Benefits and Shortcomings of Wine Consumption

CHIȚU Roxana Florentina1, DOMILESCU Georgia1, MITITELU Magdalena1*, NEACȘU Sorinel Marius1, HÎNCU Lucian2

1Clinical Laboratory and Food Hygiene Department, Faculty of Pharmacy, ”Carol Davila” University of Medicine and Pharmacy, 6, Traian Vuia Street, 020956, Bucharest (ROMANIA)

2Pharmaceutical Industry, Faculty of Pharmacy, ”Carol Davila” University of Medicine and Pharmacy, 6, Traian Vuia Street, 020956, Bucharest (ROMANIA)

*corresponding author: magdamititelu@yahoo.com

Abstract

     Wine is an alcoholic beverage resulting from the fermentation of sugar from certain organic substrates. The process of making wine is called winery. Wine has a variable concentration of water, alcohol, and phenolic compounds, of which tannins, resveratrol and quercetin have been the most studied. These polyphenols have positive effects on cardiac functions and the prevention of cardiovascular diseases, by modulating the cellular and molecular mechanisms that lead to anti-inflammatory, antioxidant and hypotensive responses. Some of these mechanisms have been widely described and explored in therapeutic and preventive approaches for cardiovascular disease. We cannot ignore the fact that pure alcohol is harmful to health, however numerous studies have shown the beneficial effects of wine and its components when consumed in moderation. Plenty of scientifically argued information suggests the need for low to moderate consumption of wine as part of a healthy lifestyle.

Keywords: wine, phenolic compounds, resveratrol, biogenic amines

Introduction

     Wine is one of the oldest drinks in the world. There is ample archaeological evidence that it has been consumed since 6,000 BC in Georgia, Iran, Greece, and Armenia. The best known substrate for making wine is grapes, but there are also wines obtained by fermenting other substrates rich in sugars such as other fruits (blueberries, pineapples, bananas, currants, apples, blackberries, plums, pomegranates, shock, cherries, raspberries) as well as cereals (rice) but also honey (the alcoholic product called mied) or mare’s milk (called kumis in the steppes of Central Asia) [1].

     The phytochemical content of grapes from all varieties is related to the environmental conditions, but the level of the wine compounds is influenced by the practices of viticulture, variety, as well as the way of processing the grapes [2,3,4].

      The compounds found in wines of interest in terms of health after consumption, in addition to water, alcohol and sugars are: phenolic acids (p-coumarinic, cinnamic, caffeic, gentisic, ferulic, vanillic), tri-hydroxy stilbene ( resveratrol and polydatin), flavonoids (anthocyanins, catechin, epicatechin, myricetin, campferol, quercetin), biogenic amines (histamine, tyramine, cadaverine, 2-phenyl-ethyl-amine, putrescine, agmatine and ethanol-amine may be abundant, but in are rarely researched), aflatoxins with carcinogenic effects (ochratoxin A – OTA), fungicides, insecticides, fertilizers in wine after treatment of vineyards with these substances, preservatives, clarifiers, residues from cleaning wooden containers in which wine is stored or of wine processing and bottling facilities (sulphites, bentonite, 2,4,6 tribromophenol and derivatives), etc [5,6].

     Non-flavonoid compounds such as hydroxy-benzoic acids, hydroxy-cinnamic acids and stilbenes add up to 40% of the total phenolic acids and polyphenols. Flavonoids account for the remaining 60%. The total amount of polyphenols in red wine varies between 2000-6000 mg / L. The main polyphenolic compounds found in red wine are flavonoids, anthocyanins and resveratrol. Flavonoids represent about 85% of phenolic compounds and include different molecular families such as flavonols (eg monomers – catechin, epicatechin; oligomeric, polymeric – proanthocyanins), flavones and anthocyanins [6,7].

     Anthocyanins are found in the largest proportion in the flavonoid fraction. An increased amount of these compounds is found in the skin and kernels of grapes. Thus, the longer the contact time of the must with the skins and kernels of the grapes during the fermentation process, the higher the flavonoid content. That is why red wine contains these compounds in larger quantities than white wine [5,8].

The health effects of wine consumption

     Wine polyphenols have positive effects on cardiac function and the prevention of cardiovascular diseases, by modulating the cellular and molecular mechanisms that lead to anti-inflammatory, antioxidant and hypotensive responses. Some of these mechanisms have been extensively described and explored in therapeutic and preventive approaches to cardiovascular disease. Red wine is one of the most powerful aphrodisiacs known and can improve libido, but consumed in large quantities has the complete opposite effect. A group of Italian researchers found that red wine increases women’s libido more than other drinks, because it stimulates blood circulation in women’s erogenous zones. For men, red wine increases blood testosterone levels [7].

