diet and nutrition


The intensity of binge alcohol consumption among U.S. adults. PDF Print E-mail

Am J Prev Med. 2010 Feb;38(2):201-7.

The intensity of binge alcohol consumption among U.S. adults.

Naimi TS, Nelson DE, Brewer RD.

Alcohol Team, Emerging Investigations and Analytic Methods Branch, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia, USA. This e-mail address is being protected from spambots. You need JavaScript enabled to view it

BACKGROUND: Binge drinking (consuming five or more drinks during a drinking occasion) is responsible for more than half of the 79,000 annual deaths due to excessive drinking in the U.S. Although studies show a strong dose-response relationship between the intensity of binge drinking (i.e., the number of drinks consumed per binge episode) and adverse outcomes, there are no population-based studies assessing this measure. PURPOSE: This study aims to analyze population-based data from a module of questions on binge drinking among U.S. adults to assess the number of drinks consumed by binge drinkers and the associated independent risk factors for consuming more drinks. METHODS: Data were analyzed from 14,143 adult binge drinkers who responded to the Behavioral Risk Factor Surveillance System binge drinking module in 2003 and 2004. Total drinks were calculated by summing the total number of beer, wine, and liquor-containing drinks consumed during a respondents' most recent binge drinking episode. RESULTS: Binge drinkers consumed an average of 8.0 drinks (median 6) during their most recent binge drinking episode; 70.0% of binge drinkers consumed six or more drinks, and 38.4% consumed eight or more drinks. Men consumed more drinks during their last binge episode than women (M = 8.3 vs 7.0, median = 7 vs 6), and those aged 18-34 years consumed more drinks than those aged >34 years for both men and women. Independent risk factors for consuming eight or more drinks included being male; being aged <35 years; being other than white race/ethnicity; having less education; not being married; binge drinking three or more times in the past 30 days; and drinking mostly beer. CONCLUSIONS: Most adult binge drinkers drink in excess of the five-drink threshold defining this risky behavior. The intensity of binge drinking should be monitored regularly by health agencies to improve surveillance and to better assess the impact of interventions designed to reduce binge drinking and its consequences.

 

 
health benefits of red wine chemical unclear PDF Print E-mail

Michelle Brandt, Senior Communication Manager, Stanford University School of Medicine asked the WineDoctors to comment on a recent article published in Nature magazine on January 19, 2010, entitled: Health benefits of red-wine chemical unclear.1

Background. In 2007, Christopher Wesphal et al, reported that resveratrol directly activated sirtuin-1 (SIRT1). SIRT1 is a mediator of the pathways involved in calorie restriction that have been shown to delay the onset and reduce the incidence of age-related diseases such as type 2 diabetes. Westphal et al. identified 3 compounds that were 1000 times more potent than resveratrol called Sirtuis compounds. These compounds are now in Phase II clinical trials for treatment of Diabetes Mellitus type II and one for cancer. A recent study published by Kay Ahn et al calls this into question.3 Specifically, Dr. Ahn and her colleagues reported that resveratrol has to be linked to a substrate or a chemical called a fluorophore to activate SIRT1. Further, in their study, the Sirtuis compounds do not directly activate sirtuin-1 without linkage to a fluorophore.

Response. Scientific literature is fraught with examples of chemicals and molecules that have beneficial effects in vitro that are not translated into clinical medicine. In translational medicine, basic science and clinical researchers work to bring hypotheses from “bench to bedside” or from a test tube with the ultimate goal of helping patients. Steps from bench to bedside include a preclinical “proof of concept” study that is a misnomer but a rigorous scientific process to form hypotheses to be tested. “Prevention trials look for better ways to prevent disease in people who have never had the disease or to prevent a disease from returning. These approaches may include medicines, vaccines, vitamins, minerals, or lifestyle changes. Treatment trials test experimental treatments, new combinations of drugs, or new approaches to surgery or radiation therapy.

Clinical trials are conducted in phases. The trials at each phase have a different purpose and help scientists answer different questions:

In Phase I trials, researchers test an experimental drug or treatment in a small group of people (20-80) for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.

