Wine, and especially red wine, is a luxury product, usually consumed as part of a full meal, and it is astringent and bitter. As a result, spontaneous wine consumption, within pre-1991 populations particularly, depends on multiple cultural, social, economic, and gender- and age-related factors (31). These complex factors that underlie spontaneous wine consumption make it possible that some other important variable or coincident patterns of behavior that have yet to be statistically isolated and that are highly correlated with wine consumption are truly responsible for increased longevity within wine drinking populations. Indeed, the correlation of wine consumption with other health-promoting dietary factors is highly significant (186). Thus, ecological epidemiology has served as an excellent means to generate hypotheses, but, at the same time, the bias inherent to wine drinking among the populations studied provides this approach with little ability to resolve the health benefits of wine.