Wine, beer, alcohol and polyphenols on cardiovascular disease and cancer.

The protective effect of moderate alcohol consumption on the risk of cardiovascular disease has been consistently shown in many epidemiological studies. Antiatherogenic alterations in plasma lipoproteins, particularly increase in high-density lipoprotein (HDL) cholesterol,are considered as the most plausible mechanism of the protective effect of alcohol consumption on coronary artery disease (CHD). Other potential mechanisms contributing to the cardio-protective effects of moderate alcohol consumption include anti-thrombotic down regulation of blood platelet function, as well as of the coagulation and fibrinolysis balance. Since the proposal of a "French paradox" in the early Nineties, the possibility that consuming alcohol in the form of wine might confer a protection against CHD above that expected from its alcohol content, has made the topic"wine and health" increasingly popular. Many epidemiological studies have explored such a possibility, by comparing specific alcoholic beverage types (wine,beer, liqueur) in respect to their relative capacity to reduce the risk of CHD. In parallel, experimental studies have been done, in which wine and wine-derived products have been tested for their capacity to interfere with molecular and cellular mechanisms relevant to the pathogenesis of CHD. Wine might indeed conceivably have other ethanol unrelated beneficial effects. The biological rationale for such a hypothesis has been linked to the enrichment in grape-derived, non-alcoholic components, that possibly make it peculiar in respect to other alcoholic beverages. In fact, while the mechanisms underlying the effects of alcohol on cardiovascular disease have been limited to lipid metabolism and the haemostatic system, those related to wine consumption have also been extended to specific anti-inflammatory, antioxidant and nitric oxide related vaso-relaxant properties of its polyphenolic constituents. The effect of wine consumption has been carefully investigated to account for potential confounding of several conditions (inappropriate use of abstainers as control population, correlation between wine or total alcohol consumption and markers of healthy lifestyle and socioeconomic factors, diet, etc.). Strong evidence indicates that moderate wine consumption rather than confounders reduces both fatal and non fatal CHD events. In spite of the fact that the healthy effect of moderate intake of wine is by now well accepted, important issues remain to be resolved about the relationship between wine, alcohol and alcoholic beverages, the (possibly different) optimal amount of alcohol intake in men and women, the individual or environmental modulation of the alcohol related effect and the pattern of drinking. Some of these issues have been recently addressed in a large meta-analysis, in which the relationship between wine or beer consumption and CHD risk was quantitatively evaluated. We shall summarize here the experimental and epidemiological studies with wine or wine-derived products aimed at finding biological explanations for the supposed superior cardio-protective effects of wine consumption and to discuss some open questions about wine and vascular disease as approached in epidemiological studies.

AHA Science Advisory: Wine and your heart: a science advisory for healthcare professionals from the Nutrition Committee, Council on Epidemiology and Prevention, and Council on Cardiovascular Nursing of the American Heart Association.

3 Department of Family Preventive Medicine, UCSD, La Jolla, CA, USA; 4 Brigham and Womens Hospital, Boston, MA, USA; 5 Danish Epidemiology Science Center, Institute of Preventive Medicine, Kommunehospitalet, Copenhagen, Denmark; 6 Department of Community Health, University of Aukland, NZ; 7 Kaiser Permanente Medical Center, Oakland, CA, USA; 8 University of Kuopio, Kuopio, Finland; and 9 Royal Free and University College Medical School, London, UK

Excessive alcohol consumption is associated with increased morbidity and mortality as well as with labour and traffic accidents. However, current evidence suggests beneficial effects of moderate drinking on cardiovascular events including coronary heart disease, ischaemic stroke, peripheral arterial disease and congestive heart failure. The underlying mechanisms to explain these protective effects against coronary heart disease include an increase in high-density lipoprotein cholesterol and an increase in insulin sensitivity, and a decrease in platelet aggregation and circulating concentrations of fibrinogen. However, there are discrepancies regarding the specific effects of different types of beverages on the cardiovascular system, and also whether the possible protective effects of alcoholic beverages are due to their alcohol component (ethanol) or non-alcoholic products containing, mainly polyphenols. Recent randomised clinical trials have shown that wine, a polyphenol-rich alcoholic beverage, provides higher antioxidant and anti-inflammatory effects than some spirits such as gin, a polyphenol-free alcoholic beverage. In addition, dealcoholized red wine decreases blood pressure through a nitric oxide mediated mechanism, suggesting a protective effect of polyphenols on vascular function. Other studies performed in women have observed that daily doses of 15-20 g of alcohol as red wine are sufficient to elicit protective effects similar to those observed in men who consumed higher doses of wine. In conclusion, moderate consumption of wine exerts a protective effect on biomarkers related to the progression and development of atherosclerosis due to its alcoholic (ethanol) and non-alcoholic (polyphenols) content. Women are more sensitive to the beneficial effects of wine.

