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MALADIES
DU COEUR :
9
 Remise en cause du paradoxe français ?
(24/01/2001) ©
La Journée Vinicole
Un article paru le 23 janvier dans la revue scientifique américaine “Circulation” publiée par l’American Heart Association recommande aux médecins de conseiller à leurs patients d’autres méthodes que la consommation de vin pour réduire les risques de maladies cardiovasculaires. Malgré une documentation scientifique abondante sur les bénéfices potentiels d’une consommation modérée de vin dans la réduction du risque de ces maladies, les auteurs estiment “qu’il n’existe aucune preuve scientifique que boire du vin ou tout autre boisson alcoolisée puisse remplacer des moyens conventionnels efficaces”. Ils considèrent que les bénéfices constatés dans des régions où l’on consomme traditionnellement du vin sont essentiellement à mettre sur le compte d’une alimentation riche en fruits et légumes ou en poisson. Serait-ce là un signe de plus d’une remontée en puissance des discours anti-alcooliques aux Etats-Unis, susceptible -de par la portée des recommandations émanant de l’AHA- de faire évoluer des politiques de santé, non seulement outre-Atlantique mais aussi dans d’autres pays ? Quoi qu’il en soit, la filière rejoint ces recommandations dans le sens où elle considère le vin comme partie intégrante de l’alimentation, et non comme la panacée, à elle seule, des grandes maladies de notre époque.
Chemoprevention of cancer and cardiovascular disease by resveratrol.
(08/01/2001) ©
La Journée Vinicole
Lin JK, Tsai SH
Institute of Biochemistry, College of Medicine, National Taiwan University, Taipei, R.O.C.
Resveratrol (trans-3,4’,5-trihydroxystibene) is a phytopolyphenol isolated from the seeds and skins of grapes. Recent studies indicate that resveratrol can block the process of multistep carcinogenesis, namely, tumor initiation, promotion and progression. Resveratrol can also reduce the risk of cardiovascular disease in man. The molecular mechanisms of resveratrol in chemoprevention of cancer and cardiovascular disease are interesting and under intensive investigation. Resveratrol was found to strongly inhibit nitric oxide (NO) generation in activated macrophages, as measured by the amount of nitrite released into the culture medium, and resveratrol strongly reduced the amount of cytosolic inducible nitric oxide synthase (iNOS) protein. The activation of nuclear factor kappa B (NF kappa B) induced by lipopolysaccharide (LPS) was inhibited by resveratrol. The phosphorylation and degradation of nuclear factor inhibitor kappa B alpha (I kappa B alpha) were inhibited by resveratrol simultaneously. Reactive oxygen species (ROS) are regarded as having carcinogenic potential and have been associated with tumor promotion. Resveratrol may act as a reactive oxygen species scavenger to suppress tumor development. In addition, resveratrol may block multistep carcinogenesis through mitotic signal transduction blockade. Reactive oxygen species are pivotal factors in the genesis of heart disease. Meanwhile, efficient endogenous antioxidants, including superoxide dismutase (SOD), glutathione peroxidase (GSHPx), and catalase, are present in tissues. A fine balance between reactive oxygen species and endogenous antioxidants is believed to exist. Any disturbance of this balance in favor of reactive oxygen species causes an increase in oxidative stress and initiates subcellular changes, leading to cardiomyopathy and heart failure. The experimental results indicate that exogenous antioxidant resveratrol is of value in chemopreventing the development of heart disease. It is urgent that more efforts be made to investigate newer therapies employing antioxidants for the chemoprevention of cardiovascular disease and cancer.
Proc Natl Sci Counc Repub China B 1999 Jul;23(3):99-106
Type of alcoholic drink and risk of major coronary heart disease events and all-cause mortality.
(08/01/2001) ©
La Journée Vinicole
Wannamethee SG, Shaper AG
Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, London, England.
