new research on red wine

Is there a correlation between acute and chronic red wine intake and health?

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In a recent study published in the Nutrients Journal, researchers evaluated randomized controlled trials (RCTs), examining recent scientific literature on the correlations between acute and chronic red wine (RW) intake and health.

The health benefits of red wine consumption continue to be debatable. Guidelines for preventing cardiovascular diseases (CVD) and neoplasms advise against alcohol consumption; however, studies have reported that low-level intake of red wine may benefit cardiovascular health.

RW contains nutrients such as monosaccharides (such as fructose and glucose), varying levels of micronutrients (such as calcium, potassium, magnesium, copper, and iron), and a few B complex vitamins. Moreover, >100.0 polyphenols, including flavonoids, have been detected in red wine.

About the study

In the present study, researchers assessed the potential health benefits of consuming red wine. The team evaluated randomized controlled trials (RCTs) published on PubMed in English between January 1, 2000, and February 28, 2023.

The effects of consuming red wine on the following were evaluated: (i) antioxidant status; (ii) cardiovascular function; (iii) platelet function and coagulation; (iv) arterial stiffness and endothelial cell function; (v) hypertension; (vi) immunological function; (vii) lipid profiles and protein (homocysteine) levels; (viii) biological complication, glucose metabolism, and type 2 diabetes (ix) gastrointestinal activity and intestinal microbiota.

Initially, 6,429 records were identified, from which 636 duplicates were excluded. Subsequently, the remaining records (n=5,793) were screened, and the team removed studies concerning cytotoxicity, functional food items, supplementations, probiotics, sensory aspects, dysphagia, labeling and glass differences, alcohol pharmacokinetics, asthma, or nasal symptoms.

Excluded studies assessed osmotic-type stress-affected wines, wine intake biomarkers, wine extracts, drug interactions, allergens, food combinations, hypothalamic-pituitary-adrenal (HPA) axis, leptin or adiponectin, catechin, monocyte migration, and leukocyte functions.

Further, studies on natural wines, intelligence tests, diuretic effects, gastric emptying, hormones (including aromatase), and customized beverage interventions were excluded.

Moreover, conference proceedings, reviews, short surveys, abstracts, books, letters, and in vitro and animal studies were not included.

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The entire text of 209 RCTs was assessed independently by two reviewers, and disagreements were resolved by another reviewer. After the full-text screening, the team excluded 118 records focusing on white wine, RW derivatives, or supplemental or nutraceutical usage. As a result, 91 RCTs were considered for the final review.

Among the included RCTs, most involved primarily type 2 diabetes patients , and seven RCTs had a >6.0-month duration (between six months and two years).

Consuming red wine improved antioxidant levels, thrombotic activity, inflammatory biomarker expression, lipid levels, and intestinal microbiome , with contradictory findings for cardiac function and hypertension.

Of note, RW conferred protection against inflammation, renal damage, and oxidative stress, with a modest lowering of cardiovascular risks in most (five of seven) RCTs evaluating the effects of red wine consumption.

Moderate RW intake increased levels of enzymatic antioxidants that are involved in reducing reactive oxygen species (ROS), including superoxide dismutase-2 (SOD-2), glutathione peroxidase, and catalase (CAT), primarily due to the polyphenol content.

In addition, RW lowered the activation of inflammation-associated nuclear factor-kappa B pathways. Likewise, protein carbonyl levels and oxidized guanine species were significantly lowered among RW consumers, preventing low-density lipoprotein (LDL) oxidation.

Acute RW intake, compared to gin, had a greater down-regulatory effect on genes associated with atherosclerosis progression among males at an increased risk of CVD, likely due to the high phenolic composition.

In addition, acute RW consumption reduced vasoconstrictive peptide endothelin-1 levels. However, RW intake did not significantly affect coronary epicardial diameters or flow rate, coronary microcirculation, total carotid plaque volume, the velocity of blood flow of the middle cerebral or internal carotid artery among atherosclerosis patients.

RW can reduce platelet aggregation and coagulation by reducing prothrombin, activated factor VII, fibrinogen, and von Willebrand factor (vWF) levels and increasing plasminogen activator inhibitor-1 (PAI-1) levels.

However, polyphenols in red wine do not preserve endothelial functions. Further, RW can lower postprandial blood pressure with an increase in nitric oxide (NO) levels; however, contradictory results have been reported.

Furthermore, RW can lower serological C-reactive protein, LDL/high-density cholesterol (HDL), factor VII, and fibrinogen levels and increase those of apolipoprotein A1, tumor growth factor-beta 1 (TGF-β1), PAI, tissue plasminogen activator (tPA), and the total antioxidant capacity.

The expression of pro-inflammatory cytokines such as alpha tumor necrosis factor (TNF-α), interleukin-6 (IL-6), interferon-gamma (IFN-γ), and lipoprotein (a), reduces after RW consumption.

Moreover, RW may improve glycemic control and lower insulin levels and urinary protein levels, benefiting diabetic patients, especially those with diabetic nephropathy, with no effects on the weight of type 2 diabetic patients.

On the contrary, red wine consumption increases leptin levels, and therefore energy regulation, and improves intestinal microbial composition, along with lowering metabolic syndrome (MetS) risk factors.

RW polyphenols inhibit non-beneficial (lipopolysaccharide-producing) bacterial organisms and promote the growth of probiotic, beneficial (butyrate-producing) bacterial organisms, including Bifidobacteria , Prevotella , Enterococcus , and Bacteroides species.

Based on the study findings, moderate-level RW consumption confers cardiometabolic, immunological, and prebiotic health benefits, mainly due to the polyphenol content; however, further research, including long-term RCTs, is required to verify the findings and assess the safety profile of RW.

De-alcoholized-type RW (DRW) could be a good source of antioxidants to prevent oxidative damage and improve overall health. While short-term RW intake can improve the antioxidant status, lipid profile, thrombosis and inflammatory marker expression, and intestinal microbiome, longer-term RW intake could improve cardiac and renal function in type 2 diabetes patients.

Lombardo, M. et al. (2023) "Health Effects of Red Wine Consumption: A Narrative Review of an Issue That Still Deserves Debate",  Nutrients , 15(8), p. 1921. doi: 10.3390/nu15081921.   https://www.mdpi.com/2072-6643/15/8/1921

Posted in: Medical Science News | Medical Research News | Medical Condition News

Tags: Adiponectin , Alcohol , Antioxidant , Apolipoprotein , Arterial Stiffness , Asthma , Atherosclerosis , Biomarker , Blood , Blood Pressure , Calcium , Cardiometabolic , Cell , Cholesterol , Chronic , Copper , C-Reactive Protein , Cytokines , Cytotoxicity , Diabetes , Diabetic Nephropathy , Dysphagia , Endothelial cell , Endothelin , Enterococcus , Food , Fructose , Genes , Glucose , Glucose Metabolism , Growth Factor , Guanine , Homocysteine , in vitro , Inflammation , Insulin , Interferon , Interferon-gamma , Interleukin , Interleukin-6 , Leptin , Leukocyte , Lipoprotein , Magnesium , Metabolic Syndrome , Metabolism , Microbiome , Monocyte , Necrosis , Nephropathy , Nitric Oxide , Nutraceutical , Nutrients , Oxidative Stress , Oxygen , Pharmacokinetics , Platelet , Polyphenol , Potassium , Probiotic , Probiotics , Protein , Red Wine , Research , Stress , Syndrome , Thrombosis , Tumor , Tumor Necrosis Factor , Type 2 Diabetes , Vitamins , Wine

Pooja Toshniwal Paharia

Pooja Toshniwal Paharia is an oral and maxillofacial physician and radiologist based in Pune, India. Her academic background is in Oral Medicine and Radiology. She has extensive experience in research and evidence-based clinical-radiological diagnosis and management of oral lesions and conditions and associated maxillofacial disorders.

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Should red wine be removed from the Mediterranean diet?

Miguel Martínez-González discussed contradictory findings on alcohol and health during the Department of Nutrition’s 18 th annual Stare-Hegsted lecture.

October 12, 2023 — There’s a large body of research pointing to a link between alcohol consumption and reduced risk of cardiovascular disease. But studies in recent years have contradicted these findings, suggesting that no amount of alcohol is safe for health. Physician and researcher Miguel Martínez-González recently outlined the controversy for a Harvard T.H. Chan School of Public Health audience, exploring whether alcohol—particularly red wine—still has a place in healthy eating plans such as the Mediterranean diet .

Martínez-González is the principal investigator on PREDIMED-PLUS , a Mediterranean diet and lifestyle clinical trial focused on prevention of cardiovascular disease . He is an adjunct professor of nutrition at Harvard Chan School and a professor of preventive medicine and public health at the University of Navarra in Spain. He delivered the 18th annual Stare-Hegsted Lecture on October 2 in Kresge G-2 to a hybrid audience. The event, sponsored by the Department of Nutrition , honors department founders Fredrick Stare and D. Mark Hegsted.

Research by Martínez-González and colleagues has found that a Mediterranean diet including alcohol reduced risk of cardiovascular disease by 30% compared to a low-fat diet which did not specifically include alcohol.

In another study, they found that people who followed what the researchers defined as a moderate Mediterranean drinking plan—choosing red wine, drinking with meals, and spreading consumption over the course of the week—had a lower risk of mortality than people who abstained from alcohol. Martínez-González noted that additional recent studies have found that light to moderate alcohol consumption lowered the relative risks for premature mortality, and mortality from cancer and cardiovascular disease.

However, Martínez-González noted that alcohol’s potential harms must be considered, particularly for young people. One out of every four deaths of Americans ages 20 to 34 can be attributed to alcohol, he said, noting that in addition to increasing the risk of accidental deaths, alcohol may also increase the risk of breast cancer. Some imaging studies of the brain suggest that alcohol may be toxic to neurons, Martínez-González said, adding that it is more broadly toxic to the body if consumed in large amounts.

“So, should we remove wine from the Mediterranean diet?” he asked. “Yes, definitely for those under 35 years.” But for older adults, it’s more complicated. He and his colleagues, and other researchers, have found that the Mediterranean diet loses up to 23.5% of its protective effect if wine is removed.

Randomized controlled trials are needed to ensure that potential benefits or harms from alcohol consumption are adequately assessed, Martínez-González said. He and his colleagues at the University of Navarra received funding for such a study earlier this year. The study is recruiting physicians ages 50 to 75, who will be randomized to moderate drinking or abstention groups. Both groups will receive free beverages—red wine or an alcohol-free alternative—during the five-year study.

Martínez-González hopes that this trial will help clarify whether red wine should be part of the Mediterranean diet for adults over 35.

— Amy Roeder

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New Research Re-examines the Cause of a Red Wine Headache

Klaus Vedfelt / Getty Images

Key Takeaways

• Red wine headaches can occur as soon as 30 minutes after drinking just one glass of wine.
• Researchers have long studied potential causes for red wine headaches.
• A new paper suggests the headaches could be triggered by quercetin, a compound found in the skin of grapes more common in red wines than white wines.

A new study published last month in Scientific Reports suggests red wine headaches (RWH) could be triggered by a chemical compound called “ quercetin .”

Red wines usually contain much higher levels of quercetin than white wines, Andrew Waterhouse, PhD , a wine chemist at the University of California, Davis, and an author of the new report, told Verywell.

RWH is not the same thing as a hangover: It can occur just 30 minutes to three hours after drinking a small amount of red wine—as little as one glass.

