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Medical Forum / Diseases and Disorders / Prostate Cancer / September 2004

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4+ glasses of red wine per week may reduce risk of pca by 50%

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c palmer - 23 Sep 2004 20:52 GMT
Posted By: News-Medical in Men's Health NewsPublished: Thursday,
23-Sep-2004 

Four or more glasses of red wine per week may reduce risk of prostate
cancer by 50 percent

Drinking a glass of red wine a day may cut a man's risk of prostate
cancer in half, and the protective effect appears to be strongest
against the most aggressive forms of the disease, according to a new
study led by investigators at Fred Hutchinson Cancer Research Center.
The findings, by Janet L. Stanford, Ph.D., and colleagues in Fred
Hutchinson's Public Health Sciences Division, appear online in The
International Journal of Cancer.
"We found that men who consumed four or more glasses of red wine per
week reduced their risk of prostate cancer by 50 percent," Stanford
said. "Among men who consumed four or more 4-ounce glasses of red wine
per week, we saw about a 60 percent lower incidence of the more
aggressive types of prostate cancer," said Stanford, senior author of
the study. "The more clinically aggressive prostate cancer is where the
strongest reduction in risk was observed."
Stanford and colleagues found no significant effects – positive nor
negative – associated with the consumption of beer or hard liquor and
no consistent risk reduction with white wine, which suggests that there
must be a beneficial compound in red wine that other types of alcohol
lack. That compound, Stanford and colleagues believe, may be an
antioxidant called resveratrol, which is abundant in the skins of red
grapes but much less so in the skins of white grapes. The compound is
also found in peanuts and raspberries and is available as a dietary
supplement, which has been suggested to protect against cardiovascular
disease.
Laboratory studies indicate that resveratrol influences a variety of
biological pathways that are important in cancer development. For
example:
As an antioxidant, it helps sweep dangerous, cancer-causing free
radicals from the body.
As a potent anti-inflammatory agent, it blocks certain enzymes that
promote tumor development.
The compound also reduces cell proliferation, curtailing the number of
cell divisions that could lead to cancer or the continued growth of
cancer cells.
It also enhances apoptosis, or programmed cell death, which helps rid
the body of cancerous cells.
It may act as an estrogen, reducing levels of circulating male hormones
such as testosterone that fuel the growth of prostate cancer.
While the researchers found that the risk of prostate cancer decreased 6
percent for every glass of red wine consumed per week, Stanford is quick
to point out that research shows the law of diminishing returns comes
into play when consumption increases beyond moderation. "From a
public-health standpoint, it's difficult to recommend any alcohol
consumption given the risks associated with heavy consumption, from
increased overall cancer risk to accidental injury and social problems.
But for men who already are consuming alcohol, I think the results of
this study suggest that modest consumption of red wine – four to eight
4-ounce drinks per week – is the level at which you might receive
benefit. Clearly other studies show that more than that may have adverse
effects on health."
For the study, the researchers interviewed 753 newly diagnosed
Seattle-area prostate-cancer patients as well as 703 healthy controls
who served as a comparison group. Detailed information about tumor
aggressiveness (such as tumor grade and disease stage) was obtained
through the National Cancer Institute's Seattle-Puget Sound
Surveillance, Epidemiology and End Results cancer registry.
"Even though this study is based on relatively small numbers, the
results are very intriguing and suggest that the potential beneficial
effect of red wine and resveratrol – if indeed resveratrol is the
active chemopreventive agent involved – would be very important,
because it's the more aggressive forms of prostate cancer than are most
important to prevent," she said.
A particular strength of the study, Stanford said, is that the
participants were relatively young, ranging in age from 40 to 64, and
the majority were under 60.
"By focusing on men under age 65, whose incidence of prostate cancer is
much lower than that of older men, we can tease out the effect of a
particular environmental exposure on cancer risk, such as wine
consumption, more easily than if we were looking at men across the
entire age range," she said. This is particularly true when studying
complex diseases such as prostate cancer in which numerous genetic and
environmental factors are thought to play a role over an individual's
lifetime.
Another strength of the study is that in addition to being surveyed
about lifetime alcohol consumption, participants were asked about a
variety of other risk factors for prostate cancer, such as diet, family
history of cancer, screening for prostate cancer and tobacco use, all of
which were taken into account and adjusted for when analyzing the data.
While the majority of studies to date have assessed the effects of
overall alcohol use on prostate-cancer risk, fewer studies have
attempted to compare the effects of wine versus beer versus hard liquor,
and only one previous study has compared the impact of red versus white
wine on prostate-cancer risk, said Stanford, also a professor of
epidemiology at the University of Washington School of Public Health and
Community Medicine.
The previous study, the Netherlands Cohort Study, evaluated
prostate-cancer risk in relation to white and red wine consumption.
Increased risks were found in men who consumed "white and fortified
wines," but not red wine, as compared to nondrinkers, although there was
not a consistent trend in risks with levels of intake. Interestingly,
among men who consumed 15 or more grams of red wine per day (about one
and a half glasses per day), there was an overall 18 percent reduction
in risk and a 16 percent lower risk of advanced-stage prostate cancers.
The Netherlands Cohort Study was initiated in 1986 and collected
information by self-administered mailed questionnaires that asked about
alcohol consumption during the prior year only. Thus, the Netherlands
Cohort Study results only reflect associations with recent wine
consumption, as investigators were unable to examine lifetime intake as
was done in the current Fred Hutchinson study.
"One of the reasons we wanted to do this study is because overall, most
of the scientific literature – around 17 studies to date – haven't
shown a consistent relationship between alcohol consumption and prostate
cancer," Stanford said. "Some have shown an increase, some a decrease,
and most no association whatsoever. Part of the problem, we believe, is
that few of the studies have attempted to sort out the effects of
different types of alcohol intake over a man's lifetime."
Stanford and colleagues plan to seek funding to conduct a larger study
to see if their results hold up. In collaboration with Norm Greenberg,
Ph.D., of Fred Hutchinson's Clinical Research Division, they also plan
to test the effects of resveratrol on mouse models of prostate cancer to
see if giving mice this chemical compound will reduce the onset of
prostate cancer and/or decrease the aggressiveness of the disease.
The first author of the study, W. Marieke Schoonen, M.S., formerly a
graduate student in Stanford's group, is now a doctoral student at the
London School of Hygiene and Tropical Medicine. The National Cancer
Institute, National Institutes of Health and U.S. Department of Health
and Human Services funded the research.
http://www.fhcrc.org/

