View source for Health effects of wine

{{short description|Potential health effects resulting from drinking wine}}
{{broader|Health effects of alcohol}}
[[File:Tempranillowine.jpg|thumb|A glass of [[red wine]]]]
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The '''health effects of wine''' are mainly determined by its active ingredient {{ndash}} [[alcohol (drug)|alcohol]].<ref>{{cite journal | vauthors = Trichopoulou A, Lagiou P | title = Healthy traditional Mediterranean diet: an expression of culture, history, and lifestyle | journal = Nutrition Reviews | volume = 55 | issue = 11 Pt 1 | pages = 383–9 | date = November 1997 | pmid = 9420448 | doi = 10.1111/j.1753-4887.1997.tb01578.x | doi-access = free }}</ref><ref name="md">{{cite journal | vauthors = Shen J, Wilmot KA, Ghasemzadeh N, Molloy DL, Burkman G, Mekonnen G, Gongora MC, Quyyumi AA, Sperling LS | title = Mediterranean Dietary Patterns and Cardiovascular Health | journal = Annual Review of Nutrition | volume = 35 | pages = 425–49 | year = 2015 | pmid = 25974696 | doi = 10.1146/annurev-nutr-011215-025104 | doi-access = free }}</ref> Preliminary studies found that drinking small quantities of [[wine]] (up to one [[standard drink]] per day for women and one to two drinks per day for men), particularly of [[red wine]], may be associated with a decreased risk of [[cardiovascular disease]]s, [[cognitive decline]], [[stroke]], [[diabetes mellitus]], [[metabolic syndrome]], and early death. Other studies found no such effects.<ref name=md/><ref name="Kee2014">{{cite journal | vauthors = O'Keefe JH, Bhatti SK, Bajwa A, DiNicolantonio JJ, Lavie CJ | title = Alcohol and cardiovascular health: the dose makes the poison…or the remedy | journal = Mayo Clinic Proceedings | volume = 89 | issue = 3 | pages = 382–93 | date = March 2014 | pmid = 24582196 | doi = 10.1016/j.mayocp.2013.11.005 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Stockwell T, Zhao J, Panwar S, Roemer A, Naimi T, Chikritzhs T | title = Do "Moderate" Drinkers Have Reduced Mortality Risk? A Systematic Review and Meta-Analysis of Alcohol Consumption and All-Cause Mortality | language = EN | journal = Journal of Studies on Alcohol and Drugs | volume = 77 | issue = 2 | pages = 185–98 | date = March 2016 | pmid = 26997174 | pmc = 4803651 | doi = 10.15288/jsad.2016.77.185 }}</ref>

Drinking more than the standard drink amount increases the risk of [[cardiovascular disease]]s, [[high blood pressure]], [[atrial fibrillation]], [[stroke]], and [[cancer]].<ref name="Kee2014"/><ref name="Jin 807–816">{{cite journal | vauthors = Jin M, Cai S, Guo J, Zhu Y, Li M, Yu Y, Zhang S, Chen K | title = Alcohol drinking and all cancer mortality: a meta-analysis | journal = Annals of Oncology | volume = 24 | issue = 3 | pages = 807–16 | date = March 2013 | pmid = 23104725 | doi = 10.1093/annonc/mds508 | doi-access = free }}</ref> Mixed results are also observed in light drinking and cancer mortality.<ref name="Jin 807–816"/><ref>{{cite journal | vauthors = Bagnardi V, Rota M, Botteri E, Tramacere I, Islami F, Fedirko V, Scotti L, Jenab M, Turati F, Pasquali E, Pelucchi C, Bellocco R, Negri E, Corrao G, Rehm J, Boffetta P, La Vecchia C | title = Light alcohol drinking and cancer: a meta-analysis | journal = Annals of Oncology | volume = 24 | issue = 2 | pages = 301–8 | date = February 2013 | pmid = 22910838 | doi = 10.1093/annonc/mds337 | doi-access = free }}</ref><ref name="poli">{{cite journal | vauthors = Poli A, Marangoni F, Avogaro A, Barba G, Bellentani S, Bucci M, Cambieri R, Catapano AL, Costanzo S, Cricelli C, de Gaetano G, Di Castelnuovo A, Faggiano P, Fattirolli F, Fontana L, Forlani G, Frattini S, Giacco R, La Vecchia C, Lazzaretto L, Loffredo L, Lucchin L, Marelli G, Marrocco W, Minisola S, Musicco M, Novo S, Nozzoli C, Pelucchi C, Perri L, Pieralli F, Rizzoni D, Sterzi R, Vettor R, Violi F, Visioli F | title = Moderate alcohol use and health: a consensus document | journal = Nutrition, Metabolism, and Cardiovascular Diseases | volume = 23 | issue = 6 | pages = 487–504 | date = June 2013 | pmid = 23642930 | doi = 10.1016/j.numecd.2013.02.007 | hdl = 10447/94503 | url = https://iris.unipa.it/bitstream/10447/94503/1/PDF%20art%2037.pdf | hdl-access = free }}</ref><ref name="LoConte2017">{{cite journal | vauthors = LoConte NK, Brewster AM, Kaur JS, Merrill JK, Alberg AJ | title = Alcohol and Cancer: A Statement of the American Society of Clinical Oncology | journal = Journal of Clinical Oncology | volume = 36 | issue = 1 | pages = 83–93 | date = January 2018 | pmid = 29112463 | doi = 10.1200/JCO.2017.76.1155 | quote = Clearly, the greatest cancer risks are concentrated in the heavy and moderate drinker categories. Nevertheless, some cancer risk persists even at low levels of consumption. A meta-analysis that focused solely on cancer risks associated with drinking one drink or fewer per day observed that this level of alcohol consumption was still associated with some elevated risk for squamous cell carcinoma of the esophagus (sRR, 1.30; 95% CI, 1.09 to 1.56), oropharyngeal cancer (sRR, 1.17; 95% CI, 1.06 to 1.29), and breast cancer (sRR, 1.05; 95% CI, 1.02 to 1.08), but no discernable associations were seen for cancers of the colorectum, larynx, and liver. }}</ref>

