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Wojtowicz JS. Long-Term Health Outcomes of Regular, Moderate Red Wine Consumption. Cureus 2023; 15:e46786. [PMID: 37954791 PMCID: PMC10634232 DOI: 10.7759/cureus.46786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 11/14/2023] Open
Abstract
Studies that are conducted to assess alcohol's long-term health outcomes generally report the results as a pooled analysis across all types of alcohol. Questions have been raised regarding potential health differences between types of alcohol, such as beer, wine, or spirits. While these three share the same alcohol in the form of ethanol, they differ in the other compounds they contain that are particular to each type of alcohol, specifically the polyphenols in red wine. The generalizability of pooled results may be limited due to the differences in health outcomes that may exist between different types of alcohol and lead to overall conclusions that differ from the subset analysis by type of alcohol that is often reported in the data tables of an article. The objective of this systematic review was to specifically address the assessment of the long-term health outcomes of regular, moderate, red wine consumption. PubMed was searched from 1987 through June 2023. Studies were included if they met all the following criteria: adult participants, red wine consumption and its frequency (close to daily), volume in moderation (1 glass/day for women, 2 glasses/day for men), and measurement of long-term (> 2 years) health outcomes. Nonclinical animal studies, or studies with an endpoint as a marker or biomarker, without a health outcome, of short duration (< 2 years), small size (< 25 subjects), a focus on binge drinking, no wine analysis performed, review articles, meta-analysis, or editorial/commentary were excluded. A total of 74 studies met the inclusion/exclusion criteria. Of these, 27 (36%) evaluated cancer outcomes, 14 (19%) evaluated cardiovascular outcomes, 10 (14%) evaluated mortality, 7 (9%) evaluated weight gain, 5 (7%) evaluated dementia, and the remaining 11 evaluated a variety of health outcomes. There were no studies that demonstrated an association between red wine consumption and negative health outcomes. Forty-seven studies demonstrated an association between red wine consumption and positive health outcomes, whereas 26 studies were neutral, and one had mixed results where women had a positive health outcome and men were neutral. All studies on mortality and dementia showed positive health outcomes. From this systematic review of the literature, there is no evidence of an association between moderate red wine consumption and negative health outcomes. Across the various outcomes assessed, a beneficial effect of moderate red wine consumption was consistently seen for mortality and dementia, along with certain cancers (e.g., non-Hodgkin lymphoma) and cardiovascular conditions (e.g., metabolic syndrome). For other health outcomes, the association was neutral, i.e., neither harmful nor beneficial. This review is not intended to encourage red wine consumption for health outcomes but rather to avoid discouraging moderate red wine consumption based on misunderstanding or misinterpretation of the red wine data due to the reporting of pooled data across all types of alcohol.
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Zhang L, Ji R, He G, Tian A, Huo X, Zheng Y, Qi L, Mi Y, Yan X, Wang B, Lei L, Li J, Liu J, Li J. Individual Trajectories of Health Status During the First Year of Discharge From Hospitalization for Heart Failure and Their Associations With Death in the Following Years. J Am Heart Assoc 2023; 12:e028782. [PMID: 37421271 PMCID: PMC10382098 DOI: 10.1161/jaha.122.028782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 06/08/2023] [Indexed: 07/10/2023]
Abstract
Background Improving health status is one of the major goals in the management of heart failure (HF). However, little is known about the long-term individual trajectories of health status in patients with acute HF after discharge. Methods and Results We enrolled 2328 patients hospitalized for HF from 51 hospitals prospectively and measured their health status via the Kansas City Cardiomyopathy Questionnaire-12 at admission and 1, 6, and 12 months after discharge, respectively. The median age of the patients included was 66 years, and 63.3% were men. Six patterns of Kansas City Cardiomyopathy Questionnaire-12 trajectories were identified by a latent class trajectory model: persistently good (34.0%), rapidly improving (35.5%), slowly improving (10.4%), moderately regressing (7.4%), severely regressing (7.5%), and persistently poor (5.3%). Advanced age, decompensated chronic HF, HF with mildly reduced ejection fraction, HF with preserved ejection fraction, depression symptoms, cognitive impairment, and each additional HF rehospitalization within 1 year of discharge were associated with unfavorable health status (moderately regressing, severely regressing, and persistently poor) (P<0.05). Compared with the pattern of persistently good, slowly improving (hazard ratio [HR], 1.50 [95% CI, 1.06-2.12]), moderately regressing (HR, 1.92 [1.43-2.58]), severely regressing (HR, 2.26 [1.54-3.31]), and persistently poor (HR, 2.34 [1.55-3.53]) were associated with increased risks of all-cause death. Conclusions One-fifth of 1-year survivors after hospitalization for HF experienced unfavorable health status trajectories and had a substantially increased risk of death during the following years. Our findings help inform the understanding of disease progression from a patient perception perspective and its relationship with long-term survival. Registration URL: https://www.clinicaltrials.gov; unique identifier: NCT02878811.
