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喝紅酒真的有益健康嗎?

Can drinking red wine ever be good for us?
喝紅酒真的有益健康嗎?

Even though alcohol kills millions of people every year, humans have been imbibing for millennia. In the last few decades, wine, in particular, has gained a reputation for being good for our health. Red wine even has been linked with longevity and lower risk of heart disease.

即或每年有數百萬人死于好酒貪杯,但人類飲酒之歷史已有幾千年。而在過去的幾十年里,特別是葡萄酒,還贏得了有益于我們身體健康的美譽。紅酒甚至被認為能幫助我們延年益壽,降低患心臟病的風險。

But could wine really be good for us?

但飲葡萄酒真的對我們有益嗎?

The first question, of course, is what we mean by “good for us”. Many people think of heart health when we think of the potential upsides of wine.

當然,首先要問的是何謂“對我們有益”。當我們想到葡萄酒的潛在益處時,許多人想到的是有益于心臟健康。

What is less well-known is that research has found strong links between alcohol and cancer. One bottle of wine per week is associated with an increased absolute lifetime cancer risk for non-smokers of 1% for men and 1.4% for women. This equates one bottle of wine per week to five cigarettes for men, or 10 for women.

但鮮少人知道的是,研究發現飲酒和癌癥之間關系很大。以一個不抽煙的人來說,每周喝一瓶葡萄酒肯定會增加他們一生中患癌癥的風險率,男性增加1%,女性增加1.4%。每周喝一瓶酒,這相當于男人抽5支煙,或者女人抽10支煙。

“While a lot of work [has] been done to communicate the link between smoking and cancer, this is less so for alcohol because public health officials control messaging for smoking, whereas with alcohol, it’s largely been up to the alcohol industry to communicate this itself,” says Mark Bellis, director of policy, research and international development at Public Health Wales.

威爾士公共衛生中心(Public Health Wales)的政策研究和國際發展部主管馬克?貝利斯(Mark Bellis)說:“雖然有關吸煙與癌癥之間的關系,已對公眾有大量的宣傳,但是很少宣傳談到飲酒之弊,因為有關煙草的公開信息受到公共衛生官員的控制,而有關酒的信息,則主要受制于酒類行業自己。”

The idea that research shows a tipple can be beneficial dates back to the 1970s, when scientists found that French people were less likely to have heart disease than other populations, despite eating more saturated fat. There was a clear relationship between lower levels of heart disease and wine consumption. This came to be known as the French paradox – a conundrum which scientists are still untangling today.

研究發現,少量飲酒有益健康的觀點可以追溯到上世紀70年代,當時科學家發現,法國人盡管攝入了較多的飽和脂肪,但心臟病的發生率比其他國家的人要低。因此就有了心臟病發病率較低與葡萄酒消費量之間存在明顯關系的說法。這就是所謂的“法國悖論”,一個至今仍未被科學家們解開的謎題。
 

七十年代科學家發現法國人心臟病的發病率較其他國家低,因此認為或許與法國人愛飲葡萄酒有關

We have since been led to believe that moderate wine-drinking can reduce our risk of heart disease, high blood pressure, diabetes, and weight gain.

我們自那以后就信以為真,相信飲酒只要不過量可以降低我們患心臟病、高血壓、糖尿病和體重過胖的風險。

“Early research found that moderate levels of wine consumption had a ‘J’-shaped curve effect,” says Helena Conibear, co-director of The International Scientific Forum on Alcohol Research. “Small, regular amounts of wine seem to lead to longer life, better health and less cognitive decline. Since then, more than 1,000 papers have been published reiterating that.”

國際酒精研究科學論壇(International Scientific Forum on Alcohol Research)聯席主任海倫娜·科尼貝爾(Helena Conibear)說:“早期研究發現,適量飲用葡萄酒會產生‘J’形曲線效應(指身體健康指數最初呈現低水平效應,然后直線上升維持于高水平,其間數據變化曲線型同英文字母J的現象)。少量、有規律的飲酒似乎能延年益壽,增進健康,減少認知能力的退化。此后有1000多篇論文發表,重申了同一看法。”

As a result, for a long time, the consensus was that abstaining from alcohol is unhealthier than consuming moderate amounts of alcohol (equivalent to one or two drinks a day).

