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Lombardo M, Feraco A, Camajani E, Caprio M, Armani A. Health Effects of Red Wine Consumption: A Narrative Review of an Issue That Still Deserves Debate. Nutrients 2023; 15:1921. [PMID: 37111141 PMCID: PMC10146095 DOI: 10.3390/nu15081921] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/04/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
A strong controversy persists regarding the effect of red wine (RW) consumption and health. Guidelines for the prevention of cardiovascular diseases (CVD) and cancers discourage alcohol consumption in any form, but several studies have demonstrated that low RW intake may have positive effects on CVD risk. This review evaluated randomised controlled trials (RCTs), examining the recent literature on the correlations between acute and chronic RW consumption and health. All RCTs published in English on PubMed from 1 January 2000 to 28 February 2023 were evaluated. Ninety-one RCTs were included in this review, seven of which had a duration of more than six months. We assessed the effect of RW on: (1) antioxidant status, (2) cardiovascular function, (3) coagulation pathway and platelet function, (4) endothelial function and arterial stiffness, (5) hypertension, (6) immune function and inflammation status, (7) lipid profile and homocysteine levels, (8) body composition, type 2 diabetes and glucose metabolism, and (9) gut microbiota and the gastrointestinal tract. RW consumption mostly results in improvements in antioxidant status, thrombosis and inflammation markers, lipid profile, and gut microbiota, with conflicting results on hypertension and cardiac function. Notably, beneficial effects were observed on oxidative stress, inflammation, and nephropathy markers, with a modest decrease in CVD risk in five out of seven studies that evaluated the effect of RW consumption. These studies were conducted mainly in patients with type 2 diabetes mellitus, and had a duration between six months and two years. Additional long-term RCTs are needed to confirm these benefits, and assess the potential risks associated with RW consumption.
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Affiliation(s)
- Mauro Lombardo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, 00166 Rome, Italy
| | - Alessandra Feraco
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, 00166 Rome, Italy
- Laboratory of Cardiovascular Endocrinology, San Raffaele Research Institute, IRCCS San Raffaele Roma, Via di Val Cannuta, 247, 00166 Rome, Italy
| | - Elisabetta Camajani
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, 00166 Rome, Italy
- Laboratory of Cardiovascular Endocrinology, San Raffaele Research Institute, IRCCS San Raffaele Roma, Via di Val Cannuta, 247, 00166 Rome, Italy
| | - Massimiliano Caprio
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, 00166 Rome, Italy
- Laboratory of Cardiovascular Endocrinology, San Raffaele Research Institute, IRCCS San Raffaele Roma, Via di Val Cannuta, 247, 00166 Rome, Italy
| | - Andrea Armani
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, 00166 Rome, Italy
- Laboratory of Cardiovascular Endocrinology, San Raffaele Research Institute, IRCCS San Raffaele Roma, Via di Val Cannuta, 247, 00166 Rome, Italy
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Mantzioris E, Muhlhausler BS, Villani A. Impact of the Mediterranean Dietary pattern on n-3 fatty acid tissue levels-A systematic review. Prostaglandins Leukot Essent Fatty Acids 2022; 176:102387. [PMID: 34929617 DOI: 10.1016/j.plefa.2021.102387] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/06/2021] [Accepted: 12/10/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The Mediterranean Diet (MedDiet) is described as a plant-based dietary pattern with adherence associated with reductions in chronic disease risk and longevity. Although the nutrient profile is diverse and complex, the MedDiet is often described as a rich source of n-3 polyunsaturated fatty acids (PUFA) derived from fish, seafood and nuts. However, whether MedDiet adherence results in appreciable increases in tissue levels of n-3 PUFAs is yet to be systematically investigated. This systematic review synthesized the literature to determine the impact of the MedDiet on n-3 PUFA tissue levels. MATERIALS AND METHODS Medline, Embase, Amed, and CINAHL databases were searched for studies reporting on adherence to a MedDiet and tissue levels of n-3 PUFAs. PROSPERO registration number is CRD 42020162114. RESULTS Twenty-two studies were included. Seven were observational studies and 15 were randomised controlled trials (RCTs). All observational studies reported a positive relationship between adherence and higher tissue n-3 PUFA levels. Two-thirds (10/15) of RCTs reported significant increases in n-3 PUFA concentrations. DISCUSSION MedDiet adherence is associated with higher tissue levels of n-3 PUFA. However, we report heterogeneity in the description across all MedDiet interventions.
