Phytochemicals in Red Wine:

A Review of the Health Protective Effects of Wine’s Phenolic Compounds

Katie Walczuk

The Sage Colleges

Phytochemicals in Red Wine Walczuk 1

Phytochemicals in Red Wine:

A Review of the Health Protective Effects of Wine’s Phenolic Compounds

Introduction

Eating and drinking among family and friends is a part of the human experience. Socially,

we gather together and enjoy one another’s company as a means of staying connected and

staying together. Inevitably, at these social arrangements—there will be alcohol present. People

who choose to drink usually have their own unique beverage preference and many factors can

influence this preference. Those who are more health conscious may choose to drink red wine,

because socially it is known as a healthier alcoholic beverage. However, most people do not

know the actual benefits of drinking red wine or if there is any truth to these common claims.

Making healthy choices is crucial in order to prevent and reduce the risks for disease, which is

why it is important to know the positive effects of drinking red wine.

Reducing risk factors associated with illnesses can help to promote the longevity and

quality of one’s life (Bertoia et al., 2016). Switching up one’s diet can be a simple and reasonable

solution for this problem. Diseases such as atherosclerosis and other non-communicable illnesses

are the largest causes of death worldwide and the aftermath is catastrophic for many families

(Cioccoloni et al., 2018). The cost of these diseases is major for the healthcare industry, which

makes prevention a big focus for these companies when it comes to cutting costs. One area in

which prevention is known to save lives is with dietetics. For, example, micronutrient

deficiencies are known to lead to various diseases within the human body (Bertoia et al., 2016).

Preventing these deficiencies is a straightforward way in which to cut costs and improve quality

of life.

Previous studies have looked at the association of a higher fruit intake and better health
Phytochemicals in Red Wine Walczuk 2

outcomes (Bertoia et al., 2016). Fruit has a variety of vitamins and minerals as well as bioactive

compounds and flavonoids (Poucheret et al., 2018). Keeping this in mind, there is similarly an

association between alcohol intake—specifically red wine intake—and benefits for our bodies

(Bullo et al., 2015). Exploring the compounds present in red wine can help to establish the

importance of consumption and how the beverage creates its positive role on health. The purpose

of this review is to identify why red wine has important health benefits by exploring how

consumption can reduce risks for disease and identifying the components in the wine that lead to

its preventative nature.

Presence and the Effects of Anthocyanins and Flavonones in Red Wine

The presence of red wine in the diet can have a positive impact on overall health

(Cioccoloni et al., 2018). The micronutrients that exist in red wine are responsible for these

benefits. Red wine has a large variety of phytochemicals that each work differently in the body

including flavonoids and non-flavonoids (De Freitas et al., 2017). Red wine specifically contains

anthocyanins and flavonones—two compounds that are responsible for the prevention of disease

(De Freitas et al., 2017). Anthocyanins are pigments that are water-soluble and found in plants

(Anderson et al., 2014). Flavonones may contain a varying amount of hydroxide groups that

work as antioxidants against free radicals (De Freitas et al., 2017). Both of these components are

flavonoids, which are polyphenolic compounds made and found in plants. Flavonoids are

directly associated with the organoleptic and health-promoting properties that are in red wine (De

Freitas et al., 2017). Anthocyanins and flavonones can alter signaling pathways by reducing or

enhancing the production of NADH oxidase-dependent compounds so that vascular

inflammation decreases (Bertoia et al., 2016). In return, these flavonoids can reduce the risk of

cardiovascular disease by improving blood flow and inhibiting platelet function (Bertoia et al.,
Phytochemicals in Red Wine Walczuk 3

2016).

A human study conducted by Bertoia et al. (2016) assessed 43,880 men aged 32 to 81

years old that were enrolled in the Health Professionals Follow-Up study on their intake of red

wine consumption and the incident of myocardial infarction and ischemic stroke for 24 years.

The cohort study found through analysis that a higher intake of anthocyanins was associated with

a 14% lower risk of non-fatal myocardial infarction (P=0.04), with the greatest effect found in

normotensive participants (P=0.03) (Bertoia et al., 2016). The study also found that a higher

consumption of flavonones was associated with a 22% lower risk of ischemic stroke (P=0.03),

with the greatest effects being in participants over the age of 65 (P=0.03) (Bertoia et al., 2016).

This research adds a basis for the claims that are commonly made about the benefits of drinking

red wine. These results also show that if a person is choosing to drink alcohol, they may want to

select red wine as their drink of choice. These benefits over time would be helpful for those that

choose to drink.

