Wine Intake in the Framework of a Mediterranean Diet and Chronic Non-Communicable Diseases: A Short Literature Review of the Last 5 Years

Insights into grape-derived health benefits: a comprehensive overview

Grapes, renowned for their diverse phytochemical composition, have long been recognized for their health-promoting properties. This narrative review aims to synthesize the current research on grapes, with a particular emphasis on their role in disease prevention and health enhancement through bioactive compounds.

A comprehensive review of peer-reviewed studies, including in vitro, in vivo, and clinical investigations, was conducted to elucidate the relationship between grape consumption and health outcomes. The review highlights the positive association of grape intake with a decreased risk of chronic diseases such as cardiovascular disease, type 2 diabetes, and certain cancers. Notable bioactive components like resveratrol are emphasized for their neuroprotective and antioxidative capabilities. Additionally, the review explores emerging research on the impact of grapes on gut microbiota and its implications for metabolic health and immune function.

This updated review underscores the importance of future research to fully leverage and understand the therapeutic potential of grape-derived compounds, aiming to refine dietary guidelines and functional food formulations. Further translational studies are expected to clarify the specific bioactive interactions and their impacts on health.

Graphical Abstract

The Potential Effects of Red Wine and Its Components on Neurocognitive Disorders: A Narrative Review

BACKGROUND

The aging population is associated with a net increase in the incidence and prevalence of chronic-degenerative diseases, particularly neurocognitive disorders. Therefore, the identification of preventative strategies to restrain the burden of such chronic conditions is of key relevance. Red wine and its components have accumulated evidence regarding their positive effects in terms of neurological pathologies associated with neurocognitive symptoms.

METHODS

Based on this background, the present narrative review aims to summarize the state-of-the-art evidence on the effects of red wine and its components on neurocognitive disorders in both preclinical and clinical settings.

RESULTS

The main findings highlight a protective effect of wine polyphenols present in red wine on dementia in different preclinical models of cognitive decline. The current translational clinical evidence remains uncertain, especially considering the risk-to-benefit ratio of alcohol consumption on brain health.

CONCLUSIONS

Given the overall health risks associated with red wine consumption and consistent with the prevailing guidelines in the literature, there is insufficient evidence to support light-to-moderate red wine consumption as an effective strategy for preventing these diseases. However, the largely preclinical findings on polyphenols derived from red wine remain of significant interest in this context.

Novel digital-based approach for evaluating wine components' intake: A deep learning model to determine red wine volume in a glass from single-view images

Estimation of wine components' intake (polyphenols, alcohol, etc.) through Food Frequency Questionnaires (FFQs) may be particularly inaccurate. This paper reports the development of a deep learning (DL) method to determine red wine volume from single-view images, along with its application in a consumer study developed via a web service. The DL model demonstrated satisfactory performance not only in a daily lifelike images dataset (mean absolute error = 10 mL), but also in a real images dataset that was generated through the consumer study (mean absolute error = 26 mL). Based on the data reported by the participants in the consumer study (n = 38), average red wine volume in a glass was 114 ± 33 mL, which represents an intake of 137-342 mg of total polyphenols, 11.2 g of alcohol, 0.342 g of sugars, among other components. Therefore, the proposed method constitutes a diet-monitoring tool of substantial utility in the accurate assessment of wine components' intake.

Antiplatelet Activity of Phenolic Compounds-Fortified Merlot Wine and Pure Phenolic Compounds

Red wines and their pomace are valuable sources of phenolic compounds (PCs), which have been proposed as potential contributors to their cardioprotective effect through the inhibition of platelet aggregation. The antiplatelet activity of an extract depends on its chemical composition, specifically the presence of certain phenolic compounds, as well as the interactions between them affecting biological activity. In order to assess the effect on platelet aggregation, we investigated the effect of the grape pomace PC enrichment of a Merlot wine, as well as the effect of the five major phenolic compounds present in wine extracts: caffeic acid, gallic acid, quercetin, epicatechin, and catechin. We analyzed how their combination influenced platelet aggregation. We found that the fortified wine sample with the highest PC content (W8) exhibited a potent antiplatelet effect in aggregation and platelet activation assays induced by the agonists TRAP-6, collagen, and ADP, with its activity being most potent against the latter agonist (78 ± 4%). Among the evaluated phenolic compounds, quercetin showed the highest antiplatelet potential against all three agonists studied, while gallic acid showed minimal antiplatelet effect. These findings suggest that the cardioprotective effect of wines is related to their chemical composition and the synergy among phenolic compounds. However, further research is required to fully understand the underlying mechanisms and clinical relevance of this activity.