Risk is greater in young people due to [[binge drinking]], which may result in violence or accidents.<ref name="Kee2014"/> About 88,000 deaths in the [[United States]] are estimated to be due to alcohol each year.<ref name="NIH2015Stats">{{cite web|title=Alcohol Facts and Statistics|url=http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics|access-date=9 May 2015|archive-date=18 May 2015|archive-url=https://web.archive.org/web/20150518081638/http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics|url-status=dead}}</ref> [[Alcoholism]] reduces a person's life expectancy by around ten years<ref name="Schu2014">{{cite journal | vauthors = Schuckit MA | title = Recognition and management of withdrawal delirium (delirium tremens) | journal = The New England Journal of Medicine | volume = 371 | issue = 22 | pages = 2109–13 | date = November 2014 | pmid = 25427113 | doi = 10.1056/NEJMra1407298 | s2cid = 205116954 | url = http://www.escholarship.org/uc/item/08b9z9th | url-access = subscription }}</ref> and excessive alcohol use is the third leading cause of early death in the United States.<ref name="Kee2014"/> According to [[systematic review]]s and [[medical association]]s, people who are [[Teetotalism|non-drinkers]] should never start drinking wine nor any other [[alcoholic drink]].<ref name="Kee2014"/><ref name="poli"/><ref name="heart.org">{{cite web|url=http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Alcohol-and-Heart-Health_UCM_305173_Article.jsp|publisher=[[American Heart Association]]|title=Alcohol and Heart Health|date=2016|access-date=12 December 2016}}</ref>

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The [[history of wine]] includes use as an [[History of medicine|early form of medication]], being recommended variously as an [[antiseptic]] for treating wounds, a [[Digestion|digestive aid]], and as a cure for a wide range of ailments including [[lethargy]], [[diarrhea]], and pain from [[child birth]].<ref name="Miscellany">{{cite book | vauthors = Harding G|title=A Wine Miscellany |ol=17897645M |pages=67–70, 90 & 108 |publisher=Clarkson Potter |location=New York |year=2005 |isbn=978-0-307-34635-3}}</ref>{{unreliable source|date=March 2025|reason=Not a serious book; uncritically "jaunts" through an array of supposed health benefits, and parrots an obvious publicity stunt on p69}} [[Ancient Egypt]]ian [[papyri]] and [[Sumer]]ian tablets dating back to 2200 BC detail the medicinal role of wine, making it the world's oldest documented human-made medicine.<ref name="Robinson_2006">{{cite book |veditors=Robinson J |title=The Oxford Companion to Wine |edition=3rd |publisher=Oxford University Press |year=2006 |isbn=978-0-19-860990-2 |url=https://archive.org/details/oxfordcompaniont00janc }}</ref>{{rp|433}} Wine continued to play a major role in medicine until the late 19th and early 20th century, when changing opinions and medical research on alcohol and [[alcoholism]] cast doubt on its role as part of a healthy lifestyle.

==Moderate consumption==
{{See also|Alcohol consumption recommendations}}
[[File:Glass of unidentified red wine.jpg|left|thumb|Some doctors define "moderate" consumption as one 5 oz (150 ml) glass of wine per day for women and two glasses per day for men.<ref name=Kee2014/>]]
Nearly all research into the positive medical benefits of wine consumption makes a distinction between moderate consumption and heavy or [[binge drinking]].<ref name=Kee2014/>  Moderate levels of consumption vary by the individual according to [[Ageing|age]], [[sex]], [[genetics]], [[weight]] and [[Human body|body stature]], as well as situational conditions, such as [[food]] consumption or use of drugs.<ref name=Kee2014/> In general, women absorb alcohol more quickly than men due to their lower [[body water]] content, so their moderate levels of consumption may be lower than those for a male of equal age.<ref name="Robinson_2006" />{{rp|341–2}} Some experts define "moderate consumption" as less than one {{convert|5|USoz|ml|adj=on}} glass of wine per day for women and two glasses per day for men.<ref name=Kee2014/><ref>{{cite web | veditors = Shuman TC |url=http://www.webmd.com/heart-disease/guide/heart-disease-alcohol-your-heart |title=Alcohol and Heart disease |publisher=WebMD |date=October 1, 2005}}</ref>

