Cardioprotective effects of moderate red wine consumption: Polyphenols vs. ethanol

Since decades, it has been suggested that regular, moderate consumption of red wine, a major component of Mediterranean diet, at main meals, may contribute to explain the healthy properties attributed to this traditional dietary style. Despite preclinical in vitro/in vivo data have shown a significant cardioprotective activity of grape phytochemicals, mostly polyphenols, evidence in humans is still debated. This lack of consensus may be due to the equilibrium between the two main components of wine relevant for health: ethanol and bioactive compounds or phytochemicals, which include not only polyphenols, but also newly detected molecules, such as melatonin and phytosterols. The state of art related to this delicate equilibrium represents the starting point for designing future clinical trials, in perspective of clinical recommendations. A better comprehension of the wine chemistry complexity with its major components embodies a pivotal issue in biomedicine, involving the fields of diet-related environmental medicine as well as chronomedicine. In this paper, we briefly reviewed putative beneficial effects of moderate red wine intake in humans, focusing on the reduction of cardiovascular risk.