Wednesday, April 27, 2016

Biodynamic Wines: Űber Organic or Vineyard Voodoo?

Whenever the topic of biodynamic winemaking comes up, I can’t help but remember a line from Hemingway’s A Moveable Feast: “They say the seeds of what we will do are in all of us, but it always seemed to me that in those who make jokes in life the seeds are covered with better soil and with a higher grade of manure.” Many consider biodynamics to be a joke, with its cultish origins and literal reliance on manure (packed into a cow’s horn, which must be precisely oriented to “preserve the etheric and astral force that the horn was accustomed to when it was on the cow,” buried over the winter, then sprayed on the vineyards in the spring). Nevertheless, biodynamics has been adopted by wineries worldwide including a few top labels, and some superb wines come from biodynamic vineyards. Is there a kernel of truth germinating beneath the pile of plop?

Biodynamic winemaking's controversial past

If biodynamics were as simple as using natural fertilizers and fostering a healthy ecosystem in the vineyards, and ditched the metaphysics and mysticism, there would be no debate. Its origins predate the organic food trend, dating to the early 20th century. It was founded by Austrian Rudolph Steiner, who created a movement he called anthroposophy, an attempt to synthesize science and spirituality. Critics point to some pretty far fetched notions from Steiner, including the concept of a “seed life force” that ancient Atlanteans used to power levitating cars. He wrote that “the heart does not pump blood” and that there are 12 senses corresponding to the signs of the zodiac. In practice, biodynamics appears to be not unlike a sort of agricultural homeopathy, employing a variety of preparations based on things such as oak bark placed inside the skull of a domesticated animal and buried, or dandelions stuffed into the mesentery of a cow and interred during winter then retrieved in the spring. Notably, Steiner had no experience in farming.
I first learned about biodynamic wines several years ago from Christophe Baron of Cayuse winery near Walla Walla. He was giving a rare tour of his vineyards, going on about the soil being a living thing, and the stones like “little ovens.” (The Cayuse are a Native American tribe whose name was derived from the French word “cailloux”—which means “stones.” Baron picked the site because the pomegranate-sized rocks were reminiscent of the southern Rhone in his native France.) Whether it is the biodynamic philosophy, the terroir, or something else, Cayuse wines have received critical acclaim and are highly sought after. Like Baron, they are unapologetically exuberant; I recall him describing one of his syrahs as being “like sex on a stick,” whatever that means.

Is there any science to biodynamics?

There is one study that applied some actual science to biodynamic winemaking. (1) Using a replicated, long-term, crossover design, a merlot vineyard in northern California was divided randomly into parcels for either biodynamic management or standard organic practices. Over 6 years, there were no differences in soil quality, nutrient analyses of leaf tissue, clusters per vine, yield per vine, or weight of the grapes. Biodynamically treated winegrapes did however have significantly higher Brix (p < 0.05) and marginally higher total phenols and anthocyanins (p < 0.1).
Whether or not the idea of biodynamics and the “seed life force” are little more than mental manure, biodynamic wines have acquired a following. Burgundy’s renowned Domaine de la Romanée-Conti, Chateau Pontet-Canet in Bordeaux, and California A-listers from Araujo to Quintessa tout their biodynamic credentials. Of course these are not inexpensive wines, and part of their appeal may be the emphasis on sustainability and connection to the earth, however fanciful. Great wines embody a numinous quality that transcends scientific scrutiny, so maybe it is sometimes best not to question but just enjoy. May the seed life force be with you.
“Drinking wine was not a snobbism nor a sign of sophistication nor a cult; it was as natural as eating and to me as necessary...” ― Ernest Hemingway, A Moveable Feast
1. Reeve JR,Carpenter-Boggs L, Reganold JP, York AL, McGourty G, McCloskey LP. Soil and Winegrape Quality in Biodynamically and Organically Managed Vineyards. Am. J. Enol. Vitic 2005 December 56 (4); 367-376.