The view of consuming wine in moderation has a history recorded as early as the Greek poet [[Eubulus (poet)|Eubulus]] (360 BC) who believed that three bowls ([[Kylix (drinking cup)|kylix]]) were the ideal amount of wine to consume. The number of three bowls for moderation is a common theme throughout Greek writing; today the standard 750 ml [[wine bottle]] contains roughly the volume of three kylix cups (250&nbsp;ml or 8&nbsp;fl&nbsp;oz each).<ref name="Johnson pg 35-46">{{cite book | vauthors = Johnson H | title = Vintage: The Story of Wine | pages = [https://archive.org/details/vintagestoryofwi00john/page/35 35–46] | publisher = Simon and Schuster | date = 1989 | isbn = 978-0-671-68702-1 | url = https://archive.org/details/vintagestoryofwi00john/page/35 }}</ref>  However, the kylix cups would have contained a [[Ancient Greece and wine#Greek wine|diluted wine]], at a 1:2 or 1:3 dilution with water.  In his circa 375 BC play ''[[Semele]] or [[Dionysus]]'', Eubulus has Dionysus say:

{{cquote|''Three bowls do I mix for the temperate: one to health, which they empty first, the second to love and pleasure, the third to sleep. When this bowl is drunk up, wise guests go home. The fourth bowl is ours no longer, but belongs to violence; the fifth to uproar, the sixth to drunken revel, the seventh to black eyes, the eighth is the policeman's, the ninth belongs to biliousness, and the tenth to madness and hurling the furniture.''<ref>Eubulus. ''Semele or Dionysus'', fr. 93.</ref>}}

Emerging evidence suggests that "even drinking within the recommended limits may increase the overall risk of death from various causes".<ref name="cdc-alc">{{cite web |title=Facts about moderate drinking {{!}} CDC |url=https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm |publisher=CDC |access-date=24 April 2022 |language=en-us |date=19 April 2022}}</ref> A 2018 systematic analysis found that "The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0–0·8) standard drinks per week".<ref>{{cite journal | vauthors = Griswold MG, Fullman N, Hawley C, Arian N, Zimsen SR, Tymeson HD |title=Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 |journal=The Lancet |date=22 September 2018 |volume=392 |issue=10152 |pages=1015–1035 |doi=10.1016/S0140-6736(18)31310-2 |pmid=30146330 |pmc=6148333 |language=English |issn=0140-6736}}</ref> On the other hand, a 2020 [[United States Department of Agriculture|USDA]] systematic review found that "low average consumption was associated with lower risk of mortality compared with never drinking status".<ref>{{Cite book |last1=Mayer-Davis |first1=Elizabeth |url=http://www.ncbi.nlm.nih.gov/books/NBK579065/ |title=Alcohol Consumption and All-Cause Mortality: A Systematic Review |last2=Leidy |first2=Heather |last3=Mattes |first3=Richard |last4=Naimi |first4=Timothy |last5=Novotny |first5=Rachel |last6=Schneeman |first6=Barbara |last7=Kingshipp |first7=Brittany James |last8=Spill |first8=Maureen |last9=Cole |first9=Natasha Chong |date=2020 |publisher=USDA Nutrition Evidence Systematic Review |series=USDA Nutrition Evidence Systematic Reviews |location=Alexandria (VA) |pmid=35353467}}</ref> As of 2022, "moderate" consumption is usually defined in average consumption ''per day'' while the patterns of consumption vary and may have implications for risks and effects on health (such as habituation from daily consumption or nonlinear dosage-harm associations from intermittent excessive alcohol use). According to the CDC, it would be important to focus on the amount people drink on the days that they drink.<ref name="cdc-alc"/>

==Effect on the body==
{{Further|Long-term effects of alcohol consumption|Alcohol education}}

===Bones===
Heavy alcohol consumption has been shown to have a damaging effect on the cellular processes that create [[bone tissue]], and long-term alcoholic consumption at high levels increases the frequency of [[fracture]]s.<ref>{{cite journal | vauthors = Walker-Bone K | title = Recognizing and treating secondary osteoporosis | journal = Nature Reviews. Rheumatology | volume = 8 | issue = 8 | pages = 480–92 | date = August 2012 | pmid = 22782006 | doi = 10.1038/nrrheum.2012.93 | s2cid = 12292033 }}</ref> A 2012 study found no relation between wine consumption and bone mineral density.<ref>{{cite journal | vauthors = McLernon DJ, Powell JJ, Jugdaohsingh R, Macdonald HM | title = Do lifestyle choices explain the effect of alcohol on bone mineral density in women around menopause? | journal = The American Journal of Clinical Nutrition | volume = 95 | issue = 5 | pages = 1261–9 | date = May 2012 | pmid = 22456655 | doi = 10.3945/ajcn.111.021600 | doi-access = free }}</ref>

===Cancer===
{{See also|Alcohol and cancer}}
The [[International Agency for Research on Cancer]] of the [[World Health Organization]] has classified alcohol as a [[List of IARC Group 1 carcinogens|Group 1 carcinogen]].<ref>{{cite book |title=Alcohol drinking |publisher=[[World Health Organization]], [[International Agency for Research on Cancer]] |location=[[Lyon]] |year=1988 |pages=[https://archive.org/details/alcoholdrinking0044iarc/page/2 2–3] |isbn=978-92-832-1244-7 |url=https://archive.org/details/alcoholdrinking0044iarc/page/2 }}</ref>

===Cardiovascular system===
{{See also|Alcohol and cardiovascular disease}}
[[File:Blood clot svg hariadhi.svg|250px|right|thumb|The anticoagulant properties of alcohol in wine may have the potential of reducing the risk of [[blood clot]]s associated with several [[cardiovascular disease]]s.]]

