While epidemiologists have long noted that consumers of wine tend to have better health outcomes than consumers of other alcoholic beverages, it has always been of concern that we were comparing drinkers, and not the drink itself. In recent years, many basic scientists have evaluated the non-alcoholic constituents in wine, and most studies show beneficial health effects from polyphenols and other components in wine as well as beneficial health effects from the alcohol in wine.
The present study provides an excellent review of clinical trials that compared the effects of wine versus no intervention or versus the effects of other alcoholic beverages. The specified outcomes related to effects on lipids, glucose/insulin metabolism, hemostatic mechanisms, and inflammatory/endothelial systems. The authors conclude that “The most repeated result of wine consumption is on lipid metabolism, attributed mainly to ethanol, while wine micro-constituents seem to have an important role mainly in haemostatic and inflammatory/endothelial systems.” Forum members cite several other important effects of wine micro-constituents, including demonstrated effects of such components at the cellular, molecular, and gene levels to sustain increased fibrinolytic activity, which is closely related to the development of cardiovascular disease.
Forum members were unanimous is considering that this was an excellent review of human clinical trials on the topic; the paper does not, however, comment on the mechanisms by which micro-constituents may operate to improve health. Given that since virtually none of the wine micro-constituents circulates in the human biofluids in their native form, it is especially important that the catabolites of wine micro-constituents be better defined and evaluated.
Overall, current data indicate that wine may be especially effective in lowering the risk of cardiovascular disease not only through the alcohol it contains, but also from a number of its key polyphenols. Forum members also point out that, for beneficial health effects of any type of alcoholic beverage, the pattern of drinking is especially important: the consumption of small or moderate amounts on a regular basis, and preferably with food.
Reference: Fragopoulou E, Cholevaa M, Antonopoulou S, Demopoulos CA. Wine and its metabolic effects. A comprehensive review of clinical trials. Metabolism Clinical and Experimental 2018;83:102-119.