Friday, March 25, 2016

New study suggests moderate drinking not so good after all – or is it?

     A very large review out recently has experts proclaiming that we had it all wrong in believing that moderate drinking was a good thing. As I so often do, I cast a dissenting vote on this one, and offer an alternative (and possible more accurate) interpretation.
     This latest study, from the University of Victoria in Canada, is impressive in scope and has been widely reported. In it, Tim Stockwell, study author and the director of the Center for Addictions Research of British Columbia, questions the long-established J-shaped curve which demonstrates that moderate drinkers are healthier and outlive nondrinkers and heavy drinkers. He cites what is termed the “abstainer bias,” meaning that people who choose to abstain from alcohol are different than people who quit drinking because of health reasons. Another term for this is the “sick quitter” hypothesis. The result of lumping sick quitters with never drinkers together is a skew toward poor health in the nondrinker group, resulting in a greater apparent difference between them and moderate drinkers. The study is a review of other published studies, called a meta-analysis, and it attempted to resolve the question by separating those that differentiate between never drinkers and sick quitters. In so doing, they found that the net benefit of moderate drinking vanishes.
     Or not. Meta-analysis can be a tool for teasing out subtle statistical trends, but it can also magnify existing biases. A better way to ask the question is “What happens to lifelong abstainers who start drinking, and what happens to healthy moderate drinkers who quit?” This was addressed neatly in a 2008 study from Australia, which prospectively followed more than 13,000 subjects for 12 years. The study substantiated the  J-shaped curve, with moderate drinkers enjoying a higher overall health score than nondrinkers, as expected. More importantly, when moderate drinkers changed their habits – either reducing or increasing their consumption – their health scores deteriorated. They further found that the health of recent abstainers and intermittent drinkers was the same as longer-term abstainers. This held true even after adjusting for chronic health conditions. In other words, no evidence for abstainer bias was found.

     Perhaps a bias not considered by the authors of the UVC study was the fact that the project was done under the auspices of an addiction center, presumably disinclined to promote healthy drinking. A commentary that accompanied the paper came from the Alcohol Research Group in Emeryville, California, whose mission “seeks to reduce alcohol-related harms,” lauded the findings. They said it could help fight back against “renewed calls from certain medical commentators to prescribe moderate drinking.” I count myself one of those certain medical commentators. 

Thursday, February 18, 2016

To Your Health: Top 10 Reasons to Celebrate National Drink Wine Day

Bacchus national drink wine dayNational Drink Wine Day was created to celebrate healthy drinking so I thought it would be a good time to list 10 reasons why wine is good for health and longevity. Each of these is well established by peer-reviewed studies, and I have included a reference for those wanting more detail. In no particular order, here are a few of my favorites:
1.       Wine drinkers are smart. A study from Denmark found a strong correlation of IQ to preference for wine.
2.       Wine drinkers live longer. Daily moderate consumption of wine is associated with longer average lifespan as compared to nondrinkers and beer or spirits drinkers.
3.       Wine helps prevent diabetes and is good for diabetics.
4.       Wine drinkers are less likely to get Alzheimer’s disease. Many studies show a strong correlation of moderate red wine consumption and better cognitive function with age.
5.       Wine drinkers have a higher quality of life, particularly in old age.
6.       Wine is good for bone health and is associated with lower odds of osteoporosis.
7.       Although the role of wine and cancer is controversial, especially for breast cancer, overall cancer deaths are lower in wine drinkers. As with other things it is a J-shaped curve.
8.       Smile! Wine is good for dental health and helps prevent cavities.
9.       Red wine drinkers have fewer colds and flu. The same is true to a lesser extent for white wine.
10.   Oh and the “French Paradox” heart health thing. This one is so well documented that I am not including a reference, but the next time you hear a report saying something like “…some studies suggest that wine lowers the risk of heart attack” I would suggest that you send this list to the reporter.

This is of course a very incomplete list and all of these things are based on the model of daily moderate consumption. So every day should be drink wine day!