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Affiliation(s)
- Lihua Zhang
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular DiseaseFuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular DiseasesBeijingPeople’s Republic of China
- Fuwai Hospital, Chinese Academy of Medical SciencesShenzhenPeople’s Republic of China
| | - Runqing Ji
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular DiseaseFuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular DiseasesBeijingPeople’s Republic of China
- Fuwai Hospital, Chinese Academy of Medical SciencesShenzhenPeople’s Republic of China
| | - Guangda He
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular DiseaseFuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular DiseasesBeijingPeople’s Republic of China
- Fuwai Hospital, Chinese Academy of Medical SciencesShenzhenPeople’s Republic of China
| | - Aoxi Tian
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular DiseaseFuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular DiseasesBeijingPeople’s Republic of China
- Fuwai Hospital, Chinese Academy of Medical SciencesShenzhenPeople’s Republic of China
| | - Xiqian Huo
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular DiseaseFuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular DiseasesBeijingPeople’s Republic of China
- Fuwai Hospital, Chinese Academy of Medical SciencesShenzhenPeople’s Republic of China
| | - Yang Zheng
- First Hospital of Jilin UniversityChangchunPeople’s Republic of China
| | - Liwei Qi
- Xinmin People’s HospitalXinminPeople’s Republic of China
| | - Yafei Mi
- Department of CardiologyTaizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical UniversityLinhaiPeople’s Republic of China
| | - Xiaofang Yan
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular DiseaseFuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular DiseasesBeijingPeople’s Republic of China
- Fuwai Hospital, Chinese Academy of Medical SciencesShenzhenPeople’s Republic of China
| | - Bin Wang
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular DiseaseFuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular DiseasesBeijingPeople’s Republic of China
- Fuwai Hospital, Chinese Academy of Medical SciencesShenzhenPeople’s Republic of China
| | - Lubi Lei
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular DiseaseFuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular DiseasesBeijingPeople’s Republic of China
- Fuwai Hospital, Chinese Academy of Medical SciencesShenzhenPeople’s Republic of China
| | - Jingkuo Li
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular DiseaseFuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular DiseasesBeijingPeople’s Republic of China
- Fuwai Hospital, Chinese Academy of Medical SciencesShenzhenPeople’s Republic of China
| | - Jiamin Liu
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular DiseaseFuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular DiseasesBeijingPeople’s Republic of China
- Fuwai Hospital, Chinese Academy of Medical SciencesShenzhenPeople’s Republic of China
| | - Jing Li
- National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular DiseaseFuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular DiseasesBeijingPeople’s Republic of China
- Fuwai Hospital, Chinese Academy of Medical SciencesShenzhenPeople’s Republic of China
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Polyphenol-Rich Beverages and Mental Health Outcomes. Antioxidants (Basel) 2023; 12:antiox12020272. [PMID: 36829831 PMCID: PMC9952274 DOI: 10.3390/antiox12020272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/27/2023] Open
Abstract
Emerging evidence suggests that diets rich in plant-based foods and beverages may exert plausible effects on human health tackling the risk of chronic diseases. Although the data are promising for numerous outcomes, including cardiovascular diseases, the data on mental health are limited. The aim of this study was to investigate the association between individual polyphenol-rich beverages intake and mental health outcomes, such as perceived stress, depressive symptoms, and sleep quality, among adult individuals living in the Mediterranean area. The demographic and dietary characteristics of a sample of 1572 adults living in southern Italy were analysed. Multivariate logistic regression analyses, controlling for confounding factors, were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of the association between individual polyphenol-rich and alcoholic beverages containing polyphenols and mental health outcomes. The multivariate model adjusted for background covariates and the Mediterranean diet showed that individuals with a moderate intake (up to 1 cup/glass per day) of coffee and tea were less likely to have high perceived stress (OR = 0.61, 95% CI: 0.45-0.84) and depressive symptoms (OR = 0.56, 95% CI: 0.39-0.80), respectively. Furthermore, regular coffee and moderate/regular red wine drinkers were less likely to have depressive symptoms (OR = 0.72, 95% CI: 0.54-0.95 and OR = 0.74, 95% CI: 0.54-0.99, respectively). No significant associations were retrieved for the intake of polyphenol-rich and alcoholic beverages and sleep quality. In conclusion, the results of the present study suggest that polyphenol-rich beverages may be associated with mental health, in terms of depressive symptoms and perceived stress. Nonetheless, further research exploring how the polyphenol-rich beverages impact brain health and what the optimal patterns of consumption are for different populations are warranted.
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Chow SL, Bozkurt B, Baker WL, Bleske BE, Breathett K, Fonarow GC, Greenberg B, Khazanie P, Leclerc J, Morris AA, Reza N, Yancy CW. Complementary and Alternative Medicines in the Management of Heart Failure: A Scientific Statement From the American Heart Association. Circulation 2023; 147:e4-e30. [PMID: 36475715 DOI: 10.1161/cir.0000000000001110] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Complementary and alternative medicines (CAM) are commonly used across the world by diverse populations and ethnicities but remain largely unregulated. Although many CAM agents are purported to be efficacious and safe by the public, clinical evidence supporting the use of CAM in heart failure remains limited and controversial. Furthermore, health care professionals rarely inquire or document use of CAM as part of the medical record, and patients infrequently disclose their use without further prompting. The goal of this scientific statement is to summarize published efficacy and safety data for CAM and adjunctive interventional wellness approaches in heart failure. Furthermore, other important considerations such as adverse effects and drug interactions that could influence the safety of patients with heart failure are reviewed and discussed.