Additionally, Bullo et al. (2015) examined the effect of red wine consumption on

metabolic syndrome after previous studies showed that food with high levels of polyphenols

increased HDL concentrations. 5801 elderly participants that were enrolled in the cohort

Prevencion con Dieta Mediterreanea Study were sampled in this cross-sectional study. The

sample included both men and women who were at a high risk for cardiovascular disease (Bullo

et al., 2015). The consumption of wine was measured using a food frequency questionnaire

(Bullo et al., 2015). The criteria needed to be considered to have metabolic syndrome included

elevated waist circumference for European standards, elevated TAG concentrations, low HDL,

elevated blood pressure, or elevated fasting blood glucose (Bullo et al., 2015.)

Bullo et al., (2015) found that consuming one 100 mL drink of red wine a day was
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associated with a 44% lower risk of developing metabolic syndrome in participants below the

age of 70 in Mediterranean populations (P<0.001). The study also found that there was no

significant difference in metabolic syndrome in those participants who were over the age of 70

(Bullo et al., 2015). Even though the focus of this study was on red wine consumption, other

researchers also included other fruits, vegetables, and nuts with similar polyphenols and their

effect on the development of metabolic syndrome (Akter et al., 2013). These foods all have anti-

inflammatory actions and antioxidants, which can help to prevent the development of metabolic

syndrome by increasing levels of HDL cholesterol (Bonow et al., 2014).

Specifically between genders, previous studies found that men inherited more benefits

from the consumption of red wine than women (De Freitas et al., 2017) However, Bullo et al.,

(2015) found that in regards to metabolic syndrome, women received more benefits from

consuming more than one drinks a day—100 mL—of red wine than did men (P<0.001). This

study has theoretical importance because previous studies and current recommendations state

that women should drink less than men when it comes to the consumption of alcohol and overall

health. It may be possible that more factors impact how much alcohol a person can consume, and

that gender coincides with multiple other aspects such as muscle mass, fat free mass, or BMI

(Bullo et al., 2015). Although this finding doesn’t have a lot of practical importance, it may open

the door for more research regarding recommendations for alcohol and the difference in

consumption for women and men.

Presence and Effects of Resveratrol in Red Wine

Resveratrol is found in the skin of red grapes and consequently is found in red wine

(McWilliams, 2017). Resveratrol is a polyphenol that acts as an antioxidant inside the body that

helps prevent blood vessel damage, increases mitochondrial biogenesis, a increase the
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functioning of mitochondria (Dain et al., 2016). In the human body, resveratrol increases cyclic

AMP by suppressing the activity of cyclooxygenase enzymes (Dain et al., 2016). The build-up of

cAMP would then result in the activation of glycolytic pathways and gluconeogenesis (Gropper

& Smith, 2013). Due to this, resveratrol may reduce inflammation in the body and lower the risk

of blood clotting.

A randomized double-blind placebo controlled study performed by Anghel et al. (2017)

examined the effects of resveratrol on cardiovascular functioning, mitochondrial biogenesis,

diabetes, and metabolism. 30 glucose-intolerant participants between the ages of 50-80 year old

without a prior diabetes diagnosis were examined (Anghel et al., 2017). 1500mg tablets of

resveratrol were obtained from the RevGenetics Corporation and were administered to 9

participants in the experimental group for two 6-week periods—due to side effects some

participants received 1000mg resveratrol tablets (Anghel et al., 2017). Participants maintained all

of their normal lifestyle habits while taking the resveratrol tablets. Participants were examined

for glucose levels, insulin levels, endothelial functioning with arterial pulse wave amplitude, and

were given skeletal muscle biopsies before and after the 6-week resveratrol supplementation

(Anghel et al., 2018). Participants were given the same breakfast the morning before testing

including the same portion size as a means of standardization. The data for both the placebo and

resveratrol groups was analyzed and compared using a paired t-test. A Wilcoxon’s test was used

for the data that was not distributed normally (Anghel et al., 2017).

Anghel et al. (2017) found that those in the resveratrol supplementation group had a 13%

higher fasting reactive hyperemia index (RHI) than did the placebo group (P=0.002).

Mitochondrial dysfunction pathways were interrupted significantly by resveratrol

supplementation (P=2.5x10-12) and oxidative phosphorylation pathways were increased

Phytochemicals in Red Wine Walczuk 6

significantly due to the increased number of mitochondria (P=1.6x10-11) (Anghel et al., 2017).

