Is wine more heart-healthy than other alcoholic beverages? The "French paradox"—the observation of a link between regular wine consumption and a low incidence of heart disease in countries such as France, where diets are typically high in heart-hindering fats—has spurred an influx of wine-and-health research since it gained international attention in 1991. In the decades since, studies have shown time and again that moderate wine consumption does indeed have a positive relationship with cardiovascular health. But studies have yet to determine whether alcohol is behind the benefits, or if it’s something unique to red wine.
Some believe that the ethanol in wine—and beer and spirits—is what confers its health benefits, while others think that it's wine's unique components (such as resveratrol, quercetin and ellagic acid) that are responsible. Others say that it's a combination.
In an effort to provide some clarity, a group of researchers from the University of Athens and Harokopio University (both in Athens, Greece) performed a meta-analysis of 76 past scientific reports regarding wine's long-term and acute health effects. The analysis, published in the scientific journal Metabolism, looked at studies concerning biomarkers associated with cardiovascular disease, including lipid metabolism, hemostatic mechanisms, inflammation, and glucose and insulin metabolism.
They selected studies that either compare the effects of wine against other alcoholic beverages, or against abstaining from alcohol. Comparing the results of these studies helps determine whether the benefits come from wine-specific compounds (referred to in the study's text as "micro-constituents") or ethanol.
Wine has long been associated with increased levels of high-density lipoprotein (HDL), the so-called "good cholesterol" that helps reduce the risk of heart disease. After looking at the studies concerning lipid metabolism, the researchers suggested that increased HDL levels were associated with the ethanol found in any type of alcoholic beverage, not just wine. (They also found that in typical study participants, a minimum of around 30 grams of alcohol per day—equivalent to about two glasses of wine—seemed to be required for higher HDL levels; in diabetic or postmenopausal participants, smaller doses appeared effective.) Data on wine's effects on other lipid-related biomarkers, including low-density lipoproteins—the "bad cholesterol"—was inconclusive.
The hemostatic system, which essentially controls bleeding and blood clots, appeared to be positively affected both by wine specifically, as well as by alcohol in general. The researchers noted that platelet aggregation appeared to be positively affected by wine's micro-constituents, while lower levels of fibrinogen (a glycoprotein involved in many steps of the hemostatic system) were attributed to ethanol.
Similarly, the endothelium (the cell lining of blood vessels) was also shown to benefit from the anti-inflammatory properties of both ethanol and wine-specific compounds, though the researchers stated that a clear outcome couldn't be determined.
While the analysis' text concludes with a confirmation that wine does indeed appear to have positive effects on the different systems that contribute to cardiovascular health, it's difficult to determine the exact sources of these benefits—alcohol, resveratrol or otherwise—in a methodologically sound way. The analysis calls for further controlled studies to explore this topic more thoroughly.
Want to learn more about how wine can be part of a healthy lifestyle? Sign up for Wine Spectator's free Wine & Healthy Living e-mail newsletter and get the latest health news, feel-good recipes, wellness tips and more delivered straight to your inbox every other week!