Table 1.
Summary of study characteristics, outcomes and main results of studies included in the analysis.
| Reference | Design, Subjects (n), Follow-up | Population | Intervention/Dose | Outcomes | Main Results |
|---|---|---|---|---|---|
| Y. Gepner et al. [104] | Randomized controlled trial, n = 54, 6 months | Adults, T2D, alcohol abstainers | 150 mL water, white wine, or red wine | BP (24-h ABPM) | Moderate daily red wine intake (150 mL) had no effect on mean daily BP, but showed transient hypotensive response at midnight (3–4 h after ingestion), decreasing SBP −10.6 mmHg (95% CI −14.1 to −0.6; p = 0.03) and DBP −7.7 mmHg (−11.8 to 0.9; p = 0.076). |
| T.A. Mori et al. [105] | Randomized controlled trial, cross-over design, n = 28, 16 weeks | Adults, T2DM, men and post-menopausal women, regular drinkers | Red wine or DRW 230 mL/day for women and 300 mL/d for men, or water. | Effect of wine consumption on 24 h ambulatory BP, heart rate and other markers | Red wine significantly increased awake SBP (2.5 ± 1.2 mmHg; p = 0.033) and DBP (1.9 ± 0.7 mmHg; p = 0.008) compared to water and decreased DBP overnight (2.0 ± 0.8 mmHg; p = 0.016) compared to DRW. Nonetheless, there was no significant overall effect of red wine on mean 24 h SBP or DBP. Red wine had no effect on TC, TG, HDL-C, LDL-C, fasting glucose and insulin levels, or HOMA-IR score. |
| S. McDonagh et al. [106] | Randomized, crossover trial, n = 12, 2 weeks | Healthy normotensive men | 175 mL red wine, vodka or water | BP response to NO3− rich salad and red wine | Red wine and NO3− rich salad lowered SBP at 2 h (−5 mmHg) and 5 h (−4 mmHg) and DBP (2–4 mmHg) after intake. |
| I. Roth et al. [107] | Randomized controlled trial, cross-over design, n = 38, 10 weeks | Adults, men, T2DM or ≥3 cardiovascular risk factors | 30g ethanol from white wine or gin | Effect of white wine on BP and plasma NO concentration | White wine decreased SBP (−4.91 mmHg, 95% CI −9.41 to −0.42; p = 0.033) and DBP (−2.90, 95% CI −5.50 to −0.29; p = 0.030) significantly compared to gin (p < 0.040); and significantly increased plasma NO concentrations (27.86, 95% CI −6.86 to 62.59; p = 0.013). |
| M.T. García-Conesa et al. [108] | Meta-analysis of 128 human randomized controlled trials (n = 5538) | Adults, distributed over five continents | 250 to 400 mL red wine | Association between intake of wine and other foods on different biomarkers of cardio-metabolic risk | Anthocyanin rich products (wine/red grapes) reduced systolic (−3.31 mmHg; p = 0.014) and diastolic (−1.50 mmHg; p = 0.002) BP, but increased Hb1Ac (+0.26; p = 0.026) |
| S. Weaver et al. [109] | Meta-analysis, 37 studies | Adults, healthy or T2DM/obesity/MS | RWP supplementation (dose ND) | Effect of RWP on vascular health | RWP significantly improved SBP (−2.6 mmHg, 95% CI −4.8 to −0.4; p = 0.010), especially in at risk population (−3.2 mmHg, 95% CI −5.7 to −0.8; p = 0.010) |
| J. Ye et al. [110] | Meta-analysis, 9 studies, N/D | Adults, T2DM | Red wine 120–360 mL/d | Effect of wine intake on BP, glucose parameters and lipid profile in T2DM | Red wine intake significantly reduced DBP (MD 0.10, 95% CI 0.01–0.20; p = 0.03). No significant differences in glucose or lipid parameters. |