Tuesday, January 12, 2016

Why the UK's new guidelines on alcohol consumption are misguided

   Dismissing decades of research on alcohol and health, the UK’s new stringent guidelines on drinking bring to mind a quote from champagne lover Sir Winston Churchill: “Statistics are like a lamppost to a drunk; used more for support than illumination.” In announcing the new policy, England’s chief medical officer and neo-prohibitionist Sally Davies scorned the idea that a daily glass of wine could be healthy, proclaiming it an “old wives’ tale” and suggesting a cup of tea instead. The policy is said to be based on the latest statistics, but do these truly shed any new light? We are hardly in the dark about the effects of wine on health, with many thousands of research papers on record.
   Davies’ fundamental mistake is to judge all types of drinking the same while focusing the outcome narrowly on cancer, failing to consider the opposite: that an equally narrow focus on wine drinkers might have different outcomes when overall health is concerned. Nothing in the “latest data” counters the fact that on average, people who drink wine with meals on a daily basis outlive nondrinkers, are healthier, and enjoy a higher quality of life by objective measures. Davies’ advice to avoid any drinking at all several days a week is similarly imprudent as it can only serve to encourage bingeing instead of healthy drinking. All types of drink are not the same, and all types of drinking are also varied in their effect on health.
   The policy shines a spotlight on alcohol and cancer where broad daylight is needed in order to see the whole picture. But even here the statements in the new policy take liberties with the facts, with assertions such as “no level of alcohol consumption is safe” while acknowledging in the same document that drinking within the guidelines carries the same cancer risk as not drinking. But even that self-contradictory statement oversimplifies the question, because the relationship is nonlinear; for wine, many disease conditions including most types of cancer plot out on a J-shaped curve. In other words the risk is lower for moderate drinkers, then about the same, and increasing rapidly with heavy drinking.  Unfortunately for the Brits and their pub culture, the J curve is shallower for beer. Unfortunately for the new policy, it similary fails when alternating drinking and teetotaling.

   Perhaps the UK would do well to heed Churchill’s view on drinking: “I have taken more out of alcohol than alcohol has taken out of me.”

Thursday, January 7, 2016

Increasing alcohol levels in wine spurs debate on health effects

     Much ado has been made about a recent article documenting that the alcohol content in wines is often higher than stated on the label, and increasing. It’s been an open secret among winemakers for some time, but if the trend continues it threatens the whole concept of healthy drinking. Policymakers in the UK and elsewhere are already using it to bolster anti-drinking campaigns.
     The analysis, from the University of California Davis and others, was comprehensive and included several factors.  Over the past 2 decades, Old World wines have seen a greater increase in alcohol levels, but New World wines started out higher. Using heat index climate data, the authors found that part of the increase correlated to warmer growing conditions (resulting in higher sugar content translating into more alcohol), and part driven by consumer preference for riper wines with more concentrated flavors. Several factors contribute to the trend and confusion about what it means.
     In the U.S., federal law allows for a tolerance of plus or minus 1.5% of stated alcohol content for wines with less than 14%, which means that a label can say for example 13.5% but actually contain almost 15. Studies on wine and health typically presume an alcohol content of 13% or less, consistent with how wines have traditionally been made. Because people tend to like higher alcohol wines, the regulation is essentially a health benefit loop-hole; it’s sort of like telling us we can get credit for eating our vegetables even though they are deep-fried.
     Alcohol is a part of the healthy drinking equation, but only up to a point. Wine is not just sugar-free grape juice, and there is evidence that de-alcoholized wine does not provide the same level of health benefits. The problem is not that wine has alcohol, it’s a matter of how much is ideal.

     The concept of healthy drinking goes back thousands of years. Philosophers in ancient Greece gathered around wine drinking parties (called symposia) and developed the very ideas upon which civilization is grounded. What is worth noting however is that the wine was always diluted with water, and it was considered unsophisticated to drink it undiluted; even a 50:50 mixture was deemed quite strong. The average wine from recent vintages today would have been judged barbaric by ancient standards.