Professional cardiology associations recommend that people who are currently nondrinkers should abstain from drinking alcohol.<ref name="heart.org"/> Heavy drinkers have increased risk for [[heart disease]], [[cardiac arrhythmia]]s, [[hypertension]], and elevated [[cholesterol]] levels.{{medical citation needed|date=August 2021}}

The alcohol in wine has [[anticoagulant]] properties that may limit blood clotting.<ref>{{cite journal |doi=10.5344/ajev.2011.11013 |title=Wine and Health: A Review |year=2011 | vauthors = Guilford JM, Pezzuto JM |journal=American Journal of Enology and Viticulture |volume=62 |issue=4 |pages=471–86|doi-access=free }}</ref>

===Digestive system===
The risk of infection from the bacterium ''[[Helicobacter pylori]]'', which is associated with [[gastritis]] and [[peptic ulcer]]s, appears to be lower with moderate alcohol consumption.<ref>{{cite journal | vauthors = Brenner H, Berg G, Lappus N, Kliebsch U, Bode G, Boeing H | title = Alcohol consumption and Helicobacter pylori infection: results from the German National Health and Nutrition Survey | journal = Epidemiology | volume = 10 | issue = 3 | pages = 214–218 | date = May 1999 | pmid = 10230827 | doi = 10.1097/00001648-199905000-00004 | jstor = 3703585 | doi-access = free }}</ref><ref name="Liu">{{cite journal | vauthors = Liu SY, Han XC, Sun J, Chen GX, Zhou XY, Zhang GX | title = Alcohol intake and Helicobacter pylori infection: a dose-response meta-analysis of observational studies | journal = Infectious Diseases | volume = 48 | issue = 4 | pages = 303–309 | date = April 2016 | pmid = 26585858 | doi = 10.3109/23744235.2015.1113556 | s2cid = 30825790 }}</ref>

===Headaches===
{{See also|Red wine headache}}
There are several potential causes of so-called "red wine headaches", including [[histamine]] and [[tannin]]s from [[grape skin]] or other [[Phenolic content in wine|phenolic compounds in wine]].<ref name="harvard">{{cite web |title=Ask the doctor: What causes red wine headaches? |url=https://www.health.harvard.edu/diseases-and-conditions/what-causes-red-wine-headaches |publisher=Harvard Health Publishing, Harvard Medical School |access-date=15 May 2019 |date=2019 |archive-date=25 July 2019 |archive-url=https://web.archive.org/web/20190725224220/https://www.health.harvard.edu/diseases-and-conditions/what-causes-red-wine-headaches |url-status=dead }}</ref> [[Sulfite]]s &ndash; which are used as a [[preservative]] in wine &ndash; are unlikely to be a headache factor.<ref name=harvard/> Wine, like other alcoholic beverages, is a [[diuretic]] which promotes [[dehydration]] that can lead to headaches (such as the case often experienced with [[hangover]]s),<ref name="Miscellany"/> indicating a need to maintain hydration when drinking wine and to consume in moderation.<ref name=harvard/> A 2017 review found that 22% of people experiencing [[migraine]] or [[tension headache]]s identified alcohol as a precipitating factor, and red wine as three times more likely to trigger a headache than beer.<ref name="Davis">{{cite journal | vauthors = Davis-Martin RE, Polk AN, Smitherman TA | title = Alcohol Use as a Comorbidity and Precipitant of Primary Headache: Review and Meta-analysis | journal = Current Pain and Headache Reports | volume = 21 | issue = 10 | pages = 42 | date = August 2017 | pmid = 28844083 | doi = 10.1007/s11916-017-0642-8 | s2cid = 20870984 }}</ref>

===Food intake===
{{See also|Apéritif and digestif|Alcohol and weight}}
[[File:Carracci - Der Bohnenesser.jpeg|right|thumb|Wine has a long history of being [[wine and food pairing|paired with food]] and may help reduce food intake by suppressing [[appetite]].]]

{{cquote|Alcohol can stimulate the appetite so it is better to drink it with food. When alcohol is mixed with food, it can slow the stomach's emptying time and potentially decrease the amount of food consumed at the meal.<ref name="diet">{{cite web| vauthors = Zelman KM |author-link=Kathleen Zelman|date=January 26, 2005|title=Wine: How Much Is Good for You?|url=http://www.webmd.com/food-recipes/features/wine-how-much-is-good-for-you|publisher=WebMD}}</ref>}}

A {{convert|5|USfloz|mL|order=flip|abbr=off|adj=on}} serving of red or white wine provides about {{convert|120|to|130|kcal|kJ|order=flip|abbr=off}} of [[food energy]], while [[dessert wine]]s provide more.<ref name="hughes">{{cite web | vauthors = Hughes L |title=How Many Calories Are in Your Wine? |url=https://www.webmd.com/diet/features/how-many-calories-in-wine |publisher=WebMD |access-date=15 May 2019 |date=22 March 2017}}</ref> Most wines have an [[alcohol by volume]] (ABV) percentage of about 11%; the higher the ABV, the higher the energy content of a wine.<ref name=hughes/>