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Affiliation(s)
- Evangeline Mantzioris
- UniSA: Clinical & Health Sciences, Alliance for Research in Nutrition, Exercise and Activity (ARENA), University of South Australia, North Terrace and Frome Rd, Adelaide SA 5000, Australia.
| | | | - Anthony Villani
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Queensland, Australia
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Moustafa F, Dopeux L, Mulliez A, Boirie Y, Morand C, Gentes E, Farigon N, Richard D, Lebreton A, Teissandier D, Dutheil F, Schmidt J. Severe undernutrition increases bleeding risk on vitamin-K antagonists. Clin Nutr 2020; 40:2237-2243. [PMID: 33077273 DOI: 10.1016/j.clnu.2020.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/25/2020] [Accepted: 10/01/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Hemorrhage occurs in 7-10% of patients treated with vitamin K antagonist (VKA), with major bleeding in 1-3%. Impact of nutritional status on the bleeding risk of patients on anticoagulants is still poorly documented. Our study aimed to analyze the link between the nutritional status of patients on VKA and the occurrence of hemorrhagic events. We also analyzed micronutrients status. METHODS A case-control, monocentric, and prospective study was conducted from August 2012 to October 2015. The case patients were those presenting with major bleeding and control patients those without any bleeding under VKA treatment. RESULTS Overall, 294 patients under VKA treatment were paired according to age, gender, and index normalized ratio (INR). Out of these, 98 (33.3%) had major bleeding and 196 (66.7%) did not have any bleeding. Additionally, more than two-thirds of patients displayed undernutrition, which was more prevalent in bleeding than non-bleeding patients (OR = 1.85, CI95%: 1.07-3.21). There was a higher bleeding risk for those with severe undernutrition (OR = 2.66, CI95%: 1.58-4.46), with no difference found concerning moderate undernutrition. Bleeding patients had lower plasma-zinc concentrations than non-bleeding patients (9.4 ± 3.6 vs. 10.5 ± 3.7 μmol/L, p = 0.003); among them, there was a higher rate of patients with plasma zinc under 5 μmol/L (9% vs. 2%, p < 0.001). CONCLUSION Patients with undernutrition on VKA exhibit a significantly higher bleeding risk, which increases three-fold in case of severe undernutrition. The evaluation of nutritional status provides additional, valuable prognosis information prior to initiating VKA therapy. CLINICALTRIALS. GOV NUMBER NCT01742871.
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Affiliation(s)
- Farès Moustafa
- Emergency Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France; Université Clermont Auvergne, Clermont-Ferrand, France.
| | - Loïc Dopeux
- Emergency Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Aurelien Mulliez
- Biostatistics Unit, DRCI, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Yves Boirie
- Service de Nutrition Clinique, CHU Clermont-Ferrand, Unité de Nutrition Humaine, INRA, Université Clermont Auvergne, 63003, Clermont-Ferrand, France; Université Clermont-Auvergne, Unité de Nutrition, CRNH, Clermont-Ferrand, France
| | - Christine Morand
- Université Clermont Auvergne, INRAE, UNH, Unité de Nutrition Humaine, Clermont-Ferrand, France
| | - Elodie Gentes
- Service de Nutrition Clinique, CHU Clermont-Ferrand, Unité de Nutrition Humaine, INRA, Université Clermont Auvergne, 63003, Clermont-Ferrand, France; Université Clermont-Auvergne, Unité de Nutrition, CRNH, Clermont-Ferrand, France
| | - Nicolas Farigon
- Service de Nutrition Clinique, CHU Clermont-Ferrand, Unité de Nutrition Humaine, INRA, Université Clermont Auvergne, 63003, Clermont-Ferrand, France
| | - Damien Richard
- Université Clermont Auvergne, CHU Clermont-Ferrand, Laboratoire de Pharmacologie et Toxicologie, Clermont-Ferrand, France
| | - Aurélien Lebreton
- Université Clermont Auvergne, INRAE, UNH, Unité de Nutrition Humaine, Clermont-Ferrand, France; Service d'Hématologie Biologique, CHU Clermont-Ferrand, Clermont-Ferrand, France; Centre de Ressources et Compétences des Maladies Hémorragiques Constitutionnelles, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Dorian Teissandier
- Emergency Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Frederic Dutheil