Mediterranean lifestyle index and 24-h systolic blood pressure and heart rate in community-dwelling older adults

Specific foods, nutrients, dietary patterns, and physical activity are associated with lower blood pressure (BP) and heart rate (HR), but little is known about the joint effect of lifestyle factors captured in a multidimensional score. We assessed the association of a validated Mediterranean-lifestyle (MEDLIFE) index with 24-h-ambulatory BP and HR in everyday life among community-living older adults. Data were taken from 2,184 individuals (51% females, mean age: 71.4 years) from the Seniors-ENRICA-2 cohort. The MEDLIFE index consisted of 29 items arranged in three blocks: 1) Food consumption; 2) Dietary habits; and 3) Physical activity, rest, and conviviality. A higher MEDLIFE score (0-29 points) represented a better Mediterranean lifestyle adherence. 24-h-ambulatory BP and HR were obtained with validated oscillometric devices. Analyses were performed with linear regression adjusted for the main confounders. The MEDLIFE-highest quintile (vs Q1) was associated with lower nighttime systolic BP (SBP) (-3.17 mmHg [95% CI: -5.25, -1.08]; p-trend = 0.011), greater nocturnal-SBP fall (1.67% [0.51, 2.83]; p-trend = 0.052), and lower HR (-2.04 bpm [daytime], -2.33 bpm [nighttime], and -1.93 bpm [24-h]; all p-trend < 0.001). Results were similar for each of the three blocks of MEDLIFE and by hypertension status (yes/no). Among older adults, higher adherence to MEDLIFE was associated with lower nighttime SBP, greater nocturnal-SBP fall, and lower HR in their everyday life. These results suggest a synergistic BP-related protection from the components of the Mediterranean lifestyle. Future studies should determine whether these results replicate in older adults from other Mediterranean and non-Mediterranean countries.

Reduction of ethanol content in wine with an improved combination of yeast strains and process conditions

One interesting strategy to address the increasing alcohol content of wines, associated with climate change, is to reduce the ethanol yield during fermentation. Within this strategy, the approach that would allow the clearest reduction in alcohol content is the respiration of part of the grape sugars by yeasts. Non-Saccharomyces species can be used for this purpose but suffer from a limited ability to dominate the process and complete fermentation. In turn, Saccharomyces cerevisiae shows a high production of acetic acid under the growth conditions required for respiration. Previously proposed procedures used combinations of non-Saccharomyces and S. cerevisiae starters, or a strain of S. cerevisiae (PR1018), with unique metabolic properties. In both cases, precise management of oxygen availability was required to overcome the acetic acid problem. In this work, we have developed a laboratory scale process to take advantage of the properties of PR1018 and a strain of Metschnikowia pulcherrima. This process is more robust than the previous ones and does not rely on strict control of oxygenation or even the use of this particular strain of S. cerevisiae. Aeration can be interrupted instantly without impairing the volatile acidity. Under the selected conditions, an ethanol reduction of around 3% (v/v) was obtained compared to the standard fermentation control.

The interaction effects of pesticides with Saccharomyces cerevisiae and their fate during wine-making process

Pesticide residues in grapes could be transferred to fermentation system during the wine-making process, which may interfere the normal proliferation of Saccharomyces cerevisiae and subsequently affect the safety and quality of wine products. However, the interaction between pesticides and Saccharomyces cerevisiae is still poorly understood. Herein, the fate, distribution and interaction effect with Saccharomyces cerevisiae of five commonly-used pesticides during the wine-making process were evaluated. The five pesticides exerted varied inhibition on the proliferation of Saccharomyces cerevisiae, and the order of inhibition intensity was difenoconazole > tebuconazole > pyraclostrobin > azoxystrobin > thiamethoxam. Compared with the other three pesticides, triazole fungicides difenoconazole and tebuconazole showed stronger inhibition and played a major role in binary exposure. The mode of action, lipophilicity and exposure concentration were important factors in the inhibition of pesticides. Saccharomyces cerevisiae had no obvious impacts on the degradation of target pesticides in the simulated fermentation experiment. However, the levels of target pesticides and their metabolite were significantly reduced during the wine-making process, with the processing factors ranged from 0.030 to 0.236 (or 0.032 to 0.257) during spontaneous (or inoculated) wine-making process. As a result, these pesticides were significantly enriched in the pomace and lees, and showed a positive correlation (R² ≥ 0.536, n = 12, P < 0.05) between the hydrophobicity of pesticides and distribution coefficients in the solid-liquid distribution system. The findings provide important information for rational selection of pesticides on wine grapes and facilitate more accurate risk assessments of pesticides for grape processing products.