OBJECTIVES: This study examined the effects of beer, spirits, and wine drinking on coronary heart disease (CHD) events (fatal and nonfatal) and all-cause mortality. METHODS: Men aged 40 to 59 years (n = 7735) were drawn at random from one general practice in each of 24 British towns and followed up for an average of 16.8 years. RESULTS: Regular drinkers showed a significantly lower relative risk of CHD, but no all-cause mortality, than occasional drinkers, even after adjustment for potential confounders. The benefit for CHD of regular drinking was seen within both beer drinkers and spirit drinkers but not among men who reported wine drinking. However, all men who reported wine drinking (both occasional and regular) showed significantly lower age-adjusted risks of CHD and all-cause mortality than men drinking beer or spirits; beer and spirit drinkers showed similar risks. CONCLUSIONS: The findings suggest that regular intake of all alcoholic drinks is associated with a lower risk of CHD, but not all-cause mortality, than occasional drinking. A large part, but not all, of the greater benefit seen in wine drinkers relative to other drinkers can be attributed to advantageous lifestyle characteristics (e.g., low rates of smoking and obesity).
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Am J Public Health 1999 May;89(5):685-90
Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine, or spirits.
(08/01/2001) ©
La Journée Vinicole
Rimm EB, Klatsky A, Grobbee D, Stampfer MJ
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
OBJECTIVES: To review the effect of specific types of alcoholic drink on coronary risk. DESIGN: Systematic review of ecological, case-control, and cohort studies in which specific associations were available for consumption of beer, wine, and spirits and risk of coronary heart disease. SUBJECTS: 12 ecological, three case-control, and 10 separate prospective cohort studies. MAIN OUTCOME MEASURES: Alcohol consumption and relative risk of morbidity and mortality from coronary heart disease. RESULTS: Most ecological studies suggested that wine was more effective in reducing risk of mortality from heart disease than beer or spirits. Taken together, the three case-control studies did not suggest that one type of drink was more cardioprotective than the others. Of the 10 prospective cohort studies, four found a significant inverse association between risk of heart disease and moderate wine drinking, four found an association for beer, and four for spirits. CONCLUSIONS: Results from observational studies, where alcohol consumption can be linked directly to an individual’s risk of coronary heart disease, provide strong evidence that all alcoholic drinks are linked with lower risk. Thus, a substantial portion of the benefit is from alcohol rather than other components of each type of drink.
BMJ 1996 Mar 23;312(7033):731-6
Red wine intake prevents nuclear factor-kappaB activation in peripheral blood mononuclear cells of healthy volunteers during postprandial lipemia.
(07/01/2001) ©
La Journée Vinicole
Blanco-Colio LM, Valderrama M, Alvarez-Sala LA, Bustos C, Ortego M, Hernandez-Presa MA, Cancelas P, Gomez-Gerique J, Millan J, Egido J
Research Laboratory, Instituto de Investigacion Medica, Fundacion Jimenez Diaz, Universidad Autonoma de Madrid, Spain.
BACKGROUND: Several epidemiological studies have demonstrated the beneficial effect of red wine intake in reducing total and cardiovascular mortality. This effect has been attributed in part to its antioxidant properties. Because the monocytes/macrophages and the nuclear transcription factor kappaB (NF-kappaB) are implicated in the pathogenesis of atherosclerotic lesions, we examined the effect of red wine intake on the activation of NF-kappaB in peripheral blood mononuclear cells. METHODS AND RESUTLS: Sixteen healthy volunteers were studied 3 times each: after a moderate dose, a low dose, and no wine with a fat-enriched breakfast. Lipid profile and NF-kappaB activation (electrophoretic mobility shift assay) were examined in blood samples taken before and 3, 6, and 9 hours after wine intake. In addition, mononuclear cells were incubated with VLDL in the presence of some antioxidants (quercetin and alpha-tocopherol succinate) contained in red wine to study their effects on NF-kappaB activation. Subjects receiving a fat-enriched breakfast had increased NF-kappaB activation in peripheral blood mononuclear cells coinciding with the augmentation in total triglycerides and chylomicrons. Red wine intake prevented NF-kappaB activity even though it induced a certain increase in serum lipids, particularly VLDL, that did not increase after the fat ingestion alone. However, another form of alcohol intake (vodka) did not modify the NF-kappaB activation provided by postprandial lipemia. In cultured mononuclear cells, isolated human VLDL caused NF-kappaB activation in a time-dependent manner that did not occur in the presence of the red wine antioxidants quercetin and alpha-tocopherol. CONCLUSIONS: Our results provide a new potential mechanism to explain the beneficial effects of red wine intake in the reduction of cardiovascular mortality.
