1. Does drinking red wine protect against heart disease ? By Brian Eccleston

2. INTRODUCTION Ever since the discovery that red wine could help in the reduction of Coronary Heart Disease, CHD the controversy surrounding its effects has not stop. Currently there is a wealth of evidence to suggest the benefits but there are some detractors who believe there other reasons such as food and exercise is best.

3. Key Dates As early as 1819 was the connection between wine and health detected ( ‘French Paradox’). 1980- Honolulu Heart study showed moderate alcohol consumption reduced CHD. The subject did not re-merged until the early 1990s after the screening of the ‘60minutes’ documentary in the USA on this subject. 1992 -British Medical Journal *reports drinking up to two glasses of wine lowers CHD in women.

4. Key Dates 2 Doll studied 12 321 British doctors,publishing in 1994. The lowest risk of death occurred with one to two drinks per day. CHD deaths were reduced in all. Gaziano et al, publishing in 2000, studied 89299 US male physicians. Up to one drink per day conferred a lower overall mortality. There was no benefit from drinking more than two drinks per day.

5. So what’s all the fuss about ? The ‘fuss’ is about red wine being cardio- protective against heart disease. Majority of evidence has come from epidemiological studies in USA,UK and France.The focus of the studies has been on the antioxidant properties of wine’s phenolic compounds and flavanoids which appear to reduce risk of atherosclerosis and heart attacks.

6. The Evidence As early as 1992 in the The New England Journal of Medicine researchers* have concluded mild to moderate drinking of alcohol particularly red wine is beneficial for reducing coronary heart disease. Other evidence* points to alcohol suppressing cancer growth, platelet aggregation and increasing antioxidant activity. The focus being on red wine and its properties

7. Chemical compounds in wine The Main ones: Resveratrol-first studied by E H Siemann and Leroy Creasy in 1992 at Cornell University who first described it in wine (see structure) It is the main phenolic compound in wine. Results show resveratol could: 1.) Inhibit the oxidation of low density lipoproteins (LDL). 2.) Inhibit platelet aggregation by blocking the production of eicosanoid synthesis.

9. Other compounds in wine-Flavonoids More abundant than reserveratol >100mg/l. There are four major classes:the anthocyanin, the catechins (theflavanols),and oligomers (also called procyanidins).There is another group of called polymers of catechins (tanins ) Main facts: 1) Wine flavanoids inhibit platelet aggregation by blocking the oxygenase enzymes. 2) the catechins are a powerful antioxidant especially epicatechin (see structure)

10. Catechins, are a special group of flavanoids are believed to be protective against both coronary heart disease and certain types of cancer. They can also be found in fresh fruit, vegetables and Tea. In terms of potency for antioxidants epicatechin and quercetin (see structure) are the most potent while resveratrol is less potent. The flavanoids are also thought to improve immune function.

11. What is the 'French paradox' In essence, the 'French paradox' is the observation that although the French don't eat a particularly healthy diet, they show much reduced rates of coronary heart disease when compared with northern European nations such as the UK and Germany. Why might this so? The most popular explanation has been that the relatively high consumption of alcohol, and in particular red wine, by the French, which in some way acts to protect them from heart disease.

12. Main points: About red wine and CHD Studies about red wine and heart disease mainly based on epidemiological studies done on Northern Europeans. Red wine contains more flavanoids than red or purple grape juice because the process of wine making extracts more from the seeds and skins..

13. The J-shaped curve ?

14. Conclusion The combination of epidemiological,clinical and mechanistic studies strongly suggests that wine phenolics are beneficial nutrients that can reduce CHD mortality and their effects. These phenolics must absorbed into the blood stream to have any direct effect on coronary diseases.

15. Summary Heart Disease may be reduced by taking: 2 glasses red wine or purple grape juice. Green or black tea can also be taken. Nearly all researchers have reported that more than two glasses of red wine tends to have a negative effect on heart disease. Some detractors have said that other causes such as exercise, low fat diets,not smoking and treating hypertension as well as taking low-dose aspirin.should be included. as contributing factors

16. Thank you for watching. Cheers !