Cardiovascular risk and benefits from antioxidant dietary intervention with red wine in asymptomatic hypercholesterolemics

Comprehensive Strategies for Metabolic Syndrome: How Nutrition, Dietary Polyphenols, Physical Activity, and Lifestyle Modifications Address Diabesity, Cardiovascular Diseases, and Neurodegenerative Conditions

Several hallmarks of metabolic syndrome, such as dysregulation in the glucose and lipid metabolism, endothelial dysfunction, insulin resistance, low-to-medium systemic inflammation, and intestinal microbiota dysbiosis, represent a pathological bridge between metabolic syndrome and diabesity, cardiovascular, and neurodegenerative disorders. This review aims to highlight some therapeutic strategies against metabolic syndrome involving integrative approaches to improve lifestyle and daily diet. The beneficial effects of foods containing antioxidant polyphenols, intestinal microbiota control, and physical activity were also considered. We comprehensively examined a large body of published articles involving basic, animal, and human studie, as well as recent guidelines. As a result, dietary polyphenols from natural plant-based antioxidants and adherence to the Mediterranean diet, along with physical exercise, are promising complementary therapies to delay or prevent the onset of metabolic syndrome and counteract diabesity and cardiovascular diseases, as well as to protect against neurodegenerative disorders and cognitive decline. Modulation of the intestinal microbiota reduces the risks associated with MS, improves diabetes and cardiovascular diseases (CVD), and exerts neuroprotective action. Despite several studies, the estimation of dietary polyphenol intake is inconclusive and requires further evidence. Lifestyle interventions involving physical activity and reduced calorie intake can improve metabolic outcomes.

HPLC Analysis of Polyphenols Derived from Hungarian Aszú from Tokaj Wine Region and Its Effect on Inflammation in an In Vitro Model System of Endothelial Cells

Many studies have been published in recent years regarding the fact that moderate wine consumption, as a part of a balanced diet can have a beneficial effect on human health. The biologically active components of wine continue to be the subject of intense research today. In this study, the bioactive molecules of Hungarian aszú from the Tokaj wine region were analyzed using high-performance liquid chromatography (HPLC) and investigated in an in vitro model system of endothelial cells induced by bacterial-derived lipopolysaccharide. The HPLC measurements were performed on a reversed phased column with gradient elution. The non-cytotoxic concentration of the active substance was determined based on 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyltetrazolium bromide (MTT)-, apoptosis, and necrosis assays. The antioxidant effect of the extract was determined by evaluating its ability to eliminate ROS. The expressions of the interleukin-(IL)1α, IL1-β, IL-6, and IL-8 pro-inflammatory cytokines and nitric oxide synthase (eNOS) at the mRNA level were evaluated using a quantitative polymerase chain reaction (qPCR). We found that the lipopolysaccharides (LPS)-induced increases in the expressions of the investigated cytokines were significantly suppressed by Hungarian aszú extract, excluding IL-6. In our experimental setup, our treatment had a positive effect on the eNOS expression, which was impaired as a result of the inflammatory manipulation. In our experimental model, the Hungarian aszú extract decreased the LPS-induced increases in the expression of the investigated cytokines and eNOS at the mRNA level, which presumably had a positive effect on the endothelial dysfunction caused by inflammation due to its strong antioxidant and anti-inflammatory effects. Collectively, this research contributes to a more thorough understanding of the bioactive molecules of aszú from the Tokaj wine region.

Deciphering the interactions between lipids and red wine polyphenols through the gastrointestinal tract

This paper investigates the mutual interactions between lipids and red wine polyphenols at different stages of the gastrointestinal tract by using the simgi® dynamic simulator. Three food models were tested: a Wine model, a Lipid model (olive oil + cholesterol) and a Wine + Lipid model (red wine + olive oil + cholesterol). With regard to wine polyphenols, results showed that co-digestion with lipids slightly affected the phenolic profile after gastrointestinal digestion. In relation to lipid bioaccessibility, the co-digestion with red wine tended to increase the percentage of bioaccessible monoglycerides, although significant differences were not found (p > 0.05). Furthermore, co-digestion with red wine tended to reduce cholesterol bioaccessibility (from 80 to 49 %), which could be related to the decrease in bile salt content observed in the micellar phase. For free fatty acids, almost no changes were observed. At the colonic level, the co-digestion of red wine and lipids conditioned the composition and metabolism of colonic microbiota. For instance, the growth [log (ufc/mL)] of lactic acid bacteria (6.9 ± 0.2) and bifidobacteria (6.8 ± 0.1) populations were significantly higher for the Wine + Lipid food model respect to the control colonic fermentation (5.2 ± 0.1 and 5.3 ± 0.2, respectively). Besides, the production of total SCFAs was greater for the Wine + Lipid food model. Also, the cytotoxicity of the colonic-digested samples towards human colon adenocarcinoma cells (HCT-116 and HT-29) was found to be significantly lower for the Wine and Wine + Lipid models than for the Lipid model and the control (no food addition). Overall, the results obtained using the simgi® model were consistent with those reported in vivo in the literature. In particular, they suggest that red wine may favourably modulate lipid bioaccessibility - a fact that could explain the hypocholesterolemic effects of red wine and red wine polyphenols observed in humans.

