Together with its pleasurable and uplifting accomplishments the potential beneficial effects of red wine on health have long been recognized, especially when consumed in moderation. Hypocrites (377 AD) suggested the application of wine as a tranquilizer, pain remedy and also used its fluid relieving properties. In addition, Caesar (130 BC) recommended tannin-rich red wine with meals in order to protect his soldiers from infections arising from the gut and to protect them from pain in the heart. Furthermore, Hildeberg of Bingen (Germany, 1098) applied a special wine recipe to ‘treat’ heart disease. The problems with alcoholism were also recognized early when documented by Pharaoh Rameses II, who complained of poor work rate and loss of skill in those Egyptians imbibing too heavily.What is the evidence for protection?The French ParadoxThe French Paradox concerns the phenomenon that heart attacks are closely correlated with the intake of dairy fat. The French (and the Swiss) however, consume as much if not more dairy fat (especially in cheese) than other populations and yet their risk of heart disease is much lower. Research suggests that this effect may be as a result of consuming red wine. Other research suggests that this evidence could be biased by the lifestyle influence that might occur in those who consume red wine, often being more expensive than other beverages. A more affluent lifestyle allows for better health care access and a better awareness of ones overall health. And the Swedes…Interestingly, in Sweden an affluent country, male red wine drinkers (2-3 glasses per day) have a lower risk of both heart attacks and strokes, especially in those who digest alcohol slowly. Such slow digestion or metabolism of red wine is genetically determined and is directly related to the type of alcohol enzyme (alcohol dehydrogenase) present in the liver. In women unfortunately, such an enzyme is not as proficient and thus women have a less protective effect from red wine and have a greater chance of developing liver cirrhosis from alcohol than do men.The science of red wine and its protective propertiesElevated levels of lipids or fatty solvents (cholesterol) produced by the liver and found in the bloodstream have a profound influence on the risk of heart attacks. People with high cholesterol (especially the low-density type or LDL) commonly develop heart disease. Red wine reduces the level of LDL and improves the level of HDL (the high-density type) which is protective against heart attacks. Furthermore, phenolic substances found in red wine viz. resveratrol and quercetin, slightly inhibit the function of platelets, which does not increase the risk of bleeding, but actually decreases the risk of blood clotting in the blood vessels of the heart.The lining of blood vessels, especially arteries, are particularly sensitive to breakdown products of metabolism called oxygen radicals. These are produced during stress and when produced they attach to lipids, LDL specifically, and cause these lipids to deposit on the blood vessel wall. Eventually this narrows the blood vessel and if this vessel is in the heart or brain, then such narrowing is a risk for heart attack and stroke. Now when red Bordeaux is consumed, there is a significant increase in the capacity of the body to get rid of these radicals, thus reducing the chance of the blood vessels narrowing and the risk of heart attacks and stroke. Furthermore ‘Én barrique’ harvested wines, like Barolo or Chateauneuf du Pape, inhibit the growth of abnormal cells on the wall of blood vessels that have been damaged by lipids. Such abnormal cell growth adds to the narrowing of blood vessels and thus the beneficial effects of these delicious wines protect blood vessels further. To add to these effects, Flavonoids, which accumulate in red wine during fermentation, have similar properties and also promote the release of dilating substances. And so…There is scientific evidence that compounds specific for red wine reduce the risk of heart attacks and strokes. They have to be well balanced against the risks of excessive alcohol consumption, such as cirrhosis and cancer, which are particularly important in women. Red wine does not protect against the risks of smoking but will add to the benefits of a healthy diet and regular exercise. Two to 3 glasses on a daily basis are recommended for optimal satisfaction and maximum benefit.By: Dr Geoffrey Bihl, Winelands Kidney and Dialysis Centre, Somerset WestEmail: gkbihl@icon.co.za