Effects of alcohol and polyphenols from beer on atherosclerotic biomarkers in high cardiovascular risk men: A randomized feeding trial
Introduction
Atherosclerosis, the main cause of coronary heart disease (CHD), is considered a low-grade inflammatory disease mediated by the endothelial secretion of chemokines and adhesion molecules, such as integrins and selectins, which recruit circulating monocytes and T-cells to the endothelium and further migrate to the arterial wall triggering atherosclerotic lesions [1].
Moderate alcohol consumption is associated with a decreased cardiovascular risk and mortality independently of the type of alcoholic beverage consumed [2], [3]. Nevertheless, red wine, a high polyphenolic fermented beverage, seems to confer greater cardioprotective effects than distilled beverages, which do not contain polyphenols [4], by down-regulating the expression of chemokines and adhesion molecules [5], [6], [7], [8]. Recent meta-analyses suggest that beer, a fermented beverage with intermediate polyphenol content, could also confer greater cardioprotection than spirits [9], [10], [11], but the results of different trials are controversial, and this question is still under debate [12].
Therefore, we embarked on a randomized, crossover, controlled clinical trial to evaluate and compare the effects of moderate consumption of 30 g alcohol/d of gin, a non-polyphenolic alcoholic beverage, beer, an alcoholic beverage with a medium polyphenolic content, and the same polyphenolic amount of non-alcoholic beer, a medium polyphenolic non-alcoholic beverage, on several biomarkers related to the early stages of atherosclerosis in subjects at high risk for CHD.
Section snippets
Subjects
A total of 36 male moderate alcohol consumers between 55 and 75 years of age were recruited for the study in the outpatient clinic of the Internal Medicine Department of our institution. Subjects were at high risk for CVD (family history of premature CVD and/or the presence of diabetes, hypertension, dyslipidemia, and overweight/obesity). Exclusion criteria included documented CVD, human immunodeficiency virus infection, chronic liver disease, malnutrition, neoplastic or acute infectious
Characteristics of study subjects and measures of compliance and dietary control
Of the 36 subjects included, three withdrew before completing the study. The reasons for withdrawal were work-related (n = 2) and need to travel (n = 1). Therefore, 33 subjects completed the study. The baseline characteristics are shown in Table 1. There were no individual deviations from the interventions according to the participants' dietary reports. Protocol adherence was optimum in all subjects according to their self reports. As a measure of intervention compliance, IX -a biomarker of
Discussion
Moderate beer intake may exert higher protection against CHD than spirits [9], [10], [11]. However, even in prospective cohort studies it is difficult to assess the type and amount of alcohol consumed by the subjects and to control important confounding factors such as diet and exercise. In fact, the issue of nutrition and physical activity can only be solved in well-designed randomized clinical trials. In the current study, we have carefully monitored food intake with a 7-d food recall
Acknowledgments
We are grateful for the collaboration of the participants. We are indebted to the Asociación de Cerveceros de España for providing the non-alcoholic and regular beers, and Gin Xoriguer for providing the gin used in this study. CIBEROBN is an initiative from the Instituto de Salud Carlos III. This work was developed at the Centre de Recerca Biomèdica Cellex, Barcelona, Spain. Supported by grants from The European Foundation for Alcohol Research (ERAB) EA 11 17, CICYT (AGL2010-22319-C03), the
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Present address: Cardiovascular Research Center (CSIC-ICCC), C/Sant Antoni Mª Claret 167, 08025 Barcelona, Spain.