Health benefits of moderate wine consumption have been studied during the past decades, first in observational studies and more recently, in experimental settings and randomized controlled studies. Suggested biological pathways include antioxidant, lipid regulating, and anti-inflammatory effects. Both the alcoholic and polyphenolic components of wine are believed to contribute to these beneficial effects. Although several of these studies demonstrated protective associations between moderate drinking and cardiovascular disease, atherosclerosis, hypertension, certain types of cancer, type 2 diabetes, neurological disorders, and the metabolic syndrome, no conclusive recommendations exist regarding moderate wine consumption. Yet, it is suggested that the physician and patient should discuss alcohol use. In the CASCADE (CArdiovaSCulAr Diabetes & Ethanol) trial, 224 abstainers with type 2 diabetes were randomized to consume red wine, white wine or mineral water for two years. Here, we summarize our previous findings, offer new evidence concerning the differential effects of wine consumption among men and women, and further suggest that initiating moderate alcohol consumption among well-controlled persons with type 2 diabetes is apparently safe, in regard to changes in heart rate variability and carotid plaque formation.
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Rimm EB, Williams P, Fosher K, Criqui M, Stampfer MJ. Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. BMJ. 1999;319:1523–8. [PMID: 10591709]
Stampfer MJ, Colditz GA, Willett WC, Speizer FE, Hennekens CH. A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women. N Engl J Med. 1988;319:267–3. [PMID: 3393181]
Solomon CG, et al. Moderate alcohol consumption and risk of coronary heart disease among women with type 2 diabetes mellitus. Circulation. 2000;102:494–9.
Koppes LL, Dekker JM, Hendriks HF, Bouter LM, Heine RJ. Meta-analysis of the relationship between alcohol consumption and coronary heart disease and mortality in type 2 diabetic patients. Diabetologia. 2006;49:648–2.
House of Commons Science and Technology Committee. Alcohol guidelines – Eleventh Report of Session 2010–122011. Available at: http://www.publications.parliament.uk/pa/cm201012/cmselect/cmsctech/1536/1536.pdf
Department of Health. Scientific report of the2015 dietary guidelines advisorycommittee2015. https://health.gov/dietaryguidelines/2015-scientific-report/PDFs/Scientific-Report-of-the-2015-Dietary-Guidelines-Advisory-Committee.pdf
Goldberg IJ. 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. Circulation. 2001;103:472–5.
Lichtenstein AH. Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation. 2006;114:82–96.
American Diabetes Association. Standards of medical care in diabetes—2012. Diabetes Care. 2012;35:S11-63. [PMID:22187469]
Goldberg IJ, Mosca L, Piano MR, Fisher EA, Nutrition Committee. Council on Epidemiology and Prevention, and Council on Cardiovascular Nursing of the American Heart Association. 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. Circulation. 2001;103:472–5. [PMID: 11157703]
Rimm EB, Klatsky A, Grobbee D, Stampfer MJ. Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine, or spirits? BMJ. 1996;312:731–6.
Chiva-Blanch G, et al. Differential effects of polyphenols and alcohol of red wine on the expression of adhesion molecules and inflammatory cytokines related to atherosclerosis: a randomized clinical trial. Am J Clin Nutr. 2012;95:326–334.
Estruch R, et al. Red wine, but not gin, decreases erythrocyte superoxide dismutase activity: a randomized crossover trial. Nutr Metab Cardiovasc Dis. 2011;21:46–53.
Guilford JM, Pezzuto JM. Wine Health: a Rev Am J Enol Vitic. 2011;62:471–86.
Cleophas TJ. Wine, beer and spirits and the risk of myocardial infarction: a systematic review. Biomed & Pharmacother. 1999;53:417–23.
Mukamal KJ, et al. Roles of drinking pattern and type of alcohol consumed in coronary heart disease in men. New Engl J Med. 2003;348:109–18.
Hansen AS, et al. Effect of red wine and red grape extract on blood lipids, haemostatic factors, and other risk factors for cardiovascular disease. Eur J Clin Nutr. 2005;59:449–55.
Shai I, et al. Moderate alcohol intake and markers of inflammation and endothelial dysfunction among diabetic men. Diabetologia. 2004;47:1760–67.
Shai I, et al. Glycemic effects of moderate alcohol intake among patients with type 2 diabetes. Diabetes Care. 2007;30:3011–16.
Gepner Y, et al. Effects of Initiating Moderate Alcohol Intake on Cardiometabolic Risk in Adults With Type 2 Diabetes A 2-Year Randomized, Controlled Trial. Ann Intern Med. 2015;163:569–79.
Di Castelnuovo A, et al. Alcohol dosing and total mortality in men and women: an updated meta-analysis of 34 prospective studies. Arch Intern Med. 2006;166:2437–45.
Di Castelnuovo A, et al. Alcohol Dosing and Total Mortality in Men and Women An Updated Meta-analysis of 34 Prospective Studies. Arch Intern Med. 2006;166:2437–45.
Mukamal KJ, et al. Alcohol and coronary heart disease. N Engl J Med. 2003;2003:1719–22.
Graham K, Wilsnack R, Dawson D, Vogeltanz N. Should alcohol consumption measures be adjusted for gender differences? Addiction. 1998;93:1137–47.