“Many people have headaches after drinking different types of alcohol, [including] beer and spirits, but red wine seems to be the one that many of my patients say will trigger a headache,” Anna Pace, MD , an assistant professor of neurology at the Icahn School of Medicine at Mount Sinai, told Verywell.

“It isn’t that you have to drink a large amount—sometimes it could be a glass or a couple of sips—and there is a lot of variability in how people react to drinking red wine,” Pace explained.

However, scientists may be one step closer to determining what causes a headache after drinking red wine.

What Is It in Red Wine That Gives You a Headache?

Waterhouse and his team decided to investigate what could be causing RWH after considering what causes another common side effect that some experience when drinking alcohol , known as facial flushing.

Flushing occurs in some people who metabolize alcohol less efficiently than others so that when they drink, their face becomes discolored, often red.

“Some people get a flushed reaction when they drink, and this is caused by inflammation,” Waterhouse explained. “Headaches are also caused by inflammation.”

Waterhouse and his team knew that the inflammation that causes flushing is caused by a build-up of the chemical compound acetaldehyde in the bloodstream, so they set out to determine whether anything found in wine contributes to that accumulation.

“We had a list of different compounds, and we tested them to see if any of them inhibited” the enzyme that metabolizes acetaldehyde, Waterhouse said. “One of them, quercetin, was a very good inhibitor. That really got our attention.”

This led the team to theorize that RWH may occur after quercetin found in wine leads to a build-up of acetaldehyde.

Researchers have long surmised what causes RWH. Some researchers previously believed that histamines—compounds involved in the immune response—found in red wine could trigger headaches. However, multiple research papers published in the early 2000s disproved this theory.

Sulfites—compounds that are found in a vast number of foods and drinks—were also thought to be the culprit. “The general problem with that [theory] is that white wine usually has more sulfites than red,” Waterhouse said.

Lastly, many researchers have suggested phenolic compounds called “ tannins ” may be to blame. “Phenolics are the primary suspect, but nobody has any theories,” Waterhouse said. “There really was no sound theory; there was just a lot of speculation.”

While the new theory put forth by Waterhouse and his team could explain what causes RWH, further research needs to be done to confirm their findings. “The key thing is that we have to test this with real people,” Waterhouse said. “What we have now is enzyme data, test tube data.”

To determine whether quercetin is to blame, future research should involve people trying red wines with varying amounts of quercetin, Waterhouse said. If they’re more likely to develop a headache after drinking wines high in quercetin, that could be a sign that quercetin is to blame.

Are Certain Red Wines Less Likely to Cause Headaches?

Unfortunately, there’s no way to tell how much quercetin is in a given bottle of red wine, or whether the amounts vary drastically by type. Thus, we don’t yet know for sure if some red wines are more likely to induce headaches than others.

But researchers do know one factor that influences how much quercetin is found in red wine. “It appears to be related to the amount of sun exposure the grapes get in the vineyard,” Waterhouse said. “The practical implication of that is that less expensive red wines probably have lower levels than expensive ones. Really high-quality wines, generally speaking, have high levels of quercetin.”

What to Do If You’re Prone to Red Wine Headaches

“As the holidays are coming around, this comes up a lot at my clinic because people really enjoy having a glass of red wine,” Pace said. And people who have migraines are generally more prone to RWH, she added.

The advice she gives them depends on the severity of their RWH, Pace explained. For people who always have a headache after drinking red wine, she suggests they may simply want to avoid drinking red wine. “If it’s a pretty consistent relationship, where every time a person has red wine they will get a headache,” it may not be worth it, Pace explained.

For people who don’t always suffer from RWH—but sometimes do—Pace recommends strictly adhering to certain headache-prevention behaviors before and after drinking red wine.

If they’re just a little more vulnerable, I’ll say maybe that’s a day when you want to be extra mindful of getting enough water, getting good sleep, [and] eating three meals that day.

Other lifestyle habits that can help prevent headaches, in general, include exercising regularly and reducing stress, Pace added.

You should also be mindful of how much you’re drinking, as drinking too much of any kind of alcohol can result in a headache that isn’t specifically an RWH, Pace said.

How to Get Rid of Red Wine Headaches

If you try the above techniques but still develop a red wine headache, consider what headache remedies have worked for you in the past. “If you get [a RWH], use the tools you have to get rid of it,” Pace said.

Many people use over-the-counter medications—like aspirin, ibuprofen, and acetaminophen—to treat their headaches.

Taking other precautions may keep you comfortable until your headache resolves. These include staying in a dark space if you feel especially sensitive to light and keeping your space quiet if you feel especially sensitive to noise.

As with any health problem, if your RWH persists, you should seek medical help, Pace said. If you find yourself experiencing headaches often, it’s worth making an appointment with a headache specialist, she added.

Hopefully, Waterhouse said, his new report can help researchers understand more about headaches, in general—not just those caused by red wine. “One of the goals of the research long-term is for [experts] to use the information to understand how headaches occur,” he said. “If this can help neurologists explore causes of other types of headaches, that would be wonderful.”

What This Means For You

Red wine headaches can occur soon after drinking small amounts of wine—for example, just half an hour after drinking one glass. Though researchers have a new theory as to what causes red wine headaches, it’s too soon to say whether certain types of red wine may be more likely to cause headaches. If you experience headaches from any triggers, including red wine, often, it’s worth seeking help from a headache specialist, who can advise you on treatment options.

Devi A, Levin M, Waterhouse AL. Inhibition of ALDH2 by quercetin glucuronide suggests a new hypothesis to explain red wine headaches . Sci Rep . 2023;13(1):19503. doi:10.1038/s41598-023-46203-y

National Institute on Alcohol Abuse and Alcoholism. Alcohol flush reaction .

Peatfield RC, Fletcher G, Rhodes K, Gardiner IM, de Belleroche J. Pharmacological analysis of red-wine-induced migrainous headaches . J Headache Pain . 2003;4(1):18-23. doi:10.1007/s101940300023

Kanny G, Gerbaux V, Olszewski A, et al. No correlation between wine intolerance and histamine content of wine .  J Allergy Clin Immunol . 2001;107(2):375-378. doi:10.1067/mai.2001.112122

Vally H, Misso NL. Adverse reactions to the sulphite additives . Gastroenterol Hepatol Bed Bench . 2012;5(1):16-23.

National Library of Medicine: MedlinePlus. Managing tension headaches at home .

National Institute of Neurological Disorders and Stroke. Headache .

By Maggie O'Neill O’Neill is a reporter who covers new medical research and addiction. She previously worked at SELF magazine and Health.com, and she was a 2020 fellow at the Association of Health Care Journalists.

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Srn member links, new study suggests red wine reduces covid infection rates.

U.K. residents who drank 1 to 2 glasses of red wine per day had a lower chance of infection

• Mitch Frank

What if that glass of Châteauneuf you're sipping with dinner is also reducing your chances of contracting COVID-19? A new study analyzed health data on nearly 500,000 U.K. residents and found that subjects who drank one to two glasses of red wine a day had a 10 to 17 percent lower risk of contracting COVID than non-drinkers. Subjects who drank white wine had a 7 to 8 percent lower risk if they consumed five glasses or less per week, while those who frequently drank beer or cider had a 28 percent higher chance of contracting the virus than non-drinkers.

The study, published in the journal Frontiers in Nutrition , was conducted by a team of researchers in China at Shenzhen Kangning Hospital. They wanted to look at possible links between alcohol consumption and rates of COVID infection and mortality. They analyzed data from the U.K. Biobank Study, a comprehensive research project that has been collecting health and lifestyle information from nearly 500,000 participants in the U.K. since 2006.

"Adverse effects of alcohol consumption have been widely documented. [But] the observed relationships between alcohol consumption and diseases are often non-linear, with low-to-moderate alcohol consumption being protective and heavy alcohol consumption being harmful," noted lead authors Xi-jian Dai and Yongjun Wang. "Several cohort studies have pointed out that people who have light-to-moderate alcohol consumption survive longer than abstainers."

After analyzing the Biobank data, the researchers found that there was no significant difference in mortality rates from COVID between subjects who drank and those who abstained. But the differences in infection rates were noteworthy. In addition to the lower rates for wine drinkers and higher rates for beer and cider drinkers, the team found that people who drank five or more hard alcohol drinks per week had a higher risk of infection. And heavy drinking of any alcohol also raised the risk.

A study like this looks at correlation, not causation, so it's unclear why red wine drinkers had a lower infection rate. It could be that other factors are at play: Red wine drinkers may be less likely to suffer from other COVID risks; they may exercise more or have better nutrition; or they may be more likely to be vaccinated.

But the authors suggest that the specific results for red wine compared to other types of alcohol suggest that compounds that set red wine apart from other drinks may deserve the credit. "Red wine provides additional benefits to other alcoholic beverages probably due to its higher polyphenolic content, by decreasing blood pressure, inhibiting the oxidation of low-density lipoprotein particles and other favorable effects on the cellular redox state, improving endothelial function, inhibiting platelet aggregation, reducing inflammation and cell adhesion and activating proteins that prevent cell death," they write.

The researchers do acknowledge some limitations in their study. The U.K. Biobank is focused on people ages 49 years and older. And the data on drinking habits was collected before the pandemic—changes in drinking habits during the pandemic were unrecorded. The authors call for further study.

Want to learn more about how wine can be part of a healthy lifestyle? Sign up for Wine Spectator 's free Wine & Healthy Living e-mail newsletter and get the latest health news, feel-good recipes, wellness tips and more delivered straight to your inbox every other week!

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Watch CBS News

Get headaches from drinking red wine? New research explores why.

By Sara Moniuszko

Edited By Paula Cohen

November 20, 2023 / 1:27 PM EST / CBS News

Red wine may be on your Thanksgiving menu , but for some people, even a small glass can result in a headache. Now researchers say they may have figured out why.

In a new study, published in the Scientific Reports journal  on Monday, scientists at the University of California, Davis, found the culprit may be a flavanol that occurs naturally in red wines and can interfere with the proper metabolism of alcohol. Flavonols are a group of compounds found in many plants.

The flavanol, called quercetin, is naturally present in grapes and other fruits and vegetables and is considered a healthy antioxidant. However, when metabolized with alcohol, issues can occur. 

"When it gets in your bloodstream, your body converts it to a different form called quercetin glucuronide," wine chemist and corresponding author Andrew Waterhouse, professor emeritus with the UC Davis Department of Viticulture and Enology, said in a news release  about the study. "In that form, it blocks the metabolism of alcohol."

The result is a build up of acetaldehyde, an inflammatory toxin that can cause facial flushing, headache and nausea.

Red wine headaches — not to be confused with hangover headaches the day after drinking — do not require excessive amounts of wine, the study notes. In most cases, the headache starts 30 minutes to 3 hours after drinking only one or two glasses.

The amount of quercetin in wines also varies greatly, the researchers note. Factors like the sunlight exposure the grapes receive and how the wine is made can impact the amount present in the final product.

"If you grow grapes with the clusters exposed, such as they do in the Napa Valley for their cabernets, you get much higher levels of quercetin. In some cases, it can be four to five times higher,"  Waterhouse said.

So, is there a way to avoid the risk of a headache besides skipping the sipping? That's what scientists are looking to research next.

"We think we are finally on the right track toward explaining this millennia-old mystery. The next step is to test it scientifically on people who develop these headaches, so stay tuned," co-author Morris Levin, professor of neurology and director of the Headache Center at the University of California, San Francisco, said in the release.

That research, a small human clinical trial funded by the Wine Spectator Scholarship Foundation and led by UCSF, intends to determine why some people are more susceptible to these headaches than others and if quercetin or acetaldehyde is the primary target for ameliorating these effects. 