| Y. Gepner et al. [111] | Randomized controlled trial, n = 224, 2 years | Adults, 40–75 years with T2DM | 150 mL of red wine or white wine | Changes in lipid profile (HDL-C, apolipoprotein (a)1, TC/HDL-C ratio) and glycemic control (FPG, HOMA-IR) | Red wine intake increased HDL-C (2.9 mg/dL, 95% CI 1.6–2.2 mg/dL; p < 0.001) and apolipoprotein (a)1 (0.03 g/L, 95% CI 0–0.06 g/L; p = 0.05), and decreased TC/HDL-C ratios (0.27, 95% CI −0.52 to −0.01; p = 0.039). White wine decreased FPG (−17.2 mg/dL, 95% CI −28.9 to −5.5 mg/dL; p = 0.004) and HOMA-IR score (−1.2, 95% CI −2.1 to −0.2; p = 0.019) |
| K. Abraham et al. [112] | Randomized controlled trial, n = 9, 2 weeks | Adults, T2DM and pre-diabetic | 263 mL red wine or water | Acute effect of red wine in glycemic control | Greater insulin iAUC response after wine intake (50%; p < 0.05), but no change in glucose iAUC (p = 0.82) |
| J. Huang et al. [113] | Meta-analysis, 13 prospective studies, 397,296 subjects | Adults, T2DM or healthy | Stratified in 0–10 g/day, 10–20 g/day or >20 g/day |
Risk of T2DM | Wine intake was associated with 15% reduction in T2DM risk (RR 0.85, 95% CI 0.80–0.89), with a peak risk reduction at 20–30g/d |
| J. Woerdeman et al. [114] | Randomized controlled trial, n = 30, 8 weeks | Adults, obese (BMI ≥30 kg/m2), white ethnicity, healthy | RWP extract 600 mg/d or placebo | Effect of supplementation of RWP on insulin sensitivity in obese adults | RWP supplementation did not alter insulin sensitivity nor lipid profile compared to placebo (M-value (mg/kg/min) 3.3, CI 2.4–4.8 vs. 2.9, CI 2.8–5.9; p = 0.65, respectively) |
| R. Golan et al. [115] | Randomized controlled trial, n = 224, 2 years | Adults, T2DM, abstainers | 16.9 g of ethanol from dry red wine (150 mL), or 15.8 g from white wine (150 mL) | Effect of moderate wine intake in atherosclerosis | Moderate wine intake was associated with no progression in carotid total plaque volume (−1.2 mm3, SD 16.9, CI −3.8 to 6.2; p = 0.6 for white wine; −1.3, mm3, SD 17.6, CI −3.4 to 6.0; p = 0.5 for red wine) and with a small regression among those with higher carotid plaque burden at baseline (mean −0.11; p = 0.04) |
| M. Taborsky et al. [116] | Randomized controlled trial, n 157, 12 months | Adults, healthy, mild to moderate cardiovascular risk | Red or white wine, 0.2 L/day in women <70 kg and 0.3 L/d in women <70 kg and men | Effect of regular red and wine intake in HDL-C and other markers of atherosclerosis | HDL-C significantly decreased at 6 months in the white wine group (−0.14 (SD 0.41); p = 0.005), no changes for red wine. LDL-C significantly decreased in both groups at 6 months (−0.39 (0.74); p < 0.001 for white wine and −0.27 (0.68); p < 0.001 for red wine) and at 12 months (−0.24 (0.73); p = 0.003 for white wine and −0.24 (0.78); p = 0.013 for red wine) compared with baseline. A significant reduction in TC was observed at 6 months in both groups (−0.32 (1.13); p = 0.017 for white wine and −0.33 (0.82); p = 0.001 for red wine), but only for red wine at 12 months (−0.24 (0.82); p = 0.016). |
| L. di Renzo et al. [117] | Randomized controlled trial, n 55, 1 day | Healthy adults | 30 g of ethanol from red wine, white wine or vodka | Effect of ethanol and polyphenols present in alcoholic beverages on oxidative status when eating an antioxidant meal | Red wine intake during a HFM significantly reduced Ox-LDL-C levels (−4.97 ± 33.18; p < 0.05) compared with HFM alone. Red wine significantly up-regulated CAT gene expression (fold change 4.04) |