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
jhhtexas@ieee.org - 24 Sep 2004 17:10 GMT
I have taken this advice to heart and have a glass of Sutter Home
Cabarnet Sauvaigon every night while watching TV news. Of course I had
an RRP 3 months ago, but it's still a good excuse (more for my heart
than my departed prostate).

> Posted By: News-Medical in Men's Health NewsPublished: Thursday,
> 23-Sep-2004
[quoted text clipped - 124 lines]
> "Many more men die with prostate cancer than of it. Growing old is
> invariably fatal. Prostate cancer is only sometimes so."
c palmer - 24 Sep 2004 19:26 GMT
as a followup, my local tv station broadcasted a report on the red wine
and prostate cancer.  

they also added that it is ONLY red wine that works.  white beer, beer,
and hard drinks have no effect.  

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
Keith Lundy - 24 Sep 2004 20:23 GMT
I should have stuck with the red wine!!!!!

Keith Lundy/So. California
40 Proton Beam Radiation Treatments
Loma Linda  Univ.Med Ctr..3/03-5/03
Larry - 24 Sep 2004 23:28 GMT
Ah but this from the BBC:

Guinness good for you - official

The old advertising slogan "Guinness is Good for You" may be true after all,
according to researchers.
A pint of the black stuff a day may work as well as an aspirin to prevent
heart clots that raise the risk of heart attacks.
Drinking lager does not yield the same benefits, experts from Wisconsin
University told a conference in the US.
Guinness were told to stop using the slogan decades ago - and the firm still
makes no health claims for the drink.
The Wisconsin team tested the health-giving properties of stout against
lager by giving it to dogs who had narrowed arteries similar to those in
heart disease.
They found that those given the Guinness had reduced clotting activity in
their blood, but not those given lager.
Clotting is important for patients who are at risk of a heart attack because
they have hardened arteries.
A heart attack is triggered when a clot lodges in one of these arteries
supplying the heart.
Many patients are prescribed low-dose aspirin as this cuts the ability of
the blood to form these dangerous clots.
The researchers told a meeting of the American Heart Association in Orlando,
Florida, that the most benefit they saw was from 24 fluid ounces of
Guinness - just over a pint - taken at mealtimes.
They believe that "antioxidant compounds" in the Guinness, similar to those
found in certain fruits and vegetables, are responsible for the health
benefits because they slow down the deposit of harmful cholesterol on the
artery walls.
However, Diageo, the company that now manufactures Guinness, said: "We never
make any medical claims for our drinks."

