Resveratrol is a compound found most famously in the skin of red grapes but also in peanuts, mulberries, and a few other plants. Its presence in red wine has been used as an explanation of the “French Paradox” – the finding that some regions in France have low rates of heart disease despite a high-fat diet. Though it has been studied sparingly in humans and has never been evaluated in a clinical trial, results from studies in yeast and other animals have generated tremendous buzz, fueled in no small part by Dr. David Sinclair, an early resveratrol researcher. Sinclair is co-founder of a company called Sirtris, which is developing and testing more potent resveratrol analogs - and was acquired last year by GlaxoSmithKline for $720 million. This figure attests to the broad potential of the compound, which has been shown – in animal, yeast, and human cell lines – to have positive effects on heart disease, diabetes, dementia, and cancers. Much of resveratrol’s allure to the general public, however, derives from claims that it can delay the aging process. This is based on resveratrol’s ability to activate a set of genes encoding enzymes known as sirtuins, which regulate numerous key cellular pathways. The same pattern of sirtuin activation has previously been seen in mice fed a calorie-restricted diet (30% reduction) which has been shown to prolong life in mice. This has led to the hypothesis that the benefits of caloric restriction are mediated via sirtuins and can be replicated by resveratrol.

At present, resveratrol is available as an unregulated supplement, so it’s impossible to vouch for the quality of any proprietary formulation. Similarly, while there are no data to suggest clear risk of harm from resveratrol, Phase I studies in humans are very limited. Resveratrol may impair fertility and may activate estrogen-responsive tumors, so clearly should be avoided in situations where this is relevant. For everyone else, it’s a difficult risk/benefit analysis since we know neither its up- or downside – and won’t have good clinical trials data for years. For most, the best advice is to get resveratrol from drinking red wine or grape juice. But for some older patients, or younger patients with strong family histories of cancer or early demise, it might be worth trying. I belong to the latter group and while I’m not taking it yet, I will be following the story closely.