Heart Scan Blog Redux: Cheers to flavonoids

Because in Track Your Plaque we've been thinking a lot about anthocyanins, here's a rerun of a previous Heart Scan Blog post about red wine. (Anthocyanins are among the interesting flavonoids in red wine, along with resveratrol and quercetin.)


The case in favor of healthful flavonoids seems to grow bit by bit.

Flavonoids such as procyanadins in wine and chocolate, catechins in tea, and those in walnuts, pomegranates, and pycnogenol (pine bark extract) are suspected to block oxidation of LDL (preventing its entry into plaque), normalize abnormal endothelial constriction, and yield platelet-blocking effects (preventing blood clots).

Dr. Roger Corder is a prolific author of many scientific papers detailing his research into the flavonoids of foods, but wine in particular. He summarizes his findings in a recent book, The Red Wine Diet. Contrary to the obvious vying-for-prime-time title, Dr. Corder's compilation is probably the best mainstream discussion of flavonoids in foods and wines that I've come across. Although it would have been more entertaining if peppered with more wit and humans interest, given the topic, its straightfoward, semi-academic telling of the story makes his points effectively.

Among the important observations Corder makes is that regions of the world with the greatest longevity also correspond to regions with the highest procyanidin flavonoids in their wines.




Regarding the variable flavonoid content of wines, he states:

Although differences in the amount of procyanidins in red wine clearly occur because of the grape variety and the vineyard environment, the winemaker holds the key to what ends up in the bottle. The most important aspect of the winemaking process for ensuring high procyanidins in red wines is the contact time between the liquid and the grape seeds during fermentation when the alcohol concentration reaches about 6 percent. Depending on the fermentation temperature, it may be two to three days or more before this extraction process starts. Grape skins float and seeds sink, so the number of times they are pushed down and stirred into the fermenting wine also increases extraction of procyanidins. Even so, extraction is a slow process and, after fermentation is complete, many red wines are left to macerate with their seeds and skins for days or even weeks in order to extract all the color, flavor, and tannins. Wines that have a contact time of less than seven days will have a relatively low level of procyanidins. Wines with a contact time of ten to fourteen days have decent levels, and those with contact times of three weeks or more have the highest.

He points out that deeply-colored reds are more likely to be richer in procyanidins; mass-produced wines that are usually "house-grade" served at bars and restaurants tend to be low. Some are close to zero.

Wines rich in procyanidins provide several-fold more, such that a single glass can provide the same purported health benefit as several glasses of a procyanidin-poor wine.

So how do various wines stack up in procyanidin content? Here's an abbreviated list from his book:

Australian--tend to be low, except for Australian Cabernet Sauvignon which is moderate.

Chile--only Cabernet Sauvignon stands out, then only moderate in content.

France--Where to start? The French, of course, are the perennial masters of wine, and prolonged contact with skins and seeds is usually taken for granted in many varieties of wine. Each wine region (French wines are generally designated by region, not by variety of grape) can also vary widely in flavonoid content. Nonetheless, Bordeaux rate moderately; Burgundy low to moderate (except the village of Pommard); Languedoc-Roussillon moderate to high (and many great bargains in my experience, since these producers live in the shadow of its northern Bordeaux neighbors); Rhone (Cote du Rhone) moderate to high, though beware of their powerful "barnyard" character upon opening; decanting is wise.

Italy--Much red Italian wine is made from the Sangiovese grape and called variously Chianti, Valpolicella, and "super-Tuscan" when blended with other varietals. Corder rates the southern Italian wines from Sicily, Sardinia, and the mainland as high in procyanidins; most northern varieties are moderate.

Spain--Moderate in general.

United States--Though his comments are disappointingly scanty on the U.S., he points out that Cabernet Sauvignon is the standout for procyanidin content. He mentions only the Napa/Sonoma regions, unfortunately. (I'd like to know how the San Diego-Temecula and Virginian wines fare, for instance.)

The winner in procyanidin content is a variety grown in the Gers region of southwest France, a region with superior longevity of its residents. The wines here are made with the tannat grape within the Madiran appellation; wines labeled "Madiran" must contain 40% or more tannat to be so labeled (such is a quirk of French wine regulation). Among the producers Dr. Corder lists are Chateau de Sabazan, Chateau Saint-Go, Chateau du Bascou, Domaine Labranche Laffont, and Chateau d'Aydie. (A more complete list can be found in his book.)

How does this all figure into the Track Your Plaque program? Can you succeed without red wine? Of course you can. I doubt you could do it, however, without some attention to flavonoid-rich food sources, whether they come from spinach, tea, chocolate, beets, pomegranates, or red wine.

