The effect of chronic consumption of red wine on cardiovascular disease risk factors in postmenopausal women
Introduction
Moderate red wine consumption has been shown to reduce the risk of cardiovascular disease (CVD) to a greater extent than other alcoholic beverages, such as beer and spirits [1], [2]. The polyphenolic compounds present in red wine are thought to explain the putative beneficial effects on CVD [3]. However presently, the effect of red wine and its polyphenolic constituents on certain CVD risk factors is unclear and requires elucidation through well-controlled clinical trials.
In vitro and animal studies have provided strong scientific evidence of the potent lipid- and lipoprotein-lowering effects of red wine and its polyphenolic constituents [4], [5]. Studies from our laboratory have demonstrated a significant reduction in apolipoprotein B100 secretion, as well as an increase in LDL receptor expression and HMG-CoA reductase activity, following the incubation of HepG2 cells with full-complement red wine and dealcoholised red wine (polyphenol component), compared to controls [4]. In addition, significant reductions in chylomicron secretion were observed using the intestinal CaCO2 cell line following incubation with red wine [6]. Consistent with these findings, Vinson et al. recently showed a significant reduction in the concentration of total cholesterol and LDL cholesterol in dyslipidaemic hamsters consuming red wine and dealcoholised red wine over a 10-week period, compared to controls [5]. However, human studies investigating the effect of red wine and its polyphenol components on lipid and lipoprotein metabolism have reported only modest or insignificant changes. The majority of these clinical studies have been conducted in healthy, normolipidaemic subjects rather than dyslipidaemic subjects where an effect may more readily be identified [7], [8]. We suspect that a reduction in baseline cholesterol levels in already healthy individuals may be difficult to achieve. The lipid and lipoprotein lowering effects of red wine have not been examined in a high-risk group. In this study we have investigated hypercholesterolaemic postmenopausal women who are at an increased risk of developing CVD.
The potential lipid-lowering effects of red wine may be influenced by the duration (acute versus chronic) of consumption. We have previously described the effect of acute consumption of red wine (RW) and dealcoholised red wine (DRW) on postprandial lipid and lipoprotein metabolism, as well as insulin homeostasis, in dyslipidaemic postmenopausal women [9]. Neither RW nor DRW were efficacious in acutely modulating postprandial lipaemia and insulin homeostasis. It was speculated that a single-dose of red wine polyphenols may be insufficient to achieve a concentration in tissue and plasma which is biologically active. Studies using animal models have demonstrated significant improvements in lipid and lipoprotein concentrations following the regular consumption of red wine and red wine polyphenols over an extended period of time [5]. Based on these findings we propose that chronic consumption of red wine and its polyphenolic constituents may be required to observe cardiovascular benefits in humans. The aim of this study was to investigate the effect of chronic consumption of red wine (with and without alcohol) on the metabolism of lipids, lipoproteins, insulin and glucose in moderately hypercholesterolaemic, postmenopausal women.
Section snippets
Subjects
Forty-five moderately hypercholesterolaemic postmenopausal women, between the ages of 50 and 70 years, were recruited from the community. Subjects were screened for plasma cholesterol concentrations of ≥5.5 mmol/L and plasma triglyceride concentrations of <2 mmol/L. All subjects who met these inclusion criteria underwent a medical. Exclusion criteria included hormone replacement therapy, lipid-lowering medication, use of steroids and other agents that may influence lipid metabolism, use of
Subject characteristics
The clinical characteristics of subjects in the water, DRW and RW groups measured at screening are shown in Table 1. There was no significant difference between groups in the anthropometric or lipid parameters. According to NCEP ATP III guidelines, the postmenopausal women in this study displayed moderate to high total cholesterol and LDL cholesterol concentrations, with mean concentrations of 6.2 and 4.1 mmol/L, respectively.
Nutritional assessment
There were no significant differences in macronutrient intake by
Discussion
We have previously demonstrated that acute consumption of DRW (polyphenol component) does not affect postprandial lipaemia or insulin sensitivity in dyslipidaemic postmenopausal women [9]. Furthermore, it was shown that an acute dose of full-complement RW exacerbates postprandial lipid and insulin levels, suggesting that neither red wine nor its polyphenolic components confer cardiovascular benefits acutely through improvements in postprandial lipid and lipoprotein metabolism. Based on these
Acknowledgements
The project was supported by grants from the National Heart Foundation of Australia and the ATN Centre for Metabolic Fitness. The statistical advice received from S. Dhaliwal is appreciated. We are grateful to the Chemistry Centre, Perth, Australia for their assistance in the dealcoholising of red wine.
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