"If our hypothesis pans out, then we will have the tools to start addressing these important questions," Waterhouse said.

Sara Moniuszko is a health and lifestyle reporter at CBSNews.com. Previously, she wrote for USA Today, where she was selected to help launch the newspaper's wellness vertical. She now covers breaking and trending news for CBS News' HealthWatch.

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Older Adults Do Not Benefit From Moderate Drinking, Large Study Finds

Virtually any amount increased the risk for cancer, and there were no heart benefits, the researchers reported.

By Roni Caryn Rabin

Even light drinking was associated with an increase in cancer deaths among older adults in Britain, researchers reported on Monday in a large study. But the risk was accentuated primarily in those who had existing health problems or who lived in low-income areas.

The study, which tracked 135,103 adults aged 60 and older for 12 years, also punctures the long-held belief that light or moderate alcohol consumption is good for the heart.

The researchers found no reduction in heart disease deaths among light or moderate drinkers, regardless of this health or socioeconomic status, when compared with occasional drinkers.

The study defined light drinking as a mean alcohol intake of up to 20 grams a day for men and up to 10 grams daily for women. (In the United States, a standard drink is 14 grams of alcohol .)

“We did not find evidence of a beneficial association between low drinking and mortality,” said Dr. Rosario Ortolá, an assistant professor of preventive medicine and public health at Universidad Autónoma de Madrid and the lead author of the paper, which was published in JAMA Network Open.

On the other hand, she added, alcohol probably raises the risk of cancer “from the first drop.”

The findings add to a mounting body of evidence that is shifting the paradigm in alcohol research. Scientists are turning to new methodologies to analyze the risks and benefits of alcohol consumption in an attempt to correct what some believe were serious flaws in earlier research, which appeared to show that there were benefits to drinking.

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Red wine and resveratrol: good for your heart.

Resveratrol might be key to what could make red wine heart healthy. Learn the facts and hype about red wine and how it affects the heart.

Red wine, in limited amounts, has long been thought of as healthy for the heart. The alcohol and certain substances in red wine called antioxidants may help prevent coronary artery disease, the condition that leads to heart attacks.

Links between red wine and fewer heart attacks aren't well understood. But antioxidants in red wine may increase levels of high-density lipoprotein (HDL) cholesterol, also called the "good" cholesterol, and protect against cholesterol buildup.

Experts say not to start drinking alcohol to help your heart. This is especially true if you have alcohol use disorder or if alcohol use disorder is in your family. Too much alcohol can harm the body in many ways.

But if you already have a glass of red wine with your evening meal, drinking it in limited amounts may improve your heart health.

How is red wine heart healthy?

Antioxidants in red wine called polyphenols may help protect the lining of blood vessels in the heart. A polyphenol called resveratrol is one part of red wine that's gotten noticed for being healthy.

Resveratrol in red wine

Resveratrol might help prevent damage to blood vessels, lower low-density lipoprotein (LDL) cholesterol, also called the "bad" cholesterol, and prevent blood clots.

But study results on resveratrol are mixed. Some research shows that resveratrol could be linked to a lower risk of swelling and irritation, called inflammation, and blood clotting. Both can lower the risk of heart disease.

But other studies have found that resveratrol does not protect against heart disease. More research is needed.

Resveratrol in grapes, supplements and other foods

The resveratrol in red wine comes from the skin of grapes used to make wine. Simply eating grapes or drinking grape juice might be a way to get resveratrol without drinking alcohol. Red and purple grape juices may have some of the same heart-healthy pluses of red wine.

Peanuts, blueberries and cranberries also have some resveratrol. It's not yet known whether eating grapes or other foods promotes heart health the way drinking red wine might. And it's not known how much resveratrol is needed to protect the heart. The amount of resveratrol in food and red wine can vary widely.

There also are resveratrol supplements. However, they might cause side effects. And research suggests that the body can't absorb most of the resveratrol in supplements.

How might alcohol help the heart?

Many studies have shown that drinking regular, limited amounts of any type of alcohol helps the heart. It's not just red wine. It's thought that alcohol:

• Raises HDL cholesterol, also called the "good" cholesterol.
• Helps keep blood clots from forming.
• Helps prevent artery damage from high levels of LDL cholesterol, also called the "bad" cholesterol.
• May improve how well the layer of cells that line the blood vessels works.

Drink in moderation — or not at all

Researchers keep studying whether red wine and other alcoholic drinks can help the heart. Those who drink regular, limited amounts of alcohol, including red wine, seem to have a lower risk of heart disease. Drinking regular, limited amounts is called drinking in moderation.

But there might be other reasons for the lower risk of heart disease in people who drink red wine in moderation. For instance, they might eat a healthier diet and be more active than those who don't drink red wine. And they might have higher incomes and better access to health care as well.

More research is needed about whether red wine is better for the heart than other types of alcohol, such as beer or hard liquor.

The American Heart Association and National Heart, Lung, and Blood Institute advise against starting to drink alcohol just to prevent heart disease. Some people who drink alcohol have trouble stopping, called addiction. And drinking alcohol can cause other health problems or make them worse.

Drinking too much alcohol increases the risk of:

• Accidents, violence and suicide.
• Certain types of cancer.
• Heart failure.
• Irregular heart rhythms such as atrial fibrillation, which can lead to stroke.
• High blood pressure.
• Liver and pancreas diseases.
• Weight gain and obesity.

Do not drink alcohol at all if you:

• Are pregnant, think you might be pregnant or are trying to become pregnant.
• Have a personal or strong family history of alcohol use disorder.
• Have liver disease.
• Have pancreas disease linked to alcohol use.
• Have heart failure or a weak heart.
• Take medicines that don't mix well with alcohol.
• Are breastfeeding, especially within two hours of drinking alcohol.

If you have questions about the plusses and risks of alcohol, talk with your health care professional.

If you already drink alcohol, do so in moderation. For healthy adults, that means:

• Up to one drink a day for women.
• Up to two drinks a day for men. The limit for men is higher because men most often weigh more than women and have more of the substance that breaks down alcohol in the body.

A drink is defined as:

• 12 ounces (355 milliliters) of regular beer.
• 5 ounces (148 milliliters) of wine.
• 1.5 ounces (44 milliliters) of hard liquor or distilled spirits.

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• Tangney CC, et al. Cardiovascular benefits and risks of moderate alcohol consumption. https://www.uptodate.com/contents/search. Accessed June 15, 2023.
• Mukamal KJ. Overview of the risks and benefits of alcohol consumption. https://www.uptodate.com/contents/search. Accessed June 15, 2023.
• Libby P, et al., eds. Cardiomyopathies induced by drugs or toxins. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed June 15, 2023.
• Rethinking drinking: Alcohol and your health. National Institute on Alcohol Abuse and Alcoholism. https://www.rethinkingdrinking.niaaa.nih.gov/. Accessed June 15, 2023.
• 2020-2025 Dietary Guidelines for Americans. U.S. Department of Health and Human Services and U.S. Department of Agriculture. https://www.dietaryguidelines.gov. Accessed June 15, 2023.
• Scientific Report of the 2020 Dietary Guidelines Advisory Committee. Alcoholic beverages. U.S. Department of Health and Human Services and U.S. Department of Agriculture. https://www.dietaryguidelines.gov/2020-advisory-committee-report. Accessed June 15, 2023.
• Is drinking alcohol part of a healthy lifestyle? American Heart Association. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/alcohol-and-heart-health. Accessed June 15, 2023.
• Drinking red wine for heart health? Read this before you toast. American Heart Association. https://www.heart.org/en/news/2019/05/24/drinking-red-wine-for-heart-health-read-this-before-you-toast. Accessed June 15, 2023.
• Krittanawong C, et al. Alcohol consumption and cardiovascular health. The American Journal of Medicine. 2022; doi:10.1016/j.amjmed.2022.04.021.
• Lopez-Jimenez F (expert opinion). Mayo Clinic. June 20, 2023.

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Why Red Wine May Cause Headaches, According to New Research

Isn't science great?

Jelisa Castrodale has been a staff writer with Food & Wine since 2019.

Getty Images

How many times have you had a single glass of red wine at dinner —  or even half a glass — and had a headache before you could even summon an Uber to take you home? Red wine has earned a reputation for causing headaches, even when you haven’t had a second or third round. Researchers have spent years trying to find the connection between reds and headaches, but a group of scientists from the University of California, Davis, think they’re coming closer to figuring it out. 

According to their study, which was published this week in the journal Scientific Reports , 37% of alcohol drinkers have reported that imbibing beer, wine, or spirits can cause “occasional” headaches. In drinkers who have experienced a “primary headache” — a headache that begins within three hours of drinking and isn’t as delayed as the dreaded hangover headache — over one quarter (28%) identified red wine as a cause. Red wine was also implicated as a headache trigger more often than spirits (14%), white wine (10%), sparkling wine (10%), or beer (10%). The study also says that “in most cases,” just one to two glasses of red wine were enough to conjure a headache. 

In previous studies, researchers have surmised that the cause could be preservatives called sulfites, the tannins found in the wine, or histamines. This time, the researchers focused on a plant flavanol called quercetin that is present in red wine. Quercetin, also an antioxidant, is found in various fruits and vegetables, including citrus fruits, dark berries, and grapes. However, since eating a handful of grapes or cherries doesn’t typically lead to headaches the way that a glass of red wine does, the study authors believe that the problem could be the combination of quercetin and alcohol. 

“When [quercetin] gets in your bloodstream, your body converts it to a different form called quercetin glucuronide,” Andrew Waterhouse, wine chemist and professor emeritus with the UC Davis Department of Viticulture and Enology, said in a statement. “In that form, it blocks the metabolism of alcohol.”Because it interferes with an enzyme that helps break down alcohol, quercetin glucuronide can also cause a buildup of a chemical called acetaldehyde, which can cause facial flushing, nausea, and — you guessed it — headaches. 

“We postulate that when susceptible people consume wine with even modest amounts of quercetin, they develop headaches, particularly if they have a preexisting migraine or another primary headache condition,” Morris Levin, the director of the Headache Center at the University of California, San Francisco, and one of the study’s co-authors said. “We think we are finally on the right track toward explaining this millennia-old mystery.” 

To further test this hypothesis, the researchers will conduct a “small human clinical trial” that will compare whether quercetin-rich red wines cause headaches more frequently than reds that are lighter in that particular flavanol. Until then, maybe we should stick to Chardonnay? 

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Are There Health Benefits To Drinking Red Wine?

What Is Red Wine?

Red wine is an alcoholic drink with a deep red color that comes from dark-colored grapes. To produce red wine, winemakers ferment crushed grapes, including the grape skin. Yeast grows and takes in the natural sugars, converting them into alcohol. The grape skin gives red wine some of its color and flavor.

Tannins, which are a group of naturally occurring chemicals found in plant cells present in wine, form during fermentation and are responsible for the wine's bitter but pleasant taste.

There is some evidence that drinking red wine may offer health benefits. If you are a nondrinker, health experts do not recommend that you start drinking alcohol. But if you enjoy alcohol in moderation, red wine is worth considering.

Red wine may be healthier than white wine because of the different fermentation processes. Unlike red wine, most white wine is fermented after the grape skins are separated from the mashed fruit and juice. As many of the antioxidants in grapes are in the skin, red wine contains more antioxidants than white wine.

