WINE AND HEALTH by Lisha de Villiers Submitted in partial fulfilment of the requirements for the Cape Wine Masters Study leader: Mary-Louise Nash Date of submission 31 January 2020 1 STATEMENT Dissertation submitted to the Cape Wine Academy in partial fulfilment of the requirements for the Diploma of Cape Wine Master. Signed: Dated: 31 January 2020 Lisha de Villiers 2 ABSTRACT The use of wine for medicinal purposes can be traced back to ancient times. Current research associates health benefits with moderate wine consumption. Certain wine constituents could, however, have a harmful effect on human health. This dissertation reviews the health benefits and risks associated with wine consumption. The primary objective was to identify the substances in wine that can either have a positive or a negative impact on health, where they originate from and the factors that influence their occurrence. A secondary objective was to determine whether it is possible for winemakers to produce healthier wines. Research suggests that the main components in wine that may contribute to health are alcohol, various phenolic compounds and melatonin. There is no consensus on how wine consumption could protect one against diseases or ailments and further research is needed. The main health risk associated with wine consumption is excessive alcohol intake. Excessive exposure to toxic compounds such as sulphur dioxide, heavy metals, biogenic amines, ethyl carbamate, ochratoxin A, phthalates and pesticide residue, are also concerns. These can be controlled during the winemaking process. Recently allergens have received attention, with mandatory labelling requirements being implemented in certain countries. A survey was done to gauge consumer awareness of health benefits and risks associated with wine consumption. Consumers appear to be aware of the fact that wine consumption benefits health. Detailed knowledge of the positive and negative constituents in wine is, however, lacking. A winemaker’s survey was sent to producers to determine what they understood regarding wine and health. Most agreed that winemaking techniques and viticulture practices play an important role in the healthiness of wine. 3 DECLARATION I, Lisha de Villiers, declare that this research report is my own, unaided work. It is submitted in partial fulfilment of the requirements for the Diploma of the Cape Wine Masters at the Cape Wine Academy. It has not been submitted before for qualification of examination to this or any other educational organisation. 4 DEDICATION To my father Alan Nelson 5 ACKNOWLEDGEMENTS I would like to express my sincere gratitude and appreciation to the following persons and institutions: GOD ALMIGHTY, for his guidance and strength. MY FAMILY, my husband, Petrus de Villiers for all your encouragement, patience and support. Without your support it would not have been possible for me to pursue further studies and take the time needed to complete this dissertation. My children, Peter-Alan and Marguerite for your patience, and understanding that I could not always give you all the attention that you needed. MY PARENTS, Alan & Marguerite Nelson and Pieter & Hanna de Villiers for the much-needed support and assistance with our children to allow me additional time to work on this dissertation. ALAN NELSON, my father and mentor, a special thank you for all the hours of your time during the editing of this dissertation. I enjoy our shared interest in wine and the love for nature. CAPE WINE ACADEMY & INSTITUTE OF CAPE WINE MASTERS, for assistance, support and training. FELLOW CAPE WINE MASTER STUDENTS, for the encouragement, support and assistance during my Cape Wine Academy journey. CONSUMERS, that participated in the consumer survey. WINEMAKERS, for taking the time to reply to the questionnaire. 6 DISCLAIMER Trade names, products, methods and processes used in this dissertation are for information purposes only. I, Lisha de Villiers, do not warrant those mentioned, nor do I intend or imply discrimination against those not mentioned. 