Health Effects of Red Wine Consumption: A Narrative Review of an Issue That Still Deserves Debate

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.

Comparison and Intercorrelation of Various Bentonite Products for Oenological Properties, Elemental Compositions, Volatile Compounds and Organoleptic Attributes of White Wine

Bentonite fining is one of the generally applied wine-making technological elements that may seriously affect wine components. The aim of this study was (i) to investigate the effect of 21 bentonite products on eight oenological parameters, 19 elements, 21 volatile organic compounds (VOCs) and 10 organoleptic properties of white wine; and (ii) to quantify intercorrelations among the parameters separately for each of the four quality attributes. Among oenological parameters, sugar, acidity, malic-, lactic-, citric acid and total phenol contents were significant among several bentonite products. The amounts of elements were the lowest in the control wine treatments (with exceptions of, e.g., Ni and Cu); and these values were significantly different from several bentonite products. The relative presence of the VOCs was above 100% for most VOCs, but it was below 100% for 1-propanol, 4-amino-1,5-pentandioic acid and butane-dioic acid, and diethyl ester in all treatments. For organoleptic parameters, the values of clearness, colour, flavour intensity and taste persistency was the lowest in the control wine treatment, while the values of flavour character, flavour quality, taste intensity, taste character, and overall harmony were the highest for the bentonite products of AP, EBE, M-SA, EBE, EBE, respectively. Results of correlation and factor analyses showed strong intercorrelative effects of bentonite fining on the four quality attributes. In conclusion, this study can help in the proper choice of a specific bentonite product in relation to complexity effects of bentonite fining.

Moderate Wine Consumption and Health: A Narrative Review

Although it is clearly established that the abuse of alcohol is seriously harmful to health, much epidemiological and clinical evidence seem to underline the protective role of moderate quantities of alcohol and in particular of wine on health. This narrative review aims to re-evaluate the relationship between the type and dose of alcoholic drink and reduced or increased risk of various diseases, in the light of the most current scientific evidence. In particular, in vitro studies on the modulation of biochemical pathways and gene expression of wine bioactive components were evaluated. Twenty-four studies were selected after PubMed, Scopus and Google Scholar searches for the evaluation of moderate alcohol/wine consumption and health effects: eight studies concerned cardiovascular diseases, three concerned type 2 diabetes, four concerned neurodegenerative diseases, five concerned cancer and four were related to longevity. A brief discussion on viticultural and enological practices potentially affecting the content of bioactive components in wine is included. The analysis clearly indicates that wine differs from other alcoholic beverages and its moderate consumption not only does not increase the risk of chronic degenerative diseases but is also associated with health benefits particularly when included in a Mediterranean diet model. Obviously, every effort must be made to promote behavioral education to prevent abuse, especially among young people.

Mediterranean Alcohol-Drinking Patterns and All-Cause Mortality in Women More Than 55 Years Old and Men More Than 50 Years Old in the "Seguimiento Universidad de Navarra" (SUN) Cohort

BACKGROUND

Most of the available epidemiological evidence on alcohol and chronic disease agrees on recommending alcohol abstention to young people, but some controversy exists about the most appropriate recommendation for alcohol abstention for people of older ages. A growing body of evidence suggests that the pattern of alcohol consumption is likely to be a strong effect modifier. The Mediterranean Alcohol Drinking Pattern (MADP) represents a score integrating several dimensions of drinking patterns (moderation, preference for red wine, drinking with meals, and avoiding binge drinking). Our aim was to clarify this issue and provide more precise recommendations on alcohol consumption.

METHODS

We prospectively followed-up 2226 participants (men older than 50 years and women older than 55 years at baseline) in the Seguimiento Universidad de Navarra (SUN) cohort. We classified participants into three categories of adherence to the MADP score (low, moderate, and high), and we added a fourth category for abstainers. Cox regression models estimated multivariable-adjusted hazard ratios (HR) of all-cause death and 95% confidence intervals (CI) using low MADP adherence as the reference category.

RESULTS

The strongest reduction in risk of mortality was observed for those with high adherence to the MADP, with an HR of 0.54 (95% CI: 0.37-0.80). The moderate adherence group (HR = 0.65, 95% CI: 0.44-0.96) and the abstention group (HR = 0.60, 95% CI: 0.36-0.98) also exhibited lower risks of mortality than the low MADP adherence group.

CONCLUSIONS

based on the available evidence, a public health message can be provided to people older than 50 years as follows: among those who drink alcohol, high adherence to the MADP score could substantially reduce their risk of all-cause mortality.