No significant differences were found between the placebo and resveratrol groups for glucose

tolerance or insulin sensitivity, although insulin secretion was increased in the resveratrol group

by 9% (P=0.03) (Anghel et al., 2017). These findings have theoretical importance because

resveratrol is a possible factor that may reduce the risks for cardiovascular disease by increasing

the number of mitochondria and increasing the rate of oxidative phosphorylation. Increased

fasting RHI is linked to an increase in endothelial functioning (Anghel et al.,2017). As a result, a

reduction in inflammation may occur and may lead to an increase in overall vascular health.

Amount of Red Wine Consumption Needed for Benefits

The amount of red wine that is consumed by a person makes a major difference in the

effects that the drink has on the body. The previous study mentioned by Bullo et al. (2015) also

examined the amount of red wine consumption necessary to see results and used 100mL as the

measurement for a standard drink of alcohol. Of the 5801 elderly Mediterranean study

participants with a high risk for cardiovascular disease from the PREDIMED cohort, 50% of the

participants were considered non-drinkers, 36% consumed 0-1 drink/day, 12% consumed >1

drink/day, and 0.02% of the population consumed >5 drinks/day (Bullo et al., 2015). The

participants that consumed more than 1 drink/day were found to have a lower BMI and a lower

heart rate, but there was no significant difference found (Bullo et al., 2015). The participants that

consumed between 0-1 drinks/day were found to have a significantly lower risk of developing

metabolic syndrome (P<0.001) (Bullo et al., 2015). After adjusting for heavy drinkers and

removing those that consumed > 2 drinks/day for women—200mL—a stronger and significant

association was found in female participants (Bullo et al., 2015). Participants that consumed 1

drink/day or greater within these parameters were found to have a 41% lower risk of abnormal
Phytochemicals in Red Wine Walczuk 7

waist circumference (P<0.001), a 58% lower risk of low HDL (P<0.001), a 72% reduced risk for

having high blood pressure (P<0.001), and a 33% reduced risk for high fasting blood glucose

concentrations (P<0.001) (Bullo et al., 2015). This study has theoretical implications because it

suggests that elderly Mediterranean women with a high risk for cardiovascular disease can

consume 200mL or less of red wine and receive more benefits than from the consumption of 1

drink/day or 100mL or less (Bullo et al., 2015). This is slightly higher than the current

recommendations for consumption of wine for females (McWilliams, 2017). More studies would

need to be done for this to have practical implications. Based on these results, 100 mL to 200 mL

of red wine would need to be consumed in order to lower the risk of metabolic syndrome and

cardiovascular disease.

In a study conducted by Carraro et al. (2014), 24 participants between the ages of 18 and

65 years old from the Clinical Nutrition and Nutrigenomic Section from the University of Rome

Tor Vegata were examined. This randomized control trial divided the participants into six groups

including a control, fasting and 250 mL of red wine consumption, a Mediterranean meal, a

Mediterranean meal with 250 mL of red wine, a McDonald’s meal, and a McDonald’s meal with

250 mL of red wine (Carraro et al., 2014).

Oxidative LDL values in the study by Carraro et al. (2014) were lowered significantly for

all conditions incorporating 250 mL of red wine into their diet (P<0.05). Specifically, the

McDonald’s meal with red wine had a 20.78% lower oxidative LDL than the McDonald’s meal

only group (P<0.05) (Carraro et al., 2014). Expression of antioxidant genes significantly

increased in all groups with the consumption of 250 mL of red wine (P<0.05), and C-C motif

ligand 5 (CCL5) decreased significantly in the Mediterranean meal with red wine compared to

the group with only the Mediterranean meal (P<0.05) (Carraro et al., 2014). CCL5 leads to
Phytochemicals in Red Wine Walczuk 8

inflammation in the body, which is known to enhance cardiovascular disease (Carraro et al.,

2014). Overall, these results lead to a decreased risk of cardiovascular disease from the

consumption of 250 mL of red wine.

Based on these studies, consumption of 100 mL to 250 mL of red wine is necessary to

receive the healthful benefits of the beverage. More research would need to be done to determine

a more exact volume of red wine that would be needed to see benefits.