==Heavy metals==
In 2008, researchers from [[Kingston University]] in London discovered red wine<ref>The sample wine was declared to be "a Shiraz from Southeast Australia", although no specific vintage, producer or wine region was stated in the report.</ref> to contain high levels of [[toxic metals]] relative to other beverages in the sample. Although the metal [[ions]], which included [[chromium]], [[copper]], [[iron]], [[manganese]], [[nickel]], [[vanadium]] and [[zinc]], were also present in other plant-based beverages, the sample wine tested significantly higher for all metal ions, especially vanadium.<ref name=hague>{{cite journal | vauthors = Hague T, Petroczi A, Andrews PL, Barker J, Naughton DP | title = Determination of metal ion content of beverages and estimation of target hazard quotients: a comparative study | journal = Chemistry Central Journal | volume = 2 | pages = 13 | date = June 2008 | pmid = 18578877 | pmc = 2443149 | doi = 10.1186/1752-153X-2-13 | doi-access = free }}</ref> Risk assessment was calculated using "[[target hazard quotients]]" (THQ), a method of quantifying health concerns associated with lifetime exposure to chemical pollutants. Developed by the [[United States Environmental Protection Agency|Environmental Protection Agency]] in the US and used mainly to examine [[seafood]], a THQ of less than 1 represents no concern while, for example, [[Mercury in fish|mercury level]]s in fish calculated to have THQs of between 1 and 5 would represent cause for concern.<ref>{{cite journal | vauthors = Wang X, Sato T, Xing B, Tao S | title = Health risks of heavy metals to the general public in Tianjin, China via consumption of vegetables and fish | journal = The Science of the Total Environment | volume = 350 | issue = 1–3 | pages = 28–37 | date = November 2005 | pmid = 16227070 | doi = 10.1016/j.scitotenv.2004.09.044 | bibcode = 2005ScTEn.350...28W }}</ref>

The researchers stressed that a single glass of wine would not lead to metal poisoning, pointing out that their THQ calculations were based on the average person drinking one-third of a bottle of wine (250&nbsp;ml) every day between the ages of 18 and 80. However the "combined THQ values" for metal ions in the red wine they analyzed were reported to be as high as 125.<ref name=hague /> A subsequent study by the same university using a [[meta analysis]] of data based on wine samples from a selection of mostly [[Europe]]an countries found equally high levels of vanadium in many red wines, showing combined THQ values in the range of 50 to 200, with some as high as 350.<ref name=naughton>{{cite journal | vauthors = Naughton DP, Petróczi A | title = Heavy metal ions in wines: meta-analysis of target hazard quotients reveal health risks | journal = Chemistry Central Journal | volume = 2 | pages = 22 | date = October 2008 | pmid = 18973648 | pmc = 2628338 | doi = 10.1186/1752-153X-2-22 | doi-access = free }}</ref>

The findings sparked immediate controversy due to several issues: the study's reliance on [[secondary data]]; the assumption that all wines contributing to that data were representative of the countries stated; and the grouping together of poorly understood high-concentration ions, such as vanadium, with relatively low-level, common ions such as copper and manganese. Some publications pointed out that the lack of identifiable wines and grape varieties, specific producers or even wine regions, provided only misleading generalizations that should not be relied upon in choosing wines.<ref name=ws>[http://www.winespectator.com/webfeature/show/id/Study-of-Wines-Heavy-Metal-Hazard-Raises-Doubts-Among-Other-Experts_4444 Study of Wine's Heavy Metal Hazard Raises Doubts Among Other Experts] Wine Spectator, November 2008</ref><ref name=nhs>[http://www.nhs.uk/news/2008/10October/Pages/Metalsinwine.aspx Metal in wine] {{Webarchive|url=https://web.archive.org/web/20121007104255/http://www.nhs.uk/news/2008/10October/Pages/Metalsinwine.aspx |date=2012-10-07 }}, UK NHS news bulletin, October 2008</ref>

In a news bulletin following the widespread reporting of the findings, the UK's [[National Health Service]] (NHS) were also concerned that "the way the researchers added together hazards from different metals to produce a final score for individual wines may not be particularly meaningful".<ref name=nhs /> Commentators in the US questioned the relevance of seafood-based THQ assessments to [[agriculture|agricultural]] produce, with the [[Alcohol and Tobacco Tax and Trade Bureau|TTB]], responsible for testing imports for metal ion contamination, have not detected an increased risk. George Solas, quality assessor for the Canadian [[Liquor Control Board of Ontario]] (LCBO) claimed that the levels of heavy metal contamination reported were within the permitted levels for drinking water in tested [[reservoir]]s.<ref name=ws />

Whereas the NHS also described calls for improved [[wine label]]ing as an "extreme response" to research which provided "few solid answers", they acknowledged the authors call for further research to investigate wine production, including the influence that grape variety, soil type, geographical region, [[insecticide]]s, containment vessels and seasonal variations may have on metal ion uptake.<ref name=nhs />