Mediterranean Diet Adherence in Community-Dwelling Older Adults in Spain: Social Determinants Related to the Family

The Mediterranean diet (MD), a well-established quality diet model, and regular physical activity are associated with reducing the appearance or progression of several chronic diseases and reducing morbidity and mortality. However, reduction of these goals, adherence to the MD, and regular physical activity occur at all ages, including older individuals in Mediterranean countries such as Spain, where at least adherence to the MD is culturally rooted. Objective: To evaluate the degree of adherence to the MD and physical activity in older individuals. Methods: The sample comprises 679 older adults aged 60 and over who attended activities in municipal centers for older adults in Valencia. Adherence to the Mediterranean diet, frequency of physical activity, and anthropometric assessment were used. Results: High adherence (score ≥ 9) to MD was observed only in 23.7% of the study sample. Smoking habits or having meals in fast-food restaurants on a weekly basis were significantly (p < 0.05) associated with lower MD adherence. Age, BMI, marital status, and physical activity were not significantly associated with MD adherence. Physical activity was significantly (p < 0.05) lower in individuals who were divorced or widow/ers and in those taking care of their grandchildren several times a week. Conclusions: Adherence to the MD in a big Spanish city is low among older individuals. Socio-family factors seem to play a role. Public health and governmental strategies should reinforce adherence to the MD among older individuals as a gold standard for nutrition.

The Impact of COVID-19 on Consumers’ Motives in Purchasing and Consuming Quality Greek Wine

In the rising post COVID-19 period the world is different not only from the economic point of view but also from the social and cultural point, including the selection of goods, and foods by the “new” customers. Wine is a major daily drink worldwide, affecting the lives of consumers worldwide. The aim of the study was to investigate the impact of COVID-19 on consumers’ motives for quality wine, namely the Greek wine and the local Samos’ Greek wine, assessing possible changes in their wine habits effecting current and future wine production, consumption, and sustainable regional development. Consumers’ motives were tested using variables of wine purchase and consumption (such as place of purchase, money spent, amount consumed, accompaniment meals), and preference for quality wine (such as traditional, appearance, organoleptic, sustainable, general characteristics). A self-response questionnaire survey was carried out in January and February 2022 on a sample of 1493 participants through the Google platform. Basic statistical tools, combined with cross and Chi-square tests were used in order to analyze the collected data. The results show interesting changes in consumers’ motives in the new rising global era. The participants buy less from supermarket (−4.2%), more via online (+1.8%) and equally from other places, the majority one bottle per month spending 10 to 20 euros today. They consume less wine (−5.1%), the majority one bottle per month, preferable at home (+6%), with friends (+1.6%), rather than at the restaurant (−8.2%), the club/bar (−8.9%), the night club (−5.8%), or during celebration (−3.2%). They continue to prefer the “red with red, white to white” accompaniments with meals. They select quality wines based on the conventional variables with emphasis to the taste (94.5%), aroma (83.9%), value for money (72.8%). The participants expressed similar motives for the quality Samos’ wines. However, even though they are aware of its high quality (92.9%), only 53% of them have tasted them, and fewer are consuming then occasionally (32.3%). Our findings indicate that the sustainability, and growth of the quality wine in the new socioeconomic era, should focus on the easy access (including on line), the consumption at home, with friends and family, keeping the same preferences between different kinds of wine with the different meals for the consumers.

Determinants of Choice and Wine Consumption Behaviour: A Comparative Analysis between Two Counties of Romania

Wine, one of the world’s oldest and most popular beverages, has a distinct variety matching a diverse base of consumers worldwide. The study was conducted in two counties of Romania in order to identify consumers’ perception towards wine consumption, as well as the driving factors behind wine consumption and the decision process of choosing a certain type of wine. Thus, four factors were identified through principal component analysis: intrinsic cues and consumers’ experience, extrinsic cues and origin, notoriety and the label and package of the wine, correlating them with the socio-demographic characteristics of our respondents. It might be concluded that the intrinsic cues and consumer experience ranked highest among the priorities of the participants between 35 and 45 years old when choosing a certain type of wine. Additionally, notoriety was more valued by people with higher income, and people with experience in the domain inclined to pay more for a bottle of wine.