Antioxidants are important for maintaining good health because they protect your cells from damage. The antioxidants found in wine are polyphenols, which are compounds found in plants. One polyphenol in red wine that is of interest to scientists is resveratrol , which may have benefits including protection for your brain, heart, and body.

Types Of Red Wine

There are more than 10,000 varieties of wine grapes internationally, including about 50 different types of red wine.

Cabernet Sauvignon. Internationally, t his wine comes from the most planted and popular red wine grape. Cabernet Sauvignon is considered to be bold and tannic, with flavor notes including blackberry , black cherry, vanilla, and green pepper.

Merlot. Merlot is similar in flavor to Cabernet but has some additional flavor notes, including plum and mint. It ripens earlier than Cabernet.

Malbec. The flavor of Malbec relies more on tannins, including plum, black cherry, chocolate, and mocha. It is considered to pair well with certain meats such as beef, pork, and bison.

Zinfandel. The California variety of Z infandel is usually bold, with ripe flavors including blueberry and peach. Try it with barbecue and other meals with richly flavored meat. White Zinfandel is a blush wine made from this type of red wine variety.

Pinot Noir. Pinot Noir provides various flavors including mushroom , strawberry, and cola. It's bright and acidic and is lighter in body and color than a lot of other red wines. It is very versatile and goes well with poultry and seafood.

There are also many dessert wines that are made from dried grapes, providing a deep sweetness.

Some varieties of sweet red wine include:

Port. Port wine is made in many different styles, all of which have a higher alcohol level (up to 20%) than other red wines because of the distilled grape spirits that are added during fermentation. Port wines are very sweet, have a lot of flavor, and are full-bodied, so you can sip them alone or pair them with cheese or nutty desserts.

Brachetto d’Acqui. This type of red wine is usually light, effervescent, and slightly sweet and fruity. Try it with spicy or mildly sweet dishes.

Lambrusco. This is a red sparkling wine that can be dry but is usually somewhat sweet and fruity. It has a slightly bitter taste at the end and can go nicely with sausages and other meats and cheeses.

Red Wine Nutrition Facts

One serving of red wine is about 5 ounces. The nutritional value may vary slightly according to the variety. On average, one serving of red wine contains:

• Calories: 125
• Protein: 0.1 gram
• Fat: 0 grams
• Carbohydrates: 4 grams
• Fiber: 0 grams
• Sugar: 1 gram

The bulk of the calories in red wine comes from alcohol, and the remaining calories are from carbohydrates. The carbohydrates in red wine come from the grape skin, seed extract, and leftover sugars from the grapes .

 Red wine also contains small amounts of vitamins and minerals, including:

Red Wine Benefits

Some benefits of drinking red wine can be traced to the alcohol itself, so any alcoholic drink used in moderation could have the same effect. Other research into the health benefits of red wine focuses on the particular qualities of red wine, many of which have not been fully explored.

Scientists have found these possible health benefits of red wine consumption:

Blood pressure control

The antioxidants in red wine could lower blood pressure . In a few studies of people with slightly elevated blood pressure, red wine extract lowered readings. Both systolic and diastolic pressure improved. The studies concluded that the polyphenols in red wine were responsible.

Heart health

Although more research is needed, some studies show that red wine is good for heart health because it helps reduce the risk of plaque buildup in the arteries.

Cancer risk reduction

Resveratrol, a polyphenol in red wine, has anti-inflammatory and antioxidant properties and may reduce the risk of cancer by discouraging cancer cell growth. Although more human studies are needed to confirm this effect, early research on resveratrol in wine has shown its cardiovascular benefits. It's possible, however, that compounds other than resveratrol in red wine are responsible for a lower risk of certain cancers, including colon and prostate cancer.

Reduced risk of Alzheimer's

The polyphenols, which occur naturally in red wine, prevent the formation of certain proteins that create toxic plaques that can kill brain cells. These polyphenols can also lessen the plaque toxicity that is already present in the body, thus reducing cognitive decline.

Research shows that drinking in moderation could reduce the risk of Alzheimer's disease or other forms of dementia vs. no alcohol intake. Some effects of alcohol on the brain, including reduced blood thickness and increases in HDL or “healthy” cholesterol, seem to show that moderate alcohol consumption may help lower the risk of developing dementia. However, we need more research on this.

Lower risk of diabetes

A large study of current drinkers showed that a moderate intake of alcohol, especially wine, with meals could reduce the risk of type 2 diabetes . The results were not the same for heavy drinking or drinking alcohol without a meal. The association between moderate alcohol consumption and reduced risk of new-onset type 2 diabetes is inconclusive. Talk to your doctor about the benefits and risks of moderate drinking.

Potential Health Risks Of Red Wine

While some studies have shown the health benefits of drinking red wine, you should weigh the benefits against the risks and keep in mind the dangers of alcohol abuse.

Drinking red wine presents some potential health risks:

Wine allergies

About 10% of the population is at risk of an allergic reaction to wine. Many components of wine can trigger a reaction, including yeast, molds, and sulfites. Even the flavonoids, which make red wine healthy, can cause an intolerance reaction. Red wine is one of the forms of alcohol most likely to cause a reaction in people with asthma.

Excessive drinking

Many people struggle with excessive alcohol consumption. The CDC states that an average of 1 in 6 American adults binge drink. Binge drinking is defined as consuming four or more drinks on an occasion for women and five or more for men. Many drinkers, especially those who drink heavily, which is defined as eight or more alcoholic drinks in a week in women and 15 or more in men, underreport their alcohol consumption. Hence, the problem may be worse than reports indicate.

Pregnancy concerns

Those who are pregnant should not drink alcohol. This precaution extends to those planning to get pregnant and to those who are breastfeeding. All types of alcohol, including red wine, should be avoided.

Alcohol and gout

People who suffer from gout should not drink at all. Consumption of alcohol, including wine, can worsen gout symptoms, including increased urate levels. Higher levels of uric acid in the bloodstream are a trigger for gout .

Liver damage

Drinking too much alcohol of any kind can damage the liver, leading to conditions such as cirrhosis. Alcohol can even worsen conditions caused by a virus, such as hepatitis C.

Unwanted weight gain

Wine contains a lot of calories per serving. Even moderate drinking affects your daily caloric intake, which at high levels can cause weight gain.

Increased risk of some cancers

Heavy drinking is linked to some cancers, including those of mouth and throat, esophagus, voice box, liver, colon and rectum, and breast. Chemicals that form in our bodies from drinking alcohol damage our DNA. This damage can result in a cell growing uncontrollably and leading to a cancer tumor.

Alcohol can cause physical and psychological dependence. Scientists believe that if you have a family history of misusing alcohol, you have a 50% chance of being prone to alcohol abuse and addiction. Long-term alcohol dependence can weaken your immune system and make your body more prone to infections. It can also affect your body’s  stress response , which increases your risk for many chronic diseases.

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Beneficial Effects of Red Wine Polyphenols on Human Health: Comprehensive Review

Ivana buljeta.

1 Faculty of Food Technology, Josip Juraj Strossmayer University, F. Kuhača 18, 31000 Osijek, Croatia

Anita Pichler

Josip Šimunović.

2 Department of Food, Bioprocessing and Nutrition Sciences, North Carolina State University, Raleigh, NC 27695, USA

Mirela Kopjar

Associated data.

Data presented in manuscript.

Polyphenols are secondary plant metabolites synthesized during the development of the grape berry as a response to stress conditions. They are important constituents in red wines that contribute to the sensory properties and antioxidant activity of wines. Due to the development of highly sophisticated analytical devices, it is now possible to characterize the structure of highly polymerized polyphenols and obtain a full polyphenol profile of red wines. Red wine polyphenols include the ones present in grapes as well as new polyphenol products formed during the winemaking process. Among them, the most important groups and their representatives are flavanols (catechin), stilbenes ( trans -resveratrol), flavonols (quercetin) and hydroxybenzoic acids (gallic acid). It is known that polyphenols exhibit beneficial effects on human health, such as anti-inflammatory, anticarcinogenic and cardio-protective effects. Many studies have been conducted on the health effects of red wine polyphenols in cancer chemopreventive activities, neuroprotective effects and impact on cardiovascular diseases, gut microbiota in humans, etc. This review will provide major scientific findings on the impact of red wine polyphenols on human health as well as a review of polyphenols present in red wines and their main features.

1. Introduction

Wine production dates to a period between 5400 and 5000 Before Common Era and it is still spread all over the world [ 1 ]. Wine is a widely consumed alcoholic beverage with pleasant sensory properties, and it is usually fermented from the European species Vitis vinifera and American grape species Vitis labrusca . During red wine production, the grape juice (must) is fermented at the same time with grape skin and other grape parts. The other processes include fining, filtering and bottling [ 1 , 2 ].

Over 500 compounds have been characterized in wine so far and the main components are sugars, organic acids, alcohols, minerals, pigments, polyphenols, nitrogenous substances, gums, pectins, mucilages, volatile compounds, salts, vitamins and sulfur dioxide [ 1 , 3 ]. Major bioactive compounds in wine are ethanol and polyphenols [ 3 ]. Polyphenols are secondary metabolites of plants widely present in fruits, vegetables and their derived products. Among scientists, they attract a lot of attention and were declared as nutraceuticals of modern life [ 4 ]. Berries, red wine, whole grains, citrus and green tea are examples of foods rich in polyphenols, and a diet rich with those ingredients is highly recommended due to polyphenols’ positive impact on health [ 5 , 6 ]. The presence of polyphenols affects the taste, palatability and nutritional value of foods. They also have an impact on the characteristics and quality of red wines [ 7 ]. In addition to the effect on color and flavor of wine, polyphenols act as natural wine preservatives. A glass of red wine contains around 200 mg of total polyphenols, while in the same quantity of white wine, there is around 30 mg of total polyphenols [ 3 ]. Polyphenol composition in one-year-old red wine includes around 5–8% of catechins, 5–10% dimer procyanidins, 10–15% of anthocyanidins, 3–6% phenolic acids, <1% of flavonols, <0.3% of resveratrol and 60–80% polymeric polyphenols [ 8 ]. The qualitative and quantitative polyphenol content in red wine depends on different factors, such as environmental factors in the vineyards (soil, climate, exposure to fungal infections), grape varieties and maturity, pre-fermentative practices (addition of sulfur dioxide and ascorbic acid before crushing), fermenting and aging conditions and other technological practices (ionic exchange, filtration, centrifugation, cold stabilization) [ 9 ]. It was observed that the delaying of the harvesting date resulted in higher levels of anthocyanins and extractable tannins in wine [ 1 ]. The decomposition of grape solids following crushing grapes facilitates the release of polyphenols [ 10 ]. At the beginning of winemaking, when a crushing process is carried out, the enzymatic and non-enzymatic reactions start and continue through fermentation and aging [ 8 ]. During wine aging, polyphenols from wine transform into complex molecules derived from the condensation of catechins, proanthocyanidins and anthocyanins. As a result, new pigments can form and modifications in wine color occur. New polyphenols, such as vanillin and hydrolysable tannins, during the process of oak aging can appear in the wine. Tannins protect wine from oxidation and they come into oaks from the lignin structure in the wood. Finally, it can be said that wine’s chemical composition is much more complex than the raw material [ 9 ].