Though my wife and I love wine, I confess that I've never personally drank or even seen a French Madiran wine. Any wine afficionados with some advice?

Comments (32) -

  • Anne

    11/13/2009 12:55:39 PM |

    Well that is lovely to know as we drink a glass of Languedoc red wine every day with our evening meal ! We're lucky enough to have a house in the Languedoc and we load our car up with red wine when we return home to the UK so we always have enough to keep us going between trips.  Just ordinary coteaux du languedoc, nothing fancy, comes in a 'bag in box', just what the locals drink every day and it doesn't cost a lot. Our current favourite 'cave' is at the village of  Montpeyroux.

    My little icon is a photo of the Lac du Salagou nearby.

    Santé,
    Anne

  • Anne

    11/13/2009 1:03:03 PM |

    PS - clicking my name takes you to my blogger details and link to my Web Page of photos of the Languedoc....and some vineyards Smile

  • Bill

    11/13/2009 2:02:36 PM |

    It was Dr. Corder's book that set me on the right track with my diet, back in 2006.
    Here in the UK, Madiran is available at around $15 a bottle, but discounted to around $8 periodically. I had discovered that if I drank only full bodied red wine, I didn't gain weight. Beer piles the weight on for me.
    I progressed from a mediterranean diet to a paleo diet.
    I would recommend you look for Argentinian high altitude heavy red wines.(Malbec) They are considerably cheaper and more available in The USA.
    I fully support the flavinoids mantra.
    Green tea and 90% cocoa dark chocolate are staples in my diet. Red wine 2-3 times a week.

  • John Fisher

    11/13/2009 3:22:56 PM |

    Good post. Now we can have a healthy heart and enjoy drinking red wine as well. One issue that is missing from your post is the frequent and widespread contamination of (red) wine with pesticides, fungicides, herbicides and artificial fertilizers.
    I am living near a wine region and I know that the grapes get sprayed regularly with all this, as much as 10 times per year.

    The alternative is certified organic wine, which is hard to come by.

  • Reise Rachid Jaudy

    11/13/2009 5:34:22 PM |

    Gostei do blog tanto da cor, estrutura, como do conteudo em geral. Parabéns

  • Anonymous

    11/13/2009 6:41:49 PM |

    I thought the fructose in pomegranate juice (or any juice) was very unhealthy? do the benefits of the flavonoids outweigh the costs of the fructose?

    Dave

  • Adam Wilk

    11/13/2009 9:29:51 PM |

    I'm not a wine drinker at all, but I wonder if cooking with it gives the same benefit at all, since my wife cooks with red wine alot--it makes everything even more delicious, and hopefully healthier, too!

    As far as cocoa goes, I add a teaspoon of organic cocoa to my morning coffee, with the hope that I am 'supercharging' my morning brew! (In addition to a packet of Truvia, a dab of coconut oil, and organic cream...)

    Yes, life is good... Wink
    Adam

  • Anonymous

    11/13/2009 9:46:11 PM |

    From some research I've seen the Southern US muscadine grape has the highest levels of anthocyanins (especially resveratrol).  The skins on the grapes are super thick and this variety is rather impervious to mold, rot, etc.

  • Flowerdew Onehundred

    11/13/2009 11:00:43 PM |

    I would also like to know how Virginia wine fares since we drink so much of it, but it's all produced by pretty small operations, so I would imagine it varies.

    Actually, most of what I buy is from two vineyards.  I guess I could just ask the winemakers how long the reds have the seeds and skins in the fermentation.

  • Suresh

    11/13/2009 11:21:35 PM |

    Dr. Davis,

    Would eating plain red grapes bring out the same benefits as red wine ? I have read the reserveterol is present in red grape skins.

    Thanks!

    -Suresh

  • Rick

    11/14/2009 3:55:51 AM |

    Red wine always makes me feel sick, though I can drink white wine. Is there any reason to think that procyanidins are the cause of this? Any other differences between red and white wine that could be the reason?

  • Hampers

    11/14/2009 7:24:44 AM |

    Your blog looks wonderful with info on  how do various wines stack up in procyanidin content? It was nice going to know about it. you seems to be informative and resourceful.

  • Dr. William Davis

    11/14/2009 1:50:37 PM |

    Hi, Anne--

    A fellow Telemann fan!

    I envy your easy access to Languedoc. They are only occasionally available here.

  • Bill

    11/14/2009 1:52:02 PM |

    A link to Roger Corder's wine rating page.
    http://the-red-wine-diet.com/id1.html

  • Dr. William Davis

    11/14/2009 1:53:48 PM |

    Hi, Suresh--

    No, grapes and wines are different due to the process of fermentation. Obviously, wine has alcohol, which raises HDL. Beyond this, flavonoids undergo changes as wine ages. This is actually an active area of research in wine technology.