Alcohol Consumption by Italian and Spanish University Students in Relation to Adherence to the Mediterranean Diet and to the Food Neophobia: A Pilot Study

This work aimed to relate alcohol consumption with adherence to the Mediterranean diet (MD) and with food neophobia (FN) among Italian and Spanish university students. Volunteers (n = 194, 108 Italian and 86 Spanish), recruited at the La Sapienza University of Rome and the Catholic University of Murcia, filled in standardized questionnaires to evaluate alcohol consumption (AUDIT), FN (FN Scale: FNS), and adherence to the MD (MDS-14, MED-55, QueMD). In addition to the previously reported QueMD sub-score (aMED), a sub-score for non-typical MD foods (ntMED, carbonated and/or sugar-sweetened beverages (soft drinks), butter, margarine, or cooking cream, and manufactured sweets, pastries, and cakes) was evaluated. Italian females had higher MED-55 and FNS scores, and a lower AUDIT score than Spaniards (p < 0.01). Students who stayed with their family (resident) were more adherent to MD than those who moved away from home. Resident Italians consumed less beer, hard liquors, and cocktails than Spaniards on Saturday nights (p < 0.01). There were negative correlations between AUDIT and QueMD (R squared: 0.137, p < 0.05), and AUDIT and ntMED (R squared: 0.201, p < 0.01) in Spaniards, however, there was no relationship between AUDIT and other MD scores. In conclusion, this pilot study suggests that non-typical MD foods and Saturday night consumptions, related to being far from home, have a great impact on alcohol consumption.

Does Having a Usual Primary Care Provider Reduce Polypharmacy Behaviors of Patients With Chronic Disease? A Retrospective Study in Hubei Province, China

Background: Within China's hierarchical medical system, many patients seek medical care in different hospitals independently without integrated management. As a result, multi-hospital visiting is associated with fragmented service utilization and increased incidence of polypharmacy behaviors, especially for patients with chronic disease. It has been confirmed that factors from the perspective of patients may cause polypharmacy behaviors in Chinese community patients; whether having a usual primary care provider for chronic disease patients could reduce the polypharmacy behaviors and the effect size remains unanswered, and that is what our study aimed to answer.

Methods: Our study adopted a cluster sampling method to select 1,196 patients with hypertension or diabetes and measured some information about them. The propensity score weighting method was adopted to eliminate the influence of confounding bias, and then a multivariate logistic regression model was conducted to test the relationship between having a usual primary care provider and polypharmacy behaviors.

Results: Patients without usual primary care providers were significantly correlated with polypharmacy behaviors (OR = 2.40, 95%CI: 1.74–3.32, p < 0.001), and the corresponding marginal effect is 0.09 (95%CI: 0.06–0.12). Patients who suffer from two kinds of diseases (OR = 3.05, 95%CI: 1.87–5.10, p < 0.001), with more than three kinds of diseases (OR = 21.03, 95%CI: 12.83–35.65, p < 0.001), with disease history of 20 years and above (OR = 1.66, 95%CI: 1.14–2.42, p = 0.008), who communicate frequently with doctors (OR = 3.14, 95%CI: 1.62–6.19, p < 0.001), alcoholic patients (OR = 2.14, 95%CI: 1.08–4.19, p = 0.027), who used to have meat-based food (OR = 1.42, 95%CI: 1.00–2.00, p = 0.049), and have vegetarian-based diet (OR = 1.42, 95%CI: 1.00–2.00, p = 0.049) are more likely to have polypharmacy behaviors, while patients aged between 65 and 75 years (OR = 0.50, 95%CI: 0.33–0.77, p = 0.020), used to be brain workers (OR = 0.67, 95%CI: 0.45–0.99, p = 0.048), with disease history between 10 and 20 years (OR = 0.56, 95%CI: 0.37–0.83, p = 0.005), have had adverse drug reactions (OR = 0.64, 95%CI: 0.45–0.93, p = 0.019), and participated in medical insurance for urban and rural residents (OR = 0.35, 95%CI: 0.21–0.58, p < 0.001) were less likely to have polypharmacy behaviors.

Conclusion: The results suggest that having a usual primary care provider may reduce the incidence of having polypharmacy behaviors; we can take intervention measures to promote establishing a long-term relationship between patients and primary care providers.

Adherence to Mediterranean Diet and Tendency to Orthorexia Nervosa in Professional Athletes

Among many lifestyle components that professional athletes have to follow, nutrition is gradually growing to be one of the key factors for achieving and maintaining optimal sport performance. The Mediterranean diet (MD) is recognized as one of the healthiest dietary patterns worldwide; however, data regarding adherence to the MD among professional athletes are still scarce. Moreover, with the imposed need for a healthy diet among professional athletes, orthorexia nervosa (ON) could become a rising issue. This cross-sectional study included 150 professional athletes and 150 matched recreational athletes from Croatia. Four questionnaires were used for the assessment: general information, a test for the diagnosis of ON (ORTO-15), the International Physical Activity Questionnaire (IPAQ) and the Mediterranean Diet Serving Score (MDSS). Significantly more professional athletes were adherent to the MD (p < 0.001) and had a tendency to ON (p < 0.001). Moreover, there was a significant negative correlation between the ORTO-15 score and the total MET min/week score (r = −0.524, p < 0.001) and a significant positive correlation between the MDSS score and the total MET min/week score in the professional athlete group (r = 0.478, p < 0.001). All of these results imply that professional athletes are more concentrated on their dietary patterns than recreational athletes, and that due to this dedication, they possibly have a higher adherence to the MD but also possibly a higher risk for developing ON. However, the association between ON and the MD should be further addressed in the future.