Previously published scientific studies discussed the role of diet in the prevention of chronic diseases by highlighting dietary intervention on health status and restoring the balance due to previous imbalances caused by lifestyle and environmental factors [ 11 ]. Polyphenols possess many biological properties, such as anti-inflammatory responses, antiviral, carcinostatic properties, prevention of low-density lipoprotein oxidation, antihypertensive effect, antimicrobial, antiaging properties, etc. [ 10 , 12 ]. Further, higher polyphenol exposure resulted in lower levels of inflammatory biomarkers [ 13 ]. An explanation of some mechanisms for health benefits of polyphenols is their ability to interact with biological systems through modulation of gene expression. Such mechanisms are usually investigated in vitro and in animal models. That includes activation of endothelial nitric oxide production, reduction in tau aggregation and neuroinflammation, interaction with intracellular signaling pathways, etc. [ 14 ]. Polyphenols showed a positive impact on lipid metabolism by alleviating lipid metabolism disorders and lowering blood glucose levels [ 6 ]. The health-promoting effect of red wine is supported by epidemiological evidence and includes improvements in endothelial dysfunction and hypertension, dyslipidemia and metabolic disorders [ 11 ]. Moderate and regular wine consumption is one of the possible reasons for the low rates of coronary heart disease in the French population, despite the high intake of dietary cholesterol and saturated fat. The ”French paradox” increased interest among scientists in the relationship between wine consumption and cardiovascular health [ 15 , 16 ]. Studies have shown correlation between wine consumption and prevention of metabolic syndrome and its related medical complications [ 17 ].

Considering the widespread consumption of wine and the significance of its positive effects on human health, this review summarizes the health benefits of polyphenols as well as the main bioactive components in red wine.

2. Polyphenols in Red Wine

Polyphenols are classified according to the number of phenol rings and the chemical groups attached to the rings. They are generally made of two aromatic rings connected via a three-carbon bridge and each ring contains at least one hydroxyl group. Simple polyphenols are made of a single aromatic ring with one or more hydroxyl groups attached [ 9 ]. Polyphenols are usually divided into flavonoids and non-flavonoids. Flavonols, flavones, flavan-3-ols, flavanones, anthocyanidins, isoflavonoids and dihydrochalcones belong to the group of flavonoids. Non-flavonoids include phenolic acids, tannins and lignans [ 18 ].

Polyphenols found in grapes include anthocyanins, flavanols, flavonols, phenolic acids and stilbenes (such as resveratrol and picetannol). They are usually found in the solid parts of grapes (skins, seeds and stems). In addition to proanthocyanidins, which occur as polymers and oligomers, other grape polyphenols are found in monomeric or low-weight forms. In the grape skin, anthocyanins are usually found while flavonoids are mainly found in seeds and stems. The proanthocyanidins are mainly found in seeds, followed by stem and skin, while the pulp is free of them [ 19 ].

2.1. Phenolic Acids

Phenolic acids are divided into two subgroups: hydroxybenzoic acids and hydroxycinnamic acids. Both subgroups are present in wine. The hydroxybenzoic acid group includes gallic acid, ellagic acid, protocatechuic acid, vanillic acid, p -hydroxybenzoic acid and syringic acid derived from benzoic acid [ 1 , 20 ]. Gallic acid is present in red wine but not in grapes. It is assumed that gallic acid is formed by the hydrolysis of tannins [ 21 ]. From the group of hydroxycinnamic acids, chlorogenic acid is the main representative, while some others are sinapic acid, coutaric acid, caffeic acid, ferulic acid, caftaric and fertaric acid [ 1 , 20 ].

2.2. Resveratrol

Resveratrol (3,5,4′-trihydroxystilbene) is a non-flavonoid polyphenol present in a small number of foods, such as grapes and red wine [ 22 ]. Its biosynthesis occurs through the phenylalanine route [ 1 ]. It is produced by grapes as a response to stress stimuli, such as injury, ultraviolet exposure or fungal infection [ 3 ]. This molecule exists in two isoforms, cis - and trans -resveratrol. Before the fermentation of grape juice, the major compound is the cis -isomer while the final product contains a higher amount of trans -isomer [ 3 ]. However, other research reported that high concentrations of cis -resveratrol were determined in wine while it was not detected in grape juice or skins. The authors suggested its formation by trans -resveratrol isomerization or the breakdown of resveratrol polymers during fermentation occurred [ 23 ]. The concentration of resveratrol depends on the variety, geographical location maturity, time of harvest and health of the grape [ 22 ].

2.3. Anthocyanins

Anthocyanins are responsible for the color of some fruits and vegetables as well as their products such as red wine [ 4 ]. The chemical structure of anthocyanins is made of three cyclic carbon rings C6–C3–C6, known as a flavylium cation with a positive charge [ 24 ]. They are flavonoids present in the form of glycoside and acylglycoside of anthocyanidins. Representatives of anthocyanidins (aglycone) with different hydroxyl or methoxyl groups are cyanidin, delphinidin, malvidin and peonidin. Sugars usually abundant in anthocyanins are glucose, xylose, rhamnose, galactose, fructose and arabinose. Glycosylation and acylation enhance the solubility of anthocyanins and it is known that glycosides are more stable than the corresponding aglycone. Anthocyanins present in red wine are malvidin-3- O -glucoside, cyanidin-3- O -glucoside, peonidin-3- O -glucoside and delphinidin-3- O -glucoside [ 25 ]. Depending on the pH, anthocyanins vary in color, changing between red and blue due to different chemical forms in an aqueous solution [ 4 , 24 ]. At pH values from 1 to 3, the flavylium cation (red) predominates. By increasing pH values, deprotonation from C7, C4′ and C5 occurs and forms three quinonoidal basic forms (purple). An increase in pH value above 7 causes the formation of secondary deprotonation yielding quinonoidal anions (blue) [ 24 ]. In addition to being responsible for the initial color of red wine, anthocyanins are associated with changes that occur during wine aging due to their condensation with flavanols and/or other smaller compounds (vinylphenol, pyruvic acid, glyoxylic acid) [ 4 ].

2.4. Flavan-3-ols

Flavan-3-ols are one of the most abundant polyphenols in nature, whose structures differ in the stereochemistry of the carbon 3 of ring C and in the hydroxylation degree of ring B. They consist of a monomeric unit ((+)-catechin or (−)-epicatechin) and they can combine to form polymers and proanthocyanidins (condensed tannins). In grape skin tannins, polymers with up to 80 units were found. Further, flavan-3-ols can be esterified with gallic acid (epigallocatechin, epigallocatechin gallate) [ 4 ].

2.5. Flavonols

Flavonols present in red wine include aglycons, such as quercetin, myricetin, kaempferol and rutin, as well as their glycosides (glucosides, galactosides, glucuronides and diglycosides) [ 1 , 21 ]. Quercetin is one of the most abundant flavonoids present in red wines. Among the flavonoid groups, these compounds are recognized as the main active compounds due to their wide range of biological activities [ 21 ].

2.6. Tannins

Tannins contribute to the astringency of wine and have the ability to interact and precipitate proteins. They are divided into hydrolyzable and condensed tannins. Hydrolyzable tannins are esters of monosaccharides with gallic acid or oligomers of gallic/ellagic acids [ 4 ]. Due to interaction with proteins, tannins can be responsible for the transportation of polyphenols through the body and the expression of their antioxidant potential [ 4 ]. Hydrolyzable tannins originate from barrels of wood and are extracted into the wine during wine aging [ 21 ].

3. Red Wine Polyphenols and Health

In the next several sections, the health benefits of moderate red wine consumption and its polyphenols will be described. Figure 1 presents the main polyphenols present in red wine and their health benefits proven by in vivo and in vitro studies.

Polyphenols present in red wine and the health benefits of moderate red wine consumption.

3.1. Red Wine Polyphenols for Cancer Prevention and Treatment

Cancer is one of the main reasons for death worldwide. It affects more than 6 million people a year [ 26 ]. A promising strategy named chemoprevention is defined as the use of natural or synthetic substances or their combinations for blocking, reversing or retarding the process of carcinogenesis [ 27 ]. Polyphenols are considered constituents in foods and beverages responsible for reducing the risk of cancer. They are proven to be protective for cell cultures and in animals pre-treated with carcinogenic chemicals or cancer cells [ 26 ]. Colorectal cancer affects 1.8 million people each year and it is the third-most-common type of cancer. Most of the diagnoses start as non-cancerous polyps in the intestinal epithelium on the inner lining of the colon or rectum, which accumulated oncogenic mutations over time. These non-cancerous polyps can transform into malignant adenomatous polyps if not detected in time. Among other things, environmental factors, such as diet, smoking, alcohol consumption and a sedentary lifestyle, have a significant impact on this progression. Several studies highlight the benefits of a proper diet (such as the Mediterranean diet) as a protective factor for many diseases, including cancer [ 28 , 29 ]. The consumption of polyunsaturated fatty acids through the Mediterranean diet or food rich in polyphenols has a beneficial effect on cancer prevention [ 30 ].

The apoptotic effects of red wine polyphenols on human colon cancer cells (SNU-C4) have been investigated [ 31 ]. The results showed that polyphenols (100 µg/mL) increased the apoptosis of SNU-C4 cells through morphological changes in chromatin condensation and apoptotic body formation. In comparison with a control group, it was observed that polyphenols reduced the expression of gene Bcl-2 and increased the expression of Bax and Caspase-3 genes. It can be suggested that polyphenols have potential as an anti-colon-cancer agent [ 31 ]. Polyphenol-rich plant extracts (red wine, pomegranate, white grape and rosemary extracts), as inhibitors of colon carcinogenesis in rats, were investigated [ 32 ]. The extracts were added to workshop-made cured meat, whose intake promotes colon carcinogenesis. The supplementation lasted for 14 days for rats and 100 days for azoxymethane-induced rats. The results showed a positive impact of dried red wine, pomegranate extract and α-tocopherol on the decreased number of mucin-depleted foci per colon. It was suggested that the incorporation of these extracts in cured meat can reduce the risk of colorectal cancer that is connected with the consumption of processed meat [ 32 ]. Furthermore, the efficiency of red wine extracts on the proliferation of colon cancer cells in vitro and colonic aberrant crypt foci in vivo was investigated [ 33 ]. A long vinification process resulted in red wine extracts with superior anti-proliferative activity in tested cells and the prevention ability of the appearance of aberrant crypt foci in mice. Further, it was noticed that quercetin and trans -resveratrol showed synergistic anti-proliferative effects [ 33 ].

Prostate cancer ranks fourth place worldwide, affecting 1.28 million people each year [ 28 , 29 ]. Factors that cause this disease include radical and ethnic background, age and hereditary genes, as well as environmental and lifestyle factors [ 28 ]. The moderate consumption of red wine had a protective effect against prostate cancer while white wine moderate consumption increases the risk of prostate cancer [ 34 ]. This may be due to the polyphenols that are mainly found in red wine and their anticancerogenic effects [ 34 ].

Anticarcinogenic properties of polyphenols from red wine (quercetin, gallic acid, trans -resveratrol and (+)-catechin) were studied [ 35 ] and a mouse skin cancer model was employed. Animals were treated with polyphenols (from 0 to 125 mM) twice a week for a total of eighteen weeks topically. The probit analysis results showed that quercetin was the most effective (ED 50 < 1 µmol), followed by (+)-catechin (ED 50 5 µmol), trans -resveratrol (ED 50 6 µmol) and gallic acid (ED 50 5–10 µmol). Further, trans -resveratrol was adsorbed more efficiently than quercetin and (+)-catechin in humans after oral consumption. Authors concluded that trans -resveratrol might be the most effective anticancer polyphenol in red wines because of highly efficient adsorption after oral consumption in humans [ 35 ]. Furthermore, dehydrated–dealcoholized red wine was tested for chemopreventive activities in mice. It was reported that red wine solids supplement delayed tumor onset and that catechin was absorbed by mice. A supplemented diet (red wine polyphenols) supported normal growth and reproduction for three generations, which made it suitable for animal studies and human clinical trials [ 36 ]. One study dealt with a comparison of the effects of black and green tea and red wine on azoxymethane-induced intestinal carcinogenesis. Male rats, treated with azoxymethane, were divided into three groups, and to their diet, black tea, green tea or red wine extracts were added. Black tea and wine extract showed a significant impact on fewer colorectal tumors than in controls. These results indicated that black tea and wine extracts could protect against azoxymethane-induced colon carcinogenesis, with a mechanism that involves increased apoptosis in tumors [ 37 ]. Selected studies of red wine polyphenols’ impact on cancer are presented in Table 1 .