Intracellular Polyphenol Wine Metabolites Oppose Oxidative Stress and Upregulate Nrf2/ARE Pathway

Moderate wine consumption has been associated with several benefits to human health due to its high polyphenol content. In this study, we investigated whether polyphenols contained in a particular red wine, rich in polyphenols, can pass the cell membrane and switch the oxidant/antioxidant balance toward an antioxidant pattern of THP-1 cells and human cardiomyocytes through a gene regulatory system. First, we identified which metabolite polyphenols present in red wine extract cross cell membranes and may be responsible for antioxidant effects. The results showed that the wine metabolites in treated cells belonged mainly to stilbenes, flavan-3-ols derivatives, and flavonoids. Other metabolites present in cells were not typical wine metabolites. Then, we found that red wine extract dose-dependently lowered reactive oxygen species (ROS) induced by tert-butyl hydroperoxide (TBHP) up to 50 ± 7% in both cell lines (p < 0.01). Furthermore, wine extract increased nuclear Nrf2 of about 35 ± 5% in both cell lines (p < 0.01) and counteracted its reduction induced by TBHP (p < 0.01). The rise in Nrf2 was paralleled by the increase in hemeoxygenase-1 and glutamate-cysteine ligase catalytic subunit gene expression (both mRNA and protein) (p < 0.01). These results could help explain the healthful activity of wine polyphenols within cells.

Red Wine and Health: Approaches to Improve the Phenolic Content During Winemaking

There is ample evidence regarding the health benefits of red wine consumption due to its content of phenolic compounds, as an alternative to improve the state of health and prevent various diseases, being the implementation of procedures that allow a greater extraction and stability of phenolic compounds during the elaboration a key aspect. The first part of this review summarizes some studies, mostly at the preclinical level, on the mechanisms by which phenolic compounds act in the human organism, taking advantage of their antioxidant, anti-inflammatory, antitumor, antithrombotic, antiatherogenic, antimicrobial, antiviral, and other activities. Although the migration of grape components into the must/wine occurs during the winemaking process, the application of new technologies may contribute to increasing the content of phenolic compounds in the finished wine. Some of these technologies have been evaluated on an industrial scale, and in some cases, they have been included in the International Code of Oenological Practice by the International Organization of Vine and Wine (OIV). In this sense, the second part of this review deals with the use of these novel technologies that can increase, or at least maintain, the polyphenol content. For example, in the pre-fermentative stage, phenolic extraction can be increased by treating the berries or must with high pressures, pulsed electric fields (PEF), ultrasound (US), e-beam radiation or ozone. At fermentative level, yeasts with high production of pyranoanthocyanins and/or their precursor molecules, low polyphenol absorption, and low anthocyanin-β-glucosidase activity can be used. Whereas, at the post-fermentative level, aging-on-lees (AOL) can contribute to maintaining polyphenol levels, and therefore transmitting health benefits to the consumer.

A systematic review with meta-analysis on the antihypertensive efficacy of Nigerian medicinal plants

ETHNOPHARMACOLOGICAL RELEVANCE

Despite the promising effects of herbal preparations in lowering blood pressure (BP), hypertension remains a major clinical challenge in Nigeria. The BP-lowering effects of medicinal plants are due to the presence of bioactive compounds.

AIM OF THE STUDY

This meta-analysis presents a precise estimate of the therapeutic benefits of medicinal plants utilized in Nigeria for the management of hypertension in animals and humans.

METHODS

A systematic literature search was performed through Cochrane, PubMed, Science Direct and Scopus databases from inception until February 28, 2021 using search terms related to randomized controlled trials of Nigerian medicinal plants for hypertension. Additional studies were identified through manual search. BP was the main outcome that was measured after the intervention. Meta-analysis was performed using the Review Manager and Meta-Essential.