  • Dr. William Davis

    11/14/2009 1:54:31 PM |

    Hi, Rick--

    I do not believe it's the flavonoids that make you ill. Otherwise, other flavonoid sources like cocoa or green tea might do the same.

  • Ana Wire

    11/14/2009 4:33:35 PM |

    Hello Dr. Davis,
    yes, the question still is: what´s about the fructose? Isn´t a harm here? Great blog, Ana

  • pmpctek

    11/14/2009 7:26:37 PM |

    I've read elsewhere that other  good sources of procyanidins that have yet to be listed are:

    red delicious apples (skin)
    granny smith apples (skin)
    macintosh apples (skin)
    raspberries
    wild blueberries
    cranberries
    bilberries
    black chokeberries
    peanuts (skin)
    cinnamon
    black currant

  • Dave

    11/14/2009 7:39:52 PM |

    Dr. Davis,

    Since Pine Bark extract is 95% oligomeric proanthocyamis, do yout thing that would qualify as a viable alternate to red wine.

  • Carl H

    11/16/2009 3:21:34 PM |

    http://www.winecountry.com/writers/w001/122707_savvy_redwine.html

    Another synopsis of the wine diet.  I noted that old-vine zinfandel from California and mountain-grown old vine malbec from Argentina offer acceptable amount of procyanidins, and these are a lot easier for me to find locally.  

    One of my favorite sources for both these wines is Patrick Campbell of Laurel Glen/CA.  He offers 'REDS' a very affordable and tasty zin 'field blend'.  This is my house wine:

    http://www.laurelglen.com/laurelglen/catalog/view_product.jsp?product_id=1039&cat_id=1005

    and for a step up - Za Zin old vine zinfandel:

    http://www.laurelglen.com/laurelglen/catalog/view_product.jsp?product_id=1040&cat_id=1005

    He also offers an affordable, tasty old vine malbec from Argentina:

    http://www.laurelglen.com/laurelglen/catalog/view_product.jsp?product_id=1038&cat_id=1008

    The winemaker knows his job & these are all tasty, very affordable and well made.  I have no interest in said winery, just know what I like - and can afford.

    Let me also recommend both concord grape juice and cranberry juice as reasonable sources to augment 'the good stuff'.

  • David

    11/18/2009 10:59:07 PM |

    I love red wine and I adore procyanidins! Corder is exactly right- these are the most bioactive compounds in wine, clearly more important than the weak resveratrol content. And I have 2 quick solutions for problems here:

    1) If you want much higher levels of procyanidins than any wine without the alcohol, sugars and/or pesticides, check out Apple Poly, the richest procyanidin pure fruit extract. Blueberries and hawthorn berries are also good sources.

    2) It turns out the wine tasters had the right idea. Resveratrol (but not procyanidins) are absorbed best in humans via buccal (cheek, gum) tissue- up to 100 times better than swallowing! So be sure to swish. Procyanidins are too large for this method, but they're well-absorbed when swallowed, especially the water-soluble apple skin variety.

    Thanks again for posting this, Doc. Procyanidins are little miracles for your heart, your brain, your colon, and your cells!

  • Jon K

    12/9/2009 2:59:18 PM |

    I was fortunate to grow up in Agen, and Madiran wines were often on our table. As were wines from Cahors (Cahors are among the darkest wines in the world). They are usually very good wines.

    Jon Kjölstad, Sweden

  • Carl H

    1/8/2010 1:17:11 AM |

    Doctor Davis, scanned a wine article by an online wine writer that I enjoy.  He was touting several 'velvety reds' and I noted one w/tannat - like the Madirans mentioned above - and some nice Malbecs.  I've found over the years that my tastes coincide well with his, if he likes a bottle I probably will too.  
    Thought you might have better luck finding something like these:  

    http://www.examiner.com/x-2207-Denver-Wine-Examiner~y2010m1d7-Sweet-dreams-of-velvety-reds?cid=examiner-email

  • Anonymous

    3/20/2010 4:28:40 AM |

    As a wine collector and a resveratrol researcher I found Corders book rather flat.  The wines with the highest none Resveratrol content worldwide are Malbecs from the Andes in Mendoza. And if you want to read a great scientific review of the cutting edge science of David Sinclair in this arena read the The Longevity Factor by Joe Maroon MD.  That book has guts.