結果是在很長一段時期,社會共識都認為,適量飲酒比起滴酒不沾更有益于健康。所謂適量,是指每天喝一兩杯酒。

But that “J”-shaped relationship between alcohol consumption, and death and disease, has come under criticism. It’s now widely understood that a lot of this data could be flawed: people abstaining from alcohol may be doing so because they’re unwell, rather than becoming unwell because they’re abstaining. (This challenge in sorting out cause from effect is the issue with many observational studies, which most nutrition studies are).

但是,這個飲酒與死亡和疾病之間的“J”形關系理論隨后受到了批評?,F在普遍認為,很多數據可能是有問題的,滴酒不沾的人可能是因為健康差所以才戒酒,而不是因為戒酒后健康變差。(這種倒果為因的現象是許多觀察性研究都會遇到的問題,可以說大多數營養學研究都是如此。)

When controlling for this, one 2006 analysis of 54 previously published studies found no correlation between moderate alcohol consumption and lower risk of heart disease.

2006年,將結果這項變量予以控制的一項研究分析了此前發表的54項研究報告后發現,適度飲酒與較低的心臟病風險之間沒有相關性。

But in the years since, says Conibear, other studies have found the opposite. “Over the last five years, research has looked at confounding factors,” she says. “We know wine drinkers tend to be better off, better educated and have a less sedentary lifestyle – and adjusting for that, the J-shaped curve can’t be denied.”

而且科尼貝爾還說,其后的幾年里,有研究甚至得出相反的結果。她說:“在過去的五年,研究人員一直在研究兩者間的多種變量。我們知道,愛喝葡萄酒的人往往比較富有,受教育程度也較高,也較少坐著不運動,按此模式,不可否認存在J型曲線。”

She says researchers have got around this bias by using participants who’ve never drunk before, rather than those who used to drink and now abstain, as they’re more likely to abstain for health reasons.

她說,后來研究人員為克服這種偏頗的研究,在試驗中使用的參與者是從來不飲酒的人,而不是過去研究的曾經飲酒,但因健康緣故最后戒酒的參與者。

In one 2019 study, researchers took a different approach to determine whether moderate alcohol intake really is linked to lower risk of heart disease. For 10 years, they followed more than 500,000 adults in China, where two genetic variants (ALDH2-rs671 and ADH1B-rs1229984) influence alcohol drinking patterns, rather than ill health. They also excluded people with poor health.

在2019年的一項研究,研究人員采用了一種不同的方法來確定少量度飲酒是否真的與降低心臟病風險有關。他們對中國50多萬名成年人進行了10年的跟蹤調查,發現兩種基因變異(ALDH2-rs671和ADH1B-rs1229984)會影響飲酒模式,而不是健康不良而影響飲酒模式。他們還排除了健康狀況不佳的人。

“Those with no defects can drink as much as they like,” says Zhengming Chen, one of the study’s authors and professor of Epidemiology, at the University of Oxford’s Nuffield Department of Population Health. “But those with a dysfunctional enzyme can’t tolerate alcohol at all,” he says.

該研究報告的作者之一、牛津大學(University of Oxford)納菲爾德人口健康(Nuffield Department of Population Health)流行病學教授陳正明表示:“基因沒有缺陷的人可以想喝多少就喝多少,但是那些酶功能失調的人根本不能耐受酒精。”

The researchers also used Chinese women as a control group, because while many Chinese women can metabolise alcohol, many don’t drink for social, rather than health reasons, Chen says.

陳說,研究人員還將中國女性作為對照組,因為雖然很多中國女性可以代謝酒精,但很多女性不會為社交而飲酒,但會為了健康而喝兩杯。

This time, the researchers found no “J”-shaped correlation. Instead, they found that the more people drank, the more likely they were to experience high blood pressure and stroke – and there was no reduced risk among people who drank one to two units per day. There was no association either way with heart attacks.