RESULTS

Nineteen trials comprising of 16 preclinical and 3 clinical studies were enrolled for the meta-analysis. A total number of 16 plants was identified of which H. sabdariffa was the highest reported plant. The plant extracts significantly lowered the systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the hypertensive subjects compared to control. Weighted mean difference (WMD) for SBP (-43.60 mmHg, 95% CI: -63.18, -24.01; p<0.0001) and DBP (-29.50 mmHg, 95 CI: -43.66, -15.34; p<0.0001) was observed for the preclinical studies. For clinical trials, the WMD was -13.98 mmHg, 95 CI: -19.08, -8.88; p<0.00001 for SBP and -10.00 mmHg, 95 CI: -12.22, -7.78; p<0.00001 for DBP. High heterogeneity was observed for the outcome measures of preclinical studies, but not for the clinical studies. The observed substantial heterogeneity in preclinical studies may be linked to methodological shortcomings as evidenced by the results of the risk of bias assessment. There was no evidence of publication bias in animal trials for BP using the funnel plot and Egger's regression test (SBP, p=0.239 and DBP, p=0.112).

CONCLUSIONS

This study provides evidence of medicinal preparations for the treatment of hypertension. A well-conducted trial with methodological rigour and a longer duration of follow-up is required for their effective clinical utilization.

The mechanisms of wine phenolic compounds for preclinical anticancer therapeutics

Background

Wine is one of the oldest and most popular drinks worldwide, which is rich in phenolic compounds. Epidemiological studies show that moderate consumption of wine can reduce the risk of certain diseases, and this effect is attributed to its phenolic compounds.

Objective

The objective of this review was to elaborate the effects of wine-derived phenolic compounds for preclinical anticancer therapeutics and their major mechanisms.

Methods

In this review, we discuss the classification and content of common phenolic compounds in wine and summarize previous studies that have evaluated the anticancer properties of wine-derived phenolic compounds and their mechanisms.

Results

Wine-derived phenolic compounds have been proven to participate in several mechanisms against cancers, including deoxyribonucleic acid damage, oxidative stress, cell proliferation, cell cycle arrest, cell apoptosis, autophagy, cell invasion and metastasis, immunity and metabolism, regulation of multiple signaling molecules, and gene expression. However, the exact anticancer mechanisms of the phenolic compounds in wine need to be further investigated.

Conclusion

Wine-derived phenolic compounds are promising chemoprotective and chemotherapeutic agents for cancer.

Urinary Tartaric Acid, a Biomarker of Wine Intake, Correlates with Lower Total and LDL Cholesterol

Postmenopausal women are at higher risk of developing cardiovascular diseases due to changes in lipid profile and body fat, among others. The aim of this study was to evaluate the association of urinary tartaric acid, a biomarker of wine consumption, with anthropometric (weight, waist circumference, body mass index (BMI), and waist-to-height ratio), blood pressure, and biochemical variables (blood glucose and lipid profile) that may be affected during the menopausal transition. This sub-study of the PREDIMED (Prevención con Dieta Mediterránea) trial included a sample of 230 women aged 60-80 years with high cardiovascular risk at baseline. Urine samples were diluted and filtered, and tartaric acid was analyzed by liquid chromatography coupled to electrospray ionization tandem mass spectrometry (LC-ESI-MS/MS). Correlations between tartaric acid and the study variables were adjusted for age, education level, smoking status, physical activity, BMI, cholesterol-lowering, antihypertensive, and insulin treatment, total energy intake, and consumption of fruits, vegetables, and raisins. A strong association was observed between wine consumption and urinary tartaric acid (0.01 μg/mg (95% confidence interval (CI): 0.01, 0.01), p-value < 0.001). Total and low-density lipoprotein (LDL) cholesterol were inversely correlated with urinary tartaric acid (-3.13 μg/mg (-5.54, -0.71), p-value = 0.016 and -3.03 μg/mg (-5.62, -0.42), p-value = 0.027, respectively), whereas other biochemical and anthropometric variables were unrelated. The results suggest that wine consumption may have a positive effect on cardiovascular health in postmenopausal women, underpinning its nutraceutical properties.

Chaya Leaf Decreased Triglycerides and Improved Oxidative Stress in Subjects With Dyslipidemia

Chaya is an edible leaf popular in Mexico and Central America because of its high nutritional value. Studies in animal models have demonstrated the beneficial effects of Chaya, which include reduction of circulating lipids and increase in antioxidant activity. However, its hypolipidemic and antioxidant effects have not been demonstrated in humans. Thus, the aim of the present study was to evaluate the effect of Chaya on the lipid profile, lipid peroxidation, inflammation, and peripheral blood mononuclear cell gene expression in a population with dyslipidemia. We performed a single-arm trial in 30 participants with dyslipidemia who consumed 500 mL of Chaya beverage per day over a 6-week period. Interestingly, we observed a significant decrease in serum triglyceride concentration (P < 0.05) and an increase in plasma antioxidant activity and polyphenol concentration (P < 0.005) after 6 weeks of Chaya consumption. This was accompanied by a reduction in the oxidative stress marker MDA (P < 0.0001) and by an increase in the antioxidant enzyme CAT expression in peripheral blood mononuclear cells (P < 0.001). Altogether, our results demonstrate that consumption of Chaya has hypotriglyceridemic and antioxidant effects in subjects with dyslipidemia.