<snip>

The original campaign in the 1920s stemmed from market research - when
people told the company that they felt good after their pint, the slogan was
born.

In England, post-operative patients used to be given Guinness, as were blood
donors, because of its high iron content. This practice continues in
Ireland.

Pregnant women and nursing mothers were at one stage advised to drink
Guinness - the present advice is against this.

The entire article: http://news.bbc.co.uk/2/hi/health/3266819.stm

> I should have stuck with the red wine!!!!!
>
> Keith Lundy/So. California
> 40 Proton Beam Radiation Treatments
> Loma Linda  Univ.Med Ctr..3/03-5/03
dale.j. - 25 Sep 2004 00:52 GMT
> I should have stuck with the red wine!!!!!
>
> Keith Lundy/So. California
> 40 Proton Beam Radiation Treatments
> Loma Linda  Univ.Med Ctr..3/03-5/03

Don't get carried away with expensive red wine.  There are many reds
that fall below 7 and 6 dollars a bottle and are very good. Look at the
Chile, Australian, of course the French and Spain, they all make very
good wine.  Shop carefully.  

A glass or two every day will do wonders.  Cheers.

Dale J.

Signature

Email:  dalej2@mac.com

Larry - 25 Sep 2004 01:32 GMT
Don't forget the Italians! I love a good sangiovese - many very good ones
for about $10.

> > I should have stuck with the red wine!!!!!
> >
[quoted text clipped - 10 lines]
>
> Dale J.
Larry Wheat - 28 Sep 2004 11:49 GMT
If you live near a Trader Joe's, go to one and ask about "two-buck
Chuck" --- Charles Shaw wines. It's better than most, at a very low
price.

Larry (not a shill, a satisfied customer)
Alan Meyer - 25 Sep 2004 19:32 GMT
> I have taken this advice to heart and have a glass of Sutter Home
> Cabarnet Sauvaigon every night while watching TV news. Of course I had
> an RRP 3 months ago, but it's still a good excuse (more for my heart
> than my departed prostate).

Welllll, I thinnkk if fore glasesss wurks in one weeek, I kin
rilly fixx myself up with foretteen glassses in one day.

Soooo.  I'm ddooin it.

  Allllannn
Beverley - 26 Sep 2004 05:39 GMT
Ccchheers! Iss goood fur da hart tooo.
Bve

> > I have taken this advice to heart and have a glass of Sutter Home
> > Cabarnet Sauvaigon every night while watching TV news. Of course I had
[quoted text clipped - 7 lines]
>
>    Allllannn
Dave P - 30 Sep 2004 00:54 GMT
Recent Research Study

In a study of hundreds of wines from around the globe, Cornell researcher
Leroy Creasy found the highest resveratrol levels in pinot noir grapes grown
in cooler, rainy places like the Finger Lakes region of upstate New York and
Oregon's Willamette Valley. (In fact, the highest resveratrol content found
in a wine was in Vinifera's Fleur de Pinot Noir, with four times as much as
the nearest California pinot noir tested; chart). Long sown in France's cool
Burgundy region, pinot noir is considered a finicky grape to grow, in part
because it is susceptible to rot, which may be the reason it produces more
resveratrol than other grapes--up to 40 times as much resveratrol as grapes
such as merlot and cabernet sauvignon

