consumption leads to decreased LDL (bad cholesterol) oxidation, increased HDL (good cholesterol) concentrations, and decreased platelet aggregation, resulting in a better blood lipid profile and less plaque formation (5). Taken together, alcohol itself improves vascular function, resulting in reduced risk of developing CHD.

So, why does wine especially red wine have additional health benefits as opposed to beer or spirits? Studies using dealcolized red wine showed that some of the cardioprotective characteristics of red wine are independent of the alcohol. Along with alcohol, red and white wine is composed of many other chemicals from the grape, including polyphenols that act as antioxidants. However, red wine typically has more antioxidant polyphenols than white wine. Plant polyphenols are responsible for the color of the grape. Red wine has a variety of polyphenols including resveratrol (stilbene) and flavinoids. The antioxidant function of red wine flavinoids decreases LDL (bad cholesterol) oxidation (7). Because oxidized LDL reduces blood vessel relaxation, it is a crucial step leading to heart disease. Along with reducing oxidized LDL concentrations, polyphenols may also reduce cholesterol absorption the gut, leading to decreased serum cholesterol concentrations. Finally, grape polyphenols decrease plasma triglyceride concentrations by 39% (8). All of these changes may result in suppression of atherosclerosis, thus reduced risk of developing CHD.

What is moderate and heavy consumption of alcohol? Moderate consumption of alcoholic beverages (1-2 drinks/day) 3 to 4 days per week results in a 30% reduction in risk of developing CHD and a 20% reduction in the risk of developing ischemic stroke. Each drink consists of 1.5 ounces of liquor, 5 ounces of wine, or 12 ounces of beer. However, heavy drinking as well as binge or weekend drinking (5+ drinks for women and 9+ drinks for men) are not associated with any cardioprotective effects. In fact, heavy and binge drinkers had a higher risk of developing CHD as compared to abstainers.

Do only healthy individuals benefit from moderate alcohol consumption? Healthy individuals along with patients with a history of heart attack or diabetes all may benefit from moderate drinking. Men with a history of ischemic heart disease had an increase in blood vessel size after ingestion of both red and white wine (9). Furthermore, in a model of insulin resistance, insulin resistant rats benefited from the consumption of alcohol, red wine polyphenols, or both (10). In this model of insulin resistance, rats are fed a high fructose diet that leads to metabolic syndrome followed by glucose intolerance, visceral obesity, hypertension, insulin resistance, and dyslipidemia. Drinking alcohol or red wine polyphenols led to increased insulin sensitivity, in turn resulting in lower blood glucose and normal blood pressure. Rats that consumed alcohol alone had decreased insulin resistance.

This article addresses the heart healthy benefits of moderate alcohol consumption. Alcohol consumption only for the purpose of cardioprotection is not advised, and

people who abstain from drinking alcohol should not start drinking alcohol for the health benefits. Furthermore, increased consumption of alcoholic beverages does not lead to increased protection. In fact, as previously mentioned, heavy or binge drinking leads to increased risk of developing CHD.

The Plateau-Proof Diet (http://www.plateauproofdiet.com) considers the caloric contribution of beverages as well as foods. As with anything you consume while participating in The Plateau-Proof Diet (http://www.plateauproofdiet.com), consult the CP and FP tables before consumption of any beverage containing alcohol or not.

1. Rehm J, Sempos CT, Trevisan M 2003 Alcohol and cardiovascular disease--more than one paradox to consider. Average volume of alcohol consumption, patterns of drinking and risk of coronary heart disease--a review. J Cardiovasc Risk 10:15-20

2. Renaud S, de Lorgeril M 1992 Wine, alcohol, platelets, and the French paradox for coronary heart disease. Lancet 339:1523-6

3. Schnohr P, Jensen JS, Scharling H, Nordestgaard BG 2002 Coronary heart disease risk factors ranked by importance for the individual and community. A 21 year follow-up of 12 000 men and women from The Copenhagen City Heart Study. Eur Heart J 23:620-6

4. Szmitko PE, Verma S 2005 Cardiology patient pages. Red wine and your heart. Circulation 111:e10-1

5. Augustin LS, Gallus S, Tavani A, Bosetti C, Negri E, La Vecchia C 2004 Alcohol consumption and acute myocardial infarction: a benefit of alcohol consumed with meals? Epidemiology 15:767-9

6. Corder R, Douthwaite JA, Lees DM, et al. 2001 Endothelin-1 synthesis reduced by red wine. Nature 414:863-4

7. Deckert V, Desrumaux C, Athias A, et al. 2002 Prevention of LDL alpha-tocopherol consumption, cholesterol oxidation, and vascular endothelium dysfunction by polyphenolic compounds from red wine. Atherosclerosis 165:41-50

8. Zern TL, Fernandez ML 2005 Cardioprotective effects of dietary polyphenols. J Nutr 135:2291-4 9. Whelan AP, Sutherland WH, McCormick MP, Yeoman DJ, de Jong SA, Williams MJ 2004 Effects of white and red wine on endothelial function in subjects with coronary artery disease. Intern Med J 34:224-8

10. Al-Awwadi NA, Bornet A, Azay J, et al. 2004 Red wine polyphenols alone or in association with ethanol prevent hypertension, cardiac hypertrophy, and production of reactive oxygen species in the insulin-resistant fructose-fed rat. J Agric Food Chem 52:5593-7

About the author:

Dr. Marjet Heitzer is a biomedical scientist specialized in cancer and endocrine research. She is the founding editor of 'Trimming America', the free journal of 'The Plateau-proof Diet Foundation'. She is a strong proponent of reversing obesity and some of its comorbidities, including type II diabetes and hypertension, with a lifestyle change that has healthy dieting at its core.

Http://www.plateauproofdiet.com