Prof. Krzysztof J. Filipiak: a cardiologist recommends a glass of wine with a meal, usually red, always dry

Proven content

We can read in many popular publications that red wine, consumed in moderate amounts, promotes health, especially heart health. This drink contains many beneficial compounds that naturally support its work. But is it true or is it a cleverly disguised advertisement for alcohol that is not officially allowed to promote? We ask prof. n. med. Krzysztof J. Filipiak, cardiologist and wine expert.

1. Small amounts of wine can work well for heart and circulatory health. This is due to the polyphenols contained in this drink
2. Prof. Filipiak says which strains contain the most cardioprotective substances
3. The expert also explains whether only red wines have a positive effect on the heart
4. – Consider moderate consumption. The cardiologist recommends wine, usually red, always dry – says the professor in an interview with Medonet
5. Check your health. Just answer these questions
6. You can find more such stories on the TvoiLokony home page

Monika Zieleniewska, MedTvoiLokony: Apparently, even doctors say that a glass of wine with dinner does not harm and even helps health. And the professor?

Prof. dr. hab. med. Krzysztof J. Filipiak: There are studies showing that even small amounts of alcohol are harmful, and its consumption is certainly associated with an increased risk of cirrhosis, certain cancers or paroxysmal cardiac arrhythmias, but the methodology of these studies is questioned. For a clinician, the most important thing is to determine whether the consumption of small amounts of alcohol contributes to the overall mortality. And here it turns out that it does not increase this mortality, and perhaps even slightly reduces it.

It is hypothesized that alcohol contributes to the increase in the incidence of liver cirrhosis and some cancers, but in return it lowers the risk of heart attack, atherosclerosis, and cardiovascular deaths. This is probably why cardiologists have been looking more liberally at small amounts of alcohol in wine for years, and gastrologists and hepatologists have a more critical attitude towards it.

1. See also: What will a hepatologist not eat? Here are the products that harm our liver the most

So what kind of wine can cardiologists tolerate and why red?

Maybe let’s start by defining what wine is first. Wine is a product obtained from alcoholic fermentation of true Vitis vinifera grapes, containing a minimum of 8,5%. alcohol.

Indeed, our interest for many years has focused on red wine, because it contains many cardioprotective substances. They come from the grape juice itself, and there are more of them in the red, dark peel of a grape berry than in its flesh. Hence, red wines, made from red grapes, seem to be more cardioprotective.

We have been talking for years about wine strains containing especially a lot of polyphenols and it is worth recommending here: Cannonau di Sardegna – an indigenous Sardegna grape, traditionally drunk by local peasants, and today – by the Sardinian population, i.e. people among whom the most centenarians live on our continent . New World strains are also worth recommending – Australian Shiraz, Argentine Malbec, Uruguayan Tannat, South African Pinotage, which contain large amounts of polyphenols and, additionally, are grown in the southern hemisphere, where the air is less polluted than in the northern hemisphere.

So European wines can be more harmful?

European strains also surprise us with their newly discovered cardioprotective properties. For example, Apulian, that is, southern Italian wines such as Negroamaro, Susumaniello or Primitivo, have a broad anti-inflammatory and antioxidant effect; The Balkan strain of Refosco describes a particularly high saturation with a particular polyphenol – furaneol, and this strain is also credited with improving peripheral blood counts. Another jewel of southern Italy – black Aliagnico – contains several dozen identified compounds from the group of polyphenols with antiatherosclerotic and anti-inflammatory properties. In the excellent – also cultivated in Poland – strains of the Pinot noir species, a large occurrence of the so-called orange anthocyanin – callistefin, also found in pomegranates, strawberries and black corn.

Going back to the previous question, should we give up white wines?

I have good news for people who like them. In the Sicilian Zibibbo, in addition to the still studied terpenes (linalool, geraniol, nerol), very interesting cyanidin derivatives with strong antioxidant, anti-cancer and anti-inflammatory effects (chrysanthemine) have been identified. This is the same compound that nature provides us in abundance in black currants.