Potential of Beetroot and Blackcurrant Compounds to Improve Metabolic Syndrome Risk Factors

Metabolic syndrome (MetS) is a group of metabolic abnormalities, which together lead to increased risk of coronary heart disease (CHD) and type 2 diabetes mellitus (T2DM), as well as reduced quality of life. Dietary nitrate, betalains and anthocyanins may improve risk factors for MetS and reduce the risk of development of CHD and T2DM. Beetroot is a rich source of dietary nitrate, and anthocyanins are present in high concentrations in blackcurrants. This narrative review considers the efficacy of beetroot and blackcurrant compounds as potential agents to improve MetS risk factors, which could lead to decreased risk of CHD and T2DM. Further research is needed to establish the mechanisms through which these outcomes may occur, and chronic supplementation studies in humans may corroborate promising findings from animal models and acute human trials.

Dietary Strategies by Foods with Antioxidant Effect on Nutritional Management of Dyslipidemias: A Systematic Review

Nutrition plays a fundamental role in the prevention and treatment of dyslipidemias and its oxidative-related complications. Currently, there is evidence about the beneficial effects of isolated antioxidants or foods enriched or added with antioxidant compounds. However, the application of the natural foods is more integrated than the analysis of a single nutrient. Our aim is compiling scientific literature regarding the nutritional strategies by foods with antioxidant effect in blood lipids, enzymatic and non-enzymatic antioxidants, and oxidative and inflammatory markers of subjects with dyslipidemia. We searched in MEDLINE/PubMed, Scopus, and Web of Science. From a total of 263 studies screened, 16 were included. Dietary strategies included walnuts, olive oil, raw almonds, G. paraguayase, white sesame, mate tea, Brazil nut flour, red wine, granulated Brazil nuts, grapes, wolfberry fruit, fermented beverage, coffee, orange, and blackberry juices showed significant differences in blood lipids, antioxidant activity, antioxidant enzymes, and oxidative and inflammatory markers. This systematic review compiling scientific studies about dietary strategies using foods with antioxidant effect to improve the antioxidant status in dyslipidemias.

Cardioprotective effect of red wine and grape pomace

Several studies have related moderate consumption of red wine with prevention of cardiovascular diseases (CVD). According to epidemiological studies, those regions with high consumption of red wine and a Mediterranean diet show a low prevalence of CVD. Such an effect has been attributed to phenolic compounds present in red wines. On the other hand, by-products obtained during winemaking are also a significant source of phenolic compounds but have been otherwise overlooked. The cardioprotective effect of red wine and its byproducts is related to their ability to prevent platelet aggregation, modify the lipid profile, and promote vasorelaxation. Phenolic content and profile seem to play an important role in these beneficial effects. Inhibition of platelet aggregation is dose-dependent and more efficient against ADP. The antioxidant capacity of phenolic compounds from red wine and its by-products, is involved in preventing the generation of ROS and the modification of the lipid profile, to prevent LDL oxidation. Phenolic compounds can also, modulate the activity of specific enzymes to promote NO production and vasorelaxation. Specific phenolic compounds like resveratrol are related to promote NO, and quercetin to inhibit platelet aggregation. Nevertheless, concentration that causes those effects is far from that in red wines. Synergic and additive effects of a mix of phenolic compounds could explain the cardioprotective effects of red wine and its byproducts.

Pleiotropic effects of polyphenols on glucose and lipid metabolism: Focus on clinical trials

Epidemiological evidence from observational studies suggests that dietary polyphenols (PPs) - phytochemicals found in a variety of plant-based foods - can reduce the risk of developing type 2 diabetes mellitus (T2DM). Clinical trials have also indicated that PPs may help manage the two key features of T2DM, hyperglycemia and dyslipidemia. Since the incidence of T2DM is dramatically increasing worldwide, identifying food-based approaches that can reduce the risk of developing it and help manage its main risk factors in early-stage disease has clinical and socioeconomic relevance. After a brief overview of current epidemiological data on the incidence of T2DM in individuals consuming PP-rich diets, we review the evidence from clinical trials investigating PP-enriched foods and/or PP-based nutraceutical compounds, report their main results, and highlight the knowledge gaps that should be bridged to enhance our understanding of the role of PPs in T2DM development and management.

Effect of alcohol on blood pressure

BACKGROUND

Alcohol is consumed by over 2 billion people worldwide. It is a common substance of abuse and its use can lead to more than 200 disorders including hypertension. Alcohol has both acute and chronic effects on blood pressure. This review aimed to quantify the acute effects of different doses of alcohol over time on blood pressure and heart rate in an adult population.