7 TABLE OF CONTENTS TITLE PAGE 1 STATEMENT 2 ABSTRACT 3 DECLARATION 4 DEDICATION 5 ACKNOWLEDGEMENTS 6 DISCLAIMER 7 TABLE OF CONTENTS 8 1 CHAPTER 1: RESEARCH METHODOLOGY 11 1.1 SCOPE & RESEARCH METHODOLOGY OF THE DISSERTATION 11 2 CHAPTER 2: LITERATURE REVIEW 12 2.1 INTRODUCTION 12 2.2 MEDICINAL USE OF WINE IN ANCIENT TIMES 12 2.3 HEALTH RISKS ASSOCIATED WITH WINE CONSUMPTION 13 2.3.1 ALCOHOL 13 2.3.1.1 Where does the alcohol in wine come from? 14 2.3.1.2 Role of alcohol in wine 14 2.3.1.3 Legal regulation of alcohol in wine and labelling requirements 15 2.3.1.4 Health risks and disadvantages of alcohol 15 2.3.1.5 Control of the alcohol content in wine 19 2.3.2 SULPHUR DIOXIDE 21 2.3.2.1 Where does the sulphur dioxide in wine come from? 21 2.3.2.2 The role of sulphur dioxide in wine 22 2.3.2.3 The physical properties of sulphur dioxide and guidelines for the most effective use thereof 23 2.3.2.4 Legal limits of sulphur dioxide in wine and labelling requirements 25 2.3.2.5 Health effects and disadvantages of using sulphur dioxide 26 2.3.2.6 Making wine without the addition of sulphur dioxide 27 2.3.2.7 Natural wines 29 2.3.3 METALS 31 2.3.3.1 Where do metals in wine come from? 31 8 2.3.3.2 The role of metals in winemaking 32 2.3.3.3 Factors that influence the levels of heavy metals and how to control them in wine 32 2.3.3.4 Recommended maximum limits of heavy metals in wines 34 2.3.3.5 Health effects and disadvantages of heavy metals 36 2.3.4 BIOGENIC AMINES 37 2.3.4.1 What are biogenic amines and how are they formed in wine? 37 2.3.4.2 Factors that influence biogenic amine formation 39 2.3.4.3 Health effects and disadvantages of biogenic amines 41 2.3.4.4 Control of biogenic amines in wine 42 2.3.5 ALLERGENS 43 2.3.5.1 The use of allergenic processing aids or additives 44 2.3.5.2 Legislation and labelling requirements for allergens in wine 45 2.3.5.3 Health risk of allergens from protein containing fining agents 47 2.3.5.4 Control of allergens found in wine 48 2.3.6 OTHER SUBSTANCES FOUND IN WINE ASSOCIATED WITH HEALTH RISKS 48 2.3.6.1 Ethyl carbamate 49 2.3.6.2 Ochratoxin A 50 2.3.6.3 Pesticide residue 51 2.3.6.4 Phthalates 52 2.3.6.5 Physical Hazards 52 2.4 HEALTH BENEFITS ASSOCIATED WITH WINE CONSUPTION 53 2.4.1 WINE CONSTITUENTS ASSOCIATED WITH HEALTH BENEFITS 54 2.4.1.1 Alcohol 54 2.4.1.2 Polyphenolic compounds 54 2.4.1.3 Melatonin 61 2.4.2 HEALTH BENEFITS OF MODERATE ALCOHOL CONSUMPTION 62 2.4.3 POSSIBLE MECHANISMS CONTRIBUTING TO HEALTH BENEFITS WITH MODERATE WINE CONSUMPTION 64 2.4.3.1 Effects on lipid metabolism 65 2.4.3.2 Antioxidant effects 65 2.4.3.3 Effect on endothelial function 66 2.4.3.4 Effect on platelet aggregation 66 2.4.3.5 Activation of sirtuins 67 2.5 CONCLUSION 67 3 CHAPTER 3: CONSUMER SURVEY ON WINE AND HEALTH 70 9 3.1 INTRODUCTION 70 3.2 RESPONDENT DEMOGRAPHIC 70 3.3 CONCLUDING REMARKS ON CONSUMER SURVEY 70 4 CHAPTER 4: WINEMAKER SURVEY ON WINE AND HEALTH 73 4.1 INTRODUCTION AND METHODOLOGY 73 4.2 WINEMAKER RESPONSES 73 4.3 CONCLUDING REMARKS ON WINEMAKER SURVEY 78 5 REFERENCES – LITERATURE CITED 80 6 APPENDICES 89 10 1. CHAPTER 1: RESEARCH METHODOLOGY 1.1 SCOPE & RESEARCH METHODOLOGY OF THE DISSERTATION The methodology was to conduct an in depth review of the available literature on both the negative as well as the positive effects of wine on health. Each and every known chemical compound of wine associated with health benefits and risk were separately identified and dealt with. The origin of each compound was examined as well as the factors that influence them. Having considered the above, attention was then given to what winemakers can do in order to produce healthier wines. Surveys were also done in an attempt to gauge consumer concerns about the health benefits and risks of wine and winemakers’ perspective on health benefits and risks of wine. The scope of the consumer survey was fairly expensive with over 600 respondents. More than 26 local winemakers were asked to respond. These included both male and female winemakers from large and small producers. All of the known producers of so-called ‘natural wines’ were approached. Unfortunately only 8 local winemakers responded. 11 2. CHAPTER 2: LITERATURE REVIEW 2.1 INTRODUCTION Mankind has consumed wine for pleasure for many millennia. Evidence of this dates back more than ten thousand years. Although the use of wine for medicinal purposes can be traced back to ancient times, scientists and researchers to this day, are still discovering new health benefits associated with moderate wine consumption (Fehér et al 2007). Grivetti (1996) states that wine contains energy and nutrients and are by any definition a food type, but it is two-faced. Wine has the unique attribute of being praised when consumed in moderation, but condemned when consumed in excess. This contrast has been expressed throughout history. The health benefits of wine seem to outperform that of most other types of alcoholic beverages. When the possible health effects of wine are considered a very important factor that should be taken into account is that not all wines are produced in the same way.