Weighty Matters
By Harvey Finkel, M.D.Vanity and health are the chief motivations ruling our attempts at weight control. I fear that the former is usually more effective than the desire for good health. Fashions change and so have our physiques. These days, anorexic models set the standards for adolescent girls who want to emulate their matchstick heroines - frightening. But visit your art museum to see how Rubens, for example, depicts a fleshy ideal of beauty in another age.
The ebb and flow of weight gain (especially) and loss continue to be mysteries that science has only begun to understand. To make matters worse, bad information abounds. Wine is often characterized as a cause of corpulence, a kiss of death for any consumable these days, but that portrayal is simply not so. Drinking, even moderately, has also been accused of causing wasting (a condition wherein nutrients are not properly absorbed or incorporated) - also not so.
To debunk these misconceptions, we'll focus only on the scientifically based facts as they relate to wine's influence on weight.
First, we'll review the nutritional makeup of wine. Doctors often hear many of the same questions from their wine-drinking patients, including: Is wine really loaded with calories and/or carbohydrates? Is wine a source of vitamins, minerals and other good stuff? No, in both cases. Dry wine provides few calories, about 80 per four-ounce glass, virtually all from its twelve percent alcohol content. (Table wine generally contains about 2.8 grams of alcohol per ounce; each gram yields seven calories.) Sweet wine and those big reds with amplified alcohol deliver more calories, but not as many as one might fear. Worst case: Port, a fortified wine with 20 percent alcohol and 10 percent residual sugar, would sock us with 178 calories per four-ounce glass, far less than the rich dessert you were eager to consume.
By way of comparison to other alcoholic beverages, consider the Henry Leigh couplet: "If you wish to grow thinner, diminish your dinner, And take to light claret instead of pale ale."
Indeed, dry wine contains no carbohydrates (sugars, starches), so it's safe for diabetics as long as they eat when drinking, and also within bounds for Atkins' dieters. Wine contains no appreciable protein, nor fat. It is a source of only negligible quantities of vitamins and minerals - for those who must restrict their intake of, say, sodium, wine poses no threat - so don't rely on it as a nutritional supplement. Abusers who drink all their calories are doubly endangered from the alcohol load and from malnutrition.
So what is actually in that glass of Chardonnay? A typical dry wine is 86 or 87 percent water and 12 percent ethyl alcohol (ethanol). Much of the rest is composed of those intriguing polyphenolic antioxidants that color, flavor and preserve wine and, along with alcohol, may enhance health and lengthen life; esters and acids important to smell and taste; and many trace materials. Alcohol is the only component that is harmful if taken in excess, other than in rare cases of specific allergies.
The relationship of drinking to weight seems even more complex and murky than the values and liabilities of various diets. We would all be well advised to stick to what's been established by research.
Men and women differ in how they handle calories, especially those provided by alcohol. Men customarily deposit excess calories as fat on their bellies. Equal calories of wine are less likely than those of beer to give one a "beer belly," though no one seems to know why. Women tend to pad their posteriors. The difference may be more than cosmetic, for a fat belly has long been shown to be a coronary risk factor. Indeed, as Hippocrates wrote circa 400 B.C., "Fat men are more likely to die suddenly than the slender."
The weight wiles of women go further. They, more than men, especially when drinking immoderately or compressing their intakes in a short time, are often able to hide calories: They gain less weight than would be calculated for the number of calories consumed. Some observations have suggested that alcohol may have a weight-lowering effect, particularly on women. "The case of the missing calories" remains a mystery. Perhaps alcohol promotes some sort of energy wastage or impairs some metabolic process. Alcohol does not tend to make lean people obese, but it may cause the obese to become more so. Part of the mystery likely reflects contrasting individual differences in handling alcohol.
On the happy contrary, moderate drinking usually helps correct weight excess and reduces the risks of diabetes and cardiovascular disease by several means. With heavy drinking, particularly when accompanied by a high fat intake, satiety may be difficult to reach, so excessive caloric intake may lead to excessive weight gain in the unfulfilled pursuit of satisfaction. A five-year study of 7,608 middle-aged men just published in the American Journal of Clinical Nutrition reports that consumption of one to three drinks per day did not lead to alcohol-related weight gain. More than three drinks per day, however, "contributes directly to weight gain and obesity, irrespective of the type of alcohol consumed." Spirit drinkers tended to be heavier than wine and beer drinkers.
I have personally witnessed impressive desired weight loss resulting from dietary restraint enabled by the satisfaction of a modicum of good wine. Seemingly paradoxical is the confirmed observation that elderly people suffering loss of appetite eat with gusto after being given wine. (Their overall health and spirits also improve.) Anorexia in young women may respond in part to small doses of wine. While we have no definitive explanation for the apparently opposing actions of wine, some of what it does is likely influenced by the condition and metabolic idiosyncrasies of who is drinking and by alcohol's relaxation of emotional tension and depression. This should also raise a caution against the risk of falling into dependency.
Recent reports of weight-loss programs for the severely obese are pleasant surprises. Those patients drinking between 7 and 36 ounces of wine per week lost significantly more weight than those who did not drink or who consumed negligible quantities. Those who drank more than 36 ounces did even better (but that quantity borders on the high side for moderate-drinking women). Is this an example of the mysterious wasting of alcohol-associated calories?
The weight of evidence supports moderate drinking as beneficial to the obese, providing the same health benefits others derive, plus possibly easing weight loss. This may be of particular importance because overweight individuals are especially susceptible to diabetes and cardiovascular disease. I would be chary of more than moderate quantities for a prolonged period. Those truly needing to put on weight may also find help in moderate drinking. As always, individual medical advice should be sought, but if you're blaming the wine instead of the whipped cream, it's time to recalculate your bottom line.
Health Editor Harvey E. Finkel, M.D., a professor at Boston University Medical Center, writes and lectures on the influences of wine on the human body.