Question 3
A patient with a family history of breast cancer asks you, as an RD, if what she’s heard about drinking a small glass of red wine each day is good for heart health. What are some key points you would want to discuss with this patient?
posted by Brittney @ 12:14 AM
16 comments
16 Comments:
I would explain to this patient that studies have shown that red wine contains vital antioxidants which help repair damaged cells. In moderation, drinking red wine can improve heart health and circulation while also preventing cancer. Further research is needed to find out the benefits and what role, if any, red wine has one’s health. Where the health benefits outweigh the risks, moderation is key. One glass per day for women, and up to two glasses for men is recommended. Individuals with a family history of alcohol problems should not begin drinking in response to any positive studies of the benefits of red wine, nor should those with pre-existing health conditions. Also, Alcohol may also interfere with certain prescription medications making them lethal or ineffective. Each individual must look at the benefits versus the risks of drinking; consider factors like health status, age, sex and weight.
There are several things you can do to improve/maintain your cardiovascular health, other than drinking red wine. This is one of those situations where you have to look at family history to determine pros/cons of a behavior based on risk. This particular patient has a history of breast cancer, which has been shown to be more prevalent in women who consume alcohol regularly. Now, one small glass of red wine each day may not present a huge risk to the patient, but I may suggest other ways to improve heart health. Exercise, proper diet (fiber, antioxidants, fruits/veggies, low saturated fat and cholesterol, low sodium, etc..) and other factors are likely to be more beneficial to heart health than the red wine. Antioxidants of a similar nature to those in wine are found in grape juice and fruits/veggies, and blood thinning properties may be duplicated by taking a baby aspirin a day. If her risk is high for cancer and low for heart disease, she should focus more on cancer prevention. The dietary/lifestyle practices that are good for heart health mentioned above have also been shown to have anti-cancer benefits. In this patients case, it may be better to avoid alcohol on a daily basis.
The polyphenol resveratrol, found in red wine, has been shown to have anti-cancer benefits...however, recent studies are suggesting that it is the resveratrol, not the alcohol that has the anti-cancer properties. Ther verdict is still out.
Sam,
I agree with your point that in this case, we have to be careful that the benefits outweigh the risks. Good point to bring up the non-cancer related risk factors of alcohol consumption. We are walking a fine line when we recommend a small glass of wine because we never know how patients may interpret that message, or stretch it and begin to drink 1 large glass a day, then 2 glasses a day....
Emily
Red wine may have some benefits to a heart healthy diet but it's still alcohol. The benficial properties in red wine are the flavonoids and nonflavonoids. Each can be found in other foods but it's obviously the grapes we are interested in when it comes to wines. Resveratol is the nonflavonoid under research in preventing clogged arteries. Entirely too envolved for the client---talk about Tannins. They are found in the grape skins. And a fun fact, the wine can take on the properties of the barrel---tannins are found in oak, so an oak barrel gives it even more tannins! These tannins also provide anti-clogging benefits to the arteries. Anyhow there are several better choices a person could make if they are really interested in preventing heart disease. However if your going to drink an alcoholic beverae red wine may be a better choice. I love red wine, but also remember moderation is the key!
Susan
I would tell the client that even though studies have showen red wine had heart protecting effects it could be a risk factor for breast cancer. With her having history of breast cancer it would be a better choice for her to avoid alcohol and eat a diet higher in fruits, vegetables, and whole grains. By doing this she would be decreasing her risk of heart disease and breast cancer at the same time.
I would discuss the possible benefits of the red wine in regards to breast cancer, but I would suggest other means of improving heart health. Some of these would be increasing physical activity, eating more fruits, vegetables, and whole grains, monitoring concentrated sweets consumption as to minimize weight gain. We would discuss her family history and determine if there was any demonstrated alcohol abuse or dependency in the family to determine if red wine consumption may be a precursor for another health problem (alcoholism). Overall, I would try to encourage the patient to consume other foods and do other things before turning to red wine for medicinal purposes.
The first thing I would tell her is that studies have shown that 1 glass of red wine can be healthy for the heart and for lowering cancer risk. But then I would want to stress that there are other diet changes that can be made that are also just as healthy. I wouldn't want her to think that red wine is the easy way out. There are better changes that can be made easily that will help more in the long run.
Tori
Emily,
I like the fact that you brought up looking at family history. We don't want to tell someone who has a history of drinking problems that it is okay to drink for health benefits.
Tori
I would try to look at it from both perspectives. What is good about drinking a glass of red wine a day for heart health and what are the negatives about drinking alcohol every day. For one, we can get antioxidants in other foods than red wine. Alcohol may not be the best option because it is high in empty calories. I am fairly certain that many doctors would not encourage alcohol intake to a woman that is at high risk for breast cancer. It may improve her heart health but increase her risk for breast cancer.
Susan,
Wow, you really did your homework. You know your oak tannins and everything! I like your simple comment about moderation because if we did a lot of things in moderation in our lives we would be a whole lot better off.
The studies as to whether alcohol helps to prevent cancer, or increase the risk of cancer have been inconclusive. Although red wine has proved to be helpful to the heart, assuming she has no history of heart disease, this patient should be focusing on the effect of alcohol and cancer. Because the results are not definative one way or another, I would tell the client that it would be acceptable to have an occasional small glass of red wine, but that too much of a good thing could be bad. Drink in moderation.
Everyone did a very good job here focusing on the bigger picture of health. Is it the alcohol, or the lycopene? Ethnicy may also be a small piece to the larger puzzle. As many people suggested, focusing on a healthy lifestyle is most important when preventing chronic diseases.
Sam,
Good idea about the alcohol possibly interfering with any prescription medications. Sometimes we get so caught up in what a nutrient can do for us we forget the possible complications it can cause as well.
Colin,
Nice point about avoiding the alcohol with a history of breast cancer. All factors need to be considered, way to look at the big picture.
Susan
I would explain that there are properties in red wine, consumed in moderate amounts (1 glass), that can be somewhat beneficial in heart health, but I would also note that there are other ways to get this same benefit (ex. drinking Concord grape juice). I would suggest the non-alcoholic beverages to my client, if they don't already drink red wine, because of the potential health problems that can come with drinking too much alcohol. If my client already consumed red wine I would affirm that it may be giving them some benefits but would caution them to limit there consumption.
Overall, I would try to steer my client toward having a balanced diet that would do the most good in lowering cancer risk, rather than just this one potential component.
Myra
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