Latest / Becker’s Healthcare Podcast / Exploring the Science of Wine and Health with Dr. Laura Catena

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Exploring the Science of Wine and Health with Dr. Laura Catena · Becker’s Healthcare Podcast

• 0:01
  This is where health care leadership comes together.
• 0:04
  Becker's sixteenth annual meeting brings more than 3,500
• 0:07
  hospital and health system executives and nearly 800
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  speakers to Chicago
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  April.
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  This series event includes keynote conversations with Dallas
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  Cowboys legend Troy Aikman and former president George
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  w Bush. For the agenda and event details,
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  visit beckershospitalreview.com
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  and click on the events tab in the
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  upper right. We're looking forward to hosting you
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  in Chicago.
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  This is Scott Becker with the Beckers Health
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  Care Podcast.
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  We're thrilled today to be joined by a
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  physician,
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  doctor Lara Catina.
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  And doctor Catina is originally from Argentina,
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  and she's gonna talk to us today about
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  something a little different than our typical podcast.
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  She's got a particular focus, and she's written
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  about the intersection of wine and health, something
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  that many of us are curious about. Doctor
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  Catina, can you take a moment to introduce
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  yourself and and describe a little bit why
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  this intersection of wine and health became so
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  important to you?
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  Yes. Absolutely. Well, I was born part of
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  a fairly well known line family in Argentina.
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  But when we came to The United States
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  in the eighties, it it was a difficult
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  time in Argentina.
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  And I went to medical school,
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  Harvard undergrad biology,
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  medical school at Stanford. I decided to become
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  an emergency physician. I had no intention of
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  ever going to work at the family winery.
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  And then I I sent a call in
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  for my father who was trying to revolutionize
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  Argentine wine,
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  and
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  I started working with him. And for almost
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  twenty seven years, I was actually practicing emergency
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  medicine
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  and
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  working for my family winery. We do a
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  lot of multicultural research, but also, you know,
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  doing the things that you do at a
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  family business. But the reason why I'm so
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  interested in this topic is well, first of
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  all, it's the business of my family. It's
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  a multi generation business.
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  Four generations in Argentina, two generations in Italy
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  before that.
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  And I've always felt that drinking wine in
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  moderation
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  could be part of a healthy lifestyle, and
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  I still think that. However,
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  there's been a lot of anti alcohol
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  spread
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  in the in the news, like, mostly in
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  the mainstream news and also in in some
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  of the the scientific news.
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  And
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  I feel that as a physician, I need
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  to make sure to tell people the correct
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  science.
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  And that's why I've been thinking a lot
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  about this topic because I think it's really
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  important to know what we know, what we
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  don't know,
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  and to not take sides, to literally
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  tell patients,
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  tell other scientists or doctors
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  what the science shows and and also welcome,
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  you know, people saying,
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  they disagree,
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  which happens a lot in this field. Like,
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  a 100%. And talk about this for a
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  second because for a very long time, it
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  was sort of commonly believed
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  that a glass or two of wine
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  might be very good, almost a part of
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  the Mediterranean
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  diet,
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  the the concept that, you know, might help
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  to thin the blood,
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  might be helpful for people.
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  And then more recently, as you've said, you
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  see some of the media saying, no. That's
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  all wrong. It's horrible
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  and and the truth on most of these
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  things is somewhere in between.
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  But but tell us, what is the reality
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  of this, the wine versus health debate?
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  Yeah. Absolutely. And we don't have that much
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  research
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  specific to wine. We have some, especially when
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  it comes to Mediterranean diet,
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  but a lot of the research is looking
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  at alcohol in moderation.
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  So the data has not changed that much
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  actually in the last
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  thirty years. We see
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  still a reduction in mortality for moderate drinkers.
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  The National Academy study, which was finished in
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  2025,
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  showed that that people who drank in moderation,
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  which is described as one glass per day
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  up to one glass per day for women
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  up to two for men compared to never
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  drinkers live longer. They also had to a
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  heart attack, and there was this,
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  slight increase in breast cancer risk, not death.