OBJECTIVES

Primary objective To determine short-term dose-related effects of alcohol versus placebo on systolic blood pressure and diastolic blood pressure in healthy and hypertensive adults over 18 years of age. Secondary objective To determine short-term dose-related effects of alcohol versus placebo on heart rate in healthy and hypertensive adults over 18 years of age.

SEARCH METHODS

The Cochrane Hypertension Information Specialist searched the following databases for randomised controlled trials up to March 2019: the Cochrane Hypertension Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 2), in the Cochrane Library; MEDLINE (from 1946); Embase (from 1974); the World Health Organization International Clinical Trials Registry Platform; and ClinicalTrials.gov. We also contacted authors of relevant articles regarding further published and unpublished work. These searches had no language restrictions.

SELECTION CRITERIA

Randomised controlled trials (RCTs) comparing effects of a single dose of alcohol versus placebo on blood pressure (BP) or heart rate (HR) in adults (≥ 18 years of age).

DATA COLLECTION AND ANALYSIS

Two review authors (ST and CT) independently extracted data and assessed the quality of included studies. We also contacted trial authors for missing or unclear information. Mean difference (MD) from placebo with 95% confidence interval (CI) was the outcome measure, and a fixed-effect model was used to combine effect sizes across studies.  MAIN RESULTS: We included 32 RCTs involving 767 participants. Most of the study participants were male (N = 642) and were healthy. The mean age of participants was 33 years, and mean body weight was 78 kilograms. Low-dose alcohol (< 14 g) within six hours (2 RCTs, N = 28) did not affect BP but did increase HR by 5.1 bpm (95% CI 1.9 to 8.2) (moderate-certainty evidence). Medium-dose alcohol (14 to 28 g) within six hours (10 RCTs, N = 149) decreased systolic blood pressure (SBP) by 5.6 mmHg (95% CI -8.3 to -3.0) and diastolic blood pressure (DBP) by 4.0 mmHg (95% CI -6.0 to -2.0) and increased HR by 4.6 bpm (95% CI 3.1 to 6.1) (moderate-certainty evidence for all).  Medium-dose alcohol within 7 to 12 hours (4 RCTs, N = 54) did not affect BP or HR. Medium-dose alcohol > 13 hours after consumption (4 RCTs, N = 66) did not affect BP or HR. High-dose alcohol (> 30 g) within six hours (16 RCTs, N = 418) decreased SBP by 3.5 mmHg (95% CI -6.0 to -1.0), decreased DBP by 1.9 mmHg (95% CI-3.9 to 0.04), and increased HR by 5.8 bpm (95% CI 4.0 to 7.5). The certainty of evidence was moderate for SBP and HR, and was low for DBP. High-dose alcohol within 7 to 12 hours of consumption (3 RCTs, N = 54) decreased SBP by 3.7 mmHg (95% CI -7.0 to -0.5) and DBP by 1.7 mmHg (95% CI -4.6 to 1.8) and increased HR by 6.2 bpm (95% CI 3.0 to 9.3). The certainty of evidence was moderate for SBP and HR, and low for DBP. High-dose alcohol ≥ 13 hours after consumption (4 RCTs, N = 154) increased SBP by 3.7 mmHg (95% CI 2.3 to 5.1), DBP by 2.4 mmHg (95% CI 0.2 to 4.5), and HR by 2.7 bpm (95% CI 0.8 to 4.6) (moderate-certainty evidence for all).  AUTHORS' CONCLUSIONS: High-dose alcohol has a biphasic effect on BP; it decreases BP up to 12 hours after consumption and increases BP > 13 hours after consumption. High-dose alcohol increases HR at all times up to 24 hours. Findings of this review are relevant mainly to healthy males, as only small numbers of women were included in the included trials.

Association between alcohol consumption and hypertension in Chinese adults: Findings from the CHNS

OBJECTIVES

To obtain information about alcohol consumption (henceforth "drinking") among Chinese adults from 1991 to 2011, and to explore the association between drinking behavior and hypertension.

METHODS

According to the longitudinal data obtained in the China Health and Nutrition Survey (1991-2011), 50,013 records of 12,577 adults were selected by applying eligibility criteria. The chi-test was employed to explore the association between drinking and hypertension, by considering the frequency of drinking, daily alcohol intake, alcohol type, and the prevalence of hypertension. A multilevel logistic regression model was used to analyze the longitudinal association between drinking frequency and the prevalence of hypertension.

