Drink smarter, not more: Moderate wine consumption with a Mediterranean diet may halve your heart disease risk!

Drinking a little or moderate amount of wine may reduce the risk of major cardiovascular disease in adults at greater risk who follow a Mediterranean diet, according to a study published today in the European Heart Journal (1).

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Link Between Wine and Heart Health

Previous research on the impact of wine on cardiovascular health has yielded mixed results. This could be because research generally relies on people reporting how much wine they consume. Instead, the current study evaluated the amount of tartaric acid in individuals’ urine. Researchers describe this as an “objective and reliable measure” of wine consumption.

Professor Ramon Estruch of the University of Barcelona and the Hospital Clinic Barcelona in Spain led the research.

The new study is part of a broader Spanish study looking at the effect of a Mediterranean diet (rich in olive oil, vegetables, fruit, nuts, and fish, and low in sugary or processed foods and beverages) on persons at risk of developing cardiovascular disease. All the participants had no cardiovascular disease at the start of the study. Still, they either had type 2 diabetes or a combination of cardiovascular disease risk factors such as smoking, high blood pressure, high cholesterol, obesity, and/or a family history of cardiovascular disease.

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Tartaric Acid in Urine to Determine Wine Consumption

In addition to filling out questionnaires about their eating and drinking habits, participants provided urine samples at the start of the trial and after a year of following a Mediterranean diet. Tartaric acid is a chemical that naturally occurs in grapes and grape-derived products such as wine. Tartaric acid is excreted in the urine, therefore it can be used to determine whether someone has drank wine and/or grapes in the previous five to six days.

Researchers surveyed 1,232 people to see how consuming wine affected them. Participants were followed for four to five years, and there were 685 cases of cardiovascular disease (heart attack, coronary revascularization, stroke, or death from cardiovascular diseases) during the research period.

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Drinking Wine Reduces Risk of Heart Disease

In this group of people at high risk of cardiovascular disease who followed a Mediterranean diet, researchers discovered that light-to-moderate wine drinkers, defined as consuming half to one glass of wine per day, had a 50% lower risk of developing a cardiovascular event than those who drank very little or no wine. Light drinking (one glass per week or less than half a glass per day) decreased cardiovascular risk by 38%. However, this protective benefit fades in persons who consume more than one glass every day.

The researchers considered other factors known to impact the risk of cardiovascular disease, but they note that the study’s design limits its ability to prove a link between consuming wine and cardiovascular events, and other factors cannot be excluded.

Professor Estruch stated that by detecting tartaric acid in urine in conjunction with food and drink questionnaires, we were able to obtain a more precise estimation of wine use. We discovered that wine has a significantly stronger protective impact than previous studies. A 50% risk reduction is significantly greater than what can be obtained with some medications, such as statins.

“This study investigates the role of moderate wine intake in a healthy dietary pattern, such as the Mediterranean diet. Previously, we hypothesized that moderate wine intake could account for 20% of the effects of the Mediterranean diet; however, these findings suggest that the effect may be substantially bigger.

“The patients in our study were elderly persons with a high risk of cardiovascular disease living in a Mediterranean country, thus the findings may not be applicable to other populations. Another important concern is at what age moderate wine consumption becomes ‘appropriate’. Recent studies show that the preventive effects of wine intake begin around the age of 35 to 40. It is also worth noting that moderate consumption for women should always be half that of men, and it should be consumed with meals.

Evaluating Alcohol’s Effect on Humans: An Ongoing Dispute

In an accompanying editorial, Professor Giovanni de Gaetano from IRCCS NEUROMED in Pozzilli, Italy, and colleagues stated, “The link between alcohol use, particularly wine, and cardiovascular disease (CVD) risk remains a topic of ongoing dispute despite decades of relevant research. Numerous studies have found that moderate wine drinking, typically defined as one glass per day, ideally during meals, is related to a lower risk of total mortality and CVD. However, the apparent protective effect is overshadowed by ongoing uncertainties. Inés Domínguez-López et al.’s paper, published in the European Heart Journal, introduces an objective biomarker, urinary tartaric acid, as a measure of wine consumption and provides compelling evidence for its association with lower CVD risk.

Domínguez-López et al. highlights the complexities of evaluating alcohol’s effects on health. While biomarkers like urine tartaric acid give a more objective measure of wine exposure, they may not account for the larger context of alcohol intake, such as drinking habits, lifestyle factors, and potential interactions with other dietary components. This limitation emphasizes the need for more sophisticated research that reflects the complexities of food habits and their impact on health.

Domínguez-López et al.’s study advances our understanding of the complex link between wine intake and cardiovascular health. By using urine tartaric acid as an objective biomarker, the authors present strong evidence that moderate wine consumption is related to decreased CVD risk in a Mediterranean population at high cardiovascular risk. This study not only emphasizes the importance of objective biomarkers in nutritional epidemiology but also supports the idea that light-to-moderate wine intake can be part of a heart-healthy diet. However, the data highlight the hazards associated with higher levels of intake, emphasizing the significance of moderation. Future studies should continue to investigate the potential of biomarkers in unravelling the intricate relationships between eating habits, lifestyle, and health outcomes.

References:

1. Urinary tartaric acid as a biomarker of wine consumption and cardiovascular risk: the PREDIMED trial
   (Inés Domínguez-López, Rosa M Lamuela-Raventós, Cristina Razquin, Camila Arancibia-Riveros, Polina Galkina, Jordi Salas-Salvadó, Ángel M Alonso-Gómez, Montserrat Fitó, Miquel Fiol, José Lapetra, Enrique Gómez-Gracia, José V Sorlí, Miguel Ruiz-Canela, Olga Castañer, Liming Liang, Lluis Serra-Majem, Frank B Hu, Emilio Ros, Miguel Ángel Martínez-González, Ramon Estruch, Urinary tartaric acid as a biomarker of wine consumption and cardiovascular risk: the PREDIMED trial, European Heart Journal, 2024;, ehae804, https://doi.org/10.1093/eurheartj/ehae804)

Source-Medindia