"French Paradox"

The French Paradox, i.e. the drinking of red wine has been attributed with the low incidence of CHD in France. The benefit comes from both the alcohol content and the polyphenols found predominately in red wine.

The "French Paradox" and the benefits of red wine have been thoroughly studied. Two 8 oz glasses of red wine a day result in the following metabolic effects:

Alcohol component:

  1. A 6 to 11% alcohol content is responsible for the absorption of procyanidins (tannins) and the most important flavinoid from the grape skin.
  2. Increase in HDL-2 & HDL-3 by 10 to 30%
  3. Decrease in platelet aggregation
  4. Decrease in fibrinogen (increase in fibrinolysis)
  5. Increases tissue-type plasminogen activator antigen for 12-14 hours
  6. Increase in Apo A-1 & Apo A-2 (increase Apo A-1 to Apo B ratio)
  7. Decrease effect of thrombin
  8. Decrease serum thromboxane B2

Polyphenolic Flavonoids: concentration in

Red wine =

1,800 - 3,000 mg/L

White wine =

90 - 150 mg/L

  1. There are numbers flavonoids that have been identified in wine from the grape - found in grape juice, white and red wine - most of which are "antioxidants". The flavonoid in the greatest amount is quercetin, which composes 60% of all the flavonoids in wine. Other flavonoids in red wine e.g. caffeic acid have greater antioxidant effect but are in small amounts. Other flavanoids, particularly resveritrol and ipicatechin are also found in red wines and not in white wines.
  2. As red wine is fermented with the grape skin, red wine contains additional flavonoids called procyanidins (tannins) whose absorption is facilitated by the 5-11% alcohol.
  3. Categorically the flavonoids decrease the oxidation potential of LDL and its uptake by macrophages.
  4. Most flavonoids decrease eicosanoid synthesis. Specifically red wine has been shown to decrease concentration (inhibits synthesis) of thromboxane B2. Overall the decrease in eicosanoid metabolism decreases thrombaxane and increases prostacyclin.
  5. Most flavonoids increase the formation of EDRF (endothelium-dependent relaxation factor) or NO. The vasorelaxation effect of red wine seems to be mediated by an increase in cyclic GMP resulting in vascular smooth muscle relaxation.
  6. Polyphenols from red wine induced cytochrome P450 concentration in the liver.

Non-Flavonoids in Red Wine:

  1. Vitamins - Red Wine is a fairly good dietary source of folic acid, biotin, pyridoxine and niacin.
  2. Minerals - Red Wine is an excellent dietary source for potassium 528 mg/16oz.; magnesium, phosphorus, calcium and iron.
  3. Stibenes - one study demonstrated a decrease in apolipoprotein B from trans-resveratrol (tri-hydroxystilbene) from the skin in red wines.
  4. Serotonin (5-HT, 5-hydroxytryptamine) is released from platelets by most red wines. Amount released may be related to the polyphenol content.

Summary: The cardiovascular benefits of red wine are a result of its alcohol and flavonoid content. Alcohol alone in doses of 20 to 30 gm/day can decrease CHD by 40%. The alcohol content of red wine is responsible for the effective absorption of flavonoids and tannins. Red wine also contains a large amount of folic acid, other vitamins and potassium and magnesium, which have beneficial cardiovascular effects.


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