Association between the Mediterranean Diet Score and Healthy Life Expectancy: A Global Comparative Study

OBJECTIVES

Extending healthy life expectancy (HALE), defined as the average number of years that a person can expect to live in "full health" by taking into account years lived in less than full health due to disease and/or injury, is a common topic worldwide. This study aims to clarify the relationships between the Mediterranean diet score (MDS) and life expectancy (LE) and HALE globally using publicly available international data.

SETTING

Analyses were conducted on 130 countries with populations of 1 million or more for which all data were available. Individual countries were scored from 0 to 9 to indicate adherence to the Mediterranean diet according to the MDS scoring method. The supply of vegetables, legumes, fruits and nuts, cereals, fish, and olive oil per 1,000 kcal per country was calculated based on the Food and Agriculture Organization Corporate Statistical Database, with a score of 1 for above the median and 0 for below. The same method was used to calculate scores of presumed detrimental components (meat and dairy), with consumption below the median given a value of 1, and consumption above the median given a value of 0. For ethanol, a score of 1 was given for 10g to 50 g of consumption. We investigated the cross-sectional associations between the MDS and LE and HALE at birth in 2009, and the longitudinal associations between the MDS in 2009 and LE and HALE between 2009 and 2019, controlling for covariates at baseline using linear mixed models.

RESULTS

In the cross-sectional analysis, the MDS was significantly positively associated with LE (β=0.906 [95% confidence interval, 0.065-1.747], p=0.037) and HALE (β=0.875 [0.207-1.544], p=0.011) after controlling for all covariates. The longitudinal analysis also revealed significantly positive associations between the MDS and LE (0.621 [0.063-1.178], p=0.030) and HALE (0.694 [0.227-1.161], p=0.004) after controlling for all covariates.

CONCLUSION

The present study, based on an analysis using 10 years of international data, showed that countries with a higher MDS showed a positive association with HALE.

Cardiovascular Effects of Chocolate and Wine-Narrative Review

The consumption of food for pleasure is mainly associated with adverse health effects. This review was carried out to verify recent reports on the impact of chocolate and wine consumption on cardiovascular health, with a particular focus on atherosclerosis. On one side, these products have proven adverse effects on the cardiovascular system, but on the other hand, if consumed in optimal amounts, they have cardiovascular benefits. The submitted data suggest that the beneficial doses are 30–50 g and 130/250 mL for chocolate and wine, respectively, for women and men. The accumulated evidence indicates that the active ingredients in the products under consideration in this review are phenolic compounds, characterized by anti-inflammatory, antioxidant, and antiplatelet properties. However, there are also some reports of cardioprotective properties of other compounds such as esters, amines, biogenic amines, amino acids, fatty acids, mineral ingredients, and vitamins. Our narrative review has shown that in meta-analyses of intervention studies, consumption of chocolate and wine was positively associated with the beneficial outcomes associated with the cardiovascular system. In contrast, the assessment with the GRADE (Grading of Recommendations Assessment, Development and Evaluation) scale did not confirm this phenomenon. In addition, mechanisms of action of bioactive compounds present in chocolate and wine depend on some factors, such as age, sex, body weight, and the presence of additional medical conditions. Patients using cardiovascular drugs simultaneously with both products should be alert to the risk of pharmacologically relevant interactions during their use. Our narrative review leads to the conclusion that there is abundant evidence to prove the beneficial impact of consuming both products on cardiovascular health, however some evidence still remains controversial. Many authors of studies included in this review postulated that well-designed, longitudinal studies should be performed to determine the effects of these products and their components on atherosclerosis and other CVD (Cardiovascular Disease) disease.