Selected studies of red wine polyphenols’ impact on cancer.

3.2. Red Wine Polyphenols and Cardiovascular Health

Coronary heart disease and stroke are the main causes of mortality and disability in developed countries [ 43 ]. Most coronary heart diseases are due to atherosclerosis. Based on scientific studies, light-moderate alcohol consumption is associated with a lower occurrence of type 2 diabetes, a higher level of high-density lipoprotein cholesterol and a reduction in lipid oxidative stress. Compared with other alcoholic beverages, red wine is more effective for the prevention of coronary heart disease. It could be that the presence of alcohol together with antioxidants had apparent beneficial properties [ 21 ].

Preclinical studies showed that polyphenols have the ability to reduce low-density lipoprotein oxidation [ 43 ]. Several mechanisms are involved in red wine’s impact on cholesterol where polyphenols participate in hepatic cholesterol and lipoprotein metabolism. It takes place by reducing cholesterol absorption and decreasing its delivery to the liver and consequently reducing plasma cholesterol. Furthermore, polyphenols have an impact on apolipoproteins A and B, the main factors for cardiovascular disease, as well as on increasing lipoprotein lipase activity and decreasing low-density lipoprotein circulation [ 44 ]. One study [ 45 ] investigated the effect of moderate consumption of red wine, dealcoholized red wine and gin on glucose metabolism and lipid profile. The study included sixty-seven men with high cardiovascular risk. All participants, for four weeks, received 30 g alcohol/day and, for dealcoholized red wine, the amount was equivalent to red wine. The results showed constant fasting glucose values during the study, a decrease in HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) and mean-adjusted plasma insulin after wine and dealcoholized wine, increased high-density lipoprotein cholesterol, apolipoprotein A-I and A-II after gin and red wine and decreased lipoprotein after red wine intake. Paraoxonase 1 is a hydrolytic enzyme and has a role in high-density lipoprotein protective properties. The impact of red wine consumption on paraoxonase 1 activity in a healthy population was investigated and the results suggested that moderate consumption of red wine positively affected paraoxonase 1 activity in a healthy Mexican population [ 46 ]. Subclinical coronary atherosclerosis was investigated by Salazar et al. [ 13 ]. The study included mainly male participants and they were subjected to plaque measurements in the carotid and femoral after polyphenol intake. The higher intake of flavonoids was connected with a lower risk of femoral and carotid subclinical atherosclerosis and a higher intake of stilbenes resulted in a lower risk of femoral subclinical atherosclerosis and positive coronary calcium. Chronic intake of red wine polyphenols in 12-, 20- and 40-week-old rats and the possibility of preventing aging-related impairments in vascular function and physical exercise capacity were examined [ 47 ]. Rats received red wine polyphenols or apocynin (antioxidant and NDPH oxidase inhibitor) from week 16 to 40. The results showed that both supplementations improved endothelial dysfunction, normalized oxidative stress and the expression of different proteins. As a conclusion, red wine polyphenols defend against aging-induced endothelial dysfunction [ 47 ]. Acute consumption of red wine and dealcoholized red wine’s impact on postprandial lipid and lipoprotein metabolism in seventeen dyslipidaemic postmenopausal women was investigated [ 48 ]. In this case, acute consumption had no impact on postprandial triglyceride, chylomicrons or insulin homeostasis; in fact, it exacerbated postprandial lipaemia and increased insulin secretion over a six-hour period. Thus, it can be assumed that chronic consumption may be beneficial for cardiovascular disease [ 48 ]. In one investigation, moderate red wine drinkers (elderly population) at high cardiovascular risk had a lower risk of developing metabolic syndrome and having abnormal waist circumference, low high-density lipoprotein cholesterol concentrations, high blood pressure and hyperglycemia, compared with non-drinkers [ 49 ].

The results of the investigation [ 50 ] showed that the estrogen receptor α contributes to the vascular protection of polyphenols and also investigated the contribution of that receptor on the effects of red wine polyphenols on cardiovascular and metabolic alterations associated with obesity. For the investigation, ovariectomized wild-type or estrogen-receptor-α-deficient mice were used. They received standard or Western diets with or without polyphenols for 12 weeks. The results showed that in Western-diet-fed mice, red wine polyphenols reduced plasma triglycerides, adiposity and oxidative stress in the heart, aorta, adipose and liver tissues. Estrogen-receptor-α deletion reduced some beneficial effects of polyphenols [ 50 ]. Malvidin-3- O glucoside, anthocyanin present in grape skin and red wine, has a role in tumor cell inhibition [ 51 ]. Further, one study provided evidence that this compound reduces mammalian myocardial contractility and relaxation and induced coronary vasodilation [ 51 ]. Resveratrol has an important role in cardiovascular diseases, by improving endothelial function and glucose metabolism, reducing inflammation and regulating blood lipids [ 22 ]. Its benefits on ischemia-reperfusion injuries are through helping in the protection during myocardial infraction. Furthermore, it helps to elicit the expression of many antioxidant enzymes (glutathione peroxidase, superoxide dismutase, catalase and heme oxygenase). Further, it may inhibit the proliferation of liver, oral, breast and prostate cell lines [ 1 ]. Selected studies of red wine polyphenols’ impact on cardiovascular diseases are presented in Table 2 .

Selected studies of red wine polyphenols’ impact on cardiovascular diseases.

3.3. Red Wine Polyphenols and Diabetes

Interest among scientists in compounds with potential anti-diabetic activities is on the rise. Such compounds could be a basis for new drugs used for the treatment and prevention of various diseases [ 57 ]. Diabetes mellitus is a complex metabolic syndrome that, according to World Health Organization statistics, will affect about 500 million people by 2025. Complications caused by this disorder include dysfunction of the retina, kidneys, limbs, heart, nerves and blood vessels and, in addition to the violation of life quality, it causes death [ 57 ]. Several studies showed that moderate consumption of wine is associated with lower risk of type 2 diabetes [ 58 ].

Enriched wine concentrate, with natural polyphenols, modulated the level of hyperglycemia, the normalized concentration of hemoglobin and the number of erythrocytes in experiments with conditions of type 1 diabetes. Treatment with wine concentrate resulted in inhibitions in lipid peroxidation and oxidative modification in proteins in the plasma of rats with experimental diabetes mellitus as well as increased activity of superoxide dismutase and reduced activity of catalase and glutathione peroxidase [ 57 ]. The anti-diabetic properties of Portugal red wine were studied in vitro [ 59 ]. Four fractions of red wine obtained by solid-phase extraction and dealcoholized red wine were used and results showed all samples had strong inhibitory activities toward α amylase and α glucosidase. The main compounds that are responsible for these activities are monomeric and oligomeric flavan-3-ol compounds [ 59 ]. One study dealt with digestion of red wine together with glucose and whey protein food models and results showed that co-digestion affected both wine polyphenol and constituent digestion, bioaccessibility and colonic metabolism. The most important result is that glucose bioaccessibility was reduced, which confirms the hypoglycemic effects related to moderate wine consumption. Further, protein degradation was retarded and short-chain fatty acid production increased (specifically butyric acid) [ 60 ]. Selected studies of red wine polyphenols’ impact on diabetes are presented in Table 3 .

Selected studies of red wine polyphenols’ impact on diabetes.

3.4. Red Wine Polyphenols and Gut Microbiota Health Status

It has been found that dietary polyphenols increase the number of beneficial bacteria as well as antimicrobial actions against pathogenic bacteria [ 67 ]. The moderate consumption of red wine can have a direct impact on the microbiota and polyphenols can increase the presence of health-related species ( Akkermansia muciniphila and Faecalibacterium prausnitzii ) [ 68 ]. Nineteen volunteer humans were subjected to an evaluation of red wine polyphenol impact on gut microbiota. Results showed a positive correlation between the total fecal concentration of red wine polyphenols and appearance of Phascolarctobacterium sp., Flavobacterium sp., Pelotomaculum sp., Prevotella copri and Prolixibacter sp. short-chain fatty acids, which appeared to increase and were in correlation with wine intake [ 68 ]. Queipo-Ortuño et al. [ 69 ] investigated the effect of red wine polyphenols on selected gut microbial groups. Ten healthy male volunteers received 272 mL per day (20 days) dealcoholized red wine. The results showed a significantly increased number of Prevotella , Enterococcus , Bifidobacterium , Bacteroides , Bacteroides uniformis , Eggerthella lenta and Blautia coccoides – Eubacterium rectale groups. Further, triglyceride, total cholesterol, high-density lipoprotein cholesterol, C-reactive protein concentrations, systolic and diastolic blood pressures decreased. Moreno-Indias et al. [ 70 ] investigated the effect of red wine polyphenols on the modulation of gut microbiota composition and the decreasing risk factors for metabolic syndrome in obese patients. In the investigation, ten healthy subjects and ten metabolic syndrome patients were included. The subjects consumed red wine and dealcoholized red wine for 30 days each (separated by washout period of 15 days). The results showed that the type of wine (normal and dealcoholized) did not affect dominant bacterial composition. The number of fecal bifidobacterial, Lactobacillus and butyrate-producing bacteria ( Faecalibacterium prausnitzi and Roseburia ) increased in the metabolic syndrome patients. By modulation of gut microbiota with red wine polyphenols, managing metabolic diseases associated with obesity could be achieved.

Gastrointestinal infections are a serious public-health problem due to mortality worldwide and increasing resistance to antibiotics [ 71 ]. New strategies, such as a diet rich in potential therapeutic compounds, may help with the treatment of these infections [ 71 ]. Adhesion of bacteria to intestinal epithelial cells and production of toxins cause their pathogenicity in the intestine [ 72 ]. As polyphenols can protect plants from pathogenic microorganisms, they are investigated to be used as antimicrobial agents for therapeutic purposes. Escherichia coli is normal intestinal microbiota, but some strains can cause serious diseases in the intestinal tract or in the urinary tract. The role of red wine polyphenol extract in the protection of the human colonic epithelial cell line against one strain of Escherichia coli ( Escherichia coli 270) was tested. The results showed that Escherichia coli 270 adheres to intestinal epithelial cells and secretes an exotoxin and that red wine polyphenol protected cells from death. The mechanisms did not include inhibition of the adhesion of Escherichia coli to the cells but inhibition of action of a protein toxin seems to have occurred [ 71 ].

3.5. The Role of Red Wine Polyphenols in Oral Health

Oral health is an important element in general health and affects life quality. Dental caries, edentulism, periodontal disease and oral cancer are oral diseases and poor mouth hygiene is the main risk factor for oral diseases [ 73 ]. The oral microbiota are represented by more than 700 species [ 74 ]. Interest in natural-origin therapies for the maintenance of oral health is on the rise. Polyphenols may be used as new strategies for the prevention and treatment of oral pathologies through antimicrobial, antiadhesive or anti-inflammatory activity [ 74 ].