To evaluate the in vivo effects of moderate consumption of red wine, beer and spirits on antioxidants, antioxidant enzymes and antioxidant capacity. Randomized, diet-controlled, cross-over study. Twelve apparently healthy, non-smoking middle-aged men were included; 11 of them completed the study. Each subject consumed four glasses of red wine, beer, spirits and water (negative control) with evening dinner during four successive periods of 3 weeks, daily at the Institute. The total diet was supplied to the subjects and had essential the same composition during these 12 weeks. Neither the enzyme activities of serum glutathion peroxidase, erythrocyte glutathion reductase and superoxide dismutase nor the plasma concentrations of alpha- and gamma-tocopherol, lutein, zeaxantin, beta-cryptoxanthin, lycopene and alpha-carotene were affected. Plasma beta-carotene concentrations were decreased after 3 weeks' consumption of red wine, beer and spirits (40 g alcohol/day) as compared to consumption of water, by 15% (P=0.0005), 11% (P=0.010) and 13% (P=0.003), respectively. Also, plasma ascorbic acid was decreased after beer (15%, P=0.004) and spirits (12%, P=0.030), but not after wine consumption. Serum uric acid concentrations were increased after consumption of beer (15%, P<0.0001), spirits (8%, P=0.008) and red wine (9%, P=0.003). The overall serum antioxidant capacity, assessed as Trolox equivalent antioxidant capacity (TEAC), was similar for all treatments. Moderate consumption of red wine, beer and spirits has counteracting effects on plasma antioxidant components, resulting in no significant effect on overall antioxidant status. The effects on antioxidant parameters are largely independent of the type of alcoholic beverage, and probably irrelevant to chronic disease risk. Dutch Foundation for Alcohol Research (SAR).

A high intake of alcohol may prolong waiting time to pregnancy, whereas a moderate intake may have no or perhaps even a positive effect on fecundity. In previous studies on fecundity, different types of beverages have not been taken into consideration, although moderate wine drinkers appear to have fewer strokes, lung and digestive tract cancers, and overall mortality than both abstainers and moderate drinkers of beer or spirits. We examined the association between different types of alcoholic beverages and waiting time to pregnancy. Self-reported data were used for 29,844 pregnant women, recruited to the Danish National Birth Cohort in 1997-2000. Main outcome measures were odds ratios for a prolonged waiting time to pregnancy according to consumption of wine, beer and spirits. All levels of wine intake compared with non-wine drinking or with consumption of beer or spirits had subfecundity odds ratios between 0.7 and 0.9. No association was seen regarding beer drinking, while the association with spirits was J-shaped. Our findings suggest that wine drinkers have slightly shorter waiting times to pregnancy than both non-wine drinkers and consumers of other alcoholic beverages. Whether this is an effect of wine itself or the characteristics of the wine drinker is not known.

Purpose The health effects of alcoholic beverages and the differentiation between moderate consumption and alcohol abuse are discussed controversially in medicine, sociology and politics. Therefore, this paper aims to analyse how consumers assess the relation among health, wine consumption and alcohol abuse. Design/methodology/approach A representative survey in Germany and in Hungary was conducted with 2,000 and 1,500 respondents, respectively. The survey included questions regarding the assessment and definition of alcohol abuse and moderate wine consumption. Findings The results show that in Hungary, moderate wine consumption is defined similarly as in Germany; on the contrary, in the case of alcohol abuse, there are significant differences. Regardless of cultural background, the respondents agreed that excessive wine consumption harms health and certain consumer groups (pregnant women or people under 16 years old) should avoid drinking wine. Practical implications These findings can contribute to a long-term goal-oriented wine in moderation strategy for consumers and support policy advice on moderate and excessive wine consumption. Originality/value The results help to understand how consumers perceive moderate and excessive wine consumption in everyday life, and how they judge wine as an alcoholic beverage. To the best of authors’ knowledge, there has not been similar study published on the perceptions of wine consumers in this regard, neither in Germany nor in Hungary.

Beer components and their beneficial effect on the hemostasis and cardiovascular diseases– truth or falsehood

Effects of moderate beer consumption on health and disease: A consensus document

ObjectiveTo investigate the impact of moderate wine consumption on the risk of prostate cancer (PCa). We focused on the differential effect of moderate consumption of red versus white wine.DesignThis study was a meta-analysis that includes data from case–control and cohort studies.Materials and methodsA systematic search of Web of Science, Medline/PubMed, and Cochrane library was performed on December 1, 2017. Studies were deemed eligible if they assessed the risk of PCa due to red, white, or any wine using multivariable logistic regression analysis. We performed a formal meta-analysis for the risk of PCa according to moderate wine and wine type consumption (white or red). Heterogeneity between studies was assessed using Cochrane’s Q test and I2 statistics. Publication bias was assessed using Egger’s regression test.ResultsA total of 930 abstracts and titles were initially identified. After removal of duplicates, reviews, and conference abstracts, 83 full-text original articles were screened. Seventeen studies (611,169 subjects) were included for final evaluation and fulfilled the inclusion criteria. In the case of moderate wine consumption: the pooled risk ratio (RR) for the risk of PCa was 0.98 (95% CI 0.92–1.05, p=0.57) in the multivariable analysis. Moderate white wine consumption increased the risk of PCa with a pooled RR of 1.26 (95% CI 1.10–1.43, p=0.001) in the multi-variable analysis. Meanwhile, moderate red wine consumption had a protective role reducing the risk by 12% (RR 0.88, 95% CI 0.78–0.999, p=0.047) in the multivariable analysis that comprised 222,447 subjects.ConclusionsIn this meta-analysis, moderate wine consumption did not impact the risk of PCa. Interestingly, regarding the type of wine, moderate consumption of white wine increased the risk of PCa, whereas moderate consumption of red wine had a protective effect. Further analyses are needed to assess the differential molecular effect of white and red wine conferring their impact on PCa risk.

