A case-cohort study from the PREDIMED trial found that light-to-moderate wine consumption was associated with reduced cardiovascular disease risk in a Mediterranean population.
Their study analyzed 1,232 participants, including 685 incident cardiovascular disease (CVD) cases and a random subcohort of 625 participants, with 78 cases overlapping, according to data published in the European Heart Journal.
Urinary tartaric acid was used as an objective biomarker of wine consumption, addressing the limitations of self-reported intake methods, noted study investigator Inés Domínguez-López, of the University of Barcelona in Spain, and colleagues.
"Unlike self-reported data, urinary tartaric acid levels can objectively quantify wine intake, thereby reducing the potential for misclassification and bias in studies of alcohol and health outcomes," wrote Giovanni de Gaetano of the Department Epidemiology and Prevention at the Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, in an accompanying editorial. "It is critical to note that the study’s findings reinforce the notion that these cardiovascular benefits are limited to moderate wine consumption."
Participants with urinary tartaric acid concentrations of 3 to 12 µg/mL (approximately 3 to 12 glasses/month) had a 38% lower CVD risk compared to those with levels of less than1 µg/mL. Those with levels of 12 to 35 µg/mL demonstrated a 50% lower risk. The findings suggested a J-shaped relationship, with no significant benefits observed at higher consumption levels.
Stronger associations were noted in men and participants with diabetes, although no significant sex interaction was detected. Among individual outcomes, myocardial infarction showed the strongest inverse association with higher tartaric acid levels.
The study population consisted of older adults (mean age 68 years) at high cardiovascular risk. Researchers controlled for potential confounders, including smoking, physical activity, BMI, and dietary patterns.
"The mechanisms underlying the potential beneficial effects of wine remain uncertain, whether they are attributed to its ethanol content or other nutritional components, such as polyphenols," noted López and colleagues. "Most studies support the hypothesis that wine and its bioactive compounds confer benefits independently of ethanol, as wine has exhibited a superior effect compared to other alcoholic beverages."
While the findings highlight the potential benefits of light-to-moderate wine intake, they noted study limitations, including focus on a Mediterranean population and exclusion of other alcoholic beverages. Residual confounding remained possible despite adjustments.
Research disclosures can be found in the published articles.