Several studies showed that wine polyphenols can modulate the composition of the oral microbiota and have prevented caries and periodontal diseases [ 75 ]. The results of one study [ 76 ] showed inhibition of adhesion and biofilm formation of Streptococcus mutans with a high-molecular-weight polyphenol fraction of red wine (proanthocyanidins). Selected wine polyphenols ( p -coumaric and caffeic acids), grape seed and red wine extracts were used for investigation of their effects on Fusobacterium nucleatum , Porphyromonas gingivalis and Streptococcus mutans adherence to human gingival fibroblasts. The results showed partial inhibition of Streptococcus mutans adhesion to human gingival fibroblast after treatment with p-coumaric and caffeic acids, while for Fusobacterium nucleatum , caffeic acid, p-coumaric acid and red wine polyphenol extracts showed inhibitory action. Porphyromonas gingivalis adhesion was inhibited with all used extracts and individual compounds [ 74 ]. The antimicrobial properties of red wine in an oral biofilm model have been investigated [ 77 ]. Five species, usually associated with oral disease, were used for the biofilm model of the supragingival plaque, such as Actinomyces oris , Streptococcus mutans , Fusobacterium nucleatum , Veillonella dispar and Streptococcus oralis . The results showed that red wine and dealcoholized red wine application reduced the Fusobacterium nucleatum and Streptococcus oralis population [ 77 ].

3.6. Red Wine Polyphenol Neuroprotective Properties

Several studies investigated resveratrol’s neuroprotective properties. In neuronal stem cells, pretreated with resveratrol, activated nuclear factor erythroid 2-related factor 2 and protection of cells from oxygen–glucose deprivation were observed [ 78 ]. A resveratrol metabolite, piceatoannol, showed protection of HT22 neuronal cells from glutamate-induced cell death [ 79 ]. In rats, supplemented with resveratrol and then induced cerebral ischemic injury, a decrease in oxidation biomarkers and reestablished superoxide dismutase activity due to resveratrol treatment were observed [ 80 ]. Glutathione is the most important antioxidant in brain cells and enzymes; glutathione peroxidase and glutathione reductase are essential to maintain its functionality. Studies showed that red wine consumption increased the activity of these enzymes [ 14 ]. A study by Rocha-Parra et al. [ 81 ] showed a protective effect of red wine powder (freeze-dried with maltodextrin and gum arabic) on human neuroblastoma SH-SY5Y cell viability co-incubated with 6-hydroxydopamine. Indeed, 150 µg/mL of red wine powder, in a concentration of 1479 ng GAE/mL, exhibited the most protective effect against 6-hydroxydopamine cytotoxicity and ensured 88.3% surviving cells. Polyphenols that have multiple hydroxyl groups have the ability to capture α-dicarbonyl species and scavenge reactive oxygen species that caused the formation of mono- and di-adducts inhibiting advanced glycation end products. In that way, neurodegenerative diseases can be prevented [ 82 ].

3.7. Red Wine Polyphenols and Red Blood Cells

Production of oxygen-derived free radicals is connected to the onset of many diseases (cancer, atherosclerosis, rheumatoid arthritis). Reactive oxygen species are involved in the damage process of red blood cells and sickle cell anemia. Many defense mechanisms are developed in living organisms to limit reactive oxygen species levels and their effect [ 10 ]. The plasma membrane redox system represents the first protection mechanism from oxidative stress to neutralize plasma free radicals in human erythrocytes. It was proved that several polyphenols (resveratrol, quercetin and myricetin) can potentiate cellular antioxidant systems (including plasma membrane redox system). Human erythrocytes, treated with red wine polyphenols (73 µg/mL gallic acid equivalents), resulted in increased glutathione intracellular concentration [ 10 ]. That increase depends upon the activation of glutathione reductase and glucose-6-phosphate dehydrogenase whose enzymatic activities increase by about 30% and 47%, respectively. Changes in the glutathione pathway caused by red wine polyphenols were connected to an increase in reactive oxygen species. Therefore, the authors concluded that the pro-oxidant effect of red wine polyphenols caused an adaptive stress response in erythrocytes, enhancing their antioxidant defense [ 10 ]. A similar study on the plasma membrane redox system (PMRS) showed that the anthocyanin fraction of red wine had the capacity to positively modulate PMRS enzymatic activity [ 83 ]. The effect of two red wine types (Aglianico and Novello) and one white wine on red blood cells was examined [ 10 ]. Under experimentally set conditions, H 2 O 2 caused red blood cell lysis. It was observed that Aglianico (the sort with a higher concentration of polyphenols) provided 25% inhibition in red blood cell hemolysis. Further, preincubation of red blood cells with that wine made a protective effect against oxidative stress (intracellular malondialdehyde maintained at a level comparable to cells without the oxidative stress) [ 10 ]. Via isolation of a specific class of polyphenols from red wine, anthocyanins, their protective effect on red blood cells against reactive oxygen species damage was evaluated. Firstly, the authors demonstrated that the tested red wine and its fractions show no toxic effect on red blood cells. Red blood cells are prone to oxidative damage due to a high level of hemoglobin, which is a promoter of oxidative processes. The results showed that fractions containing anthocyanins had strong antioxidant properties (lower reactive oxygen species levels) and lower methemoglobin production in human red blood cells with micromolar doses of H 2 O 2 [ 25 ]. A group of post-myocardial infarct patients was included in a two-week study, receiving red wine (250 mL per day) or water. The results showed that moderate red wine consumption, even for a short period, has a positive effect on blood parameters, such as increased erythrocyte membrane fluidity and antioxidant status [ 84 ]. A group of non-smoking male volunteers (39 participants) was supplemented with 200 mL per day of red wine or water for 3 weeks. In the group that received red wine, whole blood viscosity significantly decreased while the hematocrit/whole blood viscosity ratio increased. Further, red blood cell aggregation decreased and its deformability at high shear stress increased [ 85 ].

4. Conclusions and Future Perspectives

In this review, the impact of red wine polyphenols on human health was discussed and, more specifically, its impact on cardiovascular disease, cancer prevention and treatment, gut microbiota, oral health and diabetes. From the reviewed animal and human studies, it can be concluded that there is a high potential in the polyphenols of wine, i.e., in its moderate consumption. Among scientists, there is no consensus on whether these health benefits are due to ethanol or polyphenols’ presence in red wine. However, it can be concluded from all the above-mentioned studies that polyphenols are responsible to a greater extent for these properties. Future studies should be more focused on investigating the impact of red wine polyphenols on the prevention and treatment of some other diseases.

Funding Statement

This work was part of project PZS-2019-02-1595 (which was fully supported by the “Re-search Cooperability” Program of the Croatian Science Foundation and funded by the European Union’s European Social Fund under the Operational Program for Efficient Human Resources 2014–2020) and project IP-2019-04-5749 (which was fully supported by the Croatian Science Foundation).

Author Contributions

Conceptualization, M.K., A.P. and J.Š.; methodology, I.B., A.P. and M.K.; investigation, I.B., A.P., J.Š. and M.K.; writing—original draft preparation, I.B.; writing—review and editing, M.K. and J.Š.; project administration, M.K.; funding acquisition, M.K. All authors have read and agreed to the published version of the manuscript.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Data availability statement, conflicts of interest.

The authors declare no conflict of interest.

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• Nutrition & Diet

Top Red Wine Benefits That Are Backed by Science

Yep, drinking red wine in moderation can be healthy—and here's the proof.

Emily Peterson is an experienced fact-checker and editor with Bachelor's degrees in English Literature and French.

Popularly known for its heart health benefits, drinking red wine can positively impact your health in other ways, too. To answer the age-old question of whether or not red wine is good for you, here's what a nutritionist and scientific researchers have to say. From memory retention to dental health, let's explore the various benefits of red wine.

Boosts Memory and Cognitive Function

Red wine is rich in polyphenols, which are antioxidants that help the body fight off disease, among other benefits. Resveratrol, a type of polyphenol found in red wine, may also help improve short-term memory. Recent studies show that resveratrol has the power to reduce damage caused by sleep deprivation , like memory deficits, and can boost your ability to learn and your cognitive processing functions.

Another surprising red wine health benefit is its ability to potentially lower the risk of dementia, a group of conditions that impact memory function (usually in older age). "Studies show that red wine consumption can reduce the risk of having dementia, which often leads to Alzheimer's disease," says nutritionist Sally Stevens, RDN.

The key is drinking red wine in moderation, as heavier consumption can increase risk. So it's best to cap your intake around the recommended 5-ounce glass of wine per day.

Promotes Eye Health

Red wine health benefits go even further, thanks to resveratrol once again. With vascular-enhancing properties, red wine may improve microcirculation in the eye. This process can help improve eye health and prevent eye-related issues such as age-related macular degeneration, diabetic retinopathy, and glaucoma, all of which contribute to vision loss.

Improves Heart Health

One of the most celebrated red wine benefits is its ability to potentially improve heart health. Consuming foods and beverages rich in polyphenols, such as red wine, has long been associated with reduced risk of heart disease.

Red wine may protect the lining of blood vessels in the heart while also boosting HDL (or "good" cholesterol), which helps your body flush out "bad" cholesterol. (Bad cholesterol can significantly increase your risk of heart disease and stroke.)

"Drinking wine may help in decreasing low-density lipoprotein (LDL), also known as bad cholesterol," Stevens says. "[High LDL] may cause artery damage."

Maintains Dental Health

Studies show that red wine may keep your mouth healthy. Data suggests red wine—specifically those beneficial polyphenols we've talked about so much—can fight off harmful bacteria in the mouth, which can contribute to tooth decay and gum disease. By preventing the bacteria from sticking to teeth and gums, red wine essentially stops it from causing things like cavities or plaque.

Reduces Risk of Cancer

Some studies point to red wine as potentially having the ability to reduce cancer risk by preventing the growth of cancerous cells, particularly those associated with breast cancer and esophageal cancer. That's because resveratrol, a polyphenol in grape skin, can kill cancer cells, according to cancer researchers.

Polyphenols help starve cancer cells by blocking the development of a critical protein that feeds them. "Resveratrol is a powerful antioxidant that can be found in grape skin and red grape juice," Stevens explains. "Antioxidants help the body fight off free radicals that can damage our cells and organs."

Helps Regulate Blood Sugar

Despite containing natural sugars , red wine can help regulate blood sugar. Drinking a glass of red wine may lower your blood sugar for up to 24 hours, which can be beneficial for those with higher blood sugar levels. While red wine shouldn't be substituted for blood glucose management medications and treatment plans, it may be a helpful dietary addition in moderation.

Helps Fight Viruses

Keeping our immune system strong against viruses is incredibly important, and red wine may have yet another promising perk in this department. One of its benefits includes immune-boosting properties thanks to its antioxidant content. "Wine contains high levels of antioxidants in the form of flavonoids, which can combat viruses," Stevens says.

Controls Blood Pressure

Those same polyphenols in red wine can help lower or control blood pressure. Studies have shown that systolic and diastolic pressure improved after consuming dealcoholized red wine (wine with alcohol content removed). Additionally, grape wine extract (also rich in polyphenols) can help lower both systolic and diastolic blood pressure, regardless of alcohol level.

Influences Gut Health

The polyphenols in red wine may also modulate your microbiome or healthy gut bacteria. A healthy microbiome can prevent disease development, while an unhealthy microbiome can decrease your immune function, making you more susceptible to getting sick.

