Brewing Psychiatry


Shinichi Miyazaki
Professor, Faculty of Law, Chuo University
Area of Specialization: Psychiatry

Wine consumption in Japan is gradually increasing. There are two reasons behind this. The first was the airing of the health effect of red wine, later to be called the French Paradox, in November 1991 on the US television station CBS program 60 minutes. The second reason was when Shinya Tasaki won the Contest of the Best Sommelier of the World in 1995. Wine consumption prior to and after these events showed that although wine consumption stayed at 1.5l (1989-1994 variables) for the first event, consumption almost doubled to 2.8l after the second event (1995-1999 variables). However, I must add that these amounts are 1/20 of the figures for France.

Here I will talk about the French Paradox. Milk fat intake has a negative impact on heart disease, but when looking at milk fat intake and death rate from ischemic heart disease, of the countries with similar milk fat intake figures, Denmark, Germany, Netherlands, Belgium, Switzerland and France, France had the lowest death rate, comparable with those of Portugal and Spain, countries with a milk fat intake rate 1/3 of that in France. There, the calculation formula taking into consideration milk fat intake and wine consumption, namely milk fat intake x 0.138+145-wine consumption x 0.917, and ischemic heart disease death rate displaying an impressive correlation was reported in the well know medical journal Lancet (Renaud et al. 1992). In other words, the low ischemic heart disease death rate in France despite high milk fat intake is due to (high) wine consumption.

The mechanisms of the onset of hardening of the arteries causing ischemic heart disease are believed to be as follows. When the endothelial cell forming the vascular wall is damaged by causes such as high blood pressure and smoking, LDL cholesterol in the bloodstream (the so-called bad cholesterol) enters the vascular endothelium from the bloodstream, and through this process becomes oxidized LDL cholesterol from the reactive oxygen, and a type of blood cell called macrophage eats this. This soon becomes a giant lump pressing up against the endothelial cell, narrowing and blocking the vascular lumen. This condition is called hardening of the arteries and takes place in the coronary artery, a major artery that nourishes the heart, and when the lumen of the blood vessel narrows or the coronary artery is blocked by lumps formed in other places that are carried to the blood vessel in the bloodstream, serious ischemic heart diseases such as myocardial infarctions occur. In contrast to these onset mechanisms, wine plays a role in removing reactive oxygen and preventing the oxidization of LDL cholesterol.

Maxwell et al. had 10 healthy students (5 males and 5 females, average weight 67.3kg) consume 5.7ml per 1kg of weight of Bordeaux wine (383.6ml for a 67.3kg person, the equivalent of a half bottle) at lunchtime, took blood samples after drinking and measured antioxidative activity in the blood, and compared those with samples from non-drinkers. While there was virtually no change in antioxidative activity after eating in the group who didn’t drink, antioxidative activity for those who did drink was 1.25 times that of the non-drinking group one hour after eating, and 1.09 times greater even four hours later (Lancet, 1994). Even in Japan, it has been reported that antioxidative activity rises when consuming 500ml of red wine at meal times for two weeks (Kondo et al. Lancet, 1994).

The antioxidant in wine is polyphenol. Sato showed that there is a correlation between the amount polyphenol in wine and antioxidative effect, and because the older the wine becomes, the higher the antioxidant capacity becomes, suggested that the antioxidant capacity of polymerized polyphenol is high due to ageing (J. Agric. Food Chem, 1996). That is to say, in the terms of grapes, the antioxidant capacity of wine made from long-lived varieties such as Cabernet Sauvignon and Nebbiolo rises together with the price. Corder et al. postulate that there is a low occurrence of vascular disease among males living in regions that produce wine that possesses large amounts of proanthocyanidin (a type of polyphenol) composition blocking endothelin (a biological material that causes high blood pressure with blood vessel contracting effect), such as the Southwestern region, to the south of Bordeaux, in France and the Province of Nuoro on the Italian island of Sardinia, resulting in longevity (Nature, 2006).

In regards to dementia, Orgogoza et al., in a follow-up survey conducted on 3777 people aged over 65 living in the Bordeaux region over 3 years concerning alcohol intake (actually red wine consumption) and the risk of dementia, found that the risk of developing dementia for those who drank 375-500ml of red wine a day was 1/5 of that of non-drinkers (Rev. Neurol, 1997). In a Swedish follow-up survey conducted on 1462 adults, starting in 1968 over 34 years, results showed that the wine-drinking group had a 40% lower risk of developing dementia than the non-drinking group. However, in the case of spirits other than wine, the risk was more than 50% higher than the non-drinking group, suggesting that factors other than alcohol were involved in preventing dementia (Mehlig et al., Am J Epidemiol, 2008).

