Mediterranean diet may benefit health in part by incorporating moderate wine consumption

Alcohol consumption can be harmful to one’s health. However, moderate amounts of wine have been shown to have health benefits. A recent study brings together the available evidence in this area.

Review: Moderate Wine Consumption and Health: A Narrative Review.  Image Credit: Manoph /ShutterstockReview: Moderate Wine Consumption and Health: A Narrative Review. Image Credit: Manoph /Shutterstock

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While the evidence for such strict limits is controversial, many public health warnings have been issued against the consumption of even small amounts of alcohol. Current study published in the journal MDPI nutrientsIt is a narrative review that focuses on clearing some of the confusion about alcoholic beverages.

The main goal of the researchers was to test the association between cardiovascular disease, type 2 diabetes mellitus, neurodegenerative disease and premature death, as well as cancer risk. These relationships have been studied in relation to the use of different types of alcohol, particularly wine and other spirits.

The scientists also studied how wine differs from other types of alcohol and the activity of plant chemicals such as resveratrol in wine, as well as the biochemical pathways involved.

This study provides scientific data to tailor efforts to educate clinicians and the public about the relationship between wine consumption and positive disease outcomes.

Wine is an aqueous solution of alcohol. Wine contains a number of bioactive substances, including anthocyanins, flavones, flavonols and other phenolics. Many of these have been studied before. However, its synergistic biological effects are much more important and complex than these individual studies show.

Total phenolics in wine range from ~1,500 to 3,000 mg/L (in gallic acid equivalents (GAE) for red wine, but much lower at ~200 to 400 for white wines).

Stilbenes are a type of phenolic compound found in wine made from grape skins. Stilbene resveratrol has been shown to have many physiological benefits and is quite abundant in high-quality grapes and wine.

Resveratrol has poor bioavailability as it is rapidly metabolized. Therefore, it acts on many targets in cells and tissues, including vascular and metabolic targets. This is responsible for its anti-inflammatory, anti-aging, anti-tumor and cardioprotective activity. Again, “Resveratrol cannot be considered the only thing responsible for the benefits associated with moderate consumption of red wine, rather these effects can be attributed to the entire pool of antioxidants available.

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Many conditions, such as cold ripening conditions, clone, soil type, cultivation and post-harvest practices, and wine production processes, have been reported to increase resveratrol concentrations in both red and white grapes, and therefore in wine.

Another potentially more bioactive compound is a dimer of trans-resveratrol called trans-epsilon-viniferin (ε-viniferin).

How does wine affect body processes?

Both resveratrol and ε-viniferin have activity against cancers, obesity, obesity-related disorders, and cardiovascular or neurodegenerative diseases. Additionally, multiple phenolic compounds, such as quercetin, show antioxidant and anti-inflammatory properties. However, they are poorly absorbed and rapidly metabolized into other forms. This may indicate that their most important importance lies in their ability to modulate transcription and intracellular signaling pathways activated in cell survival responses.

Resveratrol-modulated biochemical targets.  AP-1, activator protein 1;  CAT, catalase;  CDK, cyclin-dependent kinase;  COX, cyclooxygenase;  CRP, C-reactive protein;  CYP, cytochrome P450;  ER, estrogen receptor;  ERK, extracellularly regulated kinase;  GPx, glutathione peroxidase;  HIF, hypoxia-causing factor;  hTERT, human telomerase reverse transcriptase;  ICAM, intracellular adhesion molecule;  IAP, inhibitor of apoptosis proteins;  iNOS, inducible nitric oxide;  MAPK, mitogen-activated protein kinase;  MMP, matrix metalloproteinase;  NFκB, nuclear factor kappa B;  PI3K, phosphoinositide-3 kinase;  Rb, retinoblastoma;  SOD, superoxide dismutase;  STAT, signal converter and transcription activator;  SPARC, secreted protein acidic and rich in cysteine;  TNF, tumor necrosis factor;  VEGF, vascular endothelial growth factor.Resveratrol-modulated biochemical targets. AP-1, activator protein 1; CAT, catalase; CDK, cyclin-dependent kinase; COX, cyclooxygenase; CRP, C-reactive protein; CYP, cytochrome P450; ER, estrogen receptor; ERK, extracellularly regulated kinase; GPx, glutathione peroxidase; HIF, hypoxia-causing factor; hTERT, human telomerase reverse transcriptase; ICAM, intracellular adhesion molecule; IAP, inhibitor of apoptosis proteins; iNOS, inducible nitric oxide; MAPK, mitogen-activated protein kinase; MMP, matrix metalloproteinase; NFκB, nuclear factor kappa B; PI3K, phosphoinositide-3 kinase; Rb, retinoblastoma; SOD, superoxide dismutase; STAT, signal converter and transcription activator; SPARC, secreted protein acidic and rich in cysteine; TNF, tumor necrosis factor; VEGF, vascular endothelial growth factor.

