Does Red Wine Prevent Breast Cancer?

3 to 6 Glasses of Wine Per Week

At first sight, the data on the effect of wine on the risk of breast cancer (BC) appear contradictory. For example, in November 2011 there was a report in the New England Journal of Medicine from Wendy Y. Chen, MD, MPH, of Brigham and Women’s Hospital (Boston), that 3 to 6 glasses of wine per week increased a woman’s lifetime risk of BC by 15%. This increase was small but statistically significant.

The NEJM study got worldwide attention and led to a spate of anti alcohol  pronouncements. “Alcohol is a real risk factor, and the more you drink the higher your  risk,” said Steven A. Narod, MD of the University of Toronto. In interviews, Dr. Chen  pointed to a possible mechanism: “When you look at people who consume alcohol  regularly, their blood estrogen levels are higher on average than women who do not  consume alcohol” (www.ktsm.com).

A Natural Aromatase Inhibitor

However, just two months later, another study showed that red wine probably decreased the risk of BC, at least in premenopausal women, by lowering the amount of the enzyme aromatase in their blood; white wine slightly increased it. Previous studies at City of Hope, Duarte, California, showed that red wine is a natural aromatase inhibitor (Eng 2001, 2002, 2003).

Aromatase is an enzyme that converts the male hormone testosterone into the female hormone estrogen. Since estrogen can fuel the growth of some cancers, one medical strategy is to decrease the hormone through ingestion of pharmaceutically engineered aromatase inhibitors (AIs), such as the drug Arimidex. Many women take AIs after completing surgery, radiation and/or chemotherapy.

The Boston study lumped together all alcoholic beverages, including red and white wines, and did not distinguish among their varied biological effects. But the second  study showed that in the case of red wine, the harmful effects of alcohol were superseded  by the health-promoting polyphenols in red wine.

Decreased The Density

Red wine also decreased the density of the breast in postmenopausal women,  whereas white wine was associated with increased density. This is important because  very dense breast tissues is associated with a 1.8 to 6 times greater BC risk compared  with women with normally dense breasts (Boyd 2002).

Other foods also have aromatase-inhibiting effects (Keloff 2003). These include  soybeans (Lee 1991), grape juice (Chen 1998), and grape seeds (Kijima 2006). In a  comparative study of five vegetables, mushrooms had the greatest inhibitory effect. All  mushroom types, including chanterelles, crimini, enoki, Italian brown, oyster, portobello,  shiitake, and wood ear, had AI activity. But, surprisingly, it was the white button  mushroom (Agaricus bisporus) that demonstrated the greatest amount of AI activity.  Years ago I was taught that white mushrooms had little nutritional value, whereas  colorful or exotic varieties were intrinsically superior. Yet it was the large button  mushroom known as the “stuffing mushroom” that outperformed all the others, including  its nearest competitor, the Italian brown (Chen 2006).

Women often ask me whether they can substitute red wine or other foods for a  pharmaceutical-grade aromatase inhibitor (AI). To answer such a question intelligently  one would have to see clinical studies, and best of all, head-to-head comparisons of the  different treatments. To my knowledge, this has never been rigorously studied. There was  once a clinical trial at the City of Hope of a grape seed extract (ActiVIN), but this was  canceled when the laboratory ran out of funds (Chen 2012).

Other Benefits

Another important aspect of this question is that moderate alcohol use significantly decreases a woman’s chances of having a cardiovascular event. In fact, the benefit in terms of cardiovascular disease greatly outweighs even the small risk of BC seen in Chen’s study. That is why she suggests that, when making the decision of  whether to drink, one should consider one’s own family history of BC and cardiovascular  disease.

I think there is little doubt, however, that if you do decide to include some  alcoholic beverage in your dietary regimen, it should be red wine. Among the reds, Pinot  noir in general has the most polyphenols (including resveratrol). Among Pinot noirs,  those from the Finger Lakes have about 50% more resveratrol than those from California  and France, according to Cornell researcher LeRoy Creasy (Siemann and Creasy) .

Among the Finger Lake varieties, Konstantin Frank’s “Fleur de Pinot Noir” has  achieved a rating of 46.1 (uMolar trans-resveratrol), whereas the average range for red  wines is between 0.1 and 12.0.