== Chemical composition ==
=== Natural phenols and polyphenols ===
Although red wine contains many chemicals under [[basic research]] for their potential health benefits, [[resveratrol]] has been particularly well studied and evaluated by regulatory authorities, such as the [[European Food Safety Authority]] and US [[Food and Drug Administration]] which identified it and other such [[polyphenol|phenolic]] compounds as not sufficiently understood to confirm their role as [[physiology|physiological]] [[antioxidants]].<ref name="efsa">{{cite journal|title=Scientific Opinion on the substantiation of health claims related to various food(s)/food constituent(s) and protection of cells from premature aging, antioxidant activity, antioxidant content and antioxidant properties, and protection of DNA, proteins and lipids from oxidative damage pursuant to Article 13(1) of Regulation (EC) No 1924/20061|journal = EFSA Journal|volume = 8|issue = 2|date=2010|doi=10.2903/j.efsa.2010.1489|doi-access=free}}</ref><ref name=roles/>

===Resveratrol===
{{Main article|Resveratrol}}

Red wine contains an average of 1.9 (±1.7) mg of trans-resveratrol per liter.<ref>{{cite journal | vauthors = Stervbo U, Vang O, Bonnesen C |title=A review of the content of the putative chemopreventive phytoalexin resveratrol in red wine |journal=Food Chemistry |date=1 January 2007 |volume=101 |issue=2 |pages=449–457 |doi=10.1016/j.foodchem.2006.01.047 |language=en |issn=0308-8146}}</ref> For comparison, [[dietary supplement]]s of resveratrol (trans-resveratrol content varies) may contain as much as 500&nbsp;mg<!--mention bioavailability-->.<ref>{{cite journal | vauthors = Galiniak S, Aebisher D, Bartusik-Aebisher D | title = Health benefits of resveratrol administration | journal = Acta Biochimica Polonica | volume = 66 | issue = 1 | pages = 13–21 | date = February 2019 | pmid = 30816367 | doi = 10.18388/abp.2018_2749 | s2cid = 73491480 | doi-access = free }}</ref><ref>{{cite journal | vauthors = García-Martínez BI, Ruiz-Ramos M, Pedraza-Chaverri J, Santiago-Osorio E, Mendoza-Núñez VM | title = Hypoglycemic Effect of Resveratrol: A Systematic Review and Meta-Analysis | journal = Antioxidants | volume = 10 | issue = 1 | pages = 69 | date = January 2021 | pmid = 33430470 | doi = 10.3390/antiox10010069 | pmc = 7827898 | doi-access = free }}</ref>

Resveratrol is a [[stilbenoid]] [[Phenolic content in wine|phenolic compound found in wine]] produced in the grape skins and leaves of grape vines.<ref name="Robinson_2006" />{{rp|569}}

The production and concentration of resveratrol is not equal among all the varieties of [[grape varieties|wine grapes]]. Differences in [[clones (plant)|clones]], [[rootstock]], ''Vitis'' species as well as climate conditions can affect the production of resveratrol. Also, because resveratrol is part of the defence mechanism in grapevines against [[vine diseases|attack]] by fungi or [[grape disease]], the degree of exposure to fungal infection and grape diseases also appear to play a role. The [[Muscadinia]] family of vines, which has adapted over time through exposure to [[North American]] grape diseases such as [[phylloxera]], has some of the highest concentrations of resveratrol among wine grapes. Among the European ''[[Vitis vinifera]]'', grapes derived from the [[Burgundian (wine)|Burgundian]] [[Pinot (grape)|Pinot]] family tend to have substantially higher amounts of resveratrol than grapes derived from the Cabernet family of [[Bordeaux (wine)|Bordeaux]]. Wine regions with cooler, wetter climates that are more prone to grape disease and fungal attacks such as [[Oregon wine|Oregon]] and [[New York wine|New York]] tend to produce grapes with higher concentrations of resveratrol than warmer, dry climates like [[California wine|California]] and [[Australia wine|Australia]].<ref name="Robinson_2006" />{{rp|569}}

Although red wine and white vine varieties produce similar amounts of resveratrol, red wine contains more than white, since red wines are produced by [[maceration (wine)|maceration]] (soaking the grape skins in the mash).  Other winemaking techniques, such as the use of certain strains of [[yeast (wine)|yeast]] during [[fermentation (wine)|fermentation]] or [[lactic acid bacteria]] during [[malolactic fermentation]], can have an influence on the amount of resveratrol left in the resulting wines. Similarly, the use of certain [[fining agents]] during the [[clarification and stabilization of wine]] can strip the wine of some resveratrol molecules.<ref name="Robinson_2006" />{{rp|569}}

===Anthocyanins===
Red grapes are high in [[anthocyanins]] which are the source of the color of various fruits, such as red grapes. The darker the red wine, the more [[anthocyanins]] present.<ref>{{cite journal | vauthors = Muñoz-Espada AC, Wood KV, Bordelon B, Watkins BA | title = Anthocyanin quantification and radical scavenging capacity of Concord, Norton, and Marechal Foch grapes and wines | journal = Journal of Agricultural and Food Chemistry | volume = 52 | issue = 22 | pages = 6779–86 | date = November 2004 | pmid = 15506816 | doi = 10.1021/jf040087y | bibcode = 2004JAFC...52.6779M }}</ref>{{original research inline|date=July 2014}}