- Emergency Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France; Université Clermont Auvergne, Clermont-Ferrand, France; School of Exercise Science, Australian Catholic University, Melbourne, VIC, Australia; UMR CNRS 6024, "Physiological and Psychosocial Stress" Team, LAPSCO, Clermont-Ferrand, France
| | - Jeannot Schmidt
- Emergency Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France; Université Clermont Auvergne, Clermont-Ferrand, France
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Abstract
BACKGROUND Alcohol is consumed by over 2 billion people worldwide. It is a common substance of abuse and its use can lead to more than 200 disorders including hypertension. Alcohol has both acute and chronic effects on blood pressure. This review aimed to quantify the acute effects of different doses of alcohol over time on blood pressure and heart rate in an adult population. OBJECTIVES Primary objective To determine short-term dose-related effects of alcohol versus placebo on systolic blood pressure and diastolic blood pressure in healthy and hypertensive adults over 18 years of age. Secondary objective To determine short-term dose-related effects of alcohol versus placebo on heart rate in healthy and hypertensive adults over 18 years of age. SEARCH METHODS The Cochrane Hypertension Information Specialist searched the following databases for randomised controlled trials up to March 2019: the Cochrane Hypertension Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 2), in the Cochrane Library; MEDLINE (from 1946); Embase (from 1974); the World Health Organization International Clinical Trials Registry Platform; and ClinicalTrials.gov. We also contacted authors of relevant articles regarding further published and unpublished work. These searches had no language restrictions. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing effects of a single dose of alcohol versus placebo on blood pressure (BP) or heart rate (HR) in adults (≥ 18 years of age). DATA COLLECTION AND ANALYSIS Two review authors (ST and CT) independently extracted data and assessed the quality of included studies. We also contacted trial authors for missing or unclear information. Mean difference (MD) from placebo with 95% confidence interval (CI) was the outcome measure, and a fixed-effect model was used to combine effect sizes across studies. MAIN RESULTS: We included 32 RCTs involving 767 participants. Most of the study participants were male (N = 642) and were healthy. The mean age of participants was 33 years, and mean body weight was 78 kilograms. Low-dose alcohol (< 14 g) within six hours (2 RCTs, N = 28) did not affect BP but did increase HR by 5.1 bpm (95% CI 1.9 to 8.2) (moderate-certainty evidence). Medium-dose alcohol (14 to 28 g) within six hours (10 RCTs, N = 149) decreased systolic blood pressure (SBP) by 5.6 mmHg (95% CI -8.3 to -3.0) and diastolic blood pressure (DBP) by 4.0 mmHg (95% CI -6.0 to -2.0) and increased HR by 4.6 bpm (95% CI 3.1 to 6.1) (moderate-certainty evidence for all). Medium-dose alcohol within 7 to 12 hours (4 RCTs, N = 54) did not affect BP or HR. Medium-dose alcohol > 13 hours after consumption (4 RCTs, N = 66) did not affect BP or HR. High-dose alcohol (> 30 g) within six hours (16 RCTs, N = 418) decreased SBP by 3.5 mmHg (95% CI -6.0 to -1.0), decreased DBP by 1.9 mmHg (95% CI-3.9 to 0.04), and increased HR by 5.8 bpm (95% CI 4.0 to 7.5). The certainty of evidence was moderate for SBP and HR, and was low for DBP. High-dose alcohol within 7 to 12 hours of consumption (3 RCTs, N = 54) decreased SBP by 3.7 mmHg (95% CI -7.0 to -0.5) and DBP by 1.7 mmHg (95% CI -4.6 to 1.8) and increased HR by 6.2 bpm (95% CI 3.0 to 9.3). The certainty of evidence was moderate for SBP and HR, and low for DBP. High-dose alcohol ≥ 13 hours after consumption (4 RCTs, N = 154) increased SBP by 3.7 mmHg (95% CI 2.3 to 5.1), DBP by 2.4 mmHg (95% CI 0.2 to 4.5), and HR by 2.7 bpm (95% CI 0.8 to 4.6) (moderate-certainty evidence for all). AUTHORS' CONCLUSIONS: High-dose alcohol has a biphasic effect on BP; it decreases BP up to 12 hours after consumption and increases BP > 13 hours after consumption. High-dose alcohol increases HR at all times up to 24 hours. Findings of this review are relevant mainly to healthy males, as only small numbers of women were included in the included trials.