Di Castelnuovo A, Iacoviello L, Furman K, Donati MB. De Gaetano G. Wine, alcohol and cardiovascular risk: open issue. J Thromb Haemost. 2004;2:2042–44.
White IR, Altmann DR, Nanchahal K. Alcohol consumption and mortality: modelling risks for men and women at different ages. BMJ. 2002;325:191.
Meibohm B, Beierle I, Derendorf H. How important are gender differences in pharmacokinetics? Clin Pharmacokinet. 2002;41:329–342.
Mumenthaler MS, Taylor JL, O'Hara R, Yesavage JA. Gender differences in moderate drinking effects. Alcohol Res Health. 1999;23:55–64.
Kohsaka S, et al. Alcohol consumption and atherosclerotic burden in the proximal thoracic aorta. Atherosclerosis. 2011;219:794–8.
Juonala M, et al. Alcohol consumption is directly associated with carotid intima–media thickness in Finnish young adults: The Cardiovascular Risk in Young Finns Study. Atherosclerosis. 2009;204:e93–8.
Liu W, Redmond EM, Morrow D, Cullen JP. Differential effects of daily-moderate versus weekend-binge alcohol consumption on atherosclerotic plaque development in mice. Atherosclerosis. 2011;219:448–54.
Eller NH, Malmberg B, Bruhn P. Heart rate variability and intima media thickness. Int J Behav Med. 2006;13:201–13.
Melillo P, Izzo R, Luca N, Pecchia L. Heart rate variability and target organ damage in hypertensive patients. BMC Cardiovasc Disord. 2012;12:105.
Gottsäter A, Ahlgren AR, Taimour S, Sundkvist G. Decreased heart rate variability may predict the progression of carotid atherosclerosis in type 2 diabetes. Clin Auton Res. 2006;16:228–23.
Spaak J, et al. Dose-related effects of red wine and alcohol on heart rate variability. Am J Physiol Heart Circ Physiol. 2010;298:H2226–31.
Berger K, et al. Light-to-moderate alcohol consumption and risk of stroke among U.S. male physicians. N Engl J Med. 1999;341:1557-64.
Thadhani R, et al. Prospective study of moderate alcohol consumption and risk of hypertension in young women. Arch Intern Med. 2002;162:569–74.
Kupari M, Eriksson CJP, Heikkila J, Ylikahri R. Alcohol and the heart: intense hemodynamic changes associated with alcohol flush in Orientals. Acta Med Scand. 1983;213:91–8.
McFadden CB, Brensinger CM, Berlin JA, Townsend RR. Systematic review of the effect of daily alcohol intake on blood pressure. Am J Hypertens. 2005;18:276–86.
Sun H, et al. Role of NAD (P) H Oxidase in Alcohol-Induced Impairment of Endothelial Nitric Oxide Synthase–Dependent Dilation of Cerebral Arterioles. Stroke. 2006;37:495–500.
Fewings JD, Hanna MJD, Walsh JA, Whelan RF. The effects of ethyl alcohol on the blood vessels of the hand and forearm in man. Br J Pharmacol. 1966;27:93–106.
Abe H, et al. Biphasic effects of repeated alcohol intake on 24-hour blood pressure in hypertensive patients. Circulation. 1994;89:2626–33.
Andriantsitohaina R, et al. Molecular mechanisms of the cardiovascular protective effects of polyphenols. Br J Nutr. 2012;108:1532–49.
Pechanova O, Rezzani R, BABAL P, Bernatova I, Andriantsitohaina R. Beneficial effects of provinols: cardiovascular system and kidney. Physiol Res. 2006;55:S17–30.
Woerdeman J, et al. Do grape polyphenols improve metabolic syndrome components? A systematic review. Eur J Clin Nutr. 2017;71:1381–92.
Gepner Y, et al. Differential effect of initiating moderate red wine consumption on 24-h blood pressure by alcohol dehydrogenase genotypes: Randomized trial in type 2 diabetes. Am J Hypertens. 2015;29:hpv126.
Bełtowski J. Adiponectin and resistin--new hormones of white adipose tissue. Med Sci Monit. 2003;9:RA55–61.
Dorn JM, et al. Alcohol drinking patterns differentially affect central adiposity as measured by abdominal height in women and men. J Nutr. 2003;133:2655–62.
Rosell M, De Faire U, Hellenius ML. Low prevalence of the metabolic syndrome in wine drinkers—is it the alcohol beverage or the lifestyle? Eur J Clin Nutr. 2003;57:227–234.
Tresserra-Rimbau A, et al. Moderate red wine consumption is associated with a lower prevalence of the metabolic syndrome in the PREDIMED population. Br J Nutr. 2015;113:S121–30.
Golan R, et al. Abdominal Superficial Subcutaneous Fat: A putative distinct protective fat sub-depot in type 2 diabetes. Diabetes Care. 2012;35:640–47.
Golan R, et al. Effects of initiating moderate wine intake on abdominal adipose tissue in adults with type 2 diabetes: a 2-year randomized controlled trial. Public Health Nutr 2016:1-7.
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This article is published as part of a supplement sponsored by the Mediterranean Diet Foundation and the Diputació de Barcelona.