Typical concentrations of free anthocyanins in full-bodied young red wines are around 500&nbsp;mg per liter.<ref>{{cite journal | vauthors = He F, Liang NN, Mu L, Pan QH, Wang J, Reeves MJ, Duan CQ | title = Anthocyanins and their variation in red wines I. Monomeric anthocyanins and their color expression | journal = Molecules | volume = 17 | issue = 2 | pages = 1571–1601 | date = February 2012 | pmid = 22314380 | doi = 10.3390/molecules17021571 | pmc = 6268338 | doi-access = free }}</ref> For comparison, 100 g of fresh [[bilberry]] contain 300–700&nbsp;mg<ref>{{cite book | vauthors = Chu WK, Cheung SC, Lau RA, Benzie IF |title=Herbal Medicine: Biomolecular and Clinical Aspects |date=2011 |publisher=CRC Press/Taylor & Francis |isbn=978-1-4398-0713-2 |edition=2nd |url=https://www.ncbi.nlm.nih.gov/books/NBK92770/ |chapter=Bilberry (Vaccinium myrtillus L.)|pmid=22593936 }}</ref> and 100 g FW [[elderberry]] contain around 603–1265&nbsp;mg.<ref>{{cite journal | vauthors = Veberic R, Jakopic J, Stampar F, Schmitzer V |title=European elderberry (Sambucus nigra L.) rich in sugars, organic acids, anthocyanins and selected polyphenols |journal=Food Chemistry |date=15 May 2009 |volume=114 |issue=2 |pages=511–515 |doi=10.1016/j.foodchem.2008.09.080 |language=en |issn=0308-8146}}</ref>

Following dietary ingestion, anthocyanins undergo rapid and extensive metabolism that makes the biological effects presumed from in vitro studies unlikely to apply in vivo.<ref name="roles">{{citation |title= New Roles for Polyphenols. A 3-Part report on Current Regulations & the State of Science | vauthors = Gross P| work = Nutraceuticals World|date= March 1, 2009 |url= http://www.nutraceuticalsworld.com/issues/2009-03/view_features/new-roles-for-polyphenols/ }}</ref><ref name=Williams>{{cite journal | vauthors = Williams RJ, Spencer JP, Rice-Evans C | title = Flavonoids: antioxidants or signalling molecules? | journal = Free Radical Biology & Medicine | volume = 36 | issue = 7 | pages = 838–49 | date = April 2004 | pmid = 15019969 | doi = 10.1016/j.freeradbiomed.2004.01.001 }}</ref>

Although anthocyanins are under [[basic research|basic]] and early-stage [[clinical trial|clinical]] research for a variety of disease conditions, there exists no sufficient evidence that they have any beneficial effect in the human body.<ref name=roles/> The US [[Food and Drug Administration|FDA]] has issued warning letters, e.g.,<ref>{{cite web|url=https://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm202832.htm|archive-url=https://web.archive.org/web/20100304141530/http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm202832.htm|url-status=dead|archive-date=March 4, 2010|title= Redco Foods, Inc.|date=22 February 2010|publisher=Wagner, RF, Inspections, Compliance, Enforcement, and Criminal Investigations, US FDA|access-date=10 November 2014}}</ref> to emphasize that anthocyanins are not a defined [[essential nutrient|nutrient]], cannot be assigned a [[Daily Value|dietary content level]] and are not regulated as a [[drug]] to treat any human disease.<ref name=roles/>

==History of wine in medicine==
{{See also|History of medicine}}
Early medicine was intimately tied with [[religion]] and the [[supernatural]], with early practitioners often being [[priest]]s and [[magician (paranormal)|magician]]s. Wine's close association with ritual made it a logical tool for these early medical practices. Tablets from Sumeria and papyri from Egypt dating to 2200 BC include recipes for wine based medicines, making wine the oldest documented human-made medicine.<ref name="Robinson_2006" />{{rp|433}}

===Early history===
[[File:Hippocrates Light.JPG|thumb|[[Hippocrates]], the father of modern medicine, prescribed wine for a variety of ailments including [[lethargy]] and [[diarrhea]].]]
[[File:De medicina V00117 00000006.tif|thumb|''De medicina'']]
When the [[Greeks]] introduced a more systematized approach to medicine, wine retained its prominent role. The Greek physician [[Hippocrates]] considered wine a part of a healthy [[diet (nutrition)|diet]], and advocated its use as a [[disinfectant]] for wounds, as well as a medium in which to mix other drugs for consumption by the patient. He also prescribed wine as a cure for various ailments ranging from diarrhea and lethargy to pain during childbirth.<ref name="Robinson_2006" />{{rp|433}}