Effects of Wine Components in Inflammatory Bowel Diseases

With the rising prevalence of Inflammatory bowel disease (IBD) worldwide, and the rising cost of treatment with novel biological drugs, there is an increasing interest in various diets and natural foods as a potential way to control/modulate IBD. As recent data indicates that diet can modify the metabolic responses essential for the resolution of inflammation, and as wine compounds have been shown to provide substantial anti-inflammatory effect, in this review we aimed to discuss the current evidence concerning the impact of biological compounds present in wine on IBD. A number of preclinical studies brought forth strong evidence on the mechanisms by which molecules in wine, such as resveratrol or piceatannol, provide their anti-inflammatory, anti-oxidative, anti-tumor, and microbiota-modulation effects. However, concerning the effects of alcohol, it is still unclear how the amount of ethanol ingested within the framework of moderate wine consumption (1–2 glasses a day) affects patients with IBD, as human studies regarding the effects of wine on patients with IBD are scarce. Nevertheless, available evidence justifies the conductance of large-scale RCT trials on human subjects that will finally elucidate whether wine can offer real benefits to the IBD population.

Effect of red wine or its polyphenols on induced apical periodontitis in rats

AIM

To evaluate the effect of red wine consumption or its polyphenols on the inflammation/resorption processes associated with apical periodontitis in rats.

METHODOLOGY

Thirty-two three-month-old Wistar rats had apical periodontitis induced in four first molars and were then arranged into four groups: control (C)-rats with apical periodontitis; wine (W)-rats with apical periodontitis receiving 4.28 ml/kg of red wine; resveratrol+quercetin (R+Q)-rats with apical periodontitis receiving 4.28 ml/kg of a solution containing 1.00 mg/L of quercetin and 0.86 mg/L of resveratrol and alcohol (ALC)-rats with apical periodontitis receiving the alcoholic dose contained in the wine. The oral gavage treatments were administered daily, from day 0 to day 45. On the 15th day, apical periodontitis was induced, and on the 45th day, the animals were euthanized. Histological, immunohistochemical (RANKL, OPG, TRAP, IL-10, TNF-⍺ and IL-1β) and micro-computed tomography for bone resorption analysis were performed in the jaws. The Kruskal-Wallis with Dunn's test was performed for nonparametric data, and the anova with Tukey's test for parametric data, p < .05.

RESULTS

The median score of the inflammatory process was significantly lower in the R+Q group (1) compared to the C (2) (p = .0305) and ALC (3) (p = .0003) groups, and not different from the W (1.5) group. The immunolabeling for OPG was significantly higher in the R+Q group (p = .0054) compared to all groups; the same was observed for IL-10 (p = .0185), different from groups C and ALC. The R+Q group had the lowest TRAP cell count (p < .0001), followed by the W group, both inferior to C and ALC groups. The lowest bone resorption value was in the R+Q group (0.50mm³  ± 0.21mm³ ), significantly lower (p = .0292) than the C group (0.88mm³  ± 0.10mm³ ). The W group (0.60 mm³  ± 0.25 mm³ ) and R+Q group had less bone resorption compared to the ALC group (0.97 mm³  ± 0.22 mm³ ), p = .0297 and p = .0042, respectively.

CONCLUSION

Red wine administration to rats for 15 days before induction of apical periodontitis decreased inflammation, TRAP marking and periapical bone resorption compared to alcohol. Resveratrol-quercetin administration reduced the inflammatory process in apical periodontitis, periapical bone resorption, and altered the OPG, IL-10 and TRAP expression compared to C and ALC groups.

Cross-sectional and longitudinal associations between adherence to Mediterranean diet with physical performance and cognitive function in older adults: A systematic review and meta-analysis

OBJECTIVES

The present study investigated the association between adherence to Mediterranean diet (MeDi) and physical performance and cognitive function in older adults.

METHODS

We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated older adults aged 60+ years and assessed adherence to MeDi diet using validated composite scores. Observational studies, including cross-sectional, case-control, and longitudinal cohort studies, if crude baseline data was available, which investigated as a primary or secondary outcome the association of MeDi diet adherence with physical performance and/or cognitive function in non-demented older adults were included in the cross-sectional analysis. For the longitudinal analysis, case-control and longitudinal cohort studies that investigated the longitudinal associations between adherence to MeDi diet with the incidence of mild cognitive impairment (MCI), dementia, and/or Alzheimer's disease (AD), and/or changes in physical performance and cognition in non-demented older adults were included. Studies published in other languages than English were excluded. Studies were retrieved from MEDLINE, SCOPUS, CINAHL, and AgeLine databases until May 19, 2021. The risk of bias was evaluated using the Newcastle - Ottawa Quality Assessment Scale (NOS). A pooled effect size was calculated based on standard mean differences (SMD), log odds ratio (OR) and log risk ratio (RR). This study is registered on PROSPERO (CRD42021250254).