In Phase II trials, the experimental study drug or treatment is given to a larger group of people (100-300) to see if it is effective and to further evaluate its safety.

In Phase III trials, the experimental study drug or treatment is given to large groups of people (1,000-3,000) to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the experimental drug or treatment to be used safely.

In Phase IV trials, post marketing studies delineate additional information including the drug's risks, benefits, and optimal use.”4

A large majority of Phase III clinical trials fail.5 Reasons include problems in preclinical translational research: variability in the model; positive bias (i.e., positive results advance scientists’ careers); negative bias (i.e., journals are less likely to publish articles with negative conclusions) and; proving feasibility of an original approach to the treatment of disease can lead to patents and lucrative licensing agreements.6

In conclusion, the implications of resveratrol research are profound and broad reaching, calling into question application of the scientific method as compounds approach evaluation by the FDA. Standardization and replication trials will be required as controversy surrounds the use of compounds that promise age-defying benefits. Ethics and conflict of interest may be called into question, but the potential that medications and supplements may be on the horizon that seem to benefit humans in ways that wine consumption does offer exciting prospects for future health benefits.

1. Buchen L. Health benefits of red-wine chemical unclear. Nature News 2010 Jan 19. http://www.bioedonline.org/news/news.cfm?art=6015.

2. Jill C. Milne1,4, Philip D. Lambert1,4, Simon Schenk2,4, David P. Carney1, Jesse J. Smith1, David J. Gagne1, Lei Jin1, Olivier Boss1, Robert B. Perni1, Chi B. Vu1, Jean E. Bemis1, Roger Xie1, Jeremy S. Disch1, Pui Yee Ng1, Joseph J. Nunes1, Amy V. Lynch1, Hongying Yang1, Heidi Galonek1, Kristine Israelian1, Wendy Choy1, Andre Iffland1, Siva Lavu1, Oliver Medvedik1, David A. Sinclair3, Jerrold M. Olefsky2, Michael R. Jirousek1, Peter J. Elliott1 & Christoph H. Westphal1 Small molecule activators of SIRT1 as therapeutics for the treatment of type 2 diabetes. Nature 450, 712-716 (29 November 2007) | doi:10.1038/nature06261; Received 3 August 2007; Accepted 17 September 2007

3. Pacholec M, Chrunyk BA, Cunningham D, Flynn D, Griffith DA, Griffor M, Loulakis P, Pabst B, Qiu X, Stockman B, Thanabal V, Varghese A, Ward J, Withka J, Ahn K. Pfizer, United States. SRT1720, SRT2183, SRT1460, and resveratrol are not direct activators of SIRT1. J Biol Chem. 2010 Jan 8.

4. www.clinicaltrials.gov.

5. Lowenstein PR, Castro MG. Uncertainty in the translation of preclinical experiments to clinical trials. Why do most phase III clinical trials fail? Curr Gene Ther. 2009 Oct;9(5):368-74.

6. Unger EF. All is not well in the world of translational research. J Am Coll Cardiol. 2007 Aug 21;50(8):738-40. Epub 2007 Aug 6.

 

 
Separating the science from MOG: Resveratrol supplements PDF Print E-mail
Sunday, 10 January 2010 23:03

Separating the science from MOG: Resveratrol supplements

Nutritional supplements are being investigated for prevention and treatment of various diseases and for their anti-aging potential. Resveratrol is a plant phenol found in grape, peanut, and berry varieties. It was first isolated from the roots of hellebore (Veratrum grandiflorum O. Loes) in 1940. The interest in this compound expanded when it was detected in wine in 1992. Resveratrol has been the focus of many basic science research labs and media reports. Unfortunately, research findings have not been translated into clinical practice, i.e., results using animal models and cells in test tubes have not been replicated in human subjects. Nonetheless, an over-the-counter market has developed that peddles resveratrol supplements (pills, capsules, and creams) for the following maladies:

 
March is National Nutrition Month PDF Print E-mail

An interview with Dr. John De Luca

March is Nutrition Month and could be no better time to talk about the role of wine and nutrition. We can think of no better person to discuss these issues with than John De Luca, Ph.D., President and CEO of the Wine Institute for 28 years, now serving in position of Executive Vice Chairman since 2003.