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Andersson C, Schou M, Gustafsson F, Torp-Pedersen C. Alcohol Intake in Patients With Cardiomyopathy and Heart Failure: Consensus and Controversy. Circ Heart Fail 2022; 15:e009459. [PMID: 35593142 DOI: 10.1161/circheartfailure.121.009459] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Alcohol is often cited to be a common cause of cardiomyopathy and heart failure. However, in most available population-based studies, a modest-to-moderate alcohol consumption has been associated with favorable effects on the cardiovascular system, including a lowered risk of heart failure, compared with no alcohol consumption. Available genetic epidemiological data have not supported a causal association between alcohol consumption and heart failure risk, suggesting that alcohol may not be a common cause of heart failure in the community. Data linking alcohol intake with cardiomyopathy risk are sparse, and the concept of alcoholic cardiomyopathy stems mainly from case series of selected patients with dilated cardiomyopathy, where a large proportion reported a history of excessive alcohol intake. This state-of-the-art paper addresses the current knowledge of the epidemiology of alcoholic cardiomyopathy and the role of alcohol intake in patients with non-alcohol-related heart failure. It also offers directions to future research in the area. The review questions the validity of current clinical teaching in the area. It is not well known how much alcohol is needed to cause disease, and the epidemiological pathways linking alcohol consumption to cardiomyopathy and heart failure are not well understood. Until more evidence becomes available, caution is warranted before labeling patients as having alcoholic cardiomyopathy due to a risk of neglecting other contributors, such as genetic causes of cardiomyopathy. In non-alcohol-related heart failure, it is unknown whether total abstinence is improving outcomes (compared with moderate drinking). Ideally, randomized clinical trials are needed to answer this question.
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Affiliation(s)
- Charlotte Andersson
- Department of Medicine, Section of Cardiovascular Medicine, Boston Medical Center, Boston University, MA (C.A.)
| | - Morten Schou
- Department of Cardiology, Herlev and Gentofte Hospital (M.S.), University of Copenhagen, Denmark
| | - Finn Gustafsson
- The Heart Centre, Rigshospitalet (F.G.), University of Copenhagen, Denmark
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Chen C, Zhang Y, Zhao Q, Wang L, An Y, Fan X. The multiple mediating effects of social connectedness and self-care confidence on the relationship between subjective social status and emotional well-being in patients with heart failure: a cross-sectional study. Eur J Cardiovasc Nurs 2021; 21:227-234. [PMID: 34244707 DOI: 10.1093/eurjcn/zvab058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/05/2021] [Accepted: 06/16/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Previous studies have shown that subjective social status (SSS) was positively associated with well-being in various populations. However, little is known about the relationship considering the underlying mechanism in patients with heart failure (HF). AIMS The aim was to study the effects of social connectedness and self-care confidence on the relationship between SSS and well-being in patients with HF according to the Reserve Capacity Model. METHODS AND RESULTS We recruited 296 patients from a general hospital using convenience sampling. SSS, social connectedness, self-care confidence, and well-being were assessed using self-reported questionnaires. A multiple mediation model was examined using the PROCESS macro in SPSS.Higher levels of SSS (r = 0.18, P < 0.01), social connectedness (r = 0.21, P < 0.01), and self-care confidence (r = 0.20, P < 0.01) were positively correlated with better emotional well-being, but not with physical well-being. The multiple mediation analysis revealed that the relationship between SSS and emotional well-being was mediated by social connectedness (effect: 0.061, 95% CI [0.014, 0.148]) and self-care confidence (effect: 0.110, 95% CI [0.006, 0.249]) separately, and together in serial (effect: 0.008, 95% CI [0.001, 0.028]). CONCLUSIONS Social connectedness and self-care confidence are multiple mediators of the relationship between SSS and emotional well-being. Interventions targeting to strengthening social connectedness and self-care confidence may improve emotional well-being directly. In addition, emotional well-being may be improved by enhancing SSS indirectly in patients with HF.