RESULTS

The prevalence of hypertension was higher in participants with a high drinking frequency than in those with a low drinking frequency among both males and females (p < 0.001). A step increase in daily alcohol intake was not associated with any obvious changes in the prevalence of hypertension in males, but the prevalence in each drinking group was higher than that in the nondrinking group, the prevalence of hypertension in females was lowest among those with a daily alcohol intake below 15 g. The types of alcohol consumed differed significantly between males and females (p < 0.001). Longitudinal analysis results showed that compared with the nondrinking group, drinking frequency ≤2 times/week was positively correlated with hypertension in both males (OR = 1.51, 95% CI = 1.26-1.82, p < 0.001) and females (OR = 1.67, 95% CI = 1.08-2.58, p < 0.05) after adjusting for covariates, meanwhile, the same positive correlation also occurred in males with drinking frequency >2 times/week (OR = 2.13, 95% CI = 1.77-2.56, p < 0.05), the risk of hypertension increased with the increase in drinking frequency.

CONCLUSIONS

Drinking can increase the prevalence of hypertension in Chinese males and females. From the analysis results of longitudinal data, drinking alcohol is still an important risk factor for hypertension among Chinese subjects, especially those who drink with high frequency.

Grape juice or wine: which is the best option?

Grapes used in the wine or juice production are mainly Vitis vinifera and Vitis labrusca and possess high amounts of polyphenolic compounds. These compounds are associated with the reduction of the inflammatory processes, oxidative stress, and protection against cardiovascular diseases. The industrial processes used for juice and wine production may interfere with the antioxidant composition of these products and the effects on human health. The aim of this review is to compare the effects of the consumption of wine or grape juice on cardiovascular risk factors. We used PRISMA guidelines and Medline/PUBMED and EMBASE to perform our search. The main effects of red wine and grape juice in humans were a reduction of body mass index, waist circumference, glycemia, plasma lipid peroxidation, total cholesterol, LDL-c, triglycerides, blood pressure, and homocysteine levels. Both wine and grape juice possess numerous bioactive compounds that are potentially responsible for many beneficial effects on human health. Nevertheless, there is a need for more double-blind, randomized controlled studies comparing the effects of juice and wine consumption without the biases that occur when comparisons are made with different populations, ages, doses, and different types of wine or juice.

The Fluid Aspect of the Mediterranean Diet in the Prevention and Management of Cardiovascular Disease and Diabetes: The Role of Polyphenol Content in Moderate Consumption of Wine and Olive Oil

A growing interest has emerged in the beneficial effects of plant-based diets for the prevention of cardiovascular disease, diabetes and obesity. The Mediterranean diet, one of the most widely evaluated dietary patterns in scientific literature, includes in its nutrients two fluid foods: olive oil, as the main source of fats, and a low-to-moderate consumption of wine, mainly red, particularly during meals. Current mechanisms underlying the beneficial effects of the Mediterranean diet include a reduction in inflammatory and oxidative stress markers, improvement in lipid profile, insulin sensitivity and endothelial function, as well as antithrombotic properties. Most of these effects are attributable to bioactive ingredients including polyphenols, mono- and poly-unsaturated fatty acids. Polyphenols are a heterogeneous group of phytochemicals containing phenol rings. The principal classes of red wine polyphenols include flavonols (quercetin and myricetin), flavanols (catechin and epicatechin), anthocyanin and stilbenes (resveratrol). Olive oil has at least 30 phenolic compounds. Among them, the main are simple phenols (tyrosol and hydroxytyrosol), secoroids and lignans. The present narrative review focuses on phenols, part of red wine and virgin olive oil, discussing the evidence of their effects on lipids, blood pressure, atheromatous plaque and glucose metabolism.

Potential Beneficial Effects of Wine Flavonoids on Allergic Diseases

Wine, a widely consumed beverage, comprises several biophenols that promote health. Flavonoids, majorly present in red wine, have been shown to have antioxidant, anti-inflammatory, anticancer, and immunomodulatory activities. Regular consumption of red wine (100 mL/day) is estimated to provide an average of 88 mg of flavonoids, whereas recent epidemiological studies indicate that wine is one of the major sources of flavonoid intake amongst wine lovers in European countries (providing an average intake of 291⁻374 mg/day of flavonoids). In addition to being antioxidants, in vitro studies suggest that flavonoids also have anti-allergic activities that inhibit IgE synthesis, activation of mast cells and basophils or other inflammatory cells, and production of inflammatory mediators, including cytokines. Furthermore, they affect the differentiation of naïve CD4+ T cells into effector T cell subsets. Moreover, several studies have reported the benefits of flavonoids in allergic models such as atopic dermatitis, asthma, anaphylaxis, and food allergy; however, evidence in humans is limited to allergic rhinitis and respiratory allergy. Although further evaluation is required, it is expected that an appropriate intake of flavonoids may be beneficial in preventing, and eventually managing, allergic diseases.

