The Intersecting Sciences of Enology and Pathology

Where to Begin?

Based on archaeological evidence, the production of wine is as old as human civilization. It was an important--even essential--factor in the development of agriculture and the transition of humans from hunter-gatherers to settled groups of farmers. This potent liquid has been referenced in mythology, captured the imagination of poets, and integrated itself in the workings of philosophy. 

The idea of drinking a fermented beverage may be credited to our innate animal nature. First proposed in 2000, the "drunken monkey" hypothesis notes that alcohol (primarily ethanol) is routinely consumed by all animals that eat fruits and nectar. Based on DNA sequence data and modern-day reconstruction of ancestral enzymes, there is evidence that a single point mutation in primitive apes led to a 20-fold increase in their ability to metabolize alcohol. This suggests an increase in dietary exposure to ethanol molecules. The point mutation may have allowed our early hunter-gatherer brethren to better tolerate fermented food and liquids, conferring an evolutionary advantage.

The Essential and Existential

Whatever the initial physiological advantages may have been at the time, they have been retained in the modern day. Beginning in the 1980s, there have been major clinical studies reporting the association between moderate wine consumption and lower mortality from coronary heart disease. Wine is composed of over 500 different chemical compounds. Science has found several standouts that are noteworthy for their antibacterial and antioxidant effects. Resveratrol, phenols, and flavonoids are several that have proved to be beneficial in their various metabolic functions. As antioxidants, they reduce oxidative stress, decrease platelet aggregation, break down blood clots, lower insulin resistance, and regulate energy levels.

The connections go further than chemicals. Cardioprotection and moderate wine consumption have an interesting history that is inexorably linked to the larger spheres of diet and lifestyle. In 1924, Dr. Paul Dudley White was one of the co-founders of the American Heart Association. His work has largely formed the basis for today's field of preventive cardiology. In 1928, Dr. White spent six months on the Isle of Capri off the Amalfi Coast. There, he directly experienced the effects of what has become known as the Mediterranean Diet. Characterized by a diet that is abundant in plant-based foods, olive oil and wine, the health benefits are directly correlated to the high levels of polyphenols in these foods and beverages. Dr. White advocated the cuisine and lifestyle of the Mediterranean diet as a key to preventing heart disease in his famous textbook, Heart Disease.

Most of modern society may view the importance of alcohol in public health as craziness. Veritably, there is an uncomfortable truth underlying the benefits of wine.  The relationship between alcohol consumption and the risk of coronary heart disease follows a dose-response curve. At its most favorable, wine is being consumed in amounts that correspond to 1 - 2 drinks per day. It is excessive consumption that brings physical damage in the form of health-related problems with the liver and spleen.

(Figure adapted from Buja, L. M. The dose-response relationship between alcohol consumption and the risk of coronary heart disease. One standard drink is defined as 12 g of pure alcohol.)

A Worthwhile Lifestyle

What can we deduce about the scientific facts, contradictions and misconceptions that all surround a beverage as recognized and renowned as wine? Promoting the healthful status of wine goes hand-in-hand with conferring due respect to its physiological effects. There is a place for wine culture in a healthy, happy lifestyle. It is up to each of us, with our individual sense of judgement, to find that point of maximal fitness and enjoyment on our dose-response curve.

Sources and Further Reading