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  So
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  that literature whether it's,
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  longer lifespan
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  for moderate drinkers
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  has always been there. There's also been literature
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  on the cancer risk even at small
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  volume. So the breast cancer data has been
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  there for a while. It's about to be
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  related to estrogen.
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  And, you know, then we've got the esophageal
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  cancers,
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  your cranial cancer risk,
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  are much more common in people who both
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  smoke and drink alcohol.
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  But
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  are mostly people who are drinking over moderate
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  levels.
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  So this data,
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  has been around for a long time and
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  shows the same thing. Now some of, the
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  challenges on the cardiovascular
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  potential
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  associated benefits. And and we really need to
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  say associated benefits because we we can't just
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  say causality
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  unless
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  we have a randomized result trial. And there's
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  a few small ones, but there isn't really
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  a large one. A large one is about
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  to happen, so I will tell you more
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  about that later. But, but, basically,
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  there's this thing called Mendelian mineralization that is
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  looking at the genetics
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  of alcohol. And what they look at is
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  people who,
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  genetically, are less likely to drink a lot.
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  And it it has to do with the
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  alcohol dehydrogenase metabolism. So some people who metabolize
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  it very quickly, they feel uncomfortable, they tend
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  to drink better.
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  But the relationship is nonlinear. And some of
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  these studies actually are interesting because they don't
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  show the cardiovascular benefit, but they also don't
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  show the cancer risk at moderate level. So,
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  you know, there's a question mark there. So
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  the bottom line is, as there is still
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  data, even the recent data showing this associated
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  longer lifespan
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  and less
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  cardiac death. And the American Heart Association published
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  a really
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  great paper in circulation. I recommend that anybody
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  that's interested in this read it, where they
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  show all these associations,
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  you know, at what level does blood pressure
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  increase,
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  and the REM hospital data versus the operational
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  data is slightly different. They see a decrease
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  in strokes for moderate drinkers, a decrease in
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  sudden death, a decrease in heart attack. And
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  then we have all the diabetes data that
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  shows that people who,
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  drink in moderation have better sugar control and
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  less incidence of of diabetes. However,
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  the big problem is that if you tell
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  people
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  drinking wine or
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  beer, whatever in moderation
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  might help you, people tend to drink more
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  and binge drink if it has a very
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  bad outcome. Because
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  people tend to think, well, if I have
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  a little
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  and that's fine, then I can have more.
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  So as physicians, you have to be really
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  careful with patients
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  to,
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  basically say what I just said. You know,
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  there's some data that shows up the lifespan.
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  There's definitely data with cancer.
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  So
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  if you really like drinking and it's part
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  of your social life and
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  drink wine with a Mediterranean diet and you're
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  exercise, well, that's wonderful. You know? That for
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  me, I'm I'm of Italian descent. That's part
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  of my culture. I really like my little
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  glass of wine,
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  that I don't have every day because I
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  I like to not drink every day.
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  And, you know, I I don't think right
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  now the data is telling us you should
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  stop that habit if you're drinking in moderation.
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  However,
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  most schools most guidelines
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  all guidelines say that you should not tell
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  somebody to start drinking for help because you
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  don't know who's gonna develop an alcohol use
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  disorder. So it's it's a complex topic, but
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  it's not that complex actually because the data
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  has shown the same thing
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  for decades.
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  No. And I and I love that. And
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  I think your point is so well taken
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  on I I know, for example, if the
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  doctor says I could eat a certain thing,
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  you know, or my weight goes down, then
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  I overdo it and and I splurge.
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  And so the concept of not encouraging people
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  to drink,
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  is is probably right because people then they
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  hear that. It's it's almost so when the
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  doctor says, oh my god. Your skin looks
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  great. We don't have a skin risk right
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  now. Then then I go out in the
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  sun too much. I think that's right on.
