Q. I've heard that drinking wine is good for your health, but then someone said you could get the same benefits with beer. What are the benefits and which is correct?

A. It's a somewhat complicated issue. The easy part is that moderate amounts of alcohol (one to two drinks daily) are clearly associated with a reduced risk for cardiovascular disease. And that holds true for any kind of alcohol—wine, beer or hard liquor. Benefits for both men and women include a reduced risk for the development of peripheral arterial disease, ischemic stroke, sudden cardiac death and angina.1

So all other things being equal, moderate drinkers decrease their cardiovascular disease risk while abstainers and heavy drinkers do not. Slightly confusing the issue is that for women it appears even moderate alcohol intake is associated with a small but statistically significant increased risk for breast cancer. One study showed that in comparison with nondrinkers, women averaging 12 g daily of alcohol (approximately one typical drink) had a 10 percent increased relative risk for breast cancer.1

As for the health differences between wine and beer, studies suggest that wine may also decrease the risk of Alzheimer's disease, but at this point it is unclear if the effect is from the alcohol itself or the wine. The polyphenols in wine have antioxidant effects that may be specifically important in Alzheimer's, but not necessarily so in CVD.2^,3

Many people are unable to drink moderately, so they shouldn't drink alcohol at all. This is because of well-known associations between heavy drinking and increased risks for cancers of the esophagus, colon, rectum, liver, breast and larynx, as well as increased risks for high blood pressure, liver cirrhosis and chronic pancreatitis.1

So what to do? I would say that if you were going to drink, and can drink in moderation, drink wine because it possibly has the added benefit of decreasing Alzheimer's risk. However, moderate alcohol in any form does have cardiovascular benefits. If you are a woman with a strong family history of breast cancer, you must weigh the very small increased risk of this cancer against the larger decreased risk for cardiovascular problems.

Q. I've heard that taking probiotics can help my irritable bowel syndrome symptoms. Is this true?

A. For many years, naturopaths have seen probiotics improve IBS symptoms in their patients. That empirical observation is now backed up by a number of controlled studies. IBS is characterized by abdominal pain or discomfort because of gas (flatulence) and bloating that is associated with a change in bowel pattern (loose or more frequent bowel movements, diarrhea and/or constipation, etc.). Probiotics appear to positively influence the intestines' bacterial composition, and changing the composition appears, in some people, to help relieve IBS symptoms.

In one double-blind, placebo-controlled trial of more than 350 women with IBS, consuming 1 billion cells daily for four weeks of a specific bifidobacteria strain called Bifidobacterium infantis 35624 significantly reduced symptoms of IBS, such as abdominal pain and bloating. Interestingly, neither a higher nor lower dose seemed to be effective.4

In another study, daily consumption of 450 billion cells for eight weeks of a combination probiotic called VSL#3 that contains strains including Bifidobacterium, Lactobacillus and Streptococcus also appeared to improve some IBS symptoms. Bloated IBS patients reported experiencing significantly improved bowel control with VSL#3 relative to placebo.⁵ Another study with VSL#3 showed improvement in flatulence but not abdominal pain or bloating after using 450 billion cells twice per day for eight weeks.⁶

Various strains of probiotic bacteria may exhibit unique properties. Thus, not all species will necessarily have the same therapeutic effect in a particular condition. And as can be seen in the above trials, the dose may be important as well. Some studies, using different strains than those quoted above, haven't shown probiotics to be helpful in IBS.7 Clearly, there is a great deal more to learn about different strains and their effects and usefulness in different conditions. For the present, I think we can say that trying probiotics could be worth it—though I would be sure to use those strains where research has demonstrated a benefit.

Q. Will eating rice lower my cholesterol levels?

A. Unlikely, but consuming rice bran oil may. Rice bran is obtained from the outer hull of rice. It contains fiber, fat, amino acids, vitamins, minerals and other phytonutrients. While many fibers will have some cholesterol-lowering properties, it seems the oil fraction of rice bran is likely responsible for the most significant health effect in rice bran. The oil contains beta-sitosterol and other phytosterols that are known to decrease cholesterol absorption. In addition, other constituents of rice bran oil are gamma oryzanol (a mixture of sterols and ferulic acid esters) and tocotrienols (part of the vitamin E family), which might lower cholesterol through other mechanisms.8^,9

Studies have found that rice bran oil modestly lowers total and "bad" low-density-lipoprotein cholesterol. A recent study convincingly showed that the oil, not the bran, lowered serum cholesterol in moderately hypercholesterolemic persons.10 In two small studies, researchers first showed that defatted rice bran (bran without the oil) did not lower cholesterol levels; then they showed a diet containing 2.1 g of sterols from rice bran oil versus a control diet significantly lowered total LDL cholesterol while leaving "good" high-density-lipoprotein cholesterol unchanged.11

References
1. Corrao G, et al. A meta-analysis of alcohol consumption and the risk of 15 diseases. Prev Med, 2004;38(5): 613-9.
2. Letenneur L. Risk of dementia and alcohol and wine consumption: a review of recent results. Biol Res, 2004;37(2): 189-93.
3. Pinder RM and Sandler M. Alcohol, wine and mental health: focus on dementia and stroke. J Psychopharmacol, 2004;18(4): 449-56.
4. Whorwell PJ, et al. Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome. Am J Gastroenterol, 2006;101(7): 1581-90.
5. Kim HJ, et al. A randomized controlled trial of a probiotic, VSL#3, on gut transit and symptoms in diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther, 2003;17(7): 895-904.
6. Kim HJ, et al., A randomized controlled trial of a probiotic combination VSL# 3 and placebo in irritable bowel syndrome with bloating. Neurogastroenterol Motil, 2005;17(5): 687-96.
7. Niv E, et al. The efficacy of Lactobacillus reuteri ATCC 55730 in the treatment of patients with irritable bowel syndrome—a double blind, placebo-controlled, randomized study. Clin Nutr, 2005;24(6): 925-31.
8. Jariwalla RJ. Rice-bran products: phytonutrients with potential applications in preventive and clinical medicine. Drugs Exp Clin Res, 2001;27(1): 17-26.
9. Sugano M, et al. Health benefits of rice bran oil. Anticancer Res, 1999;19(5A): 3651-7.
10. Vissers MN, et al. Effect of plant sterols from rice bran oil and triterpene alcohols from sheanut oil on serum lipoprotein concentrations in humans. Am J Clin Nutr, 2000;72(6): 1510-5.
11. Most MM, et al. Rice bran oil, not fiber, lowers cholesterol in humans. Am J Clin Nutr, 2005;81(1): 64-8.

Natural Foods Merchandiser volume XXVII/number 11/p. 40