Metabolites produced from these compounds may be equally or even more bioactive than the parent compounds. Local antioxidant activity may also counteract the risk posed by lipid peroxide production during the digestion of red meat in the stomach.

Melatonin is another important compound identified in wines that can provide a health-promoting effect when consumed in moderation.

Wine can prevent atherosclerosis caused by inflammation in response to oxidation of vascular cells and lipoproteins in the blood. This action contributes to the prevention of cardiovascular, neurodegenerative and cancerous conditions by strengthening the body’s antioxidant defenses.

It’s important to note that moderate amounts of wine and food, as in the Mediterranean diet, may be key to these beneficial effects.

It “It may represent the best way to reduce the toxic effects of ethanol and simultaneously increase antioxidant/detoxifying defenses.

The review showed how such uptake modulates multiple proinflammatory pathways at the gene level.

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How does wine affect genes?

Alcohol consumption, even at low levels, is linked to liver cirrhosis and various cancers. Its metabolite, acetaldehyde, is involved in most of these pathways. Aldehyde dehydrogenases (ALDHs) are responsible for the breakdown of alcohol into non-toxic metabolites. Various wine phenols and metabolites can enhance this.

In general, these areinteractive biomolecular tools” can counteract the various mechanisms that trigger stress, prevent inflammation, release reactive oxygen species (ROS) and damage genes, and increase the expression of antioxidant enzymes. Activation of these pathways results in oxidative stress, changes in cell metabolism, and reactive cell proliferation. resulting in the prevention of chronic or degenerative pathologies.

Phenols in wine can also increase gamma-glutamylcysteine ​​synthetase levels. This is the rate-limiting enzyme in the synthesis of glutathione (GSH), the most powerful antioxidant in the body. Consequences of countering the effects of ROS may include preventing accumulated changes in DNA transcription and preventing cell degeneration and death over time.

epidemiological consequences

Epidemiologists have also pointed out that moderate consumption of alcohol (especially wine) is linked to a reduced risk of cardiovascular disease, particularly heart disease. Drawing data from the French population, who have a diet high in saturated fat and wine, have high serum cholesterol levels, but have lower cardiovascular disease death rates than other Western countries, the heart-healthy role of 3-5 glasses of red wine per day has been at the forefront over other alcoholic beverages.

Recommended Mediterranean consumption style [2] It includes the recommended alcohol consumption limit, which should not exceed 30 g of ethanol for men (ie, about two glasses of wine per day with meals) and 15 g (one glass) for women..” However, guidelines differ between societies and countries.

Interestingly, low to moderate consumption of red wine or alcohol (up to 21 drinks per week or 15 g per day, respectively) was linked to an almost one-quarter reduction in cardiovascular disease. Type 2 diabetes mellitus (T2DM) was also found to be less common with insulin resistance. Overall, death rates fell by more than a third and CVD deaths by more than half compared to those who abstained.

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Again, both abstainers and heavy drinkers had a higher risk of dementia and neurodegenerative disease. The risk of stroke was reduced by 17% with weekly wine consumption, and 40% and 30% with weekly and daily consumption, respectively. This was not true for beer purchases or spirits.

Again, many articles and professional guidelines recommend abstaining from alcohol to prevent many cancers, including cancers of the head and neck, liver, esophagus, breast, colon, and rectum. However, the United States Centers for Disease Control and Prevention (CDC) says that moderate drinking is also an option. A scientist recently went even further, “Evidence of increased cancer risk is alcohol intake >30 g/day.

While it has been suggested that a longer lifespan is associated with moderate alcohol consumption, more human studies are needed to establish this on a solid footing.

What are the effects?

The analysis clearly shows that wine is different from other alcoholic beverages and that its moderate consumption not only increases the risk of chronic degenerative disease but is also associated with health benefits, especially when included in a Mediterranean diet model.

Alcohol produces toxicity to a wide variety of cells and tissues. It often leads to addiction and dependence, and is associated with premature death in one-tenth of deaths in people between the ages of 15 and 49. During childhood and adolescence, alcohol affects brain development and maturation and is much more likely to be addicted. Alcohol consumption during this period is much more dangerous than in adults.

Therefore, alcohol consumption is not recommended for non-drinkers, pending more reliable data and given the high potential for abuse, even among low-risk individuals.

Every effort should be made to promote behavioral education to prevent abuse, especially among young people.

The desired outcome of this report is the development of evidence-based guidelines on alcohol consumption that will not harm and benefit human health. This may be limited to the age group over 40, reasonable quantities and Mediterranean style food.

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