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Affiliation(s)
- Sara Tasnim
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada
| | - Chantel Tang
- Faculty of Health Sciences, McGill University, Montreal, Canada
| | - Vijaya M Musini
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada
| | - James M Wright
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada
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Delgado-Lista J, Perez-Martinez P, Garcia-Rios A, Perez-Caballero AI, Perez-Jimenez F, Lopez-Miranda J. Mediterranean Diet and Cardiovascular Risk: Beyond Traditional Risk Factors. Crit Rev Food Sci Nutr 2014; 56:788-801. [DOI: 10.1080/10408398.2012.726660] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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George TW, Paterson E, Waroonphan S, Gordon MH, Lovegrove JA. Effects of chronic consumption of fruit and vegetable puree-based drinks on vasodilation, plasma oxidative stability and antioxidant status. J Hum Nutr Diet 2012; 25:477-87. [DOI: 10.1111/j.1365-277x.2012.01279.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- T. W. George
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences; University of Reading; Whiteknights; Reading; UK
| | - E. Paterson
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences; University of Reading; Whiteknights; Reading; UK
| | - S. Waroonphan
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences; University of Reading; Whiteknights; Reading; UK
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McCall DO, McGartland CP, McKinley MC, Sharpe P, McCance DR, Young IS, Woodside JV. The effect of increased dietary fruit and vegetable consumption on endothelial activation, inflammation and oxidative stress in hypertensive volunteers. Nutr Metab Cardiovasc Dis 2011; 21:658-664. [PMID: 20392617 DOI: 10.1016/j.numecd.2010.01.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2009] [Revised: 12/22/2009] [Accepted: 01/15/2010] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS Public health campaigns recommend increased fruit and vegetable (FV) consumption as an effective means of cardiovascular risk reduction. During an 8 week randomised control trial among hypertensive volunteers, we noted significant improvements in endothelium-dependent vasodilatation with increasing FV consumption. Circulating indices of inflammation, endothelial activation and insulin resistance are often employed as alternative surrogates for systemic arterial health. The responses of several such biomarkers to our previously described FV intervention are reported here. METHODS AND RESULTS Hypertensive volunteers were recruited from medical outpatient clinics. After a common 4 week run-in period during which FV consumption was limited to 1 portion per day, participants were randomised to 1, 3 or 6 portions daily for 8 weeks. Venous blood samples for biomarker analyses were collected during the pre and post-intervention vascular assessments. A total of 117 volunteers completed the 12 week study. Intervention-related changes in circulating levels of high sensitivity C-reactive protein (hsCRP), soluble intracellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), von Willebrand factor (vWF) and plasminogen activator inhibitor-1 (PAI-1) did not differ significantly between FV groups. Similarly, there were no significant between group differences of change in homeostasis model assessment (HOMA) scores. CONCLUSIONS Despite mediating a significant improvement in acetylcholine induced vasodilatation, increased FV consumption did not affect a calculated measure of insulin resistance or concentrations of the circulating biomarkers measured during this study. Functional indices of arterial health such as endothelium-dependent vasomotion are likely to provide more informative cardiovascular end-points during short-term dietary intervention trials.
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Affiliation(s)
- D O McCall
- Nutrition and Metabolism Group, Centre for Public Health, Grosvenor Road, Belfast, UK.
