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Wine In Moderation
"Il buon vino è un bravo spiritello se è bene usato"
William Shakespeare,
1564 » 1616

Effect of alcohol consumption on biological markers
associated with risk of coronary heart disease:
systematic review and meta-analysis of interventional studies


Susan E Brien, postdoctoral fellow, Paul E Ronksley, doctoral student, Barbara J Turner, professor of medicine and director, Kenneth J Mukamal, associate professor of medicine, William A Ghali, scientific director and professor


BMJ, 2010 December



Objective
To systematically review interventional studies of the effects of alcohol consumption on 21 biological markers associated with risk of coronary heart disease in adults without known cardiovascular disease.

Design
Systematic review and meta-analysis.

Data sources
Medline (1950 to October 2009) and Embase (1980 to October 2009) without limits.

Study selection
Two reviewers independently selected studies that examined adults without known cardiovascular disease and that compared fasting levels of specific biological markers associated with coronary heart disease after alcohol use with those after a period of no alcohol use (controls). 4690 articles were screened for eligibility, the full texts of 124 studies reviewed, and 63 relevant articles selected.

Results
Of 63 eligible studies, 44 on 13 biomarkers were meta-analysed in fixed or random effects models. Quality was assessed by sensitivity analysis of studies grouped by design. Analyses were stratified by type of beverage (wine, beer, spirits). Alcohol significantly increased levels of high density lipoprotein cholesterol (pooled mean difference 0.094 mmol/L, 95% confidence interval 0.064 to 0.123), apolipoprotein A1 (0.101 g/L, 0.073 to 0.129), and adiponectin (0.56 mg/L, 0.39 to 0.72). Alcohol showed a dose-response relation with high density lipoprotein cholesterol (test for trend P=0.013). Alcohol decreased fibrinogen levels (−0.20 g/L, −0.29 to −0.11) but did not affect triglyceride levels. Results were similar for crossover and before and after studies, and across beverage types.

Conclusions
Favourable changes in several cardiovascular biomarkers (higher levels of high density lipoprotein cholesterol and adiponectin and lower levels of fibrinogen) provide indirect pathophysiological support for a protective effect of moderate alcohol use on coronary heart disease.

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The red wine hypothesis:
from concepts to protective signalling molecules.


Lionel H. Opie and Sandrine Lecour


European Heart Journal, 2007 June



We review evidence for and against the ‘red wine hypothesis’, whereby red wine is more likely to confer cardiovascular benefits than white. As background, there is a strong epidemiological and mechanistic evidence for J-shaped relation between alcohol intake and total mortality. However, epidemiological data favouring a specific benefit of red over white wine are not strong and the ‘French paradox’ could at least in part be explained by confounding factors. More convincing evidence is that human studies with de-alcoholized red but not white wine show short-term cardiovascular benefits. The specific components of the de-alcoholized wine that are active on cardiovascular endpoints, are the polyphenols found in red wine, especially resveratrol. The effects of resveratrol on isolated tissues or organs are well-described including molecular mechanisms leading to decreased arterial damage, decreased activity of angiotensin-II, increased nitric oxide, and decreased platelet aggregation. Anti-ischaemic effects include stimulation of prosurvival paths, decreased LDL-oxidation, atheroma, and on the ischaemic-beneficial metabolic changes. Most recently, the agonist effect of resveratrol on the anti-senescence factor sirtuin has lessened cell death in myocytes from failing hearts. Mechanistic feasibility strengthens the case for prospective therapeutic trials of alcohol vs. red wine vs. resveratrol, for example in those with heart failure.

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Effect of red wine and red grape extract on blood lipids, haemostatic factors, and other risk factors for cardiovascular disease.


AS Hansen, P Marckmann, LO Dragsted, I-L Finne´ Nielsen, SE Nielsen and M Grønbæk


European Journal of Clinical Nutrition, 2005 January



Objective: Some epidemiological studies found a lower risk of cardiovascular disease among wine drinkers than among drinkers of other types of ethanol. This difference might be due to an effect of nonalcohol compounds in wine on important cardiovascular risk factors. The objective of this study was to compare the effect of red wine, nonalcohol compounds of red wine and placebo on established cardiovascular risk factors.

Design: A parallel, four-armed intervention study.

Subjects: A total of 69 healthy 38–74-y-old men and women.

Interventions: Subjects were randomised to either 1: red wine (males: 300 ml/day, 38.3 g alcohol/day, female subjects: 200 ml/day, 25.5 g alcohol/day), 2: waterþred grape extract tablets (wine-equivalent dose), 3: waterþred grape extract tablets (half dose), or 4: waterþplacebo tablets for a period of 4 weeks. No other sources of alcohol or anthocyanin were allowed. Plasma high-density lipoprotein (HDL)-cholesterol (HDL-C), low-density lipoprotein (LDL)-cholesterol (LDL-C), HDL-C/LDL-C-ratio, very-low-density lipoprotein (VLDL)-triacylglycerol, total cholesterol, fibrinogen, factor VII coagulant activity (FVIIc), blood pressure, and body weight were determined before and after intervention.

Results: Wine consumption was associated with a significant 11–16% increase in fasting HDL-C and 8–15% decrease in fasting fibrinogen relative to not drinking wine. There were no significant treatment effects on fasting LDL-C, HDL-C/LDL-C-ratio, VLDLtriacylglycerol, total cholesterol, FVIIc, or blood pressure. Drinking wine was associated with relative body weight increments closely corresponding to the energy contributed by the alcohol component.

Conclusion: Moderate red wine consumption for 4 weeks is associated with desirable changes in HDL-C and fibrinogen compared with drinking water with or without red grape extract. The impact of wine on the measured cardiovascular risk factors thus seems primarily explained by an alcohol effect. Our finding suggests that the putative difference in cardiac risk associated with wine vs other alcoholic beverages might be rather explained by other life-style confounders than by red wine contents of nonalcohol components.

Sponsorship: This study was supported by Chr. Hansen A/S, Denmark.

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Overview of epidemiological studies on wine, health and mortality.


Ruf JC.


Oenology-Wine, Nutrition and Health-Methods of Analysis Unit, International Vine and Wine Office, Paris, France, 2003 Questo indirizzo email è protetto dagli spambots. E' necessario abilitare JavaScript per vederlo.



Numerous epidemiological studies have observed that moderate intake of alcohol including wine is associated with a lower risk of cardiovascular disease (CVD). However, according to several authors, moderate consumption of wine is more beneficial than that of beer or spirits. Some studies have shown that moderate consumption of wine can lower mortality from CVD and other causes. The link between drinking wine and total mortality risk (all causes combined) has been studied. The results of various prospective population studies show that intake of beer and spirits from abstention to light to moderate daily intake did not influence mortality, while wine seems to have a beneficial effect on all causes of mortality. Other studies have reached the same conclusion. In general, several authors have reported that in subjects consuming wine in moderation the risk of mortality from all causes is 20-30% lower than in abstainers. Grape wine appears to be the main alcoholic beverage that contains antioxidant phenolic substances known to inhibit oxidation of low-density lipoprotein and affect hemostasis and carcinogenesis.

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