Though both are now wine writers, Dr. Michael Apstein and Dr. Ian D’Agata met while working in a Boston hospital as gastroenterologists. (That’s the kind of doctor who puts a camera up your butthole.) Earlier this month, they held a seminar in Canada on wine and health that was candid and wide-ranging.

Some of what was said is already well-known: wine has some heart-protecting benefits, but drinking too much is bad for you. Other points were less obvious, so I’ll list them in bullet points below.

I’m glad to write this for Palate Press, because if I tried to publish it in a newspaper I would have to waste everyone’s time with long, boring disclaimers. Instead, here’s just one: I’m not a doctor. (But they are.)

Clean Livering

  • Perhaps the most interesting observation: Taking a week or a month off from drinking wine is not particularly beneficial.”This idea of doing a cleanse or having a dry January is utter nonsense,” Apstein asserts. “Those that think they need a dry January might be drinking too much the rest of the year.”

The liver creates enzymes to metabolize alcohol and “has the capacity to create more enzymes,” he clarifies. “Consistent moderate drinking is better. That’s why that first glass hits like a ton of bricks after a cold, or a few days of not drinking. The workers in the liver, the little guys who make the enzymes, they have taken the day off. They’ve thought, ‘Why should we keep making more enzymes?'”

  • Acetaminophen (aka Tylenol) should never be taken while drinking wine. “People who drink have a higher risk of getting liver disease from Tylenol,” Apstein reports.

Hard to Stomach

  • Aspirin is also not an ideal painkiller for drinkers. “Like wine, aspirin in the right quantities is beneficial,” continues Apstein. “In the wrong quantities, it put my kids through college, because it burns the stomach lining.” (His daughter is a writer for Sports Illustrated, so sports fans can thank aspirin.)
  • Sparkling wine makes people drunk faster than still wine because, according to D’Agata, “carbonation is an accelerator of stomach emptying. Keeping alcohol in the stomach longer allows it to be broken down more and absorbed less, thus limiting the rise in blood alcohol. That’s why it’s good to eat while drinking. It slows down the emptying of the stomach.”
  • Wine is close to the pH of stomach acid, which helps digestion. It also, however, makes heartburn worse.
  • Moderate drinking may be a good idea, but there is no way to universally define what that actually means. “Women have a different stomach enzyme,” notes D’Agata, “or these enzymes are blocked by estrogen, so they have a harder time breaking down alcohol than men.” In addition, Apstein adds, 50% of Asians lack the enzyme to break down acid aldeyhde, a key component of alcohol.

Headroom

  • Hangover remedies don’t work, regardless of whether they’re taken before or after drinking. To avoid a hangover, “drink a liter of water before going to bed,” D’Agata advises. “And probably a little sugar too.”
  • Sorry, but they don’t know what causes red wine headaches. “The Bordelais, who barely acknowledge the existence of white wine, say that’s what gives headaches,” recalls Apstein. “The Champenois say it’s still wine. In Burgundy, they say no wine gives headaches. There’s clearly a cultural overlay. Some think it’s histamines and try to treat it with beta blockers. But most people who get headaches stop drinking wine.”

hangover

Alternative Facts on Sulfites

  • Some people – about 1% of Americans, according to the FDA – have a genuine allergic reaction to sulfites, with symptoms like potentially dangerous asthmatic reactions and hives. For the other 99% of us, sulfites are not only not a problem, they keep the wine tasting good. To this, panel moderator Tony Aspler jokes that “the back label should say guaranteed to contain sulfites.”

“Sulfites are an overblown worry,” adds Apstein. “The gorilla in the bottle is alcohol. It’s not the sulfites. It’s not any additive. It’s the alcohol.”

He continues, via email, that there’s no obvious reason a low-sulfite wine would have greater health benefits for people not allergic to sulfites than one with higher concentrations.

  • Along those lines, D’Agata states that most natural wines smell like bruised apples. “If acetylaldehyde molecules don’t bind with sulfur, we get free acetylaldehyde,” he offers. “People talk about natural wines showing terroir. They all smell like bruised apples, and that comes from acetylaldehyde. That’s not terroir.”

Women’s Health

  • On wine and pregnancy, there isn’t good news for women. The fetus is most sensitive in the first three months, D’Agata cautions, adding that “it’s probably safe to say it’s best not to drink any alcohol in the first trimester.” The problem is, of course, that many women don’t immediately realize they’re pregnant.

As for later in pregnancy, Apstein contributes, “we know that a woman who drinks a pint of vodka a day will deliver a severely deformed child. If she drinks a teaspoon of wine a day, however, does that increase the risk of Fetal Alcohol Syndrome? We don’t know. We don’t have data, and there’s never going to be a study on pregnant women.”

  • While I’m delivering women bad news, here’s more. “Some studies show that alcohol is beneficial for some forms of cancer,” points out D’Agata. “But not breast cancer. Breast cancer is a bad issue. For the most part, if there’s history in the family, it’s probably best to abstain from alcohol.” He later follows up by email, saying there is one study implying that drinking with a family history of breast cancer may be OK.

Bloodwork

  • Breathalyzer tests measure alcohol absorbed from the mouth, even without swallowing the wine, according to Apstein. So even compulsive spitters should beware driving after big wine tastings.
  • There is good news for diabetics. “Peak blood sugar concentration is 30% lower after a meal that includes a glass of wine,” D’Agata reports. “That lower blood sugar is at the core of why wine is good for you.”

Apstein adds that “most of the advice on drinking for diabetics assumes they’re not going to be eating. With dry wines, you should be able to calculate the calories. A 750 ml bottle of 12.5% alcohol wine is about 500 calories. It’s not all that much.”

Start ‘Em Young

  • Both doctors think we should teach kids to drink. (Note: They don’t like that wording, but I do, because alcohol education in this country usually equals abstinence education. So, How To Drink 101.)

“There are a lot of activities that are pleasurable and potentially dangerous, like alcohol. Like driving. Like sex,” Apstein opines. “We have driver’s education. We have sex education. We need drinking education. This country is crazy. You can’t drink anything until age 21 and then you can drink as much as you want. We need alcohol education.”

“We could do something at the school level and get them early and promote a healthy way to drink wine,” concludes D’Agata.

About The Author

W. Blake Gray
Staff Writer

Wine writer W. Blake Gray is Chairman of the Electoral College of the Vintners Hall of Fame. Previously wine writer/editor for the San Francisco Chronicle, he has contributed articles on wine and sake to The Los Angeles Times, Food & Wine, Wine & Spirits, Wine Review Online, and a variety of other publications. He travels frequently to wine regions and enjoys coming home to San Francisco.

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