Moderater Weingenuss und Prävention der koronaren Herzkrankheit

Zusammenfassung

Moderater Alkohol- und insbesondere Weinkonsum ist in epidemiologischen Studien mit einer merklich gesenkten kardiovaskulären Morbidität und Mortalität assoziiert. Obwohl es keine randomisierten, Placebo-kontrollierten Studien mit Wein gibt – und kaum jemals geben wird – kann der beobachtete Zusammenhang aufgrund hoher biologischer Plausibilität als kausaler Effekt angesehen werden. Viel spricht dafür, dass Ethanol per se ein wesentlicher präventiver Effekt zukommt. Bei moderater Zufuhr werden die gesundheitlichen Vorteile nicht durch übermäßige Gesundheitsrisiken aufgewogen. Ob und in wie weit die vielen pflanzlichen Begleitstoffe des Weins (Polyphenole) zusätzliche gesundheitlich relevante Wirkungen ausüben, ist weiterhin Gegenstand zahlreicher Untersuchungen.

Abstract

Moderate alcohol consumption and in particular wine consumption, is associated with a significant reduction in cardiovascular morbidity and mortality in epidemiological studies. Although no randomized placebo-controlled studies with wine intervention exist – and will probably never exist – the observed association can be interpreted as causal due to the existing high biological plausibility. There is more and more evidence that ethanol per se contributes to the most relevant preventive effects. When consumed in moderation the health benefits outweigh the health risks. Whether and to what extend the numerous plant compounds of wine (polyphenolic substances) can provide additional health benefits is still under investigation.