  • Carl H

    5/11/2010 10:44:36 PM |

    A recently released bargain Malbec suggestion.  The "Black Box" folks now carry a Mendoza Malbec box wine.  Retail $25 or so for 3 liters, I just bought some on sale for $17.  At full retail it's $6ish per 750ml bottle of dark, (flavonoid-laden) and tasty juice.  At my price, $4.25/per.  I don't think I can find a better buy on a high-altitude grown dark wine - tho' there aren't a lot of tannins.  I think it tastes great.  

    http://winecentric.blogspot.com/2010/04/black-box-mendoza-argentina-malbec-2008.html

  • Dr Mashego from Revup31

    7/25/2010 5:50:57 AM |

    Hi, I am a general practitioner from South Africa and I wanted to thank you for the informative post. I will look up "The Red Wine Diet"
    I am not a wine drinker but I have been researching resveratrol for a new product RevUp31.

    I am intrigued by the sheer amount of research done on wines, wine preparation and natural compounds to prevent disease.

    I am tired of being a "legal drug pusher" and rather want to help my patients stay healthy and enjoy life.

  • Dena

    7/27/2010 11:34:36 AM |

    Thanks for your informative blog. Have been looking into Resveratrol Vitamins, an anti-oxidant which is found in the skin of red grapes.

    Do you think a sensible one glass of red wine per day can have the same benefits as Resveratrol vitamins for heart disease.

    Please keep updating, I will keep reading.

    Dena

  • Max

    8/29/2010 6:23:32 AM |

    It's amazing to me that with all of the people trying to find the next great supplement or whatever, that red wine still just trumps them all in terms of antioxidants and all sorts of goodies. Great post, really would love to get more into this.

  • Piper

    10/28/2010 4:43:25 AM |

    Red wine, their diet, and their active lifestyle are the primary reason why the French lives long. Red wine contains natural resveratrol, when consumed regularly, it regulates the heart and kills the cancer cells, therefore, giving them longevity.

    But, other than consuming red wine, there are places where you can buy resveratrol by the capsule, which contains more resveratrol than wine itself.

  • buy jeans

    11/3/2010 10:15:47 PM |

    Wines rich in procyanidins provide several-fold more, such that a single glass can provide the same purported health benefit as several glasses of a procyanidin-poor wine.

  • HERBCYCLOPEDIA

    4/30/2011 10:13:10 AM |

    Flavonoids are great, many fruits contain flavonoids but not only fruits, even cocoa contains flavonoids, that´s why dark chocolate is able to lower cholesterol levels.

  • mike

    7/29/2012 1:20:10 PM |

    Don't like the plastic liner in the black box wine. BPA leaches out into the wine. I do recall in the book that turning leaf and private selections robert mondavi cabernet sauvignons were given 2 hearts and 3 hearts respectivly with 5 hearts being the best and 1 the least.

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About comment responses and moderation

About comment responses and moderation

Just a brief word about my responses to reader comments:

I appreciate the many often insightful and interesting reader comments I receive to the Heart Scan Blog. However, managing them and responding to them has simply become impossible, due to time demands.

I'm afraid that I am unable to answer questions seeking medical advice; this is for your doctor, who knows you and can diagnose and prescribe. I cannot.

I'm also unable to engage in lengthy debates; I've had commenters become very angry when I was unable to engage in lengthy conversations on some topic. Nor am I able to do Google or literature searches for commenters, or review studies, papers, or other materials.

I would urge any readers who wish to engage in in-depth discussions about these issues, talk about lipoproteins, heart disease reversal, etc. to do so on the Track Your Plaque Forums. Yes, it is a fee-for-membership website, a model that has become necessary to pay for the services we provide (not pay me).

I wish that I could answer all the concerns and questions that come my way, but it's simply physically impossible doing so while maintaining a full-time very busy cardiology practice, developing the Track Your Plaque website (which is becoming an enormous responsibility), publishing scientific data, maintaining hospital responsibilities, and spending time with my wife and family. We're all busy and I'm no different. I'm afraid that it's my responses to blog comments that I will have to sacrifice.

I invite commenters to continue to comment on these posts, as I've learned many new things by reading them and find them helpful feedback. And I do read them. Should an especially helpful comment be made, I will feature it in a new blog post, rather than respond directly.

Comments (10) -

  • Jenny

    3/2/2008 3:09:00 PM |

    "Necessary to pay for the services we provide."

    This sounds odd to me. Blogger is free. I manage to provide a very high level of service to my bloodsugar101.com visitor base which is huge and growing monthly without charging a penny.

    I earn enough from Google ads to pay overhead. The amount of time it takes to keep the site updated is no more than most people spend watching a favorite TV show or playing golf each week.

