[ed. note: We feature the writings of Doc Gumshoe, our favorite medical writer, every few weeks here at Stock Gumshoe. He is not a doctor, but we value his insight, research, contrariness and skepticism … and, most importantly, his ability to explain complex health issues for our readers. He generates a lot of discussion with his pieces, so today he decided to share some longer responses to a few of the questions and comments that have come up in recent weeks. As always, his words and opinions are his own and we continue to welcome feedback on Doc Gumshoe’s commentaries or on any of our other work.]
Where do I get off expressing my views on current medical knowledge? No, as I’ve said numerous times, I am not an MD, nor yet do I have any academic medical credentials. I have been a medical writer for 30 plus years, and the treatment areas I have done the most work in are: cardiovascular disease, autoimmune diseases (including rheumatoid arthritis, psoriasis and psoriatic arthritis, lupus, etc), diabetes, neurologic disorders (including epilepsy, Parkinson’s disease, and migraine), behavioral disorders, and infectious diseases. I have written or co-authored papers in peer-reviewed professional medical journals, and written entire journal supplements. I have developed many continuing medical education (CME) programs, both for physicians who need CME hours and for other health professionals, such as physician assistants (PAs) and nurse practitioners (NPs). I have created material for many advisory board meetings sponsored by pharmaceutical companies.
I wouldn’t dream of giving specific treatment advice to a patient, other than the advice to consult a competent physician. At the same time, I have confidence in my capacity to read and understand the professional medical literature. I bet I read more journal papers during the course of a year than most physicians. And, by nature I am curious, skeptical (but not cynical!) and, mostly, optimistic. My response to stuff I don’t immediately understand is, think harder!
Resveratrol versus (Moderate!) Alcohol Consumption
Lots of people had comments about this. Some made the point that resveratrol’s potential benefits should not be dismissed; others made the point that the harms of alcohol, especially for women, should not be underestimated. Okay, let it be known that I yield both points!
My main point in that piece was that the benefits of wine drinking – as in the so-called “French Paradox” – could not be attributed to resveratrol. There are two big boulders over which the resveratrol hypothesis stumbles. The first is that, although resveratrol demonstrated benefit in studies in mice, the doses of resveratrol that were used in these studies would translate to immense amounts of wine in humans – somewhere between 60 and 900 liters per day. And the second boulder is that resveratrol has not demonstrated similar benefits in humans – at least, not so far.
On the other hand, the benefits of moderate alcohol consumption have been demonstrated again and again. And these benefits are not limited to red wine. And, on top of that, the actual mechanisms through which alcohol confers these benefits are pretty well known and understood. Of course, the harms of alcohol are also well known, and should not be blithely ignored. Note – the benefits, as well as the harms, are dose-related, and the dose at which alcohol starts doing more harm than good is probably lower for women than for men, because it’s largely based on body size.
As an optimist, I continue to hope that there will be evidence – the emphasis is on the word “evidence” – that resveratrol itself does indeed have some health benefits as a supplement.
To the readers who wanted more about those resveratrol studies, here are the citations:
- Gliemann L, Schmidt JF, Olesen J, Biensø RS, Peronard SL, Grandjean SU, Mortensen SP, Nyberg M, Bangsbo J, Pilegaard H, Hellsten Y. Resveratrol Blunts the Positive Effects of Exercise Training on Cardiovascular Health in Aged Men. J Physiol. 2013 Jul 22. [Epub ahead of print]
- Poulsen MM, Vestergaard PF, Clasen BF, Radko Y, Christensen LP, Stødkilde-Jørgensen H, Møller N, Jessen N, Pedersen SB, Jørgensen JO. High-dose resveratrol supplementation in obese men: an investigator-initiated, randomized, placebo-controlled clinical trial of substrate metabolism, insulin sensitivity, and