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Affiliation(s)
- Cancan Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44# Wenhua Xi Road, Jinan, Shandong 250012, China
| | - Yanting Zhang
- School of Nursing, Zhengzhou Railway Vocational and Technical College, 56# Pengcheng Avenue, Zhengzhou, Henan 450000, China
| | - Qiuge Zhao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44# Wenhua Xi Road, Jinan, Shandong 250012, China
| | - Lyu Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44# Wenhua Xi Road, Jinan, Shandong 250012, China
| | - Yan An
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44# Wenhua Xi Road, Jinan, Shandong 250012, China
| | - Xiuzhen Fan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44# Wenhua Xi Road, Jinan, Shandong 250012, China
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Micek A, Godos J, Cernigliaro A, Cincione RI, Buscemi S, Libra M, Galvano F, Grosso G. Polyphenol-Rich and Alcoholic Beverages and Metabolic Status in Adults Living in Sicily, Southern Italy. Foods 2021; 10:foods10020383. [PMID: 33572478 PMCID: PMC7916404 DOI: 10.3390/foods10020383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/05/2021] [Accepted: 02/06/2021] [Indexed: 12/15/2022] Open
Abstract
Polyphenol-rich beverage consumption is not univocally accepted as a risk modulator for cardio-metabolic risk factors, despite mechanistic and epidemiological evidence suggesting otherwise. The aim of this study was to assess whether an association between polyphenol-rich beverage consumption and metabolic status could be observed in a Mediterranean cohort with relatively low intake of tea, coffee, red and white wine, beer, and fresh citrus juice. Demographic and dietary characteristics of 2044 adults living in southern Italy were analyzed. Multivariate logistic regression analyses were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of the association between polyphenol-rich and alcoholic beverage consumption and metabolic status adjusted for potential confounding factors. Specific polyphenol-rich beverages were associated, to a various extent, with metabolic outcomes. Individuals with a higher total polyphenol-rich beverages had higher polyphenols intake and were less likely to have hypertension, type-2 diabetes, and dyslipidemia (OR = 0.57, 95% CI: 0.44–0.73; OR = 0.41, 95% CI: 0.26–0.66; and OR = 0.41, 95% CI: 0.29–0.57, respectively). However, when adjusted for potential confounding factors, only the association with hypertension remained significant (OR = 0.69, 95% CI: 0.50–0.94). Current scientific evidence suggests that such beverages may play a role on cardio-metabolic risk factors, especially when consumed within the context of a dietary pattern characterized by an intake of a plurality of them. However, these associations might be mediated by an overall healthier lifestyle.
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Affiliation(s)
- Agnieszka Micek
- Department of Nursing Management and Epidemiology Nursing, Faculty of Health Sciences, Jagiellonian University Medical College, 31-501 Krakow, Poland
- Correspondence:
| | - Justyna Godos
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (J.G.); (M.L.); (F.G.); (G.G.)
| | - Achille Cernigliaro
- Department of Health Service and Epidemiological Observatory, Health Authority Sicily Region, 90145 Palermo, Italy;
| | - Raffaele Ivan Cincione
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
| | - Silvio Buscemi
- Biomedical Department of Internal and Specialist Medicine (DIBIMIS), University of Palermo, 90123 Palermo, Italy;
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (J.G.); (M.L.); (F.G.); (G.G.)
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy
| | - Fabio Galvano
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (J.G.); (M.L.); (F.G.); (G.G.)
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (J.G.); (M.L.); (F.G.); (G.G.)
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The effect of grape products containing polyphenols on C-reactive protein levels: a systematic review and meta-analysis of randomised controlled trials. Br J Nutr 2020; 125:1230-1245. [DOI: 10.1017/s0007114520003591] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Liberale L, Bonaventura A, Montecucco F, Dallegri F, Carbone F. Impact of Red Wine Consumption on Cardiovascular Health. Curr Med Chem 2019; 26:3542-3566. [PMID: 28521683 DOI: 10.2174/0929867324666170518100606] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 03/05/2017] [Accepted: 03/05/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND The devastating effects of heavy alcohol drinking have been long time recognized. In the last decades, potential benefits of modest red wine drinking were suggested. In European countries in which red wide intake is not negligible (such as France), the association between cholesterol and cardiovascular (CV) risk was less evident, suggesting the action of some protective molecules in red wine or other foods and drinks. METHODS This narrative review is based on the material searched for and obtained via PubMed up to May 2016. The search terms we used were: "red wine, cardiovascular, alcohol" in combination with "polyphenols, heart failure, infarction". RESULTS Epidemiological and mechanistic evidence of a J-shaped relationship between red wine intake and CV risk further supported the "French paradox". Specific components of red wine both in vitro and in animal models were discovered. Polyphenols and especially resveratrol largely contribute to CV prevention mainly through antioxidant properties. They exert beneficial effects on endothelial dysfunction and hypertension, dyslipidemia, metabolic diseases, thus reducing the risk of adverse CV events such as myocardial infarction ischemic stroke and heart failure. Of interest, recent studies pointed out the role of ethanol itself as a potential cardioprotective agent, but a clear epidemiological evidence is still missing. The aim of this narrative review is to update current knowledge on the intracellular mechanism underlying the cardioprotective effects of polyphenols and ethanol. Furthermore, we summarized the results of epidemiological studies, emphasizing their methodological criticisms and the need for randomized clinical trials able to clarify the potential role of red wine consumption in reducing CV risk. CONCLUSION Caution in avowing underestimation of the global burden of alcohol-related diseases was particularly used.