Dave P

> Ccchheers! Iss goood fur da hart tooo.
> Bve
[quoted text clipped - 10 lines]
> >
> >    Allllannn
Smith - 28 Sep 2004 15:44 GMT
Are some red wines better than others to help prevent PC? Did the
study say which red wine they subjects drank?
Beverley - 29 Sep 2004 02:42 GMT
From everything I've gathered on "red" wine the only thing I've really heard
is red grape wine. Not beet wine or some flower wine but just plain red
grape wine. It doesn't matter which red grapes it came from just that it is
made with red grapes. (Which actually look bluish purple on the vine.) Most
doctors prefer you drink something that is not sweet. Mainly because the
sweetness will add extra calories to your caloric intake. It really doesn't
matter if you are drinking a Bordeaux, Sangiovese or a Cabernet Franc grape.
And if you don't want the alcohol then just drink some grape juice. Red
wines have long enjoyed a reputation for being "good for you". Moderation is
the key. A glass of wine with a meal is quite nice. Reds will also last a
little longer once opened if kept refrigerated. A bottle of white
(refrigerated) is usually only good for cooking or salad dressing after
about 48 hours. People who really get into the wines will tell you to drink
a Sangiovese with spaghetti or other tomato based food. Personally I don't
think it matters - drink what you like! If you have no clue what you like
try visiting a few wineries and taste their wines. If you don't live near a
winery then try a different bottle each time you visit the store or watch
for wine tastings in your area. Even some restaurants have wine by the inch
nights which allow the patrons to sample lots of different wines and some
exotic wines. Most of the table wines are blends. It will say "table wine"
on the label. These tend to be mild blended middle of the road type of
wines. They are little sweeter than some of the dry wines but not as sweet
as a dessert wine. It's a good place to start. Just remember every winery
will produce a different wine even with the same name. So just because you
didn't like one brand you might like another brand. After a while you'll
decide you don't like it no matter whose name is on the label. LOL
Bev

> Are some red wines better than others to help prevent PC? Did the
> study say which red wine they subjects drank?
Smith - 29 Sep 2004 15:44 GMT
Bev,

Thank you very much for the feedback. Here is my scenario. I very
rarely ever drink. I think I can count on one hand how many times I've
had any alcohol in the last two years. I guess I'm sort of scared to
drink as I've seen a family friend turn into an alcholic and his life
has been ruined. However I'm very interested in the red wine study
because the suggestions that it greatly reduced the risk of aggressive
PC.

You've indicated that I could drink red grape juice. Do you know of
this has studies that are similar to the red wine in helping prevent
PC? (I would rather drink grape juice.)
Beverley - 30 Sep 2004 02:06 GMT
Drink grape juice!

The pinot noir I believe is the darkest grape very black in color. Therefore
it probably does have more resveratrol in it. It's also in raspberries,
mulberries and peanuts. (Which {peanuts}completely blows the dark red color
assumption. LOL)

I would never tell anyone to drink alcohol. But what makes one an alcoholic?
I could not tell you. I will say drinking for the "wrong" reasons is
probably a major contributor. I doubt having a glass of wine for medicinal
reasons would turn someone into an alcoholic but I guess it could if that
person was so inclined.

If you are not used to drinking, a glass of wine is apt to knock you off
your feet. So if you do decide to try it then make sure you drink it with a
meal. Sip it slowly. Another possibility is to mix the wine with the grape
juice (gawk!) but that would give you some of the benefits of the wine
without the higher alcohol content yet still give you some resveratrol.
Another possibility is to allow the wine to age in the open air. The alcohol
will evaporate but I don't know what that would do to the resveratrol. It's
possible that would reduce the resveratrol in it, too.

The other thing is I have never heard that will reduce the risk of
aggressive PC. It seems to aid in slowing the progression of some tumorous
cancers. Personally I think red wine falls under the "can't hurt, might
help" category. I believe wine has been studied more for it cardio benefits.

Drinking lots of grape juice (not the white grape) would be better for the
tea teetotaler. But remember it is also higher in sugar than orange juice or
apple juice. Therefore your carb/sugar/calorie intake will increase.

Only you can decide if you want to supplement your diet with wine. Obviously
4 glasses a week is considered good for you. Sixteen glasses probably is
not. Would 8 half glasses be better than 4 full glasses? It might be easier
on your system. But again a glass of wine is not a big 16 oz ice tea sized
glass!!