Association of Serum Alpha-Tocopherol and Retinol with the Extent of Coronary Lesions in Coronary Artery Disease

Background and aims: Fat-soluble vitamins play an important role in the pathogenesis of cardiovascular disease and progression of atherosclerosis. This study aimed at investigating the relationship of the serum levels of alpha-tocopherol and retinol with the extent of coronary lesions in patients with coronary artery disease. Methods. Patients with coronary artery disease (n=177) aged 30-74 years, who underwent their first coronary angiography, were enrolled. The extent of coronary lesions was assessed using the Friesinger index (FI). Accordingly, patients were grouped as follows: FI = 0-4 (n=90), FI = 5-9 (n=50), and FI = 10-15 (n=37). Serum levels of vitamins were ‬determined via high-performance liquid chromatography and serum biochemical analysis. Results. Assessment of FI-based groups revealed that 50.8% patients had a coronary artery lesion to a low extent (FI 0-4). Individuals in this group were younger and had lower glucose and serum alpha-tocopherol levels than the other groups (p < 0.05). Low levels of alpha-tocopherol were more frequent in the FI 0-4 group than that in the other groups (p=0.03). No difference was observed between the mean serum retinol levels among the FI-based groups (n=0.492), and the low frequency of retinol was consistent among the FI groups (n=0.348). Conclusions. The low level of alpha-tocopherol together with the presence of dyslipidemia is probably associated with the initial events in atherosclerosis. Increased alpha-tocopherol levels in patients with more extensive coronary artery lesions may have resulted from altered vitamin E metabolism with increased oxidative stress.

French and Mediterranean-style diets: Contradictions, misconceptions and scientific facts-A review

The determination of appropriate dietary strategies for the prevention of chronic degenerative diseases, cancer, diabetes, and cardiovascular diseases remains a challenging and highly relevant issue worldwide. Epidemiological dietary interventions have been studied for decades with contrasting impacts on human health. Moreover, research scientists and physicians have long debated diets encouraging alcohol intake, such as the Mediterranean and French-style diets, with regard to their impact on human health. Understanding the effects of these diets may help to improve in the treatment and prevention of diseases. However, further studies are warranted to determine which individual food components, or combinations thereof, have a beneficial impact on different diseases, since a large number of different compounds may occur in a single food, and their fate in vivo is difficult to measure. Most explanations for the positive effects of Mediterranean-style diet, and of the French paradox, have focused largely on the beneficial properties of antioxidants, among other compounds/metabolites, in foods and red wine. Wine is a traditional alcoholic beverage that has been associated with both healthy and harmful effects. Not withstanding some doubts, there is reasonable unanimity among researchers as to the beneficial effects of moderate wine consumption on cardiovascular disease, diabetes, osteoporosis, and longevity, which have been ascribed to polyphenolic compounds present in wine. Despite this, conflicting findings regarding the impact of alcohol consumption on human health, and contradictory findings concerning the effects of non-alcoholic wine components such as resveratrol, have led to confusion among consumers. In addition to these contradictions and misconceptions, there is a paucity of human research studies confirming known positive effects of polyphenols in vivo. Furthermore, studies balancing both known and unknown prognostic factors have mostly been conducted in vitro or using animal models. Moreover, current studies have shifted focus from red wine to dairy products, such as cheese, to explain the French paradox. The aim of this review is to highlight the contradictions, misconceptions, and scientific facts about wines and diets, giving special focus to the Mediterranean and French diets in disease prevention and human health improvement. To answer the multiplicity of questions regarding the effects of diet and specific diet components on health, and to relieve consumer uncertainty and promote health, comprehensive cross-demographic studies using the latest technologies, which include foodomics and integrated omics approaches, are warranted.

Wine: An Aspiring Agent in Promoting Longevity and Preventing Chronic Diseases

INTRODUCTION

Moderate wine consumption is a characteristic of the Mediterranean diet. Studies around the world have shown a beneficial effect of moderate alcohol intake, especially wine, on health. This review aims to critically summarise the most recent studies that investigate the beneficial effects of moderate wine intake on human health.

METHODS

The PubMed database was comprehensively searched to identify trials published from 2013 to 2018 that investigated the association between moderate wine consumption and health.

RESULTS

The most recent studies confirm the valuable role of moderate wine consumption, especially red wine, in the prevention and treatment of chronic diseases such as cardiovascular disease, metabolic syndrome, cognitive decline, depression, and cancer. In the meantime, recent studies also highlight the beneficial role of red wine against oxidative stress and in favour of desirable gut bacteria. The beneficial role of red wine has been attributed to its phytochemical compounds, as highlighted by clinical trials, where the effect of red wine has been compared to white wine, non-alcoholic wine, other alcoholic drinks, and water.

CONCLUSIONS

Moderate wine intake, at 1⁻2 glasses per day as part of the Mediterranean diet, has been positively associated with human health promotion, disease prevention, and disease prognosis.