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Affiliation(s)
- Luca Liberale
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
| | - Aldo Bonaventura
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
| | - Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy.,IRCCS AOU San Martino - IST, Genova, 10 Largo Benzi, 16132 Genoa, Italy.,Centre of Excellence for Biomedical Research (CEBR), University of Genoa, 9 viale Benedetto XV, 16132 Genoa, Italy
| | - Franco Dallegri
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy.,IRCCS AOU San Martino - IST, Genova, 10 Largo Benzi, 16132 Genoa, Italy
| | - Federico Carbone
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
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Ulivi L, Maccarrone M, Giannini N, Ferrari E, Caselli MC, Montano V, Chico L, Casani A, Navari E, Cerchiai N, Siciliano G, Bonuccelli U, Mancuso M. Oxidative Stress in Cerebral Small Vessel Disease Dizziness Patients, Basally and After Polyphenol Compound Supplementation. Curr Mol Med 2019; 18:160-165. [PMID: 30033867 PMCID: PMC6225324 DOI: 10.2174/1566524018666180720165055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 06/15/2018] [Accepted: 07/16/2018] [Indexed: 01/09/2023]
Abstract
Background: Leukoaraiosis (LA) is a common radiological finding in elderly, frequently associated with several clinical disorders, including unexplained dizziness. The pathogenesis of LA is multifactorial, with a dysfunction of cerebral microcirculation resulting in chronic hypoperfusion and tissue loss, with oxidative stress involved in this cascade. Objective: The aim of this study was to analyse some oxidative stress biomarkers in a cohort of LA patients. Method: Fifty-five consecutive patients (33 males, median age 75 years) with LA were recruited. In a subgroup of 33 patients with LA and unexplained dizziness, we have then performed an open study to evaluate if 60-day supplementation with a polyphenol compound may modify these biomarkers and influence quality of life, analysed with the Dizziness Handicap Inventory (DHI) scale. Results: At baseline, blood oxidative stress parameters values were outside normal ranges and compared to matched healthy controls. After the two months supplementation, we observed a significant decrement of advanced oxidation protein products values and a significant improvement of DHI. Conclusion: Oxidative stress biomarkers may be useful to detect redox imbalance in LA and to provide non-invasive tools to monitor disease status and response to therapy.
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Affiliation(s)
- L Ulivi
- Department of Experimental and Clinical Medicine, Neurological Clinic, Pisa University, Pisa, Italy
| | - M Maccarrone
- Department of Experimental and Clinical Medicine, Neurological Clinic, Pisa University, Pisa, Italy
| | - N Giannini
- Department of Experimental and Clinical Medicine, Neurological Clinic, Pisa University, Pisa, Italy
| | - E Ferrari
- Department of Experimental and Clinical Medicine, Neurological Clinic, Pisa University, Pisa, Italy
| | - M C Caselli
- Department of Experimental and Clinical Medicine, Neurological Clinic, Pisa University, Pisa, Italy
| | - V Montano
- Department of Experimental and Clinical Medicine, Neurological Clinic, Pisa University, Pisa, Italy
| | - L Chico
- Department of Experimental and Clinical Medicine, Neurological Clinic, Pisa University, Pisa, Italy
| | - A Casani
- Department of Medical and Surgical Pathology, Otorhinolaryngology Section, Pisa University, Pisa, Italy
| | - E Navari
- Department of Medical and Surgical Pathology, Otorhinolaryngology Section, Pisa University, Pisa, Italy
| | - N Cerchiai
- Department of Medical and Surgical Pathology, Otorhinolaryngology Section, Pisa University, Pisa, Italy
| | - G Siciliano
- Department of Experimental and Clinical Medicine, Neurological Clinic, Pisa University, Pisa, Italy
| | - U Bonuccelli
- Department of Experimental and Clinical Medicine, Neurological Clinic, Pisa University, Pisa, Italy
| | - M Mancuso
- Department of Experimental and Clinical Medicine, Neurological Clinic, Pisa University, Pisa, Italy
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The effect of diet, lifestyle and psychological factors in the prognosis of ischemic heart failure. Metabol Open 2019; 1:11-18. [PMID: 32812917 PMCID: PMC7424785 DOI: 10.1016/j.metop.2019.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 03/02/2019] [Accepted: 03/04/2019] [Indexed: 12/28/2022] Open
Abstract
Background/Objective Dietary patterns may play an important role in the prognosis of heart failure. Methods Dietary habits, sleeping habits, physical activity and anxiety and depression status were recorded in 326 patients (90 females, mean age 73.45 ± 10.9 years) with ischemic heart failure prospectively followed for 30 months. Results Lower ΗADS-depression scores (p = 0.03), a low-fat meat diet (p = 0.035) and moderate coffee consumption (p = 0.005) were associated with better prognosis. Non-significant differences were recorded in outcomes with regard to consumption of other dietary categories. Conclusions A balanced diet as well as emphasis on the treatment of depression may improve outcomes in ischemic heart failure. Coffee consumption is associated with better outcomes in ischemic heart failure. A low fat meat diet is associated with better outcomes in ischemic heart failure. High ΗADS depression score is related to worst prognosis in ischemic heart failure. Sedentary lifestyle is related to worst outcomes in ischemic heart failure.
