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Wine and Health

Wine can be both a medicine and a poison - it is all about the dosage. On this page we will discuss the effects of alcohol on health. We look at the positive and negative effects of alchol, what types of wines are good for you.

Red wine, tannins and health

Wine is made up from a huge array of chemicals, some give the wine its colour, some the flavour and others the mouthfeel or texture. While the grapevine did not intend it, some of these chemicals can also be medicinal. The groupings of all these chemicals are known as Polyphenols. In most research into the health benefits of wine two key chemicals come up: Procyanidins and Resveratrol.

In experiments on mice on high calorie diets, those given large doses of resveratrol do outlive mice on a similar diet, and the resveratol almost completely mitigates the effects of a diet that is high in fat. Wine typically has 0.3% of the dosage that was given to mice though, so if you rely on wine as a source of resveratrol you will almost certainly suffer from liver disease before getting anywhere near the target dosage for mice let alone the higher dosages required for humans to benefit.

The second possible polyphenol is a chemical known as procyanidins. This is often associated with wines with tannins. The main benefit include improvements in vascular function by thinning of the blood. This reduces the risk of heart attacks and strokes, thus improving the chances of overall well-being and length of life.

Risk factors for heart disease are also risk factors for a number of other illnesses including dementure, age related molecular degeneration (old age, blindness), obesity.

In wine, polyphenols, and in particular short small procyanidins, are often associated with young tannic red wines. In older wines these chemicals are less plentiful. As wine matures those short tannins clump togehter to form longer chains eventually percipitating out of the wine and forming the sediment. So the type of wine to drink is young red wines that are rich in tannins - sorry to say that if it says 'easy drinking' it is probably not the wine to drink to improve your health. But tannic wines don't need to be hard work to drink. Tannic red wines go great with meat and cheese dishes, so consider drinking these wines with a meal. Not only will the wine taste better, but will also slow down the time it takes for the alcohol to hit your blood stream, reducing stress on your liver.

The grape varieties to look out for in order of importance are: Tannat, Cabernet Sauvignon, Nebbiolo and Malbec. Try wines from the south west of France, Cahors, Italy or Mendoza in Argentina.

Wine Allergies

Red wine headaches:-

Many people complain that red wines give them a headache. A red wine headache is often induced within 15 minutes of drinking, and is very different from a hangover that may occur 2-6 hours after drinking. The causes of a red wine headache (RWH) is still not well understood, but it is likely to be caused by either Histamines or Tyramine. The problem is that both Histamines and Tyramine are found in other foods that do not cause headaches. Both are common in red wines and are thought to develop in red wines during Malolactic Fermentation.

Tyramine although not definitively identified as the source is the most likely cause of RWH. Dr. Lynn Gretkowski, says “Tyramine is thought to be a vassal active substance that causes the dilation and contraction of blood vessels - the squeezing and relaxation component of headaches.”  Tyramine is suspected of inducing migraine headaches in about 40% of migraine sufferers.  Not all wines have the same level of Tyramine. Tyramines are highest in young and unfiltered red wines. The ageing process is known to integrate and reduce the tyramines in red wine. Therefore older wines and those with more barrel ageing could pose a significantly lower risk of causing RWH. So older and more commercial wines are less likely to be a problem.

Histamines are a common chemical in wines and come from the grape skins. As white wine making typically doesn't  leave the juice in contact with the skin it is limited to red wines, where histamine levels can be 20-200% higher. A very small study of 16  RWH sufferers published on February 2001 in the Journal of Allergy and Clinical Immunology found no difference in reactions to low and high-histamine wines. This however is a very small study and it could be the problem. If you suspect you may suffer from histamine reactions you may want to consider taking a non drowsy anti histamine before drinking a glass of red wine that you know will give you a headache.

Not all wines will cause RWH. Sufferers should identify wines that cause them and those that don’t. When you know a wine causes the problem for you. You could try taking an aspirin or Sudafed before drinking wine for some sufferers this can stop the headache before it even starts. It is too late after the headache has started.

Asthmatic Reactions:-

If wines, particularly white wines, make you wheeze after drinking then you could have an asthmatic reaction to Sulphur Dioxide. Sulphites in wine can cause people with poorly controlled asthma to cough, followed by shortness of breath, wheezing and a tight chest and is caused by inhaling the sulphites. So be careful not to smell the wine too much if you are concerned.  Poorly controlled asthma sufferers can occasionally get a headache. If this only happens with red wines and does not happen when drinking dessert wines then it is not the sulphites causing it.

Sulphites are particularly high in sweet wines,  bag in box wines, wines in PET bottles or sealed with a plastic cork. Red organic wines with screw caps tend to have low levels. Natural wines have the lowest levels and also the shortest shelf life as they are made without adding Sulphur Dioxide, although they are still there in very small quantities as a naturally occurring part of fermentation. They are added to wine as a preservative to mop up any stray oxygen that seeps into the wine.

While many people complain about Sulphur levels,  intolerance is not as common as you would think with only 1% of the population suffering.  If you think you are sulphur intolerant try eating a dried apricot. These are very high in Sulphites, in fact 1 dried apricot typically has 16mg of sulphites over the daily dosage of 15mg for a 10 year old child

Alcohol intolerance

Alcohol intolerance, is caused by a genetic condition where the body cannot break down alcohol. The symptoms are nasal congestion and flushing of the skin, often in red blotches. It is caused by a deficiency of the enzyme Aldehyde Dehydrogenase ADLH/

Alcohol is easily absorbed from the intestinal tract, however, alcohol is a toxic compound and needs to be broken down. To break down alcohol the liver produces the enzyme Aldehyde Dehydrogenase (ALDH) which metabolises alcohol into acetic acid (vinegar). Some people have an alteration in the ALDH gene which makes the enzyme inactive and makes it impossible for them to convert alcohol into acetic acid.