Bottom line you can try it. You might not even like the taste. But if you
have any reservations about drinking alcohol then just don't do it!
Resveratrol is also in "purple" grape juice. You might try looking for a no
sugar added grape juice.
Bev (just rambling)

> Bev,
>
[quoted text clipped - 9 lines]
> this has studies that are similar to the red wine in helping prevent
> PC? (I would rather drink grape juice.)
Glenn Enoch - 30 Sep 2004 12:45 GMT
Here's one definition: You're an alcoholic if your life gets better when you
quit drinking.  ;-)

On 9/29/04 9:06 PM, in article D_I6d.5860$ku4.2055@trnddc01, "Beverley"
<beverly.brown28@verizon.net> wrote:

> I would never tell anyone to drink alcohol. But what makes one an alcoholic?
> I could not tell you. I will say drinking for the "wrong" reasons is
> probably a major contributor. I doubt having a glass of wine for medicinal
> reasons would turn someone into an alcoholic but I guess it could if that
> person was so inclined.
Beverley - 30 Sep 2004 14:31 GMT
I guess we are going completely off subject but I've seen several (serious)
definitions of alcoholism over the years and I've never seen one that really
describes it. Maybe because it is slightly different for each alcoholic? But
your definition is the best nutshell! As the daughter of someone who
possibly was an alcoholic it is something I've pondered many times,
especially since I do drink. I will NEVER follow in his footsteps!!
Bev

> Here's one definition: You're an alcoholic if your life gets better when you
> quit drinking.  ;-)
[quoted text clipped - 7 lines]
> > reasons would turn someone into an alcoholic but I guess it could if that
> > person was so inclined.
Claude - 30 Sep 2004 14:47 GMT
>I guess we are going completely off subject but I've seen several (serious)
> definitions of alcoholism over the years and I've never seen one that
[quoted text clipped - 5 lines]
> especially since I do drink. I will NEVER follow in his footsteps!!
> Bev

My wife was an alcoholism counselor.  It's a very complex disease.  However,
I asked her to define an alcoholic in the simplest way possible.  She said
that it is someone who has a compulsion to drink and whose drinking causes
problems in his or her life.  Obviously the two are related.
c palmer - 30 Sep 2004 23:26 GMT
I guess we are going completely off subject but I've seen several
(serious) definitions of alcoholism over the years and I've never seen
one that really
describes it. Maybe because it is slightly different for each alcoholic?
But
your definition is the best nutshell! As the daughter of someone who
possibly was an alcoholic it is something I've pondered many times,
especially since I do drink. I will NEVER follow in his footsteps!! Bev
My wife was an alcoholism counselor. It's a very complex disease.
However, I asked her to define an alcoholic in the simplest way
possible. She said that it is someone who has a compulsion to drink and
whose drinking causes problems in his or her life. Obviously the two are
related.
=============
hi claude - when everyone started to discuss what makes up an alcoholic,
my thinking was along the lines that most people might know.  then it
dawned on me, that i'm used to it because of my training when i was
counselling.  allow me to shed some light on this subject.

first, a little lighter side.  when i was in the service and we were
standing in ranks, the military decided to crack down on drinking.  so,
they ask with a show of hands who had been drunk at least three times in
the past year.  about 1/2 the hands went up.  the senior officer said,
"ok, by the bureau's definition, you are all alcoholics."  someone in
the back asked about the 1/2 that didn't raise their hands.  the
officer's comments was, "they're all liars!!!"

now, down to business, there are basically 4 main stages to become an
alcoholic.  there was several substages inside some of the stages.  they
each have their own set of characteristics.  
this will be a very brief description of what's going on.........

the first stage - the experience of the drug.  in other words - to get
drunk.

the second stage - behavior change.  this happens the first time you
stop at the liquor store.  why?  because all the other times, you drive
by.  you now have had your behavior changed to where you are seeking out
the drug.  you are solely stopping at that store to purchase alcohol and
nothing but alcohol.  that is a behavior modification.

now, there are some sub stages within the 2nd stage, but i'm not going
into them.  it would take too long.

the third stage - the changing of the drinks.  this is when someone
switches from six beers to 3 double scotch.  getting the same amount of
alcohol, but are lying to themselves.  might switch brands of booze.