Circulation 2000 Aug 29;102(9):1020-6
Nonalcoholic red wine extract and quercetin inhibit LDL oxidation without affecting plasma antioxidant vitamin and carotenoid concentrations.
(07/01/2001) ©
La Journée Vinicole
Chopra M, Fitzsimons PE, Strain JJ, Thurnham DI, Howard AN
Northern Ireland Center for Diet and Health (NICHE), University of Ulster, Coleraine BT52 1SA, Northern Ireland. M.Chopra@ulst.ac.uk
BACKGROUND: Antioxidant enrichment of LDL can increase its resistance to oxidation and hence reduce its atherogenicity. The objective of the present study was to investigate whether in vivo supplementation with nonalcoholic red wine extract and quercetin can increase the oxidative resistance of LDL, and also whether the supplementation has any effect on other antioxidative micronutrients present in the blood. METHODS: Twenty-one male subjects were supplemented with a placebo drink for 2 weeks and randomized into two groups. One group (n = 11) received the red wine extract (1 g/day, equivalent to 375 mL of red wine) and the other group (n = 10) quercetin (30 mg/day) for 2 weeks, followed by a 5-week washout period. RESULTS: In the red wine extract-supplemented group, ex vivo copper-initiated oxidation of LDL (lag phase, mean +/- SD) was 40 +/- 11 min at the baseline, and increased significantly to 47 +/- 6 min [P <0.05 compared with placebo (38 +/- 4 min) and the washout values (40 +/- 5 min)]. In the quercetin-supplemented group, the lag phase was 44 +/- 11 and 40 +/- 5 min for the baseline and placebo, respectively, and increased significantly to 51 +/- 7 min [P <0.05 compared with placebo and washout (41 +/- 9 min)] after supplementation. Plasma lipids (triglycerides, total cholesterol, LDL- and HDL-cholesterol) did not change during the study period. Supplementation with red wine extract or quercetin had no effect on plasma vitamin C and E, retinol, and carotenoid concentrations. CONCLUSIONS: Alcohol-free red wine extract and one of its components, quercetin, can inhibit LDL oxidation after in vivo supplementation; such “inhibition” is unrelated to changes in antioxidant vitamin and carotenoid concentrations.
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Clin Chem 2000 Aug;46(8 Pt 1):1162-70
Grape juice, but not orange juice or grapefruit juice, inhibits human platelet aggregation.
(07/01/2001) ©
La Journée Vinicole
Keevil JG, Osman HE, Reed JD, Folts JD
Cardiology Section of Department of Medicine, University of Wisconsin, Madison, WI 53792, USA.
Coronary artery disease is responsible for much mortality and morbidity around the world. Platelets are involved in atherosclerotic disease development and the reduction of platelet activity by medications reduces the incidence and severity of disease. Red wine and grapes contain polyphenolic compounds, including flavonoids, which can reduce platelet aggregation and have been associated with lower rates of cardiovascular disease. Citrus fruits contain different classes of polyphenolics that may not share the same properties. This study evaluated whether commercial grape, orange and grapefruit juices, taken daily, reduce ex vivo platelet activity. In a randomized cross-over design, ten healthy human subjects (ages 26-58 y, five of each gender) drank 5-7.5 mL/(kg. d) of purple grape juice, orange juice or grapefruit juice for 7-10 d each. Platelet aggregation (whole blood impedance aggregometry, Chronolog Model #590) at baseline was compared to results after consumption of each juice. Drinking purple grape juice for one week reduced the whole blood platelet aggregation response to 1 mg/L of collagen by 77% (from 17.9 +/- 2.3 to 4.0 +/- 6.8 ohms, P = 0.0002). Orange juice and grapefruit juice had no effect on platelet aggregation. The purple grape juice had approximately three times the total polyphenolic concentration of the citrus juices and was a potent platelet inhibitor in healthy subjects while the citrus juices showed no effect. The platelet inhibitory effect of the flavonoids in grape juice may decrease the risk of coronary thrombosis and myocardial infarction.