     According publication STATISTICAL REPORT ON WORLD VITIVINICULTURE from 2019 (OIV-2019), 292 mhl is the global wine production in 2018 and 246 mhl is the world consumption of wine in 2018. Global wine production distributed on the main producing countries is presented in figure 1.

Fig. 1. Global wine production in 2019 (source oiv-2019-statistical-report-on-world-vitiviniculture.pdf)

     Low to moderate alcohol consumption can have health benefits. Chronic administration of low doses of alcohol can increase HDL-cholesterol levels and decrease LDL-cholesterol oxidation. In fact, the amount of alcohol ingested is closely related to the production of ROS (reactive oxygen species) and the harmful effects of these species. Thus, a low concentration is essential for the physiological degradation of polyunsaturated fatty acids, but high concentrations of ROS can cause damage to cellular components, leading to endothelial dysfunction and other conditions. Excessive alcohol consumption can lead to lipid peroxidation, in which reactive oxygen species damage cell membranes, sometimes irreversibly. Alcohol stimulates the activity of cytochrome P450 and alters the levels of some metals in the body, contributing to the production of ROS. In tissues, the exacerbated generation of ROS triggers an inflammatory response that affects homeostasis and culminates in tissue damage and the installation of various diseases. In this context, the negative effects of alcohol have been well described, especially on the liver, causing severe liver disease [7,8,9].

     Wine contains a multitude of compounds that act as antioxidants and antiplatelet agents or molecules with effects on metabolic processes, with anti-proliferative, chemoprotective, immunomodulatory action. Thus, light to moderate consumption of wine can have beneficial effects on health. In vitro and preclinical modeling studies have shown the association between wine polyphenols and the activation of antioxidant and anti-inflammatory mechanisms. Flavonoids, in particular quercetin, catechins, tannins and resveratrol act on free radicals, inflammation, tumors, hepato-toxins, inhibit platelet aggregation, reduce cardiovascular disease and the risk of heart attack. In addition, these molecules, present in almost all varieties of red wine, have their own action in the cells and tissues adjacent to blood vessels, especially in the endothelium. In addition to the effects already mentioned, they have a direct role in reducing cell proliferation, an action that can be exploited in anticancer therapy [6,7,8].

     Clinical studies have been performed on both healthy volunteers and individuals with chronic diseases (dyslipidemia, hypertension, type 2 diabetes, metabolic syndrome and coronary heart disease) to determine the effects of wine consumption on the parameters that characterize inflammation and cardiovascular function. However, it is important to note that these effects depend on the bioavailability of phenolic compounds that can be influenced by many factors, such as the environment, food processing, dietary factors (presence of absorption effects, such as foods high in vegetable fibers  and fats), interactions with other compounds (polyphenols with similar mechanism of action), the chemical structure of polyphenols and their concentration in foods and factors related to the host (enzymatic activity in the intestine, transit and microbiota, age, sex, associated pathology). At patients with dyslipidemia, a significant trend was observed in decreasing the ratio of LDL / HDL levels after moderate consumption of red wine for 30 days. In postmenopausal women with hypercholesterolemia, moderate chronic consumption of red wine significantly reduced LDL cholesterol levels by 8% and increased HDL cholesterol levels by 17%. Apolipoprotein A1 and A2 and HDL cholesterol also increased in men at high cardiovascular risk who consumed about 30g of red wine alcohol/day for 4 weeks [10-15].

     Clinical trials performed on patients consuming white wine did not show significant changes in the lipid profile because white wine contains a lower amount of phenolic compounds than red wine. Unabsorbed polyphenols and/or phenolic metabolites resulting from wine ingestion could influence the growth of the intestinal microbiota, thus altering their diversity and metabolic activity, stimulating the growth of beneficial bacteria and inhibiting pathogenic bacteria. Moderate consumption of wine can produce positive effects on health through the appearance of bioactive polyphenols and due to their effect on the intestinal microflora involved in the metabolism of phenolic compounds. Thus these compounds and/or their metabolites can modulate the intestinal microbiota. Among the main phenolic compounds in wine that can reach the intestine, special attention has been paid to flavan-3-ol polymer or pro-anthocyanidins (also known as condensed tannins), as there is evidence that these polyphenols promote the growth of beneficial bacteria and inhibition pathogenic bacteria, while being largely metabolized by the intestinal microbiota to produce a wide range of active metabolites (figure 2) [16].