RESULTS

Nineteen cross-sectional studies that investigated 19.734 community-dwelling and institutionalized older adults free of disability and dementia were included. A high adherence to MeDi was cross-sectionally associated with better walking speed (SMD = 0.42; 95 % Confidence Interval (CI) = 0.12-0.72, P = 0.006; I² = 65 %, P = 0.06), knee muscle strength speed (SMD = 0.26; 95 % CI = 0.17-0.36, P < 0.00001; I² = 0 %, P = 0.69), global cognition (SMD = 0.24; 95 % CI = 0.15-0.33, P < 0.00001; I² = 85 %, P < 0.00001), and memory (SMD = 0.18; 95 % CI = 0.13-0.25, P < 0.00001; I² = 100 %, P < 0.00001). The association between MeDi adherence and global cognition remained significant after stratifying the analysis by the region where the study was conducted, MeDi diet adherence composite score, and Mini Mental State Examination (MMSE). Studies had a moderate to low risk of bias. In relation to longitudinal analysis, thirty-four prospective studies with an average follow-up period that varied from 3.0 to 12.6 years and investigated 98.315 community-dwellers were included. Results indicated that older adults with high MeDi scores had a lower decline in global cognition RR = 0.26; 95 % CI = 0.23-0.29, P < 0.00001; I² = 100 %, P < 0.00001). In contrast, no significant associations between MeDi and mobility, MCI, dementia were found. A low risk of bias was found in the longitudinal studies.

DISCUSSION

Findings of the present study indicated that high adherence to MeDi was cross-sectionally associated with physical performance and cognitive function. Results of the pooled analysis of longitudinal studies revealed that high adherence to MeDi reduced the risk of global cognitive decline in non-demented older adults. However, no significant associations between MeDi adherence and the incidence of mobility problems, MCI, and dementia were found. Although important, our findings should be carefully interpreted due to the presence of heterogeneity and publication bias.

Polyphenol-Rich and Alcoholic Beverages and Metabolic Status in Adults Living in Sicily, Southern Italy

Polyphenol-rich beverage consumption is not univocally accepted as a risk modulator for cardio-metabolic risk factors, despite mechanistic and epidemiological evidence suggesting otherwise. The aim of this study was to assess whether an association between polyphenol-rich beverage consumption and metabolic status could be observed in a Mediterranean cohort with relatively low intake of tea, coffee, red and white wine, beer, and fresh citrus juice. Demographic and dietary characteristics of 2044 adults living in southern Italy were analyzed. Multivariate logistic regression analyses were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of the association between polyphenol-rich and alcoholic beverage consumption and metabolic status adjusted for potential confounding factors. Specific polyphenol-rich beverages were associated, to a various extent, with metabolic outcomes. Individuals with a higher total polyphenol-rich beverages had higher polyphenols intake and were less likely to have hypertension, type-2 diabetes, and dyslipidemia (OR = 0.57, 95% CI: 0.44–0.73; OR = 0.41, 95% CI: 0.26–0.66; and OR = 0.41, 95% CI: 0.29–0.57, respectively). However, when adjusted for potential confounding factors, only the association with hypertension remained significant (OR = 0.69, 95% CI: 0.50–0.94). Current scientific evidence suggests that such beverages may play a role on cardio-metabolic risk factors, especially when consumed within the context of a dietary pattern characterized by an intake of a plurality of them. However, these associations might be mediated by an overall healthier lifestyle.

Elemental Analysis and Phenolic Profiles of Selected Italian Wines

The study of the chemical composition of wines is nowadays a topic of great interest because of the importance of this market, especially in Italy, and also considering the numerous cases of falsification of famous and very expensive wines. The present paper focused on the analysis of metals and polyphenols in Italian wines belonging to different provenance and types. At this purpose 20 elements were quantified by inductively coupled plasma optical emission spectrometry (ICP-OES) and ICP mass spectrometry (ICP-MS). Regarding polyphenols, a total of 32 were quantified, among 6 were anthocyanins. Furthermore, in 4 samples (1 rosè and 3 red wines) 42 anthocyanins and related compounds were identified by ultra-high performance liquid chromatography (UHPLC)-Orbitrap MS technique (among these, 6 were also quantified). Non-anthocyanins were determined using UHPLC coupled with a diode array detector and triple-quadrupole mass spectrometer (UHPLC-DAD-QqQ-MS). Total phenolic content (TPC) and radical scavenging activity (RSA) were measured using spectrophotometric methods. The results obtained by elemental techniques were submitted to principal components analysis (PCA) allowing to get information on both geographical and botanical origin of the examined wine samples. Some polyphenols have been detected in higher concentrations only in a certain type of wine, as for example in the case of Grechetto wine. Most of the identified anthocyanin derivatives (pyranoanthocyanins) are formed during the aging of wine by reaction with the other wine components.