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Poznański M, Brzeziańska-Lasota E, Kiszałkiewicz J, Kurnatowska I, Kroczyńska-Bednarek J, Pękala-Wojciechowska A, Pietras T, Antczak A. Serum levels and gene expression of pentraxin 3 are elevated in COPD. Adv Med Sci 2019; 64:85-89. [PMID: 30572222 DOI: 10.1016/j.advms.2018.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 06/20/2018] [Accepted: 08/31/2018] [Indexed: 12/27/2022]
Abstract
PURPOSE Pentraxin 3 (PTX-3) is an acute phase protein that belongs to the pentraxin superfamily. It is synthesized locally at the site of inflammation and its levels are related to the damage of blood vessels. There are only a few studies examining the relationship between PTX-3 and chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the serum levels of PTX-3 and relative PTX-3 gene expression in COPD patients and their correlations with cigarette smoking history and lung function. MATERIALS/METHODS A total number of 34 participants were enrolled into this study. Only stable patients without comorbidities were recruited. After obtaining written informed consent all planned procedures were performed (pre- and post-bronchodilator spirometry, blood samples for PTX-3 serum levels and PTX-3 gene expression measurements, demographical data, medical history, COPD patients were also asked for CAT and MMRC questionnaires). RESULTS PTX-3 serum levels were significantly higher in the COPD group (29.22 (5.47) ng/ml vs. 14.64 (3.64) ng/ml). PTX-3 gene relative quantification (RQ) values were also significantly higher in the COPD group (0.15 (1.33) vs. -2.80 (1.99)). No differences in CRP serum levels were found between the control group and the COPD group. CONCLUSIONS Our study demonstrates that serum levels of PTX-3 and the relative expression values of its gene are elevated in COPD, and can be related to cigarette smoking history.
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Affiliation(s)
- Michał Poznański
- Department of General and Oncological Pulmonology, First Chair of Internal Diseases, Medical University of Lodz, Lodz, Poland.
| | - Ewa Brzeziańska-Lasota
- Department of Molecular Bases of Medicine, First Chair of Internal Diseases, Medical University of Lodz, Lodz, Poland
| | - Justyna Kiszałkiewicz
- Department of Molecular Bases of Medicine, First Chair of Internal Diseases, Medical University of Lodz, Lodz, Poland
| | - Ilona Kurnatowska
- Department of Clinical Pharmacology, First Chair of Internal Diseases, Medical University of Lodz, Lodz, Poland
| | - Jadwiga Kroczyńska-Bednarek
- Department of General and Oncological Pulmonology, First Chair of Internal Diseases, Medical University of Lodz, Lodz, Poland
| | - Anna Pękala-Wojciechowska
- Department of Clinical Pharmacology, First Chair of Internal Diseases, Medical University of Lodz, Lodz, Poland
| | - Tadeusz Pietras
- Department of Clinical Pharmacology, First Chair of Internal Diseases, Medical University of Lodz, Lodz, Poland
| | - Adam Antczak
- Department of General and Oncological Pulmonology, First Chair of Internal Diseases, Medical University of Lodz, Lodz, Poland
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Sadhu JS, Novak E, Mukamal KJ, Kizer JR, Psaty BM, Stein PK, Brown DL. Association of Alcohol Consumption After Development of Heart Failure With Survival Among Older Adults in the Cardiovascular Health Study. JAMA Netw Open 2018; 1:e186383. [PMID: 30646330 PMCID: PMC6324331 DOI: 10.1001/jamanetworkopen.2018.6383] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
IMPORTANCE More than 1 million older adults develop heart failure annually. The association of alcohol consumption with survival among these individuals after diagnosis is unknown. OBJECTIVE To determine whether alcohol use is associated with increased survival among older adults with incident heart failure. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study included 5888 community-dwelling adults aged 65 years or older who were recruited to participate in the Cardiovascular Health Study between June 12, 1989, and June 1993, from 4 US sites. Of the total participants, 393 individuals had a new diagnosis of heart failure within the first 9 years of follow-up through June 2013. The study analysis was performed between January 19, 2016, and September 22, 2016. EXPOSURES Alcohol consumption was divided into 4 categories: abstainers (never drinkers), former drinkers, 7 or fewer alcoholic drinks per week, and more than 7 drinks per week. PRIMARY OUTCOMES AND MEASURES Participant survival after the diagnosis of incident heart failure. RESULTS Among the 393 adults diagnosed with incident heart failure, 213 (54.2%) were female, 339 (86.3%) were white, and the mean (SD) age was 78.7 (6.0) years. Alcohol consumption after diagnosis was reported in 129 (32.8%) of the participants. Across alcohol consumption categories of long-term abstainers, former drinkers, consumers of 1-7 drinks weekly and consumers of more than 7 drinks weekly, the percentage of men (32.1%, 49.0%, 58.0%, and 82.4%, respectively; P < .001 for trend), white individuals (78.0%, 92.7%, 92.0%, and 94.1%, respectively, P <. 001 for trend), and high-income participants (22.0%, 43.8%, 47.3%, and 64.7%, respectively; P < .001 for trend) increased with increasing alcohol consumption. Across the 4 categories, participants who consumed more alcohol had more years of education (mean, 12 years [interquartile range (IQR), 8.0-10.0 years], 12 years [IQR, 11.0-14.0 years], 13 years [IQR, 12.0-15.0 years], and 13 years [IQR, 12.0-14.0 years]; P < .001 for trend). Diabetes was less common across the alcohol consumption categories (32.1%, 26.0%, 22.3%, and 5.9%, respectively; P = .01 for trend). Across alcohol consumption categories, there were fewer never smokers (58.3%, 44.8%, 35.7%, and 29.4%, respectively; P < .001 for trend) and more former smokers (34.5%, 38.5%, 50.0%, and 52.9%, respectively; P = .006 for trend). After controlling for other factors, consumption of 7 or fewer alcoholic drinks per week was associated with additional mean survival of 383 days (95% CI, 17-748 days; P = .04) compared with abstinence from alcohol. Although the robustness was limited by the small number of individuals who consumed more than 7 drinks per week, a significant inverted U-shaped association between alcohol consumption and survival was observed. Multivariable model estimates of mean time from heart failure diagnosis to death were 2640 days (95% CI, 1967-3313 days) for never drinkers, 3046 days (95% CI, 2372-3719 days) for consumers of 0 to 7 drinks per week, and 2806 (95% CI, 1879-3734 days) for consumers of more than 7 drinks per week (P = .02). Consumption of 10 drinks per week was associated with the longest survival, a mean of 3381 days (95% CI, 2806-3956 days) after heart failure diagnosis. CONCLUSIONS AND RELEVANCE These findings suggest that limited alcohol consumption among older adults with incident heart failure is associated with survival benefit compared with long-term abstinence. These findings suggest that older adults who develop heart failure may not need to abstain from moderate levels of alcohol consumption.