According to studies by Roy (2005) and LeBlanc (2005), the total amount of  resveratrol in a liter bottle of wine ranges from 1.98 to 7.13. The highest amounts were found in Spanish reds (1.92–12.59). Red grape juice also had significant amounts. Most  researchers conclude that no particular brand or region can claim to consistently deliver  higher amounts of resveratrol (Stervbo 2007). Wines from muscadine grapes are also said  to be high in resveratrol, but these are hard to find in the marketplace.

In early 2012 there were allegations of fraud in resveratrol research, particularly  concerning Dipak K. Das, PhD, of the University of Connecticut Health Center (Farmington, Connecticut). But this hardly negates the work done at other labs. There also are questions about whether resveratrol consumed as food or beverage actually  makes it into the bloodstream. For that reason, some people take an enteric-coated  resveratrol supplement. Such supplements are readily available.

References

• Boyd N, Martin L, Stone J, et al. A longitudinal study of the effects of menopause on mammographic  features. Cancer Epidemiol Biomark Prev. 2002;11:1048–1053.
• Cassel WA, Garrett RE. Newcastle disease virus as an antineoplastic agent. Cancer. 1965;18:863–868. Chen S, Oh S-R, Phung S, et al. Anti-aromatase activity of phytochemicals in white button mushrooms  (Agaricus bisporus). Cancer Res. 2006;66:12026–12034.
• Chen S, Sun XZ, Kao YC., et al. Suppression of breast cancer cell growth with grape juice. Pharm Biol.  1998;36:53–61.
• Chen, Shiuan. Personal communication. April 2, 2012.
• Csatary LK, Bakács T. Use of Newcastle disease virus vaccine (MTH-68/H) in a patient with high-grade  glioblastoma. JAMA. 1999;281(17):1588–1589.
• Csatary LK, Csatary E, Moss RW. Re: Scientific interest in Newcastle disease virus is reviving. J Natl  Cancer Inst. 2000;92:493–494.
• Csatary LK. Viruses in the treatment of cancer. Lancet. 1971;2(7728):825.
• Csatary LK et al. Beneficial treatment of patients with advanced cancer using a Newcastle disease virus  vaccine (MTH-68/H). Anticancer Res. 1999;19, 635–638.
• Csatary LK et al. Attenuated veterinary virus vaccine for the treatment of cancer. Cancer Detect Prev.  1993;17:619–627.
• Eng ET, Williams D, Mandava U, et al. Suppression of aromatase (estrogen synthetase) by red wine  phytochemicals. Breast Cancer Res Treat. 2001;67:133–146.
• Eng ET, Ye JJ, Williams D, et al. Suppression of estrogen biosynthesis by procyanidin dimers in red wine  and grape seeds. Cancer Res. 2003;63:8516–8522.
• Freeman AI et al. Phase I/II trial of intravenous NDV-HUJ oncolytic virus in recurrent glioblastoma  multiforme. Mol Ther. 2006;13:221–228.
• Kelloff G, Boone CW, Steele VE, et al. Development of breast cancer chemopreventive drugs. J Cell  Biochem. (suppl.) 1993;17G:2–13.
• Kijima I, Phung S, Hur G, Kwok S-L, Chen S. Grape seed extract is an aromatase inhibitor and a  suppressor of aromatase expression. Cancer Res. 2006;66:5960–5967.
• LeBlanc MR. Cultivar, juice extraction, ultra violet irradiation and storage influence the stilbene content of  muscadine grapes (Vitis rotundifolia Michx.). Dissertation submitted to the graduate faculty of  Louisiana State University. 2005.
• Lee H, Gourley L, Duffy SW, et al. Dietary effects on breast-cancer risk in Singapore. Lancet.  1991;337:1197–1200.
• Roan S. Light drinking linked to increased breast cancer risk. Los Angeles Times. Nov. 1, 2011. Roy H, Lundy S. Resveratrol. Pennington Nutrition Series. 2005; No. 7.
• Siemann EH, Creasy LL. Concentration of the phytoalexin resveratrol in wine. Am J Enol Vitic. 1992;43:9– 52.
• Stervbo U, Vang O, Bonnesen C. A review of the content of the putative chemopreventive phytoalexin  resveratrol in red wine. Food Chem. 2007;101:44957.

Original Publication 2012