In many white wines: Sauvignon blanc, Gewurztraminerach, Reslingach, we find a lot of compounds with the presence of sulfhydryl groups – SH, i.e. substances with strong antioxidant or even detoxifying properties, because they bind heavy metals. As professors of cardiology tell me jokingly – wine lovers from Italy, this is why you have to drink white wines with more and more contaminated seafood and fish.

Not everyone knows that pyrazine compounds are responsible for the characteristic notes of gooseberry, especially in my favorite New Zealand Sauvignon blanc. The same compounds can be found in commonly used anti-tuberculosis drugs and in bortezomib – a new drug for multiple myeloma.

In countries with a colder climate, the so-called hybrid strains containing many chemically active compounds supporting physiological processes. I am thinking of the so-called fatty acid degradation products – hexanal, hexanol, hexenal, hexenol, and their derivatives – these in turn are a lot in the strain grown in Poland – Marshal Foch. The so-called the chemistry of wine is really fascinating.

When discussing the positive influence of wine on our body, the heart is mentioned in the first place. What are the salutary effects of wine?

This is mainly due to the constantly expanding knowledge about the influence of alcohol – I would like to emphasize once again, consumed regularly in very small amounts – on the activity of the vascular endothelium and platelets. The alcohol contained in wine has a slightly anti-platelet effect, reduces the generation of blood clots (thrombin effect), improves the expression of substances that are natural blood clot solvents (affects endogenous fibrinolysis), reduces oxygenation of bad LDL cholesterol circulating in the blood, increases the concentration of good HDL cholesterol, increases the production of nitric oxide in endothelial cells and reduces the production of fibrinogen. So in a nutshell and simplification.

Generally, it has not been decided whether the substances contained in the wine or the alcohol itself are of greater importance here. It seems to be a collective action. It is difficult to carry out such research precisely, because wine is a low-percentage, fermented noble grapevine juice, containing hundreds of chemical compounds of an unknown role. Moreover, each grape variety is a unique species, with a different composition, and tens of thousands of them have been described.

The word polyphenols has been mentioned many times. What are these relationships?

To put it simply, polyphenols are a group of phenolic compounds with a strong antioxidant effect, and therefore potentially reducing the risk of cardiovascular diseases and cancer. Polyphenols can be further classified into tannins (esters of gallic acid and saccharides) and flavonoids of particular interest to us.

Flavonoids are colors invented by nature, responsible for the colors of all gifts of nature – fruits and vegetables. They also play an important role – antioxidants, insecticides, fungicides, therefore they are stored mainly in the surface layers of plant tissues, giving them an intense color. We come back to the understanding of the reasons why we are particularly eager to talk about red, rather than white or pink, when we think about these relationships. Flavonoids are the collective name of many compounds further classified as flavonols, flavones, flavanones, flavanonols, isoflavones, catechins and anthocyanidins.

There has been a lot of writing about resveratrol not long ago. Is it a flavonoid that is particularly important for your health?

Resveratrol is one of over eight thousand. described flavonoids, but in fact we got to know about 500 of these compounds. Resveratrol was one of the first, but current research does not indicate it is the Holy Grail of flavonoids. It seems that only the natural combination of hundreds of flavonoids gives the full antioxidant effect. Many more interesting works are currently being published, for example on quercetin.

1. You can buy a dietary supplement with resveratrol at Medonet Market

So how do you determine the dose of alcohol that is beneficial to your health?

We have a problem with that. Promotion of alcohol, especially in our part of Europe, where the consumption of strong alcohols has so far dominated, is unacceptable. As doctors, we must work to change the attitudes of our patients, never persuade them to drink alcohol, but also point out the benefits of drinking moderate amounts of red wine as part of the Mediterranean diet.

When I wrote the review of the book “Wine is good for the heart” by the senior cardiologists dealing with wine in Poland – prof. Władysław Sinkiewicz, a wave of unpleasant comments in social media fell on me. The freedom to talk about this must be ensured. As a young doctor, I once prepared a research project in which we assessed the effect of different strains of red wine on endothelial expansion. The bioethics committee of the Medical University of Warsaw at that time did not consent to its conduct, using the Polish law on upbringing in sobriety. I appealed against her decision to the bioethics committee at the Ministry of Health and this committee did not agree to a study in which students – volunteers were to drink 250 ml of red wine and be subjected to non-invasive tests of vascular endothelial function. The professor of medicine belonging to this committee asked with horror whether we would provide the examined students with sick leave from classes the next day. The study did not come to fruition, and a few years later I found a very similar American one in a good scientific journal.