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Affiliation(s)
- Justin S. Sadhu
- Cardiovascular Division, Washington University School of Medicine, St Louis, Missouri
| | - Eric Novak
- Cardiovascular Division, Washington University School of Medicine, St Louis, Missouri
| | - Kenneth J. Mukamal
- Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Jorge R. Kizer
- Cardiology Section, San Francisco Veterans Affairs Health Care System, San Francisco, California
- Department of Medicine, University of California, San Francisco
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology and Health Services, University of Washington, Seattle
- Group Health Research Institute, Group Health Cooperative, Seattle, Washington
| | - Phyllis K. Stein
- Cardiovascular Division, Washington University School of Medicine, St Louis, Missouri
| | - David L. Brown
- Cardiovascular Division, Washington University School of Medicine, St Louis, Missouri
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Pavlidou E, Mantzorou M, Fasoulas A, Tryfonos C, Petridis D, Giaginis C. Wine: An Aspiring Agent in Promoting Longevity and Preventing Chronic Diseases. Diseases 2018; 6:diseases6030073. [PMID: 30096779 PMCID: PMC6165230 DOI: 10.3390/diseases6030073] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/04/2018] [Accepted: 08/06/2018] [Indexed: 02/07/2023] Open
Abstract
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.
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Affiliation(s)
- Eleni Pavlidou
- Department of Food Science and Nutrition, University of the Aegean, Myrina, 81400 Lemnos, Greece.
| | - Maria Mantzorou
- Department of Food Science and Nutrition, University of the Aegean, Myrina, 81400 Lemnos, Greece.
| | - Aristeidis Fasoulas
- Department of Food Science and Nutrition, University of the Aegean, Myrina, 81400 Lemnos, Greece.
| | - Christina Tryfonos
- Department of Food Science and Nutrition, University of the Aegean, Myrina, 81400 Lemnos, Greece.
| | - Dimitris Petridis
- Department of Food Technology, Technological Educational Institute of Thessaloniki, 57400 Sindos, Greece.
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, University of the Aegean, Myrina, 81400 Lemnos, Greece.
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Shestakova MV, Vasilenko AF, Karpova MI, Grigoricheva EA, Epaneshnikova NV, Kochetkov IV. [Cognitive impairment and compliance in chronic heart failure]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:53-57. [PMID: 28980613 DOI: 10.17116/jnevro20171176253-57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To determine the factors of cognitive impairment and non-compliance in patients with chronic heart failure (CHF). MATERIAL AND METHODS One hundred and fifty-seven patients with CHF and 32 patients without chronic heart failure (controls) were examined. Neuropsychological assessment using a 30-minutes protocol recommended by NINDS-Canadian Stroke Standards (NINDS CSS), magnetic resonance imaging, cognitive ERP and a test of compliance were used. RESULTS AND CONCLUSION Approximately 62% of patients did not perform medical prescriptions. Non-compliance was associated with an increase in the severity of subcortical and perivenricular leukoaraiosis, a slowdown in decision-making processes (an increase in the P300 latency), worse performance on speech activity tests, optical/spatial and frontal dysfunctions and memory. Patients with non-compliance had frontal cognitive impairment (58%), memory impairment (40%) and mixed forms (21%). Cognitive impairment in patients with chronic heart failure was associated with the lower left ventricular ejection fraction and deterioration in indices of diastolic function.