• Literatur

• 1 Alkerwi A, Boutsen M, Vaillant M et al. Alcohol consumption and the prevalence of metabolic syndrome: a meta-analysis of observational studies. Atherosclerosis 2009; 204: 624-635
• 2 Arner E, Westermark PO, Spalding KL et al. Adipocyte turnover: relevance to human adipose tissue morphology. Diabetes 2010; 59: 105-109
• 3 Arranz S, Chiva-Blanch G, Valderas-Martinez P et al. Wine, beer, alcohol and polyphenols on cardiovascular disease and cancer. Nutrients 2012; 4: 759-781
• 4 Baliunas DO, Taylor BJ, Irving H et al. Alcohol as a risk factor for type 2 diabetes: A systematic review and meta-analysis. Diabetes Care 2009; 32: 2123-2132
• 5 Baur JA, Sinclair DA. Therapeutic potential of resveratrol: the in vivo evidence. Nat Rev Drug Discov 2006; 5: 493-506
• 6 Beulens JW, Algra A, Soedamah-Muthu SS et al. Alcohol consumption and risk of recurrent cardiovascular events and mortality in patients with clinically manifest vascular disease and diabetes mellitus: the Second Manifestations of ARTerial (SMART) disease study. Atherosclerosis 2010; 212: 281-286
• 7 Beulens JW, Rimm EB, Ascherio A et al. Alcohol consumption and risk for coronary heart disease among men with hypertension. Ann Intern Med 2007; 146: 10-19
• 8 Briasoulis A, Agarwal V, Messerli FH. Alcohol consumption and the risk of hypertension in men and women: a systematic review and meta-analysis. Journal Clin Hypertens (Greenwich, Conn) 2012; 14: 792-798
• 9 Brien SE, Ronksley PE, Turner BJ et al. 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
• 10 Chiva-Blanch G, Urpi-Sarda M, Llorach R et al. Differential effects of polyphenols and alcohol of red wine on the expression of adhesion molecules and inflammatory cytokines related to atherosclerosis: a randomized clinical trial. Am J Clin Nutr 2012; 95: 326-334
• 11 Costanzo S, Di Castelnuovo A, Donati MB et al. Wine, beer or spirit drinking in relation to fatal and non-fatal cardiovascular events: a meta-analysis. Eur J Epidemiol 2011; 26: 833-850
• 12 Criqui MH, Ringel BL. Does diet or alcohol explain the French paradox?. Lancet 1994; 344: 1719-1723
• 13 Davies MJ, Baer DJ, Judd JT et al. Effects of moderate alcohol intake on fasting insulin and glucose concentrations and insulin sensitivity in postmenopausal women: a randomized controlled trial. JAMA 2002; 287: 2559-2562
• 14 de Gaetano G, Di Castelnuovo A, Donati MB et al. The mediterranean lecture: wine and thrombosis--from epidemiology to physiology and back. Pathophysiol Haemost Thromb 2003; 33: 466-471
• 15 Dixon JB, Dixon ME, O'Brien PE. Alcohol consumption in the severely obese: relationship with the metabolic syndrome. Obes Res 2002; 10: 245-252
• 16 Ford ES, Zhao G, Tsai J et al. Low-risk lifestyle behaviors and all-cause mortality: findings from the National Health and Nutrition Examination Survey III Mortality Study. Am J Public Health 2011; 101: 1922-1929
• 17 Furtwaengler NA, de Visser RO. Lack of international consensus in low-risk drinking guidelines. Drug and alcohol review 2013; 32: 11-18
• 18 German JB, Walzem RL. The health benefits of wine. Annu Rev Nutr 2000; 20: 561-593
• 19 Joosten MM, Beulens JW, Kersten S et al. Moderate alcohol consumption increases insulin sensitivity and ADIPOQ expression in postmenopausal women: a randomised, crossover trial. Diabetologia 2008; 51: 1375-1381
• 20 Joosten MM, Chiuve SE, Mukamal KJ et al. Changes in alcohol consumption and subsequent risk of type 2 diabetes in men. Diabetes 2011; 60: 74-79
• 21 Kenkre PV, Lindeman RD, Lillian Yau C et al. Serum insulin concentrations in daily drinkers compared with abstainers in the New Mexico elder health survey. J Gerontol A Biol Sci Med Sci 2003; 58: M960-963
• 22 McFadden CB, Brensinger CM, Berlin JA et al. Systematic review of the effect of daily alcohol intake on blood pressure. Am J Hypertens 2005; 18: 276-286
• 23 Mukamal KJ. Understanding the mechanisms that link alcohol and lower risk of coronary heart disease. Clin Chem 2012; 58: 664-666
• 24 Mukamal KJ, Chiuve SE, Rimm EB. Alcohol consumption and risk for coronary heart disease in men with healthy lifestyles. Arch Intern Med 2006; 166: 2145-2150
• 25 Mukamal KJ, Chiuve SE, Rimm EB. Does alcohol prevent mortality or does it just prevent coronary heart disease?. Arch Intern Med 2007; 167: 970
• 26 Pai JK, Hankinson SE, Thadhani R et al. Moderate alcohol consumption and lower levels of inflammatory markers in US men and women. Atherosclerosis 2006; 186: 113-120
• 27 Pai JK, Mukamal KJ, Rimm EB. Long-term alcohol consumption in relation to all-cause and cardiovascular mortality among survivors of myocardial infarction: the Health Professionals Follow-up Study. Eur Heart J 2012; 33: 1598-1605
• 28 Pearson KJ, Baur JA, Lewis KN et al. Resveratrol delays age-related deterioration and mimics transcriptional aspects of dietary restriction without extending life span. Cell Metab 2008; 8: 157-168
• 29 Poulsen MM, Jorgensen JO, Jessen N et al. Resveratrol in metabolic health: an overview of the current evidence and perspectives. Ann N Y Acad Sci 2013; 1290: 74-82
• 30 Retterstol L, Berge KE, Braaten O et al. A daily glass of red wine: does it affect markers of inflammation?. Alcohol Alcohol 2005; 40: 102-105
• 31 Rimm EB, Williams P, Fosher K et al. Moderate alcohol intake and lower risk of coronary heart disease: meta- analysis of effects on lipids and haemostatic factors. BMJ 1999; 319: 1523-1528
• 32 Ronksley PE, Brien SE, Turner BJ et al. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ 2011; 342: d671
• 33 Rosenbloom JI, Mukamal KJ, Frost LE et al. Alcohol consumption patterns, beverage type, and long-term mortality among women survivors of acute myocardial infarction. Am J Cardiol 2012; 109: 147-152
• 34 Sierksma A, Patel H, Ouchi N et al. Effect of moderate alcohol consumption on adiponectin, tumor necrosis factor-alpha, and insulin sensitivity. Diabetes Care 2004; 27: 184-189
• 35 Sierksma A, van der Gaag MS, Kluft C et al. Moderate alcohol consumption reduces plasma C-reactive protein and fibrinogen levels; a randomized, diet-controlled intervention study. Eur J Clin Nutr 2002; 56: 1130-1136
• 36 Spanier G, Xu H, Xia N et al. Resveratrol reduces endothelial oxidative stress by modulating the gene expression of superoxide dismutase 1 (SOD1), glutathione peroxidase 1 (GPx1) and NADPH oxidase subunit (Nox4). J Physiol Pharmacol 2009; 60 (Suppl. 04) 111-116
• 37 St Leger AS, Cochrane AL, Moore F. Factors associated with cardiac mortality in developed countries with particular reference to the consumption of wine. Lancet 1979; 1: 1017-1020
• 38 Timmers S, Hesselink MK, Schrauwen P. Therapeutic potential of resveratrol in obesity and type 2 diabetes: new avenues for health benefits?. Ann N Y Acad Sci 2013; 1290: 83-89
• 39 Timmers S, Konings E, Bilet L et al. Calorie restriction-like effects of 30 days of resveratrol supplementation on energy metabolism and metabolic profile in obese humans. Cell Metab 2011; 14: 612-622
• 40 Wakabayashi I, Kobaba-Wakabayashi R, Masuda H. Relation of drinking alcohol to atherosclerotic risk in type 2 diabetes. Diabetes Care 2002; 25: 1223-1228
• 41 Zern TL, Fernandez ML. Cardioprotective effects of dietary polyphenols. J Nutr 2005; 135: 2291-2294