The symptoms are similar to an allergy including most notably nasal congestion and a  mild flushing of the skin within minutes of drinking. Other side-effects include fluttering of the heart (palpitations, tachycardia), sensation of heat, headache, abdominal discomfort or a drop in blood pressure. he lack of the gene is most common in Chinese, Japanese, and Koreans who on average are 50% deficient in ALDH.

What are the limits

Recent press releases by the Centre for Public Health gave a rude awakening to many wine drinkers in the UK. In a surprising set of results it pointed out that while Liverpool and Manchester have England’s highest harmful drinkers at around 8.1% and 8.9% of the adult population respectively, it was the affluent areas that had the most hazardous drinking, with Runnymede, Harrogate and Surrey Heath all at 26% and Guildford, Mid Sussex, Mole Valley Woverly and Leeds above 25% of the adult population.

But what are the limits and what is Harmful and Hazardous drinking?

Sensible drinking is a poorly defined and researched level. It first appeared in the UK in a 1987 pamphlet called the Limit. It was described as the amount to which people should limit their drinking if they wanted to avoid damaging their health.

Hazardous drinking is drinking above recognised sensible levels but not yet experiencing harm. The risk of harm from drinking above sensible levels increases the more alcohol that you drink and the more often you drink over these levels.

Harmful drinking is drinking at levels that lead to significant harm to physical and mental health and at levels that may cause substantial harm to others. Examples include liver damage, cirrhosis, dependence on alcohol, stress or aggression in the family.

So what are the limits in the UK?

Men should drink no more than 21 units of alcohol per week and no more than four units in any one day. Between 22 and 50 units a week, a man is considered a hazardous drinker, and 51 and above they are considered harmful drinker. Men who regularly drink over 8 units a day are at the highest risk of such alcohol related harm.

Women should drink no more than 14 units of alcohol per week and no more than three units in any one day. Between 15 and 35 units a week, a women is considered a hazardous drinker, and 36 and above they are considered harmful drinker. Women who regularly drink over 6 units a day are at the highest risk of such alcohol related harm.

But what is a 'unit'?
The UK advice to the public is based on a term known as a unit. One unit of alcohol is  defined as 10ml (1cl) alcohol by volume (abv), or 8g by weight, of pure alcohol. The table below shows the millilitres of drink for a given abv and the equivalent units.

How much have I drunk?

          Units        
  1 2 3 4 5 6 7 8
  1% 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000
  2% 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000
  3% 333 667 1,000 1,333 1,667 2,000 2,333 2,667
  4% 250 500 750 1,000 1,250 1,500 1,750 2,000
  5% 200 400 600 800 1,000 1,200 1,400 1,600
  6% 167 333 500 667 833 1,000 1,167 1,333
  7% 143 286 429 571 714 857 1,000 1,143
  8% 125 250 375 500 625 750 875 1,000
  9% 111 222 333 444 556 667 778 889
ABV 10% 100 200 300 400 500 600 700 800
  11% 91 182 273 364 455 545 636 727
  12% 83 167 250 333 417 500 583 667
  13% 77 154 231 308 385 462 538 615
  14% 71 143 214 286 357 429 500 571
  15% 67 133 200 267 333 400 467 533
  16% 63 125 188 250 313 375 438 500

Pregnant women. It is known that a lot of alcohol can damage a developing baby. A small amount probably does no harm. However, the exact amount that is safe is not known. Therefore, to play safe, advice from the Department of Health is that pregnant women and women trying to become pregnant should not drink at all. According to the Department of Health Pregnancy Book

Heavy or frequent drinking can seriously harm your baby’s development. When you drink, alcohol reaches your baby through the placenta. But your baby cannot process it as fast as you can, and is exposed to greater amounts of alcohol for longer than you are. And too much exposure to alcohol can seriously affect your baby’s development and can cause Fetal Alcohol Syndrome. Children with this have restricted growth , heart defects, facial abnormalities and learning and behavioural disorders.

The UK’s Chief Medical Officers advise that, as a general rule, pregnant women or women trying to conceive should avoid drinking alcohol. If you do choose to drink, to protect your baby you should not drink more than one or two ‘units’ of alcohol once or twice a week and should not get drunk.

But what do other countries say?

In Australia and New Zealand they use the concept of a standard drink. This is similar to a 'unit' but is based on 10 grams of alcohol while the UK’s unit system is 8 grams (rounded up and based on the specific gravity of ethyl alcohol 0.789). I have put the number of units in brackets beside the standard units. So in Australia the recommendation is:

Men should drink no more than 4 standard drinks (3.2 units) a day, on average. And never more than 6 standard drinks (4.8 units) in one day.

Women should drink no more than 2 standard drinks a day (1.6 units), on average. And never more than 4 standard drinks (3.2 units) in one day.

Everyone should have 1 or 2 alcohol-free days every week.

In New Zealand the Alcohol Advisory Council (ALAC) advise:

Men should drink no more than 3 standard drinks (2.4 units) a day, on average. And never more than 6 standard drinks (4.8 units) in one day.

Women should drink no more than 2 standard drinks a day (1.6 units), on average. And never more than 4 standard drinks (3.2 units) in one day.

Everyone should have 1 or 2 alcohol-free days every week.