Antioxidant and Antihypertensive Effects of a Chemically Defined Fraction of Syrah Red Wine on Spontaneously Hypertensive Rats

A particularly phenolic-rich fraction extracted from red wine from the São Francisco valley (Northeastern Brazil) was chemically characterized and its hypotensive and antioxidant effects on spontaneously hypertensive rats were studied both in vitro and in vivo. The liquid-liquid pH dependent fractionation scheme afforded a fraction with high content of bioactive phenolics such as flavonols, flavonol glycosides, phenolic acids and anthocyanins, whose identities were confirmed by liquid chromatography coupled to mass spectrometry analysis. Pretreatment of spontaneously hypertensive rats with this wine fraction at doses of 50 and 100 mg/kg by gavage for 15 days was able to decrease mean arterial pressure and heart rate as well as decrease serum lipid peroxidation. The fraction at concentrations of 0.01–1000 µg/mL induced concentration-dependent relaxation of isolated rat superior mesenteric artery rings pre-contracted with phenylephrine and this effect was not attenuated by endothelium removal. Our results demonstrate it is possible for phenolic constituents of red wine that are orally bioavailable to exert in vivo hypotensive and antioxidant effects on intact endothelial function.

Wine Flavonoids in Health and Disease Prevention

Wine, and particularly red wine, is a beverage with a great chemical complexity that is in continuous evolution. Chemically, wine is a hydroalcoholic solution (~78% water) that comprises a wide variety of chemical components, including aldehydes, esters, ketones, lipids, minerals, organic acids, phenolics, soluble proteins, sugars and vitamins. Flavonoids constitute a major group of polyphenolic compounds which are directly associated with the organoleptic and health-promoting properties of red wine. However, due to the insufficient epidemiological and in vivo evidences on this subject, the presence of a high number of variables such as human age, metabolism, the presence of alcohol, the complex wine chemistry, and the wide array of in vivo biological effects of these compounds suggest that only cautious conclusions may be drawn from studies focusing on the direct effect of wine and any specific health issue. Nevertheless, there are several reports on the health protective properties of wine phenolics for several diseases such as cardiovascular diseases, some cancers, obesity, neurodegenerative diseases, diabetes, allergies and osteoporosis. The different interactions that wine flavonoids may have with key biological targets are crucial for some of these health-promoting effects. The interaction between some wine flavonoids and some specific enzymes are one example. The way wine flavonoids may be absorbed and metabolized could interfere with their bioavailability and therefore in their health-promoting effect. Hence, some reports have focused on flavonoids absorption, metabolism, microbiota effect and overall on flavonoids bioavailability. This review summarizes some of these major issues which are directly related to the potential health-promoting effects of wine flavonoids. Reports related to flavonoids and health highlight some relevant scientific information. However, there is still a gap between the knowledge of wine flavonoids bioavailability and their health-promoting effects. More in vivo results as well as studies focused on flavonoid metabolites are still required. Moreover, it is also necessary to better understand how biological interactions (with microbiota and cells, enzymes or general biological systems) could interfere with flavonoid bioavailability.

The Use of Grape Seed Byproducts Rich in Flavonoids to Improve the Antioxidant Potential of Red Wines

The influence of adding seeds from grape pomace during Syrah wine fermentation in a warm climate has been studied. Seeds of Pedro Ximenez variety were rich in phenolic compounds, mainly flavonoids such as catechin and procyanidins. Changes in total phenolic content (TPC), total flavonoid content (TFC), and antioxidant activity of red wines were observed. These changes depended on the vinification stage and the amount of seeds (SW: 450 g or DW: 900 g seeds/150 kg grapes) applied. In general, antioxidant activity was greater when a simple dose (SW) was considered. Results indicate that seeds rich in flavonoids could be used as wine additives, which could improve the antioxidant potential of red wines in a warm climate.

Molecular Properties of Red Wine Compounds and Cardiometabolic Benefits

Wine has been used since the dawn of human civilization. Despite many health benefits, there is still a lot of discussion about the real properties of its components and its actions on cells and molecular interactions. A large part of these issues permeate the fine line between the amount of alcohol that causes problems to organic systems and the amount that could be beneficial for the health. However, even after the process of fermentation, wine conserves different organic compounds from grapes, such as polysaccharides, acids, and phenolic compounds, such as flavonoids and nonflavonoids. These substances have known anti-inflammatory and antioxidant capacities, and are considered as regulatory agents in cardiometabolic process. In this study, the main chemical components present in the wine, its interaction with molecules and biological mechanisms, and their interference with intra- and extracellular signaling are reviewed. Finally, the properties of wine that may benefit cardiovascular system are also revised.