Fig. 2 Catabolism of monomeric flavan-3-ols by gut microbiota [16]

     Resveratrol in wine can come from both grape skins and grape seeds (where it is found in larger quantities). This natural polyphenol has been detected in over 70 plant species and has been found in discrete amounts in red wines and various foods. As a natural food ingredient, numerous studies have shown that resveratrol has a very high antioxidant potential. Resveratrol also has antitumor activity and is considered a potential candidate for the prevention and treatment of several types of cancer. Indeed, the anticancer properties of resveratrol have been confirmed by many in vitro and in vivo studies, which show that resveratrol is able to inhibit all stages of carcinogenesis (initiation, promotion and progression). Other bioactive effects have been reported, namely anti-inflammatory, cardioprotective, vasodilators, antidiabetic, phytoestrogenic and neuroprotective effects. However, the comparative assessment of animal and human studies shows that resveratrol cannot protect against metabolic diseases and their relevant complications [6,7,8].

Harmful effects of some compounds that can be found in wines

     Toxic effects from wine consumption can be divided into acute and chronic manifestations. The acute type has been attributed to the presence of higher alcohol esters and/or the addition of various chemical compounds. Liver cirrhosis is a common chronic manifestation due to increased consumption of alcoholic beverages. These harmful effects are due to either compounds that can occur naturally in wine such as biogenic amines (which can cause allergic reactions, high blood pressure, gastric hypersecretion, etc.), aflatoxins (with carcinogenic effects), pathogenic microorganisms (which can cause food poisoning), or compounds obtained in wines as a result of processes of cultivation and growth of raw materials or processes of wine processing such as fungicides, insecticides, fertilizers, residues from cleaning wooden containers in which wine is stored or processing facilities, and bottling of wine as well as substances added to wine to stabilize it at temperature or fermentation, to correct acidity, preservatives such as sulphites (may cause allergic effects), clarifiers (bentonite), 2,4,6 tribromophenol (with carcinogenic effects) [17,18]. Low amounts of biogenic amines, as normal constituents of raw materials, can be released into grape must and pulp during the winemaking process, and the concentration of biogenic amine may increase due to alcoholic fermentation, yeast autolysis, malolactic fermentation and aging. wine, red wines are usually richer in biogenic amines than white wines (because they suffer more frequently from malolactic fermentation for maturation). Consumption of foods or beverages that contain large amounts of biogenic amines can cause toxic effects, such as high blood pressure, palpitations, headache, nausea, diarrhea, redness and localized inflammation; In extreme cases, intoxication can be fatal. In pharmacological experiments, histamine was found in wine. This finding was confirmed by chromatographic analysis. Moreover, it has been shown that histamine in alcoholic solutions has much stronger effects than in aqueous solutions. Sneezing, watery eyes, headaches, diarrhea, itchy skin, flushing and breathing problems are symptoms that occur in wine intolerant patients after drinking a glass of red wine. They are mainly caused by histamine or sulphites added to wines as preservatives [17-22].

     Numerous studies on dental erosion in wine tasters and sommelier can extrapolate the fact that a high consumption of wines with high acidity can lead to damage to tooth enamel [23].

Conclusions

     Significant research has taken place over time to determine the effects of wine on human health, and the quantity and quality of data obtained is constantly growing. We cannot ignore the fact that pure alcohol is harmful to health, however many studies have shown the beneficial effects of wine and its components. A wealth of scientifically argued information is in favor of low to moderate consumption of wine as part of a healthy lifestyle. However, the integration of the results and their efficient interpretation remains a challenge considering the multitude of factors that influence the quality of the wines, from the stage of harvesting the raw materials to obtaining the finished product [24].

     The American Heart Association recommends that women consume at most one glass of wine of 150 ml per day, while the dose indicated for men is 300 ml, ie a maximum of two glasses. The difference comes from the way each body metabolizes and absorbs alcohol, this process being faster for women, but also from the fact that women have a higher level of body fat and lower body water, so the physiological response is more strong to alcohol. Clinical studies show that people who drink a glass of wine 4-6 times a week can prolong their life and have a high level of HDL cholesterol in the blood and the high content of antioxidants also helps improve digestion [24,25].

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