefore one glass of alcoholic drink has much more effect on a young, not yet full-grown, body.

Sulphites and asthma

Wine naturally contains sulphite and an amount determined by law is allowed to be added. Sulphite improves the storage quality of wine and also of other food products. Normally speaking this amount of sulphite has no effect on your health, unless you are allergic to it. The intake of one milligram can be dangerous in the event of a sulphur allergy combined with certain asthmatic disorders.

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Alcohol slows down the reaction speed.

No alcohol in traffic, not even when riding a bicycle Alcohol and traffic do not belong together. Even after a small amount of alcohol the reaction speed slows down and thus the risk of an accident becomes greater. Even if the alcohol concentration in the blood remains under the legal maximum amount of 0.5 . For people who have had their driving licence for less than 5 years, this limit is 2 . For them, drinking one standard glass may also be a punishable offence. These limit values, incidentally, apply not only to car drivers, but also to drivers of motorbikes, moped and cyclists. To avoid accidents, the advice to everybody who participates in traffic is not to drink alcoholic drinks at all.

8. Do you want to know more?

Eating and wine
If you eat something with the wine, the alcohol is absorbed into the blood slightly more slowly.

No alcohol when your brains have to be 100% Drinking alcoholic drinks has an effect on the reaction speed and is therefore not a clever thing to do when you practise a sport. Not only does your performance decline, but the risk of injuries and accidents becomes greater. Also when studying or working, alcohol only bothers you. No alcohol with some diseases and certain medicaments Some diseases and certain medicaments interfere with or slow down the functioning of the liver. As the liver plays an important part in the breaking down of alcohol, it is not then wise to drink alcohol. Always ask your doctor or your pharmacist for information about the combination of alcohol, the disease in question and the medication.

www.alcoholengezondheid.nl www.alcoholinfo.nl www.alcoholonderde16natuurlijkniet.nl www.genietmaardrinkmetmate.nl www.stiva.nl www.wineinmoderation.eu www.wijninfo.nl www.tno.nl

List of literature Arif AA, Rohrer JE. Patterns of alcohol drinking and its association with obesity. BMC Public Heath 2005 Dec 5;5:126. Bagnardi V e.a. Does drinking pattern modify the effect of alcohol on the risk of coronary heart disease? Evidence from a meta analysis. J Epidemiol Community Health 2008; 62:615:619. Berg KM et al. Association between alcohol consumption and both osteoporotic fracture and bone density. Am J of medicine. 2008; 121:406-418. Borhi L e.a. Urine volume: stone risk factor and preventive measure. Nephron, 1999.

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Carrao G e.a. A Meta-analysis of alcohol consumption and the risk of 15 diseases. Prevfentive medine 2004; 38:613-619. Gezondheidsraad. Risicos van alcoholgebruik bij conceptie, zwangerschap en borstvoeding. Den Haag: Gezondheidsraad 2005; publicatie no. 2004/22. (Health Council. Risks of alcohol consumption ar conception, pregnancy and breastfeeding. the Hague: Health Council 2005; publication no. 2004/22) Gunzerarth L e.a. National Institute on Alcohol Abuse and Alcoholims report on moderate drinking. Alcohol Clin Exp Res 2004; 28(6):829-847. Hendriks HF, van Tol A, Alcohol. Handb (Manual) Exp Pharmacol 2005; (170):339-61. Review. Koppes LLJ e.a. Moderate alcohol consumption lowers the risk of type 2 diabetes. A meta-analysis of prospective observational mstudies. Diabetes Care 2005; 28(3):7 19-25. MacDonald I, editor. Health issues related to alcohol consumption. 2nd ed. Bodmin: Blackwell Science Ltd, 1999. Mukamal KJ e.a. Prospectivre study of alcohol consumption and risk of dementia in older adults. JAMA. 2003;289(11): 1405-1413. Mukamal KJ e.a. Roles of drinking pattern and type of alcohol consumed in coronary heart disease in men. N Eng L Med 2003; 348: 109-18. Orgogozo JM e.a. Wine consumption and dementia in the elderly: a prospective community study in the Bordeaux area. Rev neurologique. 1997; 153(3): 185-192. Reynolds K e.a. Alcohol consumption and risk of stroke: a meta-analysis. JAMA 2003 Feb 5;289(5)579-88. Rimm EB e.a. Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. BMJ. 1999; 319:1523-8. RIVM. Nationaal Kompas Volksgezondheid 2007. (National Public Health Compass 2007). Ruitenberg A e.a. Alcohol consumption and risk of demtia: the Rotterdam Study. Lancet. 2002;359(9303):281-286. Tolstrup J e.a. Prospective study of alcohol drinking patterns and coronary heart disease in women and men. BMJ 2006; 332(7552):124408. Whitfield JB. Alcohol and gene interactions. Clin Chem Lab Med 2005; 43(5):480-7. World Cancer Research Fund (WCRF) / American Institute for Cancer Research. Food, Nutrition and Physical Activity and the Prevention of Cancer: a Global Perspective. Washington DC AICR, 2007.

Colophon

Publisher: Editor and final editor: Design:

Productschap Wijn / Wijninformatiecentrum (Product Board Wine / Wine Information Centre) Productschap Wijn, BS Advies, Ruit&Rijst PIXNFLIX Visual Excitement

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Product Board Wine / Wine Information Centre Stadhoudersplantsoen 12 Postbus 29739 2502 LS Den Haag I www.wijninfo.nl

Product Board Wine T (070) 370 83 47 F (070) 370 84 08 E pw@wijninfo.nl Wine Information Centre T (070) 370 83 26 F (070) 370 84 08 E wic@wijninfo.nl Edition: 2009

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