The conclusion is therefore one – let’s not condemn the knowledge of wine and wine research. On the one hand, we have clear guidelines of the Polish Forum for the Prevention of Cardiovascular Diseases: “any recommendations regarding the initiation or intensification of alcohol consumption, aimed at achieving beneficial health effects, are not recommended”, on the other – it refers to “starting” and “intensifying”. So for people who drink wine with dinner, it is only worth modifying its type, dose, and promoting knowledge about the choice of strain. This is my interpretation.

Besides, since wine accompanies a meal, shouldn’t we pay attention to the food?

Consider what we drink, what we combine wine with, what diet, whether we eat a lot of vegetables and fruits, or limit animal fats and red meat. Maybe it’s better to drink a glass of wine instead of a caloric dessert full of sugar and fat? Today we have no doubts about it. I admit that when a patient enters the office and in the first words of the interview he proudly says that he never “smokes or drinks”, I wonder how shallow education is in Poland, since the deadly addiction of smoking has become equal in the minds of patients with drinking wine.

I read that wine also improves the health of people with dementia, type 2 diabetes, prevents depression, supports longevity and good bacteria in the intestines. Is it all true?

Too many questions for one interview … I refer to the book by prof. Władysław Sinkiewicz. The professor for many years headed the Cardiology Clinic of the Nicolaus Copernicus University in Bydgoszcz, today, retired, he probably has more time to deal with this issue and hence the first Polish monograph on this subject. Another enocardiologist (such a word – neologism – emphasizing the relationship between oenology and cardiology) is also active in the south of Poland – prof. Grzegorz Gajos from Krakow. And I am currently preparing a paper on grapevines and some cardioprotective faces of wine.

Summarizing, what to do to prevent other organs from being damaged thanks to the glass drunk with the heart in mind?

Above all, adhere to moderate consumption. There are problems with its definition, but most often we mean at most one drink a day for a woman and 1-2 drinks for a man. A drink is the amount of 10-15 g of pure alcohol, so the amount contained in 150 ml of wine. This is the equivalent of 330 ml of beer or 30-40 ml of vodka, although in the case of the latter two, the literature proving the cardioprotective effect is very scarce.

Thus, the cardiologist recommends a wine, usually red, always dry.

Consuming any kind of sweet alcohol increases the risk of diabetic disorders, so we must support diabetologists in this regard. Perhaps I would make an exception for Polish dry ciders – it is a pity that Poland stands with strong alcohol and does not support its fruit growers and Polish perfect apples. Maybe we are not a country with a calvados drinking culture (apple distillate, aged in oak barrels), but cider – we could.

An important wording is contained in the European preventive recommendations published by our cardiology society. They talk about reducing alcohol consumption, so a maximum of 7 – 14 doses of alcohol per week for men, 7 for women, but they warn that these doses must not be cumulated! So a glass of wine with dinner every day – here you go. Another model – I don’t drink during the week, the weekend comes and I catch up – never. This style of drinking is associated with the risk of an increase in blood pressure, cardiac arrhythmias, and strokes.

We talked a lot about the cardioprotective effects of polyphenols – for people who do not drink alcohol at all, I also have good news: the same polyphenols are found in fresh seasonal vegetables, fruits, good quality coffee, black chocolate and cocoa.

Why are these moderate drinking standards different for men and women?

In fact, gender is less important here and body weight is more important. Simply, in epidemiological studies, alcohol doses were converted per kilogram of body weight, and that men are larger in population and weigh more – hence the results of the research and subsequent recommendations.

Shouldn’t someone who is prone to addiction drink wine, even with the heart in mind?

It is fair to agree with this, although here I am referring to psychologists and psychiatrists. Generally, let us remember that you can become addicted to everything, and let us not condemn wine too hastily. But perhaps Louis Pasteur was right when he said: “Wine is the healthiest and most hygienic drink.” And the Latin maxim “In vino veritas” has acquired a more universal message over time – there is truth in wine, perhaps the truth about health.

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