Elsevier

Atherosclerosis

Volume 185, Issue 2, April 2006, Pages 438-445
Atherosclerosis

The effect of chronic consumption of red wine on cardiovascular disease risk factors in postmenopausal women

https://doi.org/10.1016/j.atherosclerosis.2005.06.027Get rights and content

Abstract

Background

Moderate red wine has been shown to reduce cardiovascular disease (CVD) risk, however the effects on certain CVD risk factors are unclear. In this study we have investigated the effects of dealcoholised red wine (DRW) and full-complement red wine (RW) on several cardiovascular risk factors in mildly hypercholesterolaemic postmenopausal women.

Objectives

To elucidate whether the chronic consumption of red wine polyphenols improves risk factors associated with CVD in hypercholesterolaemic postmenopausal women.

Design

Forty-five hypercholesterolaemic postmenopausal women were randomly assigned to consume 400 mL/day of either water, DRW or RW for 6 weeks following a 4-week washout. Fasting measures of lipids, lipoproteins, insulin and glucose were taken at 0 and 6 weeks.

Results

DRW consumption had no effect of fasting concentrations of lipids, lipoproteins, insulin and glucose. However, chronic consumption of RW significantly reduced fasting LDL cholesterol concentrations by 8% and increased HDL cholesterol concentrations by 17% in hypercholesterolaemic postmenopausal women.

Conclusions

Collectively, regular consumption of full-complement red wine reduces CVD risk by improving fasting lipid levels in hypercholesterolaemic postmenopausal women. This study uniquely demonstrated the LDL cholesterol-lowering effects of red wine in individuals at high CVD risk, which has not previously been shown.

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.

References (32)

  • D.M. Goldberg et al.

    Beyond alcohol: beverage consumption and cardiovascular mortality

    Clin Chim Acta

    (1995)
  • D.J. Baer et al.

    Moderate alcohol consumption lowers risk factors for cardiovascular disease in postmenopausal women fed a controlled diet

    Am J Clin Nutr

    (2002)
  • C.F. Daher et al.

    Effect of acute and chronic moderate alcohol consumption on fasted and postprandial lipemia in the rat

    Food Chem Toxicol

    (2003)
  • L. Cordain et al.

    Influence of moderate chronic wine consumption on insulin sensitivity and other correlates of syndrome X in moderately obese women

    Metabolism

    (2000)
  • A.S. St Leger et al.

    Factors associated with cardiac mortality in developed countries with particular reference to the consumption of wine

    Lancet

    (1979)
  • S. Pal et al.

    Red wine polyphenolics suppress the secretion of ApoB48 from human intestinal CaCo-2 Cells

    J Agric Food Chem

    (2005)
  • Cited by (71)

    • Polyphenol-Rich Diets in Cardiovascular Disease Prevention

      2019, Analysis in Nutrition Research: Principles of Statistical Methodology and Interpretation of the Results
    • Polyphenol-rich diets in cardiovascular disease prevention

      2018, Analysis in Nutrition Research: Principles of Statistical Methodology and Interpretation of the Results
    View all citing articles on Scopus
    View full text