Page 69 - BH-2-3

Brain & Heart Wine intake and 45-year mortality in rural men

that applied the Alcohol Use Disorders Identification Test moderate intake seems beneficial within terms of the
score showed a dose-response with all-cause mortality, but U-shaped or J-shaped relationship, mainly in the case
the assessment was different depending on the population of major CVDs. However, it seems that low or moderate
examined, and it was not always clear whether the abstainers alcohol intake is frequently associated with other lifestyle
included former drinkers. 17 behaviors. In a large meta-analysis that included 22 studies,

Among the references derived from the past 5 years, wine intake was associated with a hazard ratio of 0.76 for
there were contributions explicitly dealing with wine intake CHD mortality and 0.83 for all CVD mortality, concluding
that allow at least marginal comparisons with our findings. that high wine intake might be harmful only in cases of
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Over 500,000 participants were studied from the UK advanced age, use of medications, and other diseases.
biobank cohort, and alcohol consumption was obtained The review of 27 articles published between 2002 and
from a questionnaire separating the various sources of 2020 tends to conclude that moderate wine intake (a drink
alcohol. In a median follow-up of 7 years, beer, cider, and of wine a day) might be helpful in reducing the risk of
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spirits were significantly associated with an excess of all- major CVDs and diabetes, mainly if red wine is used. In
cause mortality, CVD events, CHD, cerebrovascular events, another narrative review, including historical notes, the
and cancer. On the other hand, champagne, white wine, and authors state that high alcohol intake might be a hazard
red wine were associated with a significantly decreased risk for the incidence of cancer, liver disease, and some CVD
for CHD only. The conclusion was that the type of alcoholic conditions. Moreover, they express some doubts about
beverage may play a different role in its impact on health the possible protective effect of red wine versus CHD in
and disease. Taking as reference the debated problem of the the absence of a final proof and recommend the use of red
French Paradox, the authors recognize that the J-shaped wine due to its high content of polyphenols. 25
relationship of alcohol intake is related to CVD events, still A limitation of the present study depends on the small
fixing a limit for maximum protection of around 20 g of numbers, which are still partially compensated by the
alcohol/day in the form of wine. They invoke the use of extremely long follow-up and the presence of men only. Some
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randomized trials to clarify the situation, insisting on the strengths are the use of almost universal wine consumption
fact that the protection may derive from the wine’s micro- in the study population as a source of alcohol, the limited
active components (such as resveratrol in red wine) and number of abstainers, and the use of six major covariates as
their potential action against inflammation and thrombosis. possible confounders, including a dietary score.
In the Polish section of the PURE study covering over
2000 adults of both sexes, the majority of participants 5. Conclusion
(55%) consumed low-alcohol drinks, 21% frequently Our study suggests that over a lifetime, the relationship
used spirits, while the non-drinkers covered the residual between wine consumption, red-one in the majority of
24%. The current drinkers had a hazard ratio of 1.5 to cases and rated as alcohol intake, exhibits a J-shaped
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develop diabetes and CVDs compared to never drinkers, curve, particularly for CVD and all-cause mortality. This
while former drinkers were at excess risk of developing trend persists even when excluding abstainers. Moderate
hypertension and CVDs. (or relatively high) wine consumption is more beneficial
In 16 cohorts of the WHO MONICA project, a total of than lower intakes, especially when coupled with vigorous
over 142,000 subjects aged 50 years or older were studied physical activity at work. However, recent meta-analyses
for their alcohol intake and subsequent mortality risk. The have highlighted uncertainties, suggesting the need for
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consumption of less than 10 g/day of alcohol, compared further investigation. Notably, the potential interaction
with abstainers, was associated with an 11% lower total between alcohol intake and vigorous physical activity
mortality risk, while 20 or more g/day corresponded to has not been adequately explored in previous studies,
an increased risk of 13%. Similar figures were found for underscoring the relevance of our findings.
CVD, while for cancer, no advantages were found for low
intakes, but an increased 22% risk was found for an alcohol Acknowledgments
intake of 20 or more g/day. Moreover, it was shown that None.
high-density lipoprotein cholesterol explained 2.9 and
18.7% of the association between low alcohol intake and Funding
total and cardiovascular mortality, respectively, reducing For the initiation of the Italian section of the SCS of CVDs,
the previously estimated impact of alcohol consumption. funds were received from Prof. Ancel Keys, University of
A narrative review suggests that high alcohol intake Minnesota, USA, obtained as research grants from the
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is a risk factor for various major diseases, while low or National Heart Institute (later NHLBI) and the American

Volume 2 Issue 3 (2024) 6 doi: 10.36922/bh.3016