這一次,研究人員沒有發現“J”形的相關性。相反,他們發現,喝得越多的人,患高血壓和中風的風險就越高,而每天喝一到兩個酒精單位(一酒精單位為一小杯葡萄酒、或一瓶啤酒或一小份烈酒)的人,患高血壓和中風的風險并沒有降低。不過兩者都看不出與心臟病有何關系。

As a result, while there was a clear link between alcohol consumption and stroke risk, something in alcohol may protect us against heart attacks.

因此,盡管飲酒與中風之間存在明顯的聯系,但或許酒精中的某些物質可能會保護我們免受心臟病的侵襲。

“Our study shows that alcohol definitely has a protective mechanism, because high alcohol consumption consistently increases blood pressure, but for heart disease the association is quite flat,” Chen says.

陳正明教授說:“我們的研究表明,酒精確實有一種保護機制,因為大量飲酒會持續升高血壓,但對于心臟病來說,沒有因為飲酒有風險升高降低的變化。”

“So even as blood pressure goes up, there may be another mechanism that offsets increased blood pressure. But we don’t know if this protective mechanism is enough to offset high blood pressure.”

他說:“所以即使血壓升高,也可能有另一種機制來抵消血壓的升高。但我們不知道這種保護機制是否足以抵消高血壓。”

It’s important to note that the researchers converted all alcoholic drinks into standard alcoholic units, so the results aren’t specific to wine. However, Chen argues wine wouldn’t have shown any different results.

值得注意的是,研究人員將所有的酒類飲料都轉換成了標準的酒精單位,所以結果并非專指葡萄酒。不過陳教授認為,葡萄酒的研究結果沒有特別的不同。

Red wine

紅酒


But wine normally is considered the “healthier” option because of its antioxidants called polyphenols. Also found in fruit and vegetables, polyphenols reduce inflammation in the body, which is a factor for disease. There are ten times as many in red wine than white.

但葡萄酒因為含有一種叫做多酚的抗氧化劑,往往被視為有“養生”作用的酒類。多酚類物質也存在于水果和蔬菜中,可以減少人體內的炎癥,而炎癥是導致疾病的一個因素。紅葡萄酒的多酚含量是白葡萄酒的十倍。

Alberto Bertelli, a researcher at the University of Milan's department of Biomedical Sciences for Health, has found that small amounts of wine can protect us against heart disease, partly due to the drink’s anti-inflammatory properties. He recommends no more than 160ml of wine a day (the size of a champagne flute), but only with a meal, Mediterranean style.

意大利米蘭大學(University of Milan)生物醫學科學(Biomedical Sciences for Health)健康研究員阿爾貝托·貝泰利(Alberto Bertelli)發現,少量飲用葡萄酒可以預防心臟病,部分原因是葡萄酒具有抗炎的特性。他建議每天喝不超過160毫升的葡萄酒(香檳酒杯大?。?,而且只在用餐時喝。這是地中海式飲酒風格。

Research has focused on the polyphenol resveratrol in particular, a naturally occurring compound found in grapes’ skin and seeds. Resveratrol is thought to protect against high blood pressure by dilating blood vessels.

研究主要集中在一種存在于葡萄皮和種子中的天然化合物多酚白藜蘆醇。白藜蘆醇被認為可以擴張血管因而能幫助預防高血壓。

But despite there being no resveratrol in white wine (even though it’s in white grapes), Bertelli observed the French paradox also applies to white wine-drinking areas in France. In other words, white wine may have the same health benefits – if wine has benefits at all.

白葡萄酒中沒有白藜蘆醇,但白葡萄中有。但貝泰利觀察到,所謂的“法國悖論”也適用于法國的白葡萄酒飲用領域。換句話說,如果葡萄酒有益于健康的話,那白葡萄酒也可能同樣有益。

“We found in white wine two compounds common to extra virgin olive oil, which is recognised as a healthy food, more or less in the same amount,” Bertelli says. These compounds, tyrosol and hydroxytyrosol, have also been found to be protective against Alzheimer’s disease.