     There’s a lot at stake for the future of the wine industry and the well-established relationship with healthy living. How will winegrowers adapt to climate change and the shift in consumer preferences without erasing our excuse to enjoy wine? Let’s have a glass or two and philosophize about it – maybe we can figure something out.

Tuesday, December 8, 2015

Resveratrol in your coffee? It’s already a healthy drink

resveratrol coffee glassWhen they come out with a coffee infused with resveratrol, that’s how you know it’s just gone too far. Vera Roasting Company just announced their “CoffVee” blend, intended to bring “the heart-healthy benefits of red wine” to coffee. Like makers of resveratrol supplements, the idea is based on the claim that it is possible for consumers “to enjoy the heart-healthy benefits of a glass of red wine” with every cup, “minus the alcohol.” If only it were so simple.
Here’s why infusing coffee with resveratrol is a bad idea:
Coffee is already a heart-healthy drink. Coffee contains some very potent natural antioxidants and anti-inflammatory compounds, so the addition of resveratrol is unnecessary. A study just out last month evaluated overall causes of mortality in a large population found that coffee consumption was related to lower chances of dying from heart disease, as well as respiratory diseases, diabetes, and pneumonia. The researchers attributed this to improved insulin sensitivity and other benefits. A study last year looking at heart disease specifically found a J-shaped curve for coffee consumption similar to that for wine drinkers: Moderate consumption (3-5 cups per day) had a lower risk than non-consumption or high consumption.
Part of the heart health benefits of red wine are attributable to the alcohol. The only thing that has all the heart health benefits of a glass of red wine is a glass of red wine. Alcohol in the right amounts improves the HDL/LDL cholesterol ratio, which translates to lower risk of cardiovascular disease. Although the effect is more pronounced for wine, drinkers outlive abstainers on average. (Similarly, in coffee, some of the health benefits are attributable to caffeine.)
There isn’t enough resveratrol in a glass of wine to explain all of the benefits of wine consumption. Although there are more than 8,000 articles on resveratrol published in the biomedical literature, it is not clear that it plays as big a role in wine’s health benefits as was thought. It does provide a mechanistic explanation for many of the specific benefits associated with wine such as lowered Alzheimer’s risk, diabetes, and cancer, but in general the doses required to demonstrate the effect experimentally far exceed what you get in a glass (or a few dozen glasses) of wine. Ergo, it can’t be resveratrol alone that explains the French Paradox.

There are some interesting parallels with wine and coffee. Both contain potent antioxidants and demonstrate a J-shaped curve. Sugar in coffee largely negates the health benefit, and that is also a reason why wine consumption is not the same as drinking grape juice. Processing the sugars into alcohol produces a healthier drink. For me, I’ll stick to regular coffee in the morning and wine with dinner.