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Affiliation(s)
- M V Shestakova
- South Ural State Medical University, Chelyabinsk, Russia
| | - A F Vasilenko
- South Ural State Medical University, Chelyabinsk, Russia
| | - M I Karpova
- South Ural State Medical University, Chelyabinsk, Russia
| | | | | | - I V Kochetkov
- South Ural State Medical University, Chelyabinsk, Russia
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Prevalence and risk markers of early psychological distress after ICD implantation in the European REMOTE-CIED study cohort. Int J Cardiol 2017; 240:208-213. [DOI: 10.1016/j.ijcard.2017.03.124] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 03/13/2017] [Accepted: 03/27/2017] [Indexed: 11/19/2022]
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Knighton AJ, Savitz LA, Benuzillo J, VanDerslice JA. It takes a village: Exploring the impact of social determinants on delivery system outcomes for heart failure patients. HEALTHCARE-THE JOURNAL OF DELIVERY SCIENCE AND INNOVATION 2017; 6:112-116. [PMID: 28655521 DOI: 10.1016/j.hjdsi.2017.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 05/30/2017] [Accepted: 06/03/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Local social determinants may act as effect modifiers for the impact of neighborhood material deprivation on patient-level healthcare outcomes. The objective of this study was to understand the mediating effect of local social determinants on neighborhood material deprivation and delivery outcomes in heart failure (HF) patients. MATERIAL AND METHODS A retrospective cohort study was conducted using 4737 HF patients receiving inpatient care (n=6065 encounters) from an integrated healthcare delivery system from 2010 to 2014. Outcomes included post-discharge mortality, readmission risk and length of stay. Deprivation was measured using an area deprivation index by address of residence. Effect modifications measured included urban-rural residency and faith identification using generalized linear regression models. Patient-level data was drawn from the delivery system data warehouse. RESULTS Faith identification had a significant protective effect on HF patients from deprived areas, lowering 30-day mortality odds by one-third over patients who did not identify with a faith (OR 0.35 95%CI:0.12-0.98;p=0.05). Significant effects persisted at the 90 and 180-day timeframes. In rural areas, lack of faith identification had a multiplicative effect on 30-day mortality for deprived patients (OR 14.0 95%CI:1.47-132.7;p=0.02). No significant effects were noted for other healthcare outcomes. CONCLUSIONS The lack of expected association between area deprivation and healthcare outcomes in some communities may be explained by the presence of effect modifiers. IMPLICATIONS Understanding existing effect modifiers for area deprivation in local communities that delivery systems serve can inform targeted quality improvement. These factors should also be considered when comparing delivery system performance for reimbursement and in population health management.
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Affiliation(s)
- Andrew J Knighton
- Intermountain Institute for Healthcare Delivery Research, Intermountain Healthcare, Salt Lake City, UT, United States.
| | - Lucy A Savitz
- Intermountain Institute for Healthcare Delivery Research, Intermountain Healthcare, Salt Lake City, UT, United States
| | - Jose Benuzillo
- Cardiovascular Clinical Program, Intermountain Healthcare, Salt Lake City, UT, United States
| | - James A VanDerslice
- Division of Public Health, School of Medicine, University of Utah, Salt Lake City, UT, United States
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Goszcz K, Duthie GG, Stewart D, Leslie SJ, Megson IL. Bioactive polyphenols and cardiovascular disease: chemical antagonists, pharmacological agents or xenobiotics that drive an adaptive response? Br J Pharmacol 2017; 174:1209-1225. [PMID: 28071785 PMCID: PMC5429332 DOI: 10.1111/bph.13708] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 12/19/2016] [Accepted: 01/05/2017] [Indexed: 12/12/2022] Open
Abstract
Polyphenols are widely regarded to have a wide range of health-promoting qualities, including beneficial effects on cardiovascular disease. Historically, the benefits have been linked to their well-recognized powerful antioxidant activity. However, the concept that the beneficial effects are attributable to direct antioxidant activity in vivo does not pay sufficient heed to the fact that polyphenols degrade rapidly, are poorly absorbed and rapidly metabolized, resulting in very low bioavailability. This review explores alternative mechanisms by which polyphenols, or their metabolites, exert biological activity via mechanisms that can be activated by physiologically relevant concentrations. Evidence is presented to support the action of phenolic derivatives on receptors and signalling pathways to induce adaptive responses that drive changes in endogenous antioxidant, antiplatelet, vasodilatory and anti-inflammatory effects. The implications are that in vitro antioxidant measures as predictors of polyphenol protective activity in vivo hold little relevance and that closer attention needs to be paid to bioavailable metabolites to understand the mode of action of these diet-derived components. LINKED ARTICLES This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc.
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Affiliation(s)
- Katarzyna Goszcz
- Department of Diabetes and Cardiovascular ScienceUniversity of the Highlands and Islands, Centre for Health ScienceInvernessUK
| | - Garry G Duthie
- Rowett Institute of Nutrition and HealthUniversity of AberdeenAberdeenUK
| | - Derek Stewart
- The James Hutton InstituteDundeeUK
- School of Engineering and Physical SciencesHeriot‐Watt UniversityEdinburghUK
| | - Stephen J Leslie
- Department of Diabetes and Cardiovascular ScienceUniversity of the Highlands and Islands, Centre for Health ScienceInvernessUK
- Cardiology UnitRaigmore HospitalInvernessUK
| | - Ian L Megson
- Department of Diabetes and Cardiovascular ScienceUniversity of the Highlands and Islands, Centre for Health ScienceInvernessUK
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