BackgroundSeveral studies have shown that moderate consumption of wine (W) or beer (B) could have beneficial effects on cardiovascular disease (CVD). It has been observed that the food pattern and anthropometric parameters in W or B consumers may be different from non-alcoholic drinkers (NAD), in populations from North of Europe and USA.ObjectiveThe main objective of this study was to evaluate the dietary pattern and anthropometric parameters among consumers of W, B and NAD, in an elderly population at high cardiovascular risk.Methods4940 participants recruited from the Predimed trial, a 5-year parallel group, multicenter, randomized, controlled clinical trial, were evaluated. We used date from a validated Food Frequency Questionnaire with 137 items, that included the amount and type of alcoholic beverage consumed. Adherence to traditional Mediterranean diet also was evaluated using a validated 14-point score test as well as anthropometric parameters (height, body weight and waist perimeter) measured using standard methods.ResultsComparisons among groups showed that W drinkers had a higher adherence to the Mediterranean Diet than drinkers of B and NAD (P &lt; 0.001; both). On the other hand, the drinkers of W showed also lower body weight and body mass index (BMI) than B and NAD drinkers (P &lt; 0.001; both).ConclusionsModerate wine consumption is associated lower body weight and BMI and a higher adherence to Mediterranean diet. Accordingly, W drinkers could have extra beneficial effects on CVD than others alcoholic beverages.

Background/Aim: Epidemiological studies have suggested that moderate alcohol consumption is associated with lower morbidity. However, intervention studies are needed to elucidate mechanisms involved. This study was aimed to determine the effects of moderate beer consumption on the immune function of healthy adults, taking into account gender differences. Methods: After a 30-day alcohol abstinence period, 57 healthy volunteers consumed a moderate intake of beer (330 ml for women and 660 ml for men) for 30 days. Total leukocyte and lymphocyte counts; absolute values of T-lymphocyte CD3+, CD4+, and CD8+ subsets; delayed-hypersensitivity skin response (DHSR); absolute values of B lymphocytes (CD19+) and serum immunoglobulin concentrations (IgG, IgA, and IgM); and cytokine production (IL-2, IL-4, IL-6, IL-10, IFN-γ, and TNF-α) were evaluated following the abstinence and alcohol consumption periods. Results: After moderate beer consumption CD3+ cells increased only in women (p < 0.05). IgG, IgM, and IgA concentrations, as well as IL-2, IL-4, IL-10, and IFN-γ cytokine production increased while IFN-γ/IL-10 ratio decreased in both men and women (p < 0.05). The rest of the immunological parameters analyzed remained unchanged. Conclusion: Moderate beer consumption produced an immunomodulatory effect in a healthy adult Spanish population; this effect appears to be more relevant in women than in men.

The health benefits of moderate consumption and the damaging consequences of excessive consumption of alcohol are well documented.1 Injury is an important alcohol related health problem but while the role...

Alcohol, Red Wine and Cardiovascular Disease

This paper presents an overview of the health benefits of wine polyphenols, induced by a moderate consumption. Several studies have shown that moderate wine intake may have many beneficial effects on human health and these effects are mainly attributed to the phenolic derivatives, especially flavonoids. Beside flavonoid compounds, phenolic acids (hydroxybenzoic acids and hydroxycinnamic acids) and stilbenes are important non-flavonoid compounds present in grapes and wine. In the present review, the biological role of these classes of polyphenols in wine is briefly introduced, together with the knowledge on their bioavailability. The health-protective properties of wines are mainly due to antioxidant activities and capability to eliminate free radicals of the phenolic compounds. Additionally, these compounds (e.g. catechin and their oligomers and proanthocyanidins, quercetin, resveratrol) have been reported to have multiple biological activities, including cardioprotective, anti-carcinogenic, anti-atherogenic, anti-inflammatory, antiviral and antibacterial properties. Epidemiological and clinical studies have pointed out that regular and moderate red wine consumption (one to two glasses a day) is associated with decreased incidence of cardiovascular disease, hypertension, diabetes, and certain types of cancer, including lung, esophagus, stomach, colon, endometrium, ovarian and prostate cancer. The bioavailability of phenolic compounds differs largely among different polyphenol molecules, thus the most abundant polyphenols in wines are not necessarily those leading to the highest levels of active metabolites in target tissues. Therefore, since wine is a complex mixture, it is likely that a multitude of chemical constituents, as well as their metabolites, act synergistically on human health.