For depression, there has been research involving a 7 year follow-up survey conducted on 5505 people aged 55-80 in Spain (Geo et al., BMC Medicine, 2013). The group which consumed 5-15g of wine a day when converted to pure alcohol had a significantly lower rate of contracting depression than the non-drinking group. This works out to be drinking one bottle of wine over a period of 6 to 18 days, and there would be individual differences in thinking of whether this is excessive or little to which you feel depressive.

Above I have presented the preventative effect of red wine, especially polyphenol, have on heart disease and mental disorder. This may be taking a giant leap, but is there no positive effect to mental health by drinking wine?

Turning the subject away from alcohol, a hint lies in therapeutic walks in forests. If we spend a while in a forest environment, we can feel the relaxing and fatigue recovery effect, and in 1982, the Forestry Agency used the term forest bathing to propose the use of forests for health and recuperation purposes. Li et al., of Nippon Medical School, in order to measure the organic immune functions of forest bathing, had 25 healthy males and females working in Tokyo walk a 2.5km long promenade in Nagano Prefecture for two and a half hours (on the first afternoon, and morning and afternoon of the second day) on a two-night, three-day trip. Results showed that natural killer activity in the blood stream related to immune function was significantly higher than when measured in Tokyo before the forest bathing. Furthermore, the subjects returned to their normal lives, and when tested 30 days later, natural killer activity levels remained significantly higher than before the forest bathing, showing that the effect of forest bathing last at least one month (Li et al., Int. J. Immnopathol. Pharmacol , 2008, Li et al., J Biol Regul Homeost Agents, 2008). By the way, including the time of taking the blood samples, Li et al. banned alcohol consumption during the experiment, thus nullifying the effect of alcohol. On the other hand, in order to nullify the effect of exercise, the time set for the walk during the forest bathing was set to be equivalent to regular exercise. To elaborate upon this further, even if the subjects consumed the same amount of regular alcohol consumption during forest bathing, the influence of alcohol consumption would be eliminated.

Here, I wondered if we could separate and measure the mental effect of a winery tour and the effect of alcohol as a chemical substance. That is to say, conduct a comparative evaluation of mental states when wine is consumed in a campus laboratory and when wine is consumed at a winery. This is linked to my proposal of brewing psychiatry. Below is the explanation used to recruit students when starting up the Brewing Psychiatry course in this university’s FLP (Faculty-Linkage Program). “Brewing is a human technology with a history spanning over thousands of years. We have been told the advantages and disadvantages of alcohol, the products of brewing, but before making judgment on the advantages and disadvantages we need to research the effect brewing has on human mental health by understanding the life phenomenon called brewing, investigate the natural environment of breweries, talk to brewers, acquire a sense of taste and smell through tasting, associate it with memory and express it in words. I want to make a big goal of creating a new science from the point of view of mental health.
I advertised the course with this but, unfortunately, nobody applied. Because this course was recruiting new second year students, I believe that it couldn’t attract their interest as they were still under the drinking age.

Finally, as an advertisement, in promoting Brewing Psychiatry, I intend to recruit volunteers who will contribute to my research. Specifically, you will be required to consume wine on campus and at wineries, and I hope for the cooperation of staff and students of drinking age at the Chuo University Tama Campus who drink wine on a daily basis.

Shinichi Miyazaki

Professor Miyazaki was born in Kanagawa Prefecture in 1957. He graduated from the Department of Agricultural Chemistry in the Faculty of Agriculture, the University of Tokyo in 1981, and entered Suntory Ltd. in the same year, working in the brewing research institute. While he was employed there he was temporarily transferred to the National Research Institute of Brewing from 1983 to 1986. He left Suntory in 1989 and entered the School of Medicine at Yokohama City University. He graduated in 1995 and obtained a medical license. After working as a psychiatrist at Tokyo Metropolitan Matsuzawa Hospital and Takatsuki Hospital, he entered his current position at the Faculty of Law, Chuo University in 2012. Doctor of Medical Science. As well as teaching at university, he continues mentally handicapped sports research and support activities. Recently he has gained an interest in the effect of alcohol on mental functions and is currently preparing for research. He holds the Japan Sommelier Association Wine Expert qualification.