Pairs Well With Healthy Foods

Wine pairing can become a hobby that encourages you to eat more nutrient-dense foods. Here are a few popular red wine pairings to try:

• Cabernet Sauvignon : This grape is the most popularly planted variety worldwide. Cabernet Sauvignon wines tend to be bold with blackberry flavors and pair well with grilled vegetables .
• Merlot : This wine is recommended as an entry-level red wine since it has fruitier notes. Merlot is the second most popular grape planted throughout the world and would taste great with a healthy beet salad .
• Zinfandel : Though the taste of this wine varies depending on where it's grown, it's known to have a juicy flavor and higher alcohol content. Try it with some spiced pecans.
• Malbec : Originating in France, this wine tends to have cherry and plum flavors that pair well with hearty grains and veggies.
• Pinot Noir : Considered one of the lightest red wines, Pinot Noir may give off a cranberry or raspberry flavor that pairs well with roasted salmon .

A standard glass of wine is 5 fl oz of 12% alcohol by volume (ABV). The recommended daily drink limit for red wine (or any wine) is one 5-ounce drink for people assigned female at birth and two 5-ounce drinks for people assigned male at birth.

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Esteban-Fernández A, Zorraquín-Peña I, Ferrer MD, et al. Inhibition of oral pathogens adhesion to human gingival fibroblasts by wine polyphenols alone and in combination with an oral probiotic.  J Agric Food Chem . 2018;66(9):2071-2082. doi:10.1021/acs.jafc.7b05466

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Why pinot noir is a fan-favorite red wine—and how to best enjoy it.

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A close-up photo of pinot noir grapes.

Celebrated for its versatility and easy-to-drink nature, pinot noir has a unique ability to reflect the terroir where it is grown, making it a favorite among winemakers and connoisseurs alike.

Pinot noir's origins can be traced back over a thousand years to the Burgundy region of France. This ancient grape has been cultivated in Burgundy since Roman times, and it remains one of the region’s most prestigious varietals. Known for its thin skin and susceptibility to disease, pinot noir is notoriously difficult to grow, earning the moniker of the "heartbreak grape." However, when conditions are just right, it produces wines of extraordinary nuance and depth.

In recent years, there has been a renewed interest in pinot noir, driven by a growing appreciation for its elegance and food-friendly nature. Wineries worldwide are investing in clones and techniques that emphasize the grape’s inherent qualities. Sustainable and organic farming practices are also becoming more prevalent, as winemakers strive to produce purer expressions of pinot noir.

Global Presence

While Burgundy remains the benchmark for pinot noir, this grape has found success in various corners of the globe.

Pinot noir makes up a substantial part of the U.S. wine market. In 2023, it was the third-most planted grape variety by acreage in California. And just to the north in Oregon , more than half of all the state’s planted grapes in 2022 were pinot noir, accounting for 60% of vines in the state.

New Zealand’s Central Otago and Marlborough regions are also gaining recognition for their vibrant and expressive interpretations of this grape.

As climate change poses challenges for grape growing, the future of pinot noir may see further shifts in where and how it is cultivated.

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What makes pinot noir so special? It’s the grape’s remarkable ability to express the nuances of its terroir. The best pinot noirs are known for their complex aromas, often featuring red and black fruits, floral notes and a hint of earthiness or minerality. On the palate, they are typically light to medium-bodied, with bright acidity and silky tannins. This makes pinot noir a versatile pairing for a wide range of foods, from roasted poultry and salmon to mushroom dishes and soft cheeses.

Tips For Enjoying Pinot Noir

• Serve at the right temperature : Pinot noir is best enjoyed slightly chilled, between 55 to 60°F. Too cold and the flavors will be muted; too warm and the wine can taste flabby
• Choose the right glass : A large-bowled glass helps to concentrate the delicate aromas of pinot noir.
• Pair thoughtfully : Thanks to its acidity and lighter body, pinot noir pairs beautifully with a variety of dishes. Experiment with different food pairings to find what works best for your palate.

And being a lighter red, pinot noir is a sublime choice for red wine drinkers looking for a bottle that isn’t too overpowering during these hot and heavy summer months. Here are five bottles below that exemplify a solid pinot noir.

Maison Louis Latour 2022 Bourgogne Pinot Noir

At approximately 10% the size of Bordeaux, Burgundy is a small yet significant region renowned for its Pinot Noir and Chardonnay wines. It is also the home of Maison Louis Latour, a family-run wine producer with over 200 years of history. Maison Louis Latour excels in crafting Burgundy wines and holds the largest collection of Grand Cru vineyards in the region, offering a wide range of price points suitable for newcomers to French wine. Among their notable wines is the 2022 Bourgogne Pinot Noir , featuring a dark ruby hue, a nose of red fruit and aromas of blackcurrant. This wine pairs well with grilled meat and aged cheeses.

Ponzi Vineyards 2022 Laurelwood Pinot Noir

This one is an ideal choice for summer grilling, thanks to its versatile and complex flavor profile that features bright red fruits and a smooth texture. These elements pair well with various BBQ dishes, while its spicy and smoky notes complement grilled foods perfectly. Touted as a benchmark for Oregon pinot noirs, the Ponzi Vineyards 2022 Laurelwood pinot noir is crafted from sustainably farmed vineyards, adding to its appeal. The Ponzi family has been producing pinot noir for over 50 years, cultivating 140 acres of certified sustainable vineyards on Laurelwood soils in the Willamette Valley. The Laurelwood District AVA, pioneered by sisters Maria and Luisa Ponzi, features ancient fractured basalts layered with fine loess, imparting unique characteristics to their wines, making this pinot noir a sophisticated yet approachable option for social celebrations.

Lang & Reed 2021 Rockhound Pinot Noir

Reed and Megan Skupny’s Rockhound Wine , a new venture from the second generation of the family-run Napa Valley winery Lang & Reed, launched a few years ago with a mission to produce innovative wines that defy traditional boundaries in the wine industry. Their 2021 pinot noir, sourced from the Radian Vineyard in the Santa Rita Hills in Southern California, was aged for 16 months in French oak barrels. This full-bodied wine showcases hints of balsam and strawberries, with flavors of bramble berry pie, dark chocolate and coffee nibs on the finish. The wine, with an alcohol content of 15.3%, is ideally served slightly chilled in warmer weather with a Niçoise salad or during winter with braised lamb shanks and parmesan polenta.

Dr. Konstantin Frank Winery 2021 Old Vines Pinot Noir

Founded in 1962 by viticulturist Dr. Konstantin Frank, this Finger Lakes winery revolutionized New York state and American viticulture at large by introducing wine grape plants to the Eastern United States. Now led by fourth-generation Meaghan Frank and her father, Frederick Frank, the winery continues to innovate with a diverse portfolio, including traditional method sparkling wines, ancient Georgian varieties and renowned rieslings and pinot noirs that highlight the Finger Lakes terroir. The winery’s original pinot noir vines, planted in 1958, produce lovely wines with notes of cranberries, cherries and subtle oak notes. This light-bodied 2021 pinot noir pairs well with foods like mushrooms, grilled chicken or tuna, pork tenderloin and seared salmon.

Yering Station 2021 Pinot Noir

Yering Station was the first vineyard with vines planted in 1838 in the state of Victoria in southeastern Australia. Situated in the Yarra Valley, the estate encompasses five vineyard sites across the Yarra Glen and Coldstream sub-regions, benefiting from elevations of 150 to 1,500 feet.. Acquired by the Rathbone family in 1996, Yering Station has achieved international acclaim for its viticultural innovation and sustainability practices. Renowned for producing top cool-climate pinot noir (as well as chardonnay and shiraz), the winery's 2021 pinot noir showcases an elegant tannin structure, bright acidity and a berry fruit profile, enhanced by 10 months of barrel fermentation in new and used French oak, which imparts warmth and spice notes.

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Is It Healthy To Drink A Beer Every Day?

Health experts weigh in on cracking a cold one.

Some research has shown that moderate beer drinking can improve heart health, specifically by boosting the good cholesterol in the blood, explains Destini Moody, R.D., the founder of The Athlete’s Dietitian and an expert on the panel of Garage Gym Reviews . (Moderate beer consumption, by the way, is defined as one beer a day for women and two beers a day for men.)

But it’s a careful balance, because drinking more than “moderately” negates these health benefits and can expose you to the negative effects of alcohol, Moody says, including risk of cancer, fat gain, and liver disease.

Curious if it’s healthy to crack open a can of beer every night with dinner or pour yourself a pint after work? Here’s what registered dietitians have to say about the health benefits and drawbacks of beer.

Drinking a beer daily can be part of a balanced lifestyle, but moderation is key, says dietitian René Ficek, R.D. and owner of Seattle Sutton's Healthy Eating .

For most adults, moderate alcohol consumption is defined as up to one drink per day for women and up to two for men.

“Consuming beer in moderation can fit into a healthy diet, but daily consumption isn’t recommended for everyone, especially those with certain medical conditions or those taking medications that interact with alcohol,” Ficek says.

Moody says she wouldn’t go so far as to say a daily beer is healthy. While there’s some research showing moderate beer drinking has some health benefits, it’s not exactly a healthy habit especially when you consider that alcohol doesn’t have any nutritional value.

“So, though drinking a beer daily may not be inherently harmful to your health, it’s not going to do much to improve it that a few extra veggies can’t accomplish,” she says.

Are There Any Health Benefits of Beer?

Beer, especially certain types like darker ales and stouts, can offer some benefits, Ficek says.

That’s because it contains antioxidants like polyphenols, primarily from hops and grains, which may help protect against heart disease, she explains. Beer also has small amounts of B vitamins, minerals (like magnesium and potassium), and dietary silicon, which is linked to bone health.

What Are The Health Concerns With Drinking A Daily Beer?

Regularly consuming beer can increase your risk of several health issues, according to dietitians.

Over time, even moderate alcohol intake may lead to an increased risk of certain cancers (such as breast and colorectal cancer), high blood pressure, and weight gain due to the extra calories, Ficek says. Daily drinking can also interfere with sleep and can contribute to dehydration if you’re not drinking enough water.

Of course, alcohol dependency can also become a concern if you’re struggling to limit the number of alcoholic beverages you’re drinking, according to the Mayo Clinic .

What Types of Beer Are The Healthiest?

Beers with lower alcohol content and less added sugars are generally better choices, Ficek says.

Light beers tend to have fewer calories and less alcohol, reducing the potential negative health impacts. Beers brewed with minimal additives and more natural ingredients may also be slightly healthier, she says.

Craft beers with more natural brewing processes and higher levels of polyphenols, like certain ales and stouts, could offer slight antioxidant benefits.

One more thing to keep in mind: Research conducted on the potential health benefits of alcohol were conducted on drinks with an ABV of 5% or lower, Moody points out, and some beers have a higher ABV.

“Considering the negative and inflammatory impact of alcohol on the body’s systems as a whole, it makes sense that those with a lower alcohol content are less harmful than stronger beers,” she says.

Are There Any Benefits To Drinking Beer After Exercising?

A lot of marathoners will crack open a can of beer at the end of a race, and hikers will enjoy a cold one at the summit. But are there any benefits to drinking beer after a workout?

After intense exercise, the primary focus should be on rehydration, replenishing electrolytes, and consuming protein and carbohydrates to support recovery, Ficek says.

“While a cold beer may be enjoyable, it’s not the most effective recovery drink,” she says. “Beer is a diuretic, which can contribute to dehydration.”

In moderation, a post-workout beer can offer a small amount of carbohydrates and even some antioxidants, she says, but be sure to balance your brew with proper hydration and a recovery meal.

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