J Nutr 2000 Jan;130(1):53-6
Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors.
(07/01/2001) ©
La Journée Vinicole
Rimm EB, Williams P, Fosher K, Criqui M, Stampfer MJ
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA. eric.rimm@channing.harvard.edu
OBJECTIVE: To summarise quantitatively the association between moderate alcohol intake and biological markers of risk of coronary heart disease and to predict how these changes would lower the risk. DESIGN: Meta-analysis of all experimental studies that assessed the effects of moderate alcohol intake on concentrations of high density lipoprotein cholesterol, apolipoprotein A I, fibrinogen, triglycerides, and other biological markers previously found to be associated with risk of coronary heart disease. PARTICIPANTS: Men and women free of previous chronic disease and who were not dependent on alcohol. Studies were included in which biomarkers were assessed before and after participants consumed up to 100 g of alcohol a day. INTERVENTIONS: Alcohol as ethanol, beer, wine, or spirits. MAIN OUTCOME MEASURES: Changes in concentrations of high density lipoprotein cholesterol, apolipoprotein A I, Lp(a) lipoprotein, triglycerides, tissue type plasminogen activator activity, tissue type plasminogen activator antigen, insulin, and glucose after consuming an experimental dose of alcohol for 1 to 9 weeks; a shorter period was accepted for studies of change in concentrations of fibrinogen, factor VII, von Willebrand factor, tissue type plasminogen activator activity, and tissue type plasminogen activator antigen. RESULTS: 61 data records were abstracted from 42 eligible studies with information on change in biological markers of risk of coronary heart disease. An experimental dose of 30 g of ethanol a day increased concentrations of high density lipoprotein cholesterol by 3.99 mg/dl (95% confidence interval 3.25 to 4.73), apolipoprotein A I by 8.82 mg/dl (7.79 to 9.86), and triglyceride by 5.69 mg/dl (2.49 to 8.89). Several haemostatic factors related to a thrombolytic profile were modestly affected by alcohol. On the basis of published associations between these biomarkers and risk of coronary heart disease 30 g of alcohol a day would cause an estimated reduction of 24.7% in risk of coronary heart disease. CONCLUSIONS: Alcohol intake is causally related to lower risk of coronary heart disease through changes in lipids and haemostatic factors.
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BMJ 1999 Dec 11;319(7224):1523-8
Type of alcohol and mortality from cardiovascular disease.
(07/01/2001) ©
La Journée Vinicole
Gronbaek M
Danish Epidemiology Science Centre at the Institute of Preventive Medicine, Copenhagen University Hospital, H:S Kommunehospitalet.
Many epidemiological studies have described a U-shaped relation between alcohol intake and all-cause mortality (Boffetta and Garfinkel, 1990; Fuchs et al., 1995; Gronbaek et al., 1994; Marmot et al., 1981). Most researchers attribute the ‘U’ to a combination of beneficial and harmful effects of ethanol itself. It has, on the other hand, been explained as an artefact due to misclassification or confounding (Shaper et al., 1998). Most of the studies of the effect of total alcohol intake have found that the descending leg of the curve mainly is attributable to death from cardiovascular disease (Rimm et al., 1991; Stampfer et al., 1988). Until recently, most studies addressed the effect of the three beverages taken together as ethanol. Studies of the correlation between wine intake per capita in different countries and incidence of ischaemic heart disease gave rise to the hypothesis that there is a a more beneficial effect of wine than of beer and spirits. Leger et al., Renaud and de Lorgeril and later Criqui and Rigel found an inverse relation between incidence rates of ischemic heart disease and wine consumption in different countries, but no such relation for the other types of beverages (Criqui and Rigel, 1994; Leger et al., 1979; Renaud and de Logeril, 1992).
Food Chem Toxicol 1999 Sep-Oct;37(9-10):921-4
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