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Panes O, Padilla O, Matus V, Sáez CG, Berkovits A, Pereira J, Mezzano D. Clot lysis time in platelet-rich plasma: method assessment, comparison with assays in platelet-free and platelet-poor plasmas, and response to tranexamic acid. Platelets 2011; 23:36-44. [PMID: 21787173 DOI: 10.3109/09537104.2011.596957] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Fibrinolysis dysfunctions cause bleeding or predisposition to thrombosis. Platelets contain several factors of the fibrinolytic system, which could up or down regulate this process. However, the temporal relationship and relative contributions of plasma and platelet components in clot lysis are mostly unknown. We developed a clot lysis time (CLT) assay in platelet-rich plasma (PRP-CLT, with and without stimulation) and compared it to a similar one in platelet-free plasma (PFP) and to another previously reported test in platelet-poor plasma (PPP). We also studied the differential effects of a single dose of tranexamic acid (TXA) on these tests in healthy subjects. PFP- and PPP-CLT were significantly shorter than PRP-CLT, and the three assays were highly correlated (p < 0.0001). PFP- and PPP-, but more significantly PRP-CLT, were positively correlated with age and plasma PAI-1, von Willebrand factor, fibrinogen, LDL-cholesterol, and triglycerides (p < 0.001). All these CLT assays had no significant correlations with platelet aggregation/secretion, platelet counts, and pro-coagulant tests to explore factor X activation by platelets, PRP clotting time, and thrombin generation in PRP. Among all the studied variables, PFP-CLT was independently associated with plasma PAI-1, LDL-cholesterol, and triglycerides and, additionally, stimulated PRP-CLT was also independently associated with plasma fibrinogen. A single 1 g dose of TXA strikingly prolonged all three CLTs, but in contrast to the results without the drug, the lysis times were substantially shorter in non-stimulated or stimulated PRP than in PFP and PPP. This standardized PRP-CLT may become a useful tool to study the role of platelets in clot resistance and lysis. Our results suggest that initially, the platelets enmeshed in the clot slow down the fibrinolysis process. However, the increased clot resistance to lysis induced by TXA is overcome earlier in platelet-rich clots than in PFP or PPP clots. This is likely explained by the display of platelet pro-fibrinolytic effects. Focused research is needed to disclose the mechanisms for the relationship between CLT and plasma cholesterol and its potential pathophysiologic and clinical relevance.
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Affiliation(s)
- Olga Panes
- Department of Hematology-Oncology, School of Medicine, P. Catholic University of Chile, Santiago, Chile
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Brien SE, Ronksley PE, Turner BJ, Mukamal KJ, Ghali WA. Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies. BMJ 2011; 342:d636. [PMID: 21343206 PMCID: PMC3043110 DOI: 10.1136/bmj.d636] [Citation(s) in RCA: 515] [Impact Index Per Article: 39.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2010] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To systematically review interventional studies of the effects of alcohol consumption on 21 biological markers associated with risk of coronary heart disease in adults without known cardiovascular disease. DESIGN Systematic review and meta-analysis. DATA SOURCES Medline (1950 to October 2009) and Embase (1980 to October 2009) without limits. STUDY SELECTION Two reviewers independently selected studies that examined adults without known cardiovascular disease and that compared fasting levels of specific biological markers associated with coronary heart disease after alcohol use with those after a period of no alcohol use (controls). 4690 articles were screened for eligibility, the full texts of 124 studies reviewed, and 63 relevant articles selected. RESULTS Of 63 eligible studies, 44 on 13 biomarkers were meta-analysed in fixed or random effects models. Quality was assessed by sensitivity analysis of studies grouped by design. Analyses were stratified by type of beverage (wine, beer, spirits). Alcohol significantly increased levels of high density lipoprotein cholesterol (pooled mean difference 0.094 mmol/L, 95% confidence interval 0.064 to 0.123), apolipoprotein A1 (0.101 g/L, 0.073 to 0.129), and adiponectin (0.56 mg/L, 0.39 to 0.72). Alcohol showed a dose-response relation with high density lipoprotein cholesterol (test for trend P = 0.013). Alcohol decreased fibrinogen levels (-0.20 g/L, -0.29 to -0.11) but did not affect triglyceride levels. Results were similar for crossover and before and after studies, and across beverage types. CONCLUSIONS Favourable changes in several cardiovascular biomarkers (higher levels of high density lipoprotein cholesterol and adiponectin and lower levels of fibrinogen) provide indirect pathophysiological support for a protective effect of moderate alcohol use on coronary heart disease.