貝泰利說:“我們在白葡萄酒中發現了兩種與特級初榨橄欖油相同的化合物。特級初榨橄欖油被公認是一種健康食品,這兩種化合物在白葡萄酒和特級初榨橄欖油的含量大致相同。”貝泰利所說的兩種化合物,是酪醇(tyrosol)和羥基(hydroxytyrosol),被發現可以預防老年癡呆癥。

Most researchers, however, have found that the vast majority of any believed health benefits apply only to red wine.

然而,大多數研究人員發現,被認為有益于健康的葡萄酒成份絕大多數只在紅酒中。

Red wine may be good for gut health, which has numerous benefits to the rest of our body, including improved immunity and digestion, and a healthier weight. In a recent study, researchers studied the drinking habits of twins and found that drinking red wine could improve the diversity of bacteria in the gut, which is linked to better health. But the observed benefits on gut health were found with just one glass of red wine per week, and anyone drinking more than two small glasses a day was excluded from the study.

紅酒可能對腸道健康有好處。腸道健康對我們身體的其他部分有很多好處,比如提高免疫力和消化能力,還有比較健康的體重。在最近的一項研究,研究人員研究了雙胞胎的飲酒習慣,發現喝紅酒可以改善與健康有關系的腸道細菌的多樣性。但是,研究發現對腸道健康有好處是每周只喝一杯紅酒,而每天喝兩小杯紅酒者不在研究之內。
 

研究發現每晚飲一杯紅酒者有比較健康的體重和腸道,但也有可能是飲紅酒的人本身就比較健康

The researchers also found that people who drank red wine had a lower body mass index (BMI). This also could be why drinking red wine in moderation is associated with health. It’s not that red wine makes you healthier; it’s that red wine drinkers may be healthier to begin with.

研究人員還發現,飲紅酒者身體質量指數(BMI)較低,即有較健康的體重。這也可以解釋為什么人們認為適量飲用紅酒與健康有關。這并不等于飲紅酒讓你更健康,有可能是喝紅酒的人本身就比較健康。

“People who drink red wine often also do more exercise and [are] more affluent and healthier,” says Bellis.

貝利斯說:“喝紅酒的人通常也會做較多的運動,他們一般家境比較富裕,體質也較健康。”

The same is true of the gut health question: because the study was observational, the researchers couldn’t establish whether a single glass of red wine a week makes your gut healthier, or people with healthier guts happened to be the kind to drink a glass a week. And randomised control trials, where participants are split into groups and their health measured as they follow different diets, can be particularly unethical when it involves alcohol.

上述現象也適用于腸道健康問題。因為這項研究是觀察性的,研究人員無法確定究竟是一周喝一杯紅酒讓你的腸道較健康,還是那些腸道較為健康的人碰巧每周喝一杯紅酒。在隨機對照試驗中,參與者被分成不同的小組,要他們采用不同的飲食模式,然后對他們的健康狀況進行測量,而當涉及到飲酒問題時,這種做法可能就不太道德。

There have been a few randomised control trials – but these have been less than conclusive. A 2016 study found that having one glass of red wine with their evening meal every day for six months didn’t affect the blood pressure of people with diabetes.

有關紅酒的飲用已有一些隨機對照試驗,不過還不足以得出任何結論。2016年的一項隨機對照試驗研究發現,連續6個月每天在晚餐時喝一杯紅酒不會影響糖尿病患者的血壓。

Another randomised control study from 2015 found that drinking 150ml of red wine (again, the amount held in a champagne flute), can lower the risk of developing stroke and heart disease among people with diabetes.

2015年的另一項隨機對照研究發現,糖尿病患者,飲用150毫升紅酒(同于一只香檳酒杯的酒量)可以降低患中風和心臟病的風險。

Healthiest option

健康的選擇


In fact, while red wine may be the healthiest drink option, it’s healthier to abstain entirely, says author of the study looking at wine consumption and gut health, Caroline Le Roy, research associate at the Department of Twins Research at Kings College London.