    I respond to emails for perhaps half an hour a day, occasionally more, where I help people clarify the issues they need to discuss with their doctors and occasionally direct them to resources relevant to a rare condition my site mentions.

    I can see charging for individual medical consultation, but not for providing a web forum where people discuss topics and where you explain concepts that do not involve personal medical counsel.

    The for-fee nature of your site buys you income at the cost of greatly limiting the number of people who can benefit from the non-specific information you have to share.

    Too many of your posts seem to tantalize with hints of information but conclude with statements making it clear people have to pay to find out the facts.

    That is NOT how the web works and it greatly limits the helpfulness of what you offer.

  • wccaguy / aCipher

    3/2/2008 4:43:00 PM |

    Dr. Davis,

    In a short time, your blog, all by itself, has become the best source of information for dealing with cardiovascular disease on the internet.

    Thank you for having the vision and commitment for sharing your depth and breadth of knowledge of this disease.

  • mike V

    3/2/2008 6:19:00 PM |

    Dear Dr. Davis
    I plead guilty to immoderation in my response to your "Hammers and Nails" piece.

    Here's my bottom line:
    I simply believe that your 'bottom up' approach (to identifying both problems and their solutions) could potentially grow to influence the entire profession for the better. I hope it spreads.
    Thanks for listening.
    MikeV

  • Anonymous

    3/3/2008 2:10:00 PM |

    Hi Dr. Davis

    I read your blog all the time and am surprised to see that you answer blog comments at all.

    I would always think . . . . how does he have time to do that ?

    I for one, understand your situation exactly and I am just thankful that you write your blog at all. I'm sure the course of my health will be forever changed by reading your words, and following them.

    On behalf of all the people who are deeply thankful for what you do, I apologize for the few "who always want more".

    You have my heartfelt appreciation (pun intended).

    Brian - Syracuse, NY

  • Rick

    3/4/2008 4:36:00 AM |

    Dr. Davis,

    Just a note of thanks for all you do on this blog and on the members forum.  My doctor was amazed when I told him that you responded personally to my query on the forum.  I've learned a tremendous amount thanks to you.

    Rick

  • Anonymous

    3/4/2008 2:26:00 PM |

    Dr. Davis
    I agree with the previous writer - surprised you have time but also thankful.
    In case you wonder if it's worth your time - You have changed my life!
    After reading your column and recognizing myself in many issues, I went out and had my vitamin D tested and it was 23 ng. So now, I also  have my husband and 4 friends on Vitamin D supplements who are also grateful.
    p.s.
    Nice of you to let "Jenny" plug her google ad site

  • Anonymous

    3/4/2008 3:12:00 PM |

    This comment is to Jenny.  Wow, just wow!  You have an overgrown sense of entitlement.  Dr. Davis is providing a lot of great information on his blog as well as in his TYP community.  He also has a full-time cardiology practice.  If you don't like what he is writing and that he would prefer to spend his energy on TYP, which I am fairly certain does not net him a profit, don't read this blog.  Not everyone has to follow your model for blogging and you ought to be respectful of that.

    -Russ

  • moblogs

    3/4/2008 4:13:00 PM |

    It's a fair deal as your posts alone help guide a lot of people.

    As a suggestion, since comments are still flying about about vitamin D, erroneously, being bad for you, and that L-form bacteria being touted as the core cause of heart disease by the same camp, it's worth doing an article about that. Approaching it with undemeaning neutrality, but it would be useful as some people have taken to heart the words of the dubious Marshall Protocol.

  • Anonymous

    3/4/2008 7:10:00 PM |

    I can understand your need for more time but while your postings are excellent I have learned far more from your comments on other peoples comments then from the original postings. What a loss.

  • Anonymous

    3/5/2008 9:25:00 AM |

    Well Dr D, as we say....Dr heal thyself. I have read all the blog and joined TYP. Best fee( and small amt I might add) I ever spent and yes to do all you provide on your forom does cost, I doubt J knows what she is talking about as I don't think she is a member of TYP. You have saved me from an early death and all I can say  since day one of coming here is I wondered how you did it all. You answer all the posts on TYP at least twice a day, you always write new articles, you volunteered your time for our web show, and your attitude is always so supportive and so wise. You know our sacred and healing VIT OSmileSmileSmile
    I have honoured you since the day I met you and I honor you even more now or making good choices to look after yourself thus in the end enable us to look after ourselves.

    I FEEL SOMEWHAT EMBARRASSED BY j's INSENSITIVE COMMENTS.........if only she knew all the work you have done for us in the past 6 months since I have been here. Thank you sooo much and I;ll read you daily on TYP website.

    Goodonya!!!!

    chick

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