Tuesday, September 22, 2015

Seeing red over breast cancer-wine reports: Why studies still get it wrong

A recent headline announcing the results of another study examining the role of alcohol and risk of breast cancer proclaimed that even a glass of wine a day “can significantly increase a woman’s cancer risk.” The connection between drinking and breast cancer has been a troublesome one, the thorn among the rosés, if you’ll pardon the metaphor. It’s not that I mean to make light of all this well-intentioned alarm bell ringing, but the way I see it research on wine and breast cancer just keeps repeating the same mistakes. When it comes to the question of wine and breast cancer, most studies still get it wrong.
That’s one reason why I can’t help but be a little bit cynical every October, when pink ribbons start sprouting everywhere, from lapels to football jerseys to cereal boxes. Increased awareness is laudable, but I wonder if these efforts do more to make us feel good than they do to actually make a difference for women with breast cancer. Case in point: the Komen Foundation, with its trademarked “for the cure” campaigns, reportedly spends less than a fifth of funds on research support to find a cure.
Advocates for breast cancer victims can’t be blamed for the misunderstandings about wine and cancer, and it’s hard to criticize the researchers - whose intentions are noble – but perspective is lacking. The Komen foundation wouldn’t even accept funds from a charitable wine auction I was involved in a few years ago when we approached the local chapter with the idea of making them a beneficiary. So we have this crazy situation where a breast cancer foundation won’t accept wine money, which may be a good thing because they don’t allocate much of it for research anyway.
Here’s the fundamental problem: When you do a study to identify which lifestyle factors are related to breast cancer (or anything else), of necessity you rely on self-reported questionnaires. With the question of drinking, there is a well-known under-reporting tendency so what subjects say they drink and what they actually drink are often not the same. This results in heavy drinking being mis-categorized as moderate drinking, with the implication that moderate drinking is riskier than it is.
When it comes to type of drinking, for example wine vs. beer or spirits, it becomes even murkier. What is well known about wine drinking and other disease conditions is that a pattern of a glass or two of wine with dinner on a daily basis is associated with lower risk than for nondrinkers. But very few people in a given North American population actually drink this way. What the studies do is ask about drinking preferences; if someone says they prefer wine with dinner, they may only do it occasionally, and sometimes have no alcoholic beverage, sometimes other types of drinks, and in varying amounts depending on circumstances. This makes it virtually impossible to know what the actual role of wine might be, even accounting for the under-reporting bias. No matter how large the study, or how long-term, it’s the same problem only amplified.
It’s clear that heavy drinking of any type is associated with higher risk, but what’s not as clear is how this extrapolates to low or moderate drinking. Generally, studies infer that a drink a day increases breast cancer risk by 10%, 2 drinks 20%, and on up. What this means (often misunderstood) is this is a percentage of baseline risk; so if you are at average lifetime risk of about 8 or 9 percent, a 10% increase is not 18 or 19%, but somewhere around 10 percent overall. (10% of 9% is 0.9%, so a 10% increase = 9.9%)
To put this in perspective it is helpful to consider that heart disease dwarfs breast cancer as a cause of death in women, and there is no question that moderate drinking (especially wine) associates with a lower risk. The same is true for diabetes, osteoporosis, and Alzheimer’s. For most women, stopping drinking to reduce breast cancer risk would result in an increased overall risk of premature death and disability.
But even that doesn’t tell the whole story. I am not convinced that moderate wine drinking contributes to even a low risk of breast cancer for the average woman. The definitive way to answer the question would be to study a population of women who only drink red wine, and in moderation as an integral part of their lifestyle. There are not very many of these studies because there are not many such populations anymore, but there is some good data. The best of these studies was done in Bordeaux a few years ago (1), and the conclusion was that wine drinkers had a substantially lower rate of breast cancer than nondrinkers.
Why should this be the case? For alcohol and breast cancer, it took years for a plausible cause-effect relationship to be put forth, and the best hypothesis is that it changes estrogen metabolism. Higher estrogen translates to greater risk of certain types of breast cancers. These types, known as estrogen-receptor positive (ER+), are often treated with drugs called aromatase inhibitors, which ramp down estrogen production. Red wine, as it turns out, is a natural aromatase inhibitor.
So forgive me if I don’t sport a pink ribbon, but I wish we had more efforts like the former Cleavage Creek Winery, which used profits to directly fund research at institutions like the Fred Hutchinson Cancer Research Center and Bastyr Naturopathic University in Seattle, bypassing “Big Pink.”  Founded by the late California winemaker Budge Brown after losing his wife of 48 years to breast cancer, Cleavage Creek donated more than $90,000 before the winery closed. So I say please do have a glass of red wine and toast to all those who are doing so much to save and improve women’s lives.

1.  Bessaoud F, Daurès JP. Patterns of alcohol (especially wine) consumption and breast cancer risk: a case-control study among a population in Southern France. Ann Epidemiol. 2008 Jun;18(6):467-75.