The medical practices of the [[Ancient Rome|Romans]] involved the use of wine in a similar manner. In his 1st-century work ''[[De Medicina]]'', the Roman encyclopedist [[Aulus Cornelius Celsus]] detailed a long list of [[Ancient Greek (wine)|Greek]] and [[Roman wine]]s used for medicinal purposes. While treating [[gladiators]] in [[Asia Minor]], the Roman physician [[Galen]] would use wine as a disinfectant for all types of wounds, and even soaked exposed [[bowels]] before returning them to the body. During his four years with the gladiators, only five deaths occurred, compared to sixty deaths under the watch of the physician before him.<ref name="nutton73">{{cite journal | vauthors = Nutton V | title = The chronology of Galen's early career | journal = Classical Quarterly | volume = 23 | issue = 1 | pages = 158–71 | date = May 1973 | pmid = 11624046 | doi = 10.1017/S0009838800036600 | jstor = 638137 | s2cid = 35645790 }}</ref>

Religion still played a significant role in promoting wine's use for health. The Jewish [[Talmud]] noted wine to be ''"the foremost of all medicines: wherever wine is lacking, medicines become necessary."'' In his [[first epistle to Timothy]], [[Paul the Apostle]] recommended that his [[Saint Timothy|young colleague]] drink a little wine every now and then for the benefit of his stomach and digestion. While the [[Islamic]] [[Koran]] contained [[Islamic dietary laws#Alcohol|restrictions on all alcohol]], Islamic doctors such as the Persian [[Avicenna]] in the 11th century AD noted that wine was an efficient digestive aid but, because of the laws, were limited to use as a disinfectant while dressing wounds. [[Catholic Church|Catholic]] [[Monastery|monasteries]] during the [[Middle Ages]] also regularly used wine for medical treatments.<ref name="Robinson_2006" />{{rp|433}} So closely tied was the role of wine and medicine, that the first printed book on wine was written in the 14th century by a physician, [[Arnaldus de Villa Nova]], with lengthy essays on wine's suitability for treatment of a variety of medical ailments such [[dementia]] and [[sinusitis|sinus]] problems.<ref>{{cite book | vauthors = Johnson H |title=Vintage: The Story of Wine |page=126 |publisher=Simon and Schuster |year=1989}}</ref>

===Risks of consumption===
The lack of safe [[drinking water]] may have been one reason for wine's popularity in medicine. Wine was still being used to sterilize water as late as the [[Hamburg]] [[cholera]] epidemic of 1892 in order to control the spread of the disease. However, the late 19th century and early 20th century ushered in a period of changing views on the role of [[alcohol (drug)|alcohol]] and, by extension, wine in health and society. The [[Temperance movement]] began to gain steam by touting the ills of [[alcoholism]], which was eventually defined by the medical establishment as [[Disease theory of alcoholism|a disease]]. Studies of the [[Long-term effects of alcohol consumption|long]]- and [[Short-term effects of alcohol consumption]] caused many in the medical community to reconsider the role of wine in medicine and diet.<ref name="Robinson_2006" />{{rp|433}} Soon, public opinion turned against consumption of alcohol in any form, leading to [[Prohibition in the United States]] and other countries. In some areas, wine was able to maintain a limited role, such as an exemption from Prohibition in the United States for "[[therapeutic]] wines" that were sold legally in drug stores. These wines were marketed for their supposed medicinal benefits, but some wineries used this measure as a loophole to sell large quantities of wine for recreational consumption. In response, the United States government issued a mandate requiring producers to include an [[emetic]] additive that would induce vomiting above the consumption of a certain dosage level.<ref name="Miscellany"/>

[[File:Château Lafite Rothschild and glass.jpg|250px|right|thumb|The French paradox indicates that a diet high in fatty [[dairy product]]s, such as [[cheese]]s, may be offset by red wine consumption to lower the risk of [[heart disease]].]]

Throughout the mid to early 20th century, health advocates pointed to the risk of alcohol consumption and the role it played in a variety of ailments such as [[blood disorders]], [[high blood pressure]], [[cancer]], [[infertility]], [[liver damage]], [[muscle atrophy]], [[psoriasis]], [[skin infections]], [[stroke]]s, and long-term [[brain damage]]. Studies showed a connection between alcohol consumption among pregnant mothers and an increased risk of [[mental retardation]] and physical abnormalities in what became known as [[fetal alcohol syndrome]], prompting the use of [[alcohol packaging warning messages]] in several countries.<ref name="Robinson_2006" />{{rp|341–2}}

===French paradox===
{{main article|French paradox}}
The hypothesis of the French paradox assumes a low prevalence of [[heart disease]] due to the consumption of red wine despite a diet high in [[saturated fat]].<ref name="haseeb">{{cite journal | vauthors = Haseeb S, Alexander B, Baranchuk A | title = Wine and Cardiovascular Health: A Comprehensive Review | journal = Circulation | volume = 136 | issue = 15 | pages = 1434–1448 | date = October 2017 | pmid = 28993373 | doi = 10.1161/circulationaha.117.030387 | s2cid = 26520546 | doi-access = free }}</ref> Although [[epidemiology|epidemiological]] studies indicate red wine consumption may support the French paradox, there is insufficient [[evidence-based medicine|clinical evidence]] to confirm it, as of 2017.<ref name=haseeb/>

== References ==
{{Reflist}}

{{Alcohol and health}}
{{Health effects of}}
{{portal bar|Drink}}

{{DEFAULTSORT:Health Effects Of Wine}}
[[Category:Health effects of alcohol|Wine]]
[[Category:Wine]]
[[Category:Health effects of food and nutrition|Wine]]