倫敦國王學院(Kings College London)雙胞胎研究所(Department of Twins Research )的研究員卡羅琳·勒羅伊(Caroline Le Roy)曾發表對紅酒飲用和腸道健康關系的研究報告。她說,盡管紅酒可能是酒類中最健康的選擇,但事實上完全不喝酒會更健康。

“We know alcohol is bad for us,” she says. “If you drink, it should be red wine, as this is the only alcoholic drink that’s been found to have a beneficial effect, but I’m not encouraging people to drink red wine.”

她說:“我們知道酒精對我們有害。如果你一定要喝酒,那就飲紅酒,因為這是唯一發現對身體有益的酒精飲料,但我不鼓勵人們喝紅酒。”

Research generally attributes any protective mechanism to resveratrol. But while some researchers believe resveratrol’s ability to be absorbed into the bloodstream is enough to derive antioxidant effects, others doubt it stays in the bloodstream for long enough to benefit us.

研究通常將對身體有益的保護機制歸功于白藜蘆醇(resveratrol)。但是雖然一些研究人員認為,白藜蘆醇被血液吸收的能力足以產生抗氧化效果,但也有一些研究人員懷疑白藜蘆醇在血液中停留的時間不足以產生對我們有益的功效。

“There’s controversy around the level of dose you can absorb from a glass of wine, and its bioavailability, which is the body’s ability to absorb it and do us good,” says Conibear.

科尼貝爾說:“你能從一杯酒中吸收多少劑量的白藜蘆醇,及其生物利用率有多大,即我們身體吸收的能力,以及對我們身體有多大好處,是存在爭議的。”

There has been increasing attention on resveratrol supplements in recent years. However, data on the effectiveness of resveratrol pills is conflicting. Bertelli argues that we need the alcohol component of wine to absorb resveratrol.

近年來,白藜蘆醇補充劑越來越受到關注。不過,有關服用白藜蘆醇片有效性的數據是相互矛盾的。貝泰利指出,我們需要葡萄酒中的酒精成分來幫助吸收白藜蘆醇。

“Resveratrol has the same bioavailability as other polyphenols in fruit, but it doesn’t matter how much you ingest, it matters how much gets into the bloodstream,” he says.

他說:“白藜蘆醇與水果中的其他多酚具有相同的生物利用率,但攝入多少并不重要,重要的是有多少被血液所吸收。”

“Before we absorb the compounds in wine, they must be dissolved. They help others absorb, they all work together, and this is unique to wine,” he says.

他說:“在我們吸收葡萄酒中的白藜蘆醇之前,這種化合物必須先溶解。酒能幫助吸收,白藜蘆醇和酒共同起作用,這種功效是葡萄酒所獨有的。”

According to UK guidelines, which are among the most stringent globally, we should drink  no more than 14 units of alcohol per week. While the research on any health benefits of wine is nascent, it is still largely agreed that the healthiest option is to abstain – and that red wine is the healthiest option for those who do drink.

根據英國的飲酒指南,我們每周飲酒不應超過14個酒精單位。英國的飲酒指南是全球最嚴格的飲酒指引之一。雖然對葡萄酒健康益處的研究還處于起步階段,但人們普遍認為,最健康的選擇是不喝酒,而對于那些飲酒的人來說,紅葡萄酒是最健康的選擇。

But we shouldn’t drink red wine for any health benefits, Bellis says, because there are numerous ways to boost our health more effectively. “Of course people want to hear that the half a bottle of wine they drink after work is at least doing them no harm, and even better, could be doing them some good. But that’s far from truth,” he says.

但是貝利斯說,我們不應該為了健康而去喝紅酒,因為有很多方法可以更有效地促進我們的健康。他表示。“當然,人們一廂情愿地希望聽到下班后喝半瓶葡萄酒至少對他們沒有害處,甚至可能對他們有好處。當然事實遠非如此。”

Want to boost your health? Eating more fruits and vegetables, and exercising, remain the best and most proven ways to do it – not pouring yourself a glass of wine.

想要增強你的健康?多吃水果和蔬菜,多鍛煉,是最好的也是最有效的方法,而不是給自己倒上一杯酒。
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