blackouts are also one of the sub stages.  most people think a blackout
is where they pass out, but it's not.  a black out in the alcoholic
means that you are talking to them and they appear to be listening to
you, but are in the black out mode.  this causes a lot of problems
because when you confront them on something they had promised to do or
be there, they have no memory of saying so.  they are telling the truth,
but to the person who isn't the alcoholic, it sounds like a cop out and
of course, starts an argument, which is turn, gives the person a reason
to go drink.

now, there are other sub stages within the 3rd stage, but going straight
to 4th stage.

fourth stage - having physical problems.  body parts are rebelling, GI
tract problems, liver problems, etc.  again, there are sub stages within
this period

the person who gets knee walking, toilet hugging drunk once a month is
not an alcoholic.  they are a drug abuser.  there is a difference.

alcoholics make the best workers.  by that - they do a great job - when
they are there.  which is why bosses don't like firing them because they
can output so much work in such a short time.  of course, the rest of
the time, they're off, but usually keeps them at the teetering point to
where the boss wants to fire them, but it is worth it to the company to
keep them.

what's people don't understand is that the family has to get as mentally
sick as the person is becoming physically sick.  and because of that,
they have certain traits.  a person can not become an alcoholic unless
there is an enabler.  this is the one who makes the excuses for why the
person is getting drunk.  they might say, "X got drunk last night
because of the  stress of the job."  or " X got drunk last night because
of the kids were really acting up"

the first born of an alcoholic family is a hard worker.  they know
something is wrong and want to leave the house as soon as they are able.
80%  usually go into social type work or services.  the other children
take on their own set of traits.  one becomes the family clown - to take
the spotlight off of the drunk.  one becomes what is known as the "quiet
one"  doesn't cause any waves.

this might be more info that people want to know, but alcoholism is a
disease, and as a disease, it has certain traits.  did you know that if
an alcoholic stops drinking after, say 5 years,  and goes 15 years
without touching a drop.  then goes back to drinking again.  the disease
will pick up where they were had they been drinking for the entire 20
years.  that is why alcoholic people have a hard time handling any
drinking.

i know this is OT, but is such an important subject, that is worth
commenting on.

hope this will help someone.

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
Smith - 29 Sep 2004 15:53 GMT
I also found this information:

Dear Drs. Dave and Dee,

Some coworkers have been talking about how everyone should drink wine
for their health! Is it true that drinking wine is now good for you?
How much is good?

Signed,

Nondrinker

Dear Nondrinker,

Drinking wine for good health seems to be getting all the press
probably because it's an intoxicating beverage.

However, there have been studies supporting intake of nonalcoholic
beverages such as grape juice, cranberry juice, or tea with lower
incidence of cancer, heart disease, and other diseases. (Click on
links below).

Support for moderate consumption of wine, 1-2 glasses, and a decrease
in coronary heart disease first came to public attention via the "60
Minutes" report on the "French Paradox". The French had a lower
incidence of coronary heart disease despite their diet high in fat.
One possible reason given for the low rate of coronary heart disease
in France was the French habit of drinking wine with meals.

The antioxidant, "resveratrol", is in grapes. Resveratrol lowers the
"bad" LDL cholesterol, but elevates the "good" HDL cholesterol levels.
More recent research indicates that perhaps the French are consuming
fewer calories citing smaller restaurant portions and prepared
packaged foods.

Red wines have a higher level of resveratrol than white wines, in
particular, the red wine, pinot noir, has about twice as much as other
reds.

For people who do not want to drink alcohol, there are alternatives.
Some research has pointed out that cranberry juice, red or purple
grape juice work as well, maybe better, than red wine. However, fresh
grapes do not have as high a concentration of antioxidants as
processed grape juice or wine.

Although some health food stores sell resveratrol as a nutritional
supplement., more research needs to be done on this supplement to see
if it has the same benefits as wine or grape juice.

In addition, other studies indicate that black or green tea may be
more beneficial than wine in reducing heart disease as well as cancer
and other diseases.

Note, 2 cups of tea have approximately the equivalent antioxidant as 2
glasses of purple grape juice, or 2 glasses of red wine, or 12 glasses
of white wine.

However, tea, grape juice, or wine consumption doesn't take the place
of a healthy lifestyle which should include exercise, no smoking, low
fat foods, lots of fruits, vegetables, grains, and water.

See links below for more information:
http://www.drdaveanddee.com/wine1.html
 
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