| Fang et al. [118] | Meta-analysis, 76 observational studies, n = 6,316,385 subjects, 11.4 years (3.3–30y) | Adults, general population | Dose ND | Association between gastric cancer and dietary factors | Alcohol consumption increased gastric cancer risk (RR 1.15, 95% CI 1.01–1.31), nonetheless wine did not significantly increase this risk (RR 1.02, 95% CI 0.77–1.34). |
| J.Y. Chen et al. [119] | Meta-analysis, 26 observational studies, n = 18,106 subjects | Adult women with breast cancer | 1 drink or 12.5 g of ethanol | Association between wine dose and breast cancer risk | Wine intake increased breast cancer risk (RR 1.36; 95% CI 1.20–1.54; p < 0.001), with a dose-response association, showing a 0.59% increase for each increment of 1g/day of ethanol from wine. However, risk decreased in women consuming <80g/day of wine (10g ethanol), with lowest risk at 40g/day of wine (5g/day ethanol). |
| M.D. Vartolomei et al. [120] | Meta-analysis, 174 studies, n = 455,413 subjects | Adults, overall population | Moderate red wine intake (ND) |
Effect of red wine on prostate cancer development | Moderate red wine consumption was associated with lower risk of prostate cancer (RR 0.88, 95% CI 0.78–0.999; p = 0.047) |
| W. Xu et al. [121] | Meta-analysis, 17 observational studies, n = 12,110 subjects | Adults, general population | Stratified in non-drinkers plus occasional drinkers (<0.5 drinks/day), light to moderate drinker (<2 drinks/day) and heavy drinkers (≥2 drinks/day) | Effects of wine intake on colorectal cancer risk | Any wine consumption did not affect colorectal cancer risk versus nondrinkers (RR 0.99, 95% CI 0.89–1.10). No difference among men and women (0.88, CI 0.66–1.18 and 0.83, CI 0.67–1.03, respectively), red or white wine (0.98, CI 0.68–1.40, and 0.95, CI 0.69–1.32, respectively) nor drinking category (light to moderate 0.93, CI 0.80–1.08, and heavy drinking 1.00, CI 0.86–1.16). |
| L. Schwingshackl et al. [34] | Meta-analysis, 83 prospective studies, n = 2,130,753 subjects | Adults, overall population | Moderate red wine intake in a Mediterranean diet (ND) |
Cancer risk and cancer mortality risk | Inverse association for moderate alcohol intake and cancer risk (RR 0.89, 95% CI 0.85–0.93) |
| W. Xu et al. [122] | Meta-analysis, 16 observational studies, 3–25 years | Adults, general population | Stratified in light (<7 drinks/week), light-to-moderate (< 14drinks/ week), moderate (7–14 drinks/ week) moderate-to-heavy (>7 drinks/week) and heavy drinkers (>14 drinks/week) | Association between quantity of alcohol intake and risk of dementia | U-shaped association between alcohol consumption and risk of dementia, Wine showed a trend towards a protective effect for dementia, for current drinkers versus never drinkers (RR 0.67, 95% CI 0.48–0.94; p = 0.2) or light-to-moderate drinker versus non-drinkers (RR 0.58, 95% CI 0.39–0.87; p = 0.196). |
24-h ABPM: ambulatory blood pressure measurement; BMI: body mass index; BP: blood pressure; CAT: catalase; CI: confidence interval; DBP: diastolic blood pressure; DRW: dealcoholized red wine; FPG: fasting plasma glucose; Hb1Ac; glycated hemoglobin; HDL-C: high-density lipoprotein cholesterol; HFM: high-fat meal; HOMA-IR: Homeostatic Model Assessment for Insulin Resistance; iAUC: incremental blood glucose area under the curve; LDL-C: low-density lipoprotein cholesterol; MS: metabolic syndrome; ND: non-defined; NO: nitric oxide; NO3−: nitrate; Ox-LDL-C: Oxidized low-density lipoprotein cholesterol; RR: relative ratio; RWP: Red wine polyphenols; SPB: systolic blood pressure; T2DM: type 2 diabetes mellitus; TC: total cholesterol; TG: tryglicerides.