It is our pleasure to introduce Dr. John De Luca.

Dr. De Luca has been Senior Advisor to the President of the University of California for Agriculture and Business, Distinguished Visiting Scholar and on the Board of Advisors at the Goldman School of Public Policy at UC Berkeley and chairs the Board of Directors for the Ernest Gallo Clinic and Research Center at UC San Francisco, a White House Fellow in the Johnson administration and Deputy Mayor of the city of San Francisco from 1968-75 among many other notable positions.

You bring with you a wealth of 20th century history as agriculture and viticulture interfaced with politics. Can you share a few of the highlights?

The challenges faced by the wine industry might sometimes have seemed as Herculean as the task that Nixon had convincing Khrushchev of capitalism. (Dr. De Luca was present at the famous "Kitchen Debate" between Nikita Khrushchev and Richard Nixon in the summer of 1959. As a Ford Foundation and Fulbright Scholar, he traveled between Rome and Moscow from 1959 - 1962). He was struck by the cultural differences in these countries, specifically in the day-to-day life where Italians drank wine regularly as they gathered socially for meals. Drinking in the USSR was usually not wine, and there was much more binge drinking. Italians enjoyed their food with their wine and excesses were seldom and frowned upon.

What has been the experience of the United States?

It was the British and not the French who won the series of battles collectively called the French and Indian Wars (1689-1763) which dramatically shaped our country's future culture and traditions. Although Puritans brought beer on the Mayflower to prevent scurvy, they taught abstinence and restraint. Long term we evolved into a Prohibitionist society, the effects of which still persist in many sections of America.

Wine, Beer and spirits have been regulated and taxed since the early years of the founding fathers. Over time our different states enacted prohibitionist laws and regulations. National Prohibition was imposed by the 18th Amendment (1920-1933); and interstate commerce was severely restricted even after Repeal by the 21st Amendment.

Two federal departments (USDA and HHS) began publishing nutritional guidelines in 1980. These original guidelines were very negative towards alcohol consumption. In 1988 the US Congress legislated the imposition of alcohol beverage warning labels. Since then there has been a mandated warning on every bottle of wine, beer and spirits sold in the United States, which states in part: According to the Surgeon General, women should not drink alcoholic beverages during pregnancy because of the risks of birth defects.

In the early 1990's, though, the French Paradox and Willet's (Harvard School of Public Health) Healthy Eating Pyramid and the 1995 Federal Dietary Guidelines revolutionized the way Americans began to look at wine and health.

Wine went from being treated as an entry-level "gateway drug" subject to "sin taxes" to taking a position at the nutritional and dietary table. Alcohol in moderation was being seriously addressed at the national research level. Scientific and medical studies, many funded at the federal level, helped shape public policy fidings to include cardiovascular benefits with moderate consumption. More recent prospective studies still alert us against abusive behavior, but now expand the association of moderate wine consumption with a reduction in all-cause morbidity and mortality. No one is pushing or promoting drinking, but it is getting more and more difficult to argue with the transparency of the scientific data and potential health benefits.

Folk wisdom is being replaced by science. A glass of wine, long a symbol used in religious ceremonies and in medicine in societies for thousands of years is now being studied in its components, e.g., resveratrol, anti-oxidants, and phytochemicals. The Mediterranean diet, day-to-day peasant food has been elevated to profound significance.

Economically, wine production in the United States is at its highest level. An independent research study on wine eight years ago showed that wine's economic impact represented well over $30 billion a year for California's overall economy (e.g. tourism, hospitality, restaurants, employment, etc.). Now, the wine industry represents more than $50 billion in California alone.

These are exciting times to study the impact of wine on health. We distilled volumes of information into a thumbnail sketch. We hope that we whetted some appetites in the process! We thank Dr. DeLuca for the cherished hours we have spent with him and the knowledge, generosity, and friendship both he and his wife, Jo have bestowed upon us.

 
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