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Affiliation(s)
- Susan E Brien
- Department of Community Health Sciences, Faculty of Medicine, Calgary Institute for Population and Public Health, University of Calgary, Alberta, Canada T2N 4Z6
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Affiliation(s)
- Francesco Violi
- Divisione I Clinica Medica, Università Sapienza, Viale del Policlinico 155, Roma, 00161, Italy.
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Abstract
The traditional Mediterranean diet, as studied in the 1950s to 1960s in the South of Europe, is characterized by moderate energy intake, low animal fat, high olive oil, high cereals, high legumes, nuts and vegetables, and regular and moderate wine. A Mediterranean-type diet is being developed to mimic the traditional one and fit with present life style. While numerous epidemiological studies have supported the concept that adherence to the traditional Mediterranean diet is beneficial for health and particularly protects against cardiovascular disease, the limited number of intervention studies in this field have not yet provided major support. Nevertheless, the dietary interventions performed until now have demonstrated that adoption of a Mediterranean-type diet reduces several cardiovascular risk factors in subjects at risk (primary prevention) and/or cardiovascular events or mortality in patients after a first cardiac event (secondary prevention). Among numerous foodstuffs characterizing the Mediterranean diet, virgin olive oil has been shown to display beneficial effects on a wide range of risk factors.
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Affiliation(s)
- Denis Lairon
- INSERM U476, Human Nutrition and Lipids, INRA, UMR 1260, Université de la Méditerranée, Faculté de Médecine, Marseille, France.
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Lopez-Miranda J, Delgado-Lista J, Perez-Martinez P, Jimenez-Gómez Y, Fuentes F, Ruano J, Marin C. Olive oil and the haemostatic system. Mol Nutr Food Res 2008; 51:1249-59. [PMID: 17879993 DOI: 10.1002/mnfr.200600307] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Interest in the Mediterranean diet (MD) has grown worldwide due to its link with greater longevity and lower cardiovascular disease rate, cancer and age cognitive decline. Despite the high complexity of its nutrients composition, olive oil emerges as its principal food, since it provides the higher percent of energy and a lot of bioactive compounds. In this review we will discuss the benefits of diets enriched in virgin olive oil, whose effects are probably due not only to its oleic acid content but also to its other potentially health-promoting components. Traditionally, the benefits of MD were linked to its effect on lipoprotein metabolism but today we realise that there exists a whole sheaf of other benefits, including the components of haemostasis: platelet function, thrombogenesis and fibrinolysis. A diet enriched in virgin olive oil can reduce the sensitivity of platelets to aggregation, decreasing von Willebrand and tromboxane B2 plasma levels. Moreover a particular interest has arisen about its capacity to decrease fasting Factor VII plasma levels and to avoid or modulate its postprandial activation. Also Tissue Factor expression in mononuclear cells could be reduced with the chronic intake of virgin olive oil and finally, studies performed in different experimental situation have shown that it could also increase fibrinolytic activity, reducing plasma concentration of Plasma Activator Inhibitor type-1.
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Affiliation(s)
- Jose Lopez-Miranda
- Lipid and Arteriosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain.
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Serra-Majem L, Roman B, Estruch R. Scientific evidence of interventions using the Mediterranean diet: a systematic review. Nutr Rev 2006; 64:S27-47. [PMID: 16532897 DOI: 10.1111/j.1753-4887.2006.tb00232.x] [Citation(s) in RCA: 345] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The Mediterranean Diet has been associated with greater longevity and quality of life in epidemiological studies, the majority being observational. The application of evidence-based medicine to the area of public health nutrition involves the necessity of developing clinical trials and systematic reviews to develop sound recommendations. The purpose of this study was to analyze and review the experimental studies on Mediterranean diet and disease prevention. A systematic review was made and a total of 43 articles corresponding to 35 different experimental studies were selected. Results were analyzed for the effects of the Mediterranean diet on lipoproteins, endothelial resistance, diabetes and antioxidative capacity, cardiovascular diseases, arthritis, cancer, body composition, and psychological function. The Mediterranean diet showed favorable effects on lipoprotein levels, endothelium vasodilatation, insulin resistance, metabolic syndrome, antioxidant capacity, myocardial and cardiovascular mortality, and cancer incidence in obese patients and in those with previous myocardial infarction. Results disclose the mechanisms of the Mediterranean diet in disease prevention, particularly in cardiovascular disease secondary prevention, but also emphasize the need to undertake experimental research and systematic reviews in the areas of primary prevention of cardiovascular disease, hypertension, diabetes, obesity, infectious diseases, age-related cognitive impairment, and cancer, among others. Interventions should use food scores or patterns to ascertain adherence to the Mediterranean diet. Further experimental research is needed to corroborate the benefits of the Mediterranean diet and the underlying mechanisms, and in this sense the methodology of the ongoing PREDIMED study is explained.
