Is wine really good for you?

"Wine is good for you" proclamations go way back. Further than the 1991 "60 Minutes" report that the wine-loving French live longer than Americans despite a higher-fat diet, more smoking and less exercise. Even further than Thomas Jefferson's declaration that a tariff on wine is "a tax on the health of our citizens."

Actually, this mantra goes all the way back to the man widely considered the father of Western medicine, Hippocrates, who called wine "an appropriate article for mankind, both for the healthy body and for the ailing man."

But since that "60 Minutes" report, which prompted a 39 percent increase in U.S. sales of red wine the next year, hundreds of researchers have conducted scores of tests on the possible benefits of wine. Many have tagged a compound called resveratrol as the "magic bullet" producing positive effects.

Wrong. Or mostly wrong, new research suggests.

The biggest benefits are derived from the component that makes millions steer clear of wine.

"The key ingredient in alcoholic beverages that affects most health outcomes is probably alcohol itself," said R. Curtis Ellison, who has spent decades studying the effects of wine consumption.

"Wine contains up to 500 different polyphenolic compounds, many of which have been shown to improve health," said Ellison, founder/director of the Institute on Lifestyle and Health at Boston University School of Medicine. "These substances strongly affect the risk of cardiovascular disease, diabetes and dementia."

Leo Sioris, a University of Minnesota pharmacy professor who, like Ellison, has spent decades studying wine, agreed.

Resveratrol has little, if anything, to do with red wine's benefit, he said. "It's the whole package of red wine, not the least of the polyphenols."

Among alcoholic beverages, red wine contains the most such compounds and thus the strongest positive effect on health, followed in order by white wine, beer and spirits.

Yet red wine affects people differently, depending on their age, health and presence of specific diseases.

Of course, there's one factor that all of this has in common: moderation.

"As with all drugs, which alcohol and wine are," Sioris said, "the dose makes the benefit, and the dose makes the poison."

Yes, red wine can be good for you — when consumed in moderation. Yet wine's potential benefits can differ depending on a person's age and relative state of health. Presented with different scenarios, two medical experts provided the lowdown on how wine affects various demographics of people and especially those with specific diseases. R. Curtis Ellison is the founder/director of the Institute on Lifestyle and Health at Boston University School of Medicine. Leo Sioris is a University of Minnesota pharmacy professor.

If you are middle-aged …

For postmenopausal women and middle-aged men consuming wine in moderation, Ellison said, "there are rather large and significant decreases in the risk of most of the 'diseases of aging,' especially coronary heart disease, stroke, diabetes and dementia. Cardiovascular diseases [CVDs] remain the leading cause of death in developed countries, and moderate drinkers, especially those who consume wine with meals, have about 30 percent or greater reductions in risk of getting these diseases or dying from them."

If you are young …

Young people derive few health benefits from drinking wine, Ellison said, because they are not susceptible to the aforementioned "diseases of aging."

If you are a senior …

The positive effects of moderate wine consumption are roughly the same as for the middle-aged. But even minor consumption can make older folks more susceptible to falls, Sioris said, especially if they are overweight and/or walking outside in slippery conditions. But the benefits of moderate consumption outweigh the risks overall.

If you are pregnant …

Some recent studies have indicated that children born to women who drink moderately during pregnancy are no more likely to have cognitive or behavioral problems than those of abstainers. At the very least, Ellison said, "there is insufficient scientific evidence that an occasional drink of alcohol during pregnancy leads to harm to the fetus."

But since this has become "an especially emotional and even a moral issue," Ellison said he and fellow attendees at a recent Alcohol Forum agreed that alcohol consumption should not be recommended for pregnant women. Part of the reason is that, should a newborn have any abnormalities, "the mother and perhaps even her doctor might blame the abnormality on alcohol consumption."

But he stressed that if a woman learns she is pregnant after consuming wine (since the baby was conceived), this "should not cause undue alarm." Finally, "heavy-drinking women who become pregnant should be strongly urged to stop their drinking," Ellison said. Such activity might cause miscarriage, stillbirth, birth defects or long-term medical issues.

If you are a smoker …

Heavy alcohol use, especially when combined with heavy smoking, is a major cause of cancers of the mouth, throat and esophagus. But most research indicates that the risk of these cancers is not increased from moderate drinking.

If you are concerned about cancer …

The bad news: There is convincing evidence, Ellison said, that breast cancer in women is slightly increased by even moderate drinking.

The not-quite-as-bad news: Among middle-aged women, alcohol avoidance might lower the chances of breast cancer, Ellison said, but "the total mortality risk will be higher than if she continued to drink moderately, as CVD is much more common than breast cancer."

The good news: The risks of a few types of cancer — lymphomas, kidney cancer, thyroid cancer — are lower among moderate drinkers than among abstainers.

If you are concerned about diabetes …

Ellison calls alcohol "the most important aspect of the reduction in the risk of diabetes, in that we see that for all beverages." Sioris pointed out that alcohol "improves insulin sensitivity and thereby lowers fasting blood sugar levels. There is probably a 40 to 60 percent decrease in the incidence of Type 2 diabetes in moderate drinkers over abstainers."

If you are concerned about dementia …

Sioris added that "the data is very consistent showing a 40 percent and greater decrease in the incidence of dementia and Alzheimer's in those 55 years of age and older" with moderate consistent drinking.

If you are prone to depression …

Low doses "might make us more relaxed and less anxious," Sioris said, but "as the dose increases … it might lead to a depressing feeling or worsen a pre-existing depression."

If you like beer or spirits but not wine …

According to Sioris, "any alcoholic beverage in moderate doses is going to afford some level of protection for CVD, stroke, diabetes and even dementia and others." But he added that the carbohydrate calorie consumption among beer drinkers can lead to increased fat storage and that the concentration of alcohol in most spirit drinks can contribute to gastrointestinal cancers. In addition, "the diets of beer and spirit drinkers generally are not as healthy as that of wine drinkers." That can create what Sioris calls "a confounding variable" in that it "may not show the degree of positive benefit seen [in] wine drinkers."

Finally, Ellison said for dementia, "several studies see much more of a protection for wine drinkers, with little or no protection among consumers of spirits."

Bill Ward • 612-673-7643