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  Yeah. No. I I think them.
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  And we Yeah.
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  We're all a little bit wired like that.
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  And and and and and what advice would
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  you have for I mean, you've you've built
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  this fascinating career,
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  great physician, Stanford and Harvard, and then also,
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  you know, love this intersection. You've got a
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  passion for this intersection partly born out of
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  a family business originally,
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  for wine and so forth. But tell me,
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  tell me what you're most excited about this
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  year and focused on.
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  Well, what I'm most excited about is this
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  study that's going on in Spain. It's the
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  first randomized controlled
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  trial
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  with wine. And so they're taking in people
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  who follow the Mediterranean diet, and they're randomizing
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  them to either keep on drinking wine because
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  most people fall in the Mediterranean diet, who
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  live in a region that falls in the
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  Mediterranean diet, drink wine as their alcohol beverage,
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  and then they randomize them to keep on
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  drinking wine or stop. And, actually, they they're
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  planning to get 10,000 people, and they're already
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  at 7,500
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  called UNACI, and it's at the University of
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  Nevada. And it's led by this researcher, Miranda
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  Martinez Gonzalez, who is also a visiting professor
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  at Harvard. And so this is the golden
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  standard
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  study. And the other really cool thing is
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  that they're actually checking urine and hair on
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  the patients to make sure that they're being
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  truthful because
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  that's one of the issues,
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  with a lot of these observational trials is
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  that people may not be telling the truth
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  about their drinking. In addition to confounders,
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  we could talk about all the problems with
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  some of the previous studies. But this study
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  will at least answer the question
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  for why.
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  And I am so excited about that because
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  it will at least tell us is there
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  a potential cardiovascular benefit because we have all
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  these, you know, mechanisms for cardiovascular benefits. We
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  have the blood thinning effect.
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  We have the diabetes effect.
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  We even have
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  this reduction in hyperactivity of the amygdala effect.
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  So I think for most patients, it'd be
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  helpful to know
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  is there
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  some associated cardiovascular benefit or not.
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  So, yeah, this is what I'm most excited
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  about, and I'm really excited about this. We're
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  not gonna have the results of 2029,
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  though.
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  Thank you. And and I tell you, such
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  an informative discussion, doctor Catina.
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  Fantastic what you do.
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  Any advice for physicians trying to have great
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  impactful careers?
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  Yeah. So first of all, I wanna say
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  that I have a conflict of interest because
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  I have a winery. So if you want
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  to look at all the data behind what
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  I'm saying that is research done by other
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  people who don't have a conflict of interest,
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  it's on my voice website, in defenseofwine.com.
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  And my main advice to physician in general,
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  really enjoy the patient. I am hoping that
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  with AI,
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  the paperwork will become less. What was hardest
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  in my last couple of years working was
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  having to charge while I was talking to
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  patients and just, you know,
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  that here is that you're never caught up
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  with your charting or the ordering.
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  And I have this great hope that with
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  AI, that will become simpler, and we'll be
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  able
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  to spend more time with patients, which is
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  what patients want.
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  And,
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  you know, basic care is what I always
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  love to do, and and I think it's
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  such a noble profession. It's so rewarding.
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  But making wine is kinda fun too. So
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  I would say to the listeners, you know,
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  do it while you can. And then if
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  you if you decide you wanna do something
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  else, you've already developed all the good habits.
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  You know, you're hardworking.
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  You're able to stay up at night. You
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  finish what you start. You have energy,
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  and so you would probably be good at
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  anything else you do. So that's what I
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  would say.
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  Thank you so much. Doctor Catino, what a
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  brilliant physician. What a pleasure to visit with
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  you. Thank you so much for taking the
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  time with us today. I really enjoyed it.
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  Thank you so much for joining us. Well,
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  thank you, Scott. I had a a a
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  good time too. Thanks for all the questions.
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  You're you're fantastic. Thank you very, very much.