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Affiliation(s)
- Lluís Serra-Majem
- Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Spain.
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Abstract
PURPOSE OF REVIEW Polyphenols are the most abundant dietary antioxidants and research on their role in the prevention of degenerative diseases has developed quickly over these last few years. This paper reviews the recent studies on the prevention of cardiovascular diseases by polyphenols, focusing on human studies. RECENT FINDINGS A large number of recent intervention studies have shown that several biomarkers of cardiovascular risk are influenced by the consumption of polyphenol-rich foods. Effects on biomarkers of oxidative stress, lipemia and inflammation appear so far inconclusive. More consistent effects have been observed on endothelial function and haemostasis and support a reduction of risk by polyphenols in agreement with the few epidemiological studies already published. All clinical studies have used foods or beverages containing a mixture of different polyphenols and the exact nature of the most active compounds remains largely unknown. Absorption, metabolism and elimination vary widely between polyphenols. These data on bioavailability should be taken into account to improve the experimental design and the interpretation of the observed effects. SUMMARY Future intervention studies should include a detailed assessment of the bioavailability of polyphenols. Beyond clinical trials carried out with polyphenol-rich foods, more studies with pure polyphenols will also be needed to establish their role in the prevention of cardiovascular diseases.
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Affiliation(s)
- Claudine Manach
- Unité des Maladies Métaboliques et Micronutriments, INRA, 63122 Saint-Genès Champanelle, France
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Mezzano D, Leighton F. Haemostatic Cardiovascular Risk Factors: Differential Effects of Red Wine and Diet on Healthy Young. PATHOPHYSIOLOGY OF HAEMOSTASIS AND THROMBOSIS 2005; 33:472-8. [PMID: 15692263 DOI: 10.1159/000083848] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Two groups (21 healthy young male each) received either Mediterranean-type diet (MD) or high-fat diet(HFD) during 90 days. Between days 30-60, both diets were supplemented with 240 ml/day of red wine. MD alone was associated with: lower plasma fibrinogen (p=0.03), factor VIIc (p=0.034) and factor VIIIc (p=0.0057); higher levels of protein S (p=0.013); longer BT (p=0.017); and marginal increases in platelet serotonin aggregation and secretion after stimulation with epinephrine. Red wine supplementation in both diets, resulted in lower plasma fibrinogen (p=0.001) and factor VIIc (p=0.05), and in increased t-PA (p=0.01) and PAI-1 (p=0.0003). The effects of wine on antithrombin III (p=0.01) were divergent, with a decrease in the HFD group and an increase in the MD group. No effects of diet or wine were detected in plasma proteins C and S, BT or VWF:Ag. Wine supplementation also resulted in a significant increase in ex vivo platelet aggregation and secretion after stimulation with collagen (1 and 2 g/ml, p<=0.01).MD and moderate consumption of red wine have complementary,mostly beneficial effects on haemostatic CV risk factors. The longer BT in individuals on MD, independently of red wine, would denote less interaction of platelets with the vascular wall, which would be beneficial from the point of view of CV risk. However,the increased platelet aggregation/secretion after wine intake, possibly a "rebound" phenomenon, would be a risk factor for thrombosis.
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Affiliation(s)
- Diego Mezzano
- Department of Hematology-Oncology, School of Medicine, and Department of Cell and Molecular Biology, Faculty of Biological Sciences, P. Catholic University of Chile, Santiago, Chile.
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