Type of Alcohol Consumption and Benefits

Other types of wine besides red, and other types of alcohol need to be considered in order

to determine if the benefits observed in the consumption of red wine are exclusive. Cioccoloni et

al. (2018) compared the differences between 250 mL of red wine, 250 mL of white wine, and

100 mL of vodka with a baseline, Mediterranean meal and a high fat meal among 55 healthy

participants. This randomized control trial compared all types of alcohol with the baseline,

Mediterranean meal, and the high fat meal (Cioccoloni et al., 2018).

Oxidative LDL levels were significantly reduced in the high fat meal with red wine

condition (P<0.05), but not in conditions with other alcohols (Cioccoloni et al., 2018). All

conditions supplemented with red wine consumption significantly increased the up-regulation of

catalase (P<0.05), and all conditions will white wine and vodka significantly increased a down-

regulation of catalase (P<0.05) (Cioccoloni et al., 2018). This regulation in antioxidant gene

expression is crucial for the prevention of cardiovascular disease (Cioccoloni et al., 2018). These

results demonstrate that red wine consumption provides benefits to reduce the risks of

cardiovascular disease, while other alcohols do not.

Resveratrol and several other polyphenols are found in red wine grapes, and they are not

present in other types of wine or alcohol (McWilliams, 2017). These components provide the
Phytochemicals in Red Wine Walczuk 9

health benefits that are observed from the consumption of red wine such as a reduced risk for

cardiovascular disease, metabolic syndrome, and inflammation. Other alcohols do not have these

polyphenols, therefore they do not provide these help benefits.

Consuming No Alcohol versus Consuming Red Wine

The benefits of drinking red wine are important to understand, but it also important to

understand the risks of drinking all types of alcohol. A study by Maclure et al. (2016)

investigated the effect and timing of alcohol consumption on sudden cardiac death. 3869

participants with the average age of 61.4 years were interviewed for four days after having an

acute myocardial infarction across 64 hospitals in the United States between 1989 and 1996.

(Maclure et al., 2016). After analyzing the data, the researchers found that after one hour of

alcohol consumption, the onset of the acute myocardial infarction was elevated 1.72 fold

(CI=1.37-2.16) with the association being stronger for liquor than for wine and beer (Maclure et

al., 2016). No significant difference occurred in daily drinkers (Maclure et al., 2016). These

results indicate that all alcohol consumption can be considered dangerous and can lead to ill-

fated health outcomes.

Additionally, a study conducted by Djousse et al. (2014) examined the effect of moderate

alcohol consumption and total morality on 449 American male physicians between the ages of 67

and 83 years old. All of the participants had heart failure. Alcohol consumption was assessed

with a food frequency questionnaire and mortality was evaluated with annual follow-up

questionnaires for seven years (Djousse et al., 2014).

Even though there was evidence found between the amount of alcohol consumed and

mortality, there was no significant result found between wine, beer, or liquor and mortality

(Djousse et al., 2014). Drinking in excess of any type of alcohol can lead to alcohol cirrhosis
Phytochemicals in Red Wine Walczuk 10

hepatic encephalopathy, increase blood ammonia, toxicity to the brain, and liver cirrhosis

(Gropper & Smith, 2013). The consumption of alcohol can complicate pre-existing conditions

and can even lead to alcohol abuse and addiction.

Overall, it is better not to consume any alcohol in the diet. If a person were to choose to

drink alcohol, red wine is the better choice for long-term consumption in regards to positive

health outcomes.

Conclusion

When choosing to drink alcohol, red wine is the beverage that provides the greatest

health benefits. The polyphenols that are found in red wine come from the skin of red wine

grapes (Dain et al., 2016). The polyphenolic compounds including anthocyanins, flavonones, and

resveratrol in red wine provide several health benefits for the human body. First, anthocyanins

and flavonones reduce the risk of cardiovascular disease and metabolic disease (Bertoia et al.,

2016). Resveratrol has been found to reduce inflammation, reduce the risk of cardiovascular

disease, increase the number of mitochondria, and increase the rate of oxidative phosphorylation

(Anghel et al., 2017). These health benefits are seen at their greatest when the consumption of

red wine is in between 100 mL and 250 mL (Carraro et al., 2014). Other alcohols and other types

of wine besides red wines do not have these benefits because they do not have the polyphenol

content that comes from the red grapes (Dain et al., 2016). The health benefits of drinking red

wine are important to understand when making the decision to drink. Over time, moderate

consumption of red wine can help to prolong health and have a positive impact on the human

body.
Phytochemicals in Red Wine Walczuk 11

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