Effects of alcohol and polyphenols from beer on atherosclerotic biomarkers in high cardiovascular risk men: A randomized feeding trial - ScienceDirect

Nutrition, Metabolism and Cardiovascular Diseases

Volume 25, Issue 1, January 2015, Pages 36-45

Nutrition, Metabolism and Cardiovascular Diseases

https://doi.org/10.1016/j.numecd.2014.07.008 Get rights and content

Highlights

•
The phenolic content of beer reduces biomarkers related to atherosclerosis.
•
Moderate alcohol consumption improves the lipid profile.
•
Non-alcoholic beer decreases systolic blood pressure and increases plasma folic acid.

Abstract

Background and aims

Moderate alcohol consumption exerts a cardioprotective effect, but no studies have evaluated the alcohol-independent cardiovascular effects of the non-alcoholic components of beer. We aimed to evaluate the effects of ethanol and the phenolic compounds of beer on classical and novel cardiovascular risk factors.

Methods and results

Thirty-three high risk male volunteers were included in a randomized, crossover feeding trial. After a washout period, all subjects received beer (30 g alcohol/d, 660 mL), the equivalent amount of polyphenols as non-alcoholic beer (990 mL), and gin (30 g alcohol/d, 100 mL) for 4 weeks. All outcomes were evaluated before and after each intervention period. Moderate alcohol consumption increased serum HDL-cholesterol (∼5%), ApoA-I (∼6%), ApoA-II (∼7%) and adiponectin (∼7%), and decreased serum fibrinogen (∼8%), and interleukin (IL)-5 (∼14%) concentrations, whereas the non-alcoholic fraction of beer (mainly polyphenols) increased the receptor antagonist of IL-1 (∼24%), and decreased lymphocyte expression of lymphocyte function-associated antigen-1 (∼11%), lymphocyte and monocyte expression of Sialil-Lewis X (∼16%) and monocyte expression of CCR2 (∼31%), and tumor necrosis factor (TNF)-β (∼14%) and IL-15 (∼22%) plasma concentrations. No changes were observed in glucose metabolism parameters or in body weight and adiposity parameters.

Conclusion

The phenolic content of beer reduces leukocyte adhesion molecules and inflammatory biomarkers, whereas alcohol mainly improves the lipid profile and reduces some plasma inflammatory biomarkers related to atherosclerosis. Trial registration number: ISRCTN95345245 (http://www.isrctn.org/).

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

References (28)

G. Chiva-Blanch et al.
Differential effects of polyphenols and alcohol of red wine on the expression of adhesion molecules and inflammatory cytokines related to atherosclerosis: a randomized clinical trial
Am J Clin Nutr
(2012)
E. Sacanella et al.
Down-regulation of adhesion molecules and other inflammatory biomarkers after moderate wine consumption in healthy women: a randomized trial
Am J Clin Nutr
(2007)
M. Vázquez-Agell et al.
Inflammatory markers of atherosclerosis are decreased after moderate consumption of cava (sparkling wine) in men with low cardiovascular risk
J Nutr
(2007)
A. Di Castelnuovo et al.
Alcohol consumption and cardiovascular risk: an epidemiological perspective
Nutr Metab Cardiovasc Dis
(2007)
P. Quifer-Rada et al.
Urinary isoxanthohumol is a specific and accurate biomarker of beer consumption
J Nutr
(2014)
J. Romeo et al.
Effects of moderate beer consumption on blood lipid profile in healthy Spanish adults
Nutr Metab Cardiovasc Dis
(2008)
N.K. Khoo et al.
Dietary flavonoid quercetin stimulates vasorelaxation in aortic vessels
Free Radic Biol Med
(2010)
G. Chiva-Blanch et al.
Effects of red wine polyphenols and alcohol on glucose metabolism and the lipid profile: a randomized clinical trial
Clin Nutr
(2013)
S.H. Kim et al.
Effect of moderate alcoholic beverage consumption on insulin sensitivity in insulin-resistant, nondiabetic individuals
Metabolism
(2009)
R. Napoli et al.
Red wine consumption improves insulin resistance but not endothelial function in type 2 diabetic patients
Metabolism
(2005)

R. Estruch et al.

Different effects of red wine and gin consumption on inflammatory biomarkers of atherosclerosis: a prospective randomized crossover trial. Effects of wine on inflammatory markers

Atherosclerosis

(2004)

L. Badimon et al.

Update on lipids, inflammation and atherothrombosis

Thromb Haemost

(2011)

P.E. Ronksley et al.

Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis

BMJ

(2011)

S.E. Brien et al.

Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies

BMJ

(2011)

Cited by (95)

Smoking and Alcohol Consumption and Risk of Incident Diverticulitis in Women
2024, Clinical Gastroenterology and Hepatology
Much of what is known about the effects of alcohol and tobacco use on diverticular disease derives from studies of asymptomatic diverticulosis or complicated diverticulitis. We examined smoking and alcohol consumption and risk of incident diverticulitis in a large cohort of women.
We conducted a prospective study of 84,232 women in the Nurses’ Health Study II (NHS II) who were 39–52 years old and without known diverticulitis at baseline in 2003. Smoking was ascertained every 2 years and alcohol use every 4 years. We used Cox proportional hazards regression to estimate multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (CIs).
During 1,139,660 person-years of follow up, we identified 3018 incident cases of diverticulitis. After adjustment for other risk factors, current (HR, 1.20; 95% CI, 1.04–1.39) and past smoking (HR, 1.20; 95% CI, 1.11–1.30) were associated with increased risk of diverticulitis when compared with never smokers. Women who consumed ≥30 g/d of alcohol had a multivariate HR of 1.26 (95% CI, 1.05–1.50) when compared with women who did not drink. A joint analysis of smoking and alcohol found that individuals who ever smoked and consumed ≥15 g/d of alcohol were at highest risk of diverticulitis (multivariate HR, 1.60; 95% CI, 1.16–2.21), compared with participants who never smoked and reported no alcohol use.
In this large prospective study of women, smoking and alcohol consumption were associated with an increased risk of incident diverticulitis. These data highlight additional modifiable risk factors for diverticulitis that may aid in prevention.
Simulated gastrointestinal digestion of beer using the simgi® model. Investigation of colonic phenolic metabolism and impact on human gut microbiota
2023, Food Research International
Beer is a source of bioactive compounds, mainly polyphenols, which can reach the large intestine and interact with colonic microbiota. However, the effects of beer consumption in the gastrointestinal function have scarcely been studied. This paper reports, for the first time, the in vitro digestion of beer and its impact on intestinal microbiota metabolism. Three commercial beers of different styles were subjected to gastrointestinal digestion using the simgi® model, and the digested fluids were further fermented in triplicate with faecal microbiota from a healthy volunteer. The effect of digested beer on human gut microbiota was evaluated in terms of microbial metabolism (short-chain fatty acids (SCFAs) and ammonium ion), microbial diversity and bacterial populations (plate counting and 16S rRNA gene sequencing). Monitoring beer polyphenols through the different digestion phases showed their extensive metabolism, mainly at the colonic stage. In addition, a higher abundance of taxa related to gut health, especially Bacteroides, Bifidobacterium, Mitsuokella and Succinilasticum at the genus level, and the Ruminococcaceae and Prevotellaceae families were found in the presence of beers. Regarding microbial metabolism, beer feeding significantly increased microbial SCFA production (mainly butyric acid) and decreased ammonium content. Overall, these results evidence the positive actions of moderate beer consumption on the metabolic activity of colonic microbiota, suggesting that the raw materials and brewing methods used may affect the beer gut effects.
Bioactive compounds and antioxidant activities of two industrial beers produced in Ivory Coast
2023, Heliyon
Beer is a world-famous beverage that is universally popular. This might be as an effect of its sensory, nutritional, and therapeutic qualities. To date, in Côte d’Ivoire, no study has been carried out focused on the eventual health benefits of industrial beer consumption. In this study, the bioactive compounds (total phenols, total tannins, total flavonoids, total anthocyanins) and corresponding antioxidant activities of two industrial beers from maize and rice from two different breweries were investigated. Results showed that for all phenolic compounds, contents were not statistically different (P > 0.05). However, antioxidant activities (antiradical activity and ferric reducing antioxydant power) were more important in industrial beer from rice (57.57 ± 0.62% and 109.46 ± 0.39 μg/mL ascorbic acid irrespectively) than industrial beer from maize (39.19 ± 1.02% and 103.51 ± 0.62 μg/mL ascorbic acid). Total phenols, total flavonoids, and total anthocyanins were mostly responsible for the antioxidant activities (antiradical activity and ferric reducing antioxydant power) of two beers, with correlation coefficients ranging from r = 0.614 to r = 1. Globally, the two industrial beers were similars but differents from local traditional sorghum beer. Occurrence of phenolic compounds in beers coupled with antioxidant activities shows that beer consumption could have health benefits to condition that beers have a low-alcohol content and light-to-moderate consumption. However, further investigations aims health benefis aspect are necessary.
Effects of polyphenols and their metabolites on age-related diseases
2023, Biochemical Pharmacology
Aging contributes to the progressive loss of cellular biological functions and increases the risk of age-related diseases. Cardiovascular diseases, some neurological disorders and cancers are generally classified as age-related diseases that affect the lifespan of individuals. These diseases result from the accumulation of cellular damage and reduced activity of protective stress response pathways, which can lead to inflammation and oxidative stress, which play a key role in the aging process. There is now increasing interest in the therapeutic effects of edible plants for the prevention of various diseases, including those associated with aging. It has become clear that the beneficial effects of these foods are due, at least in part, to the high concentration of bioactive phenolic compounds with low side effects. Antioxidants are the most abundant, and their high consumption in the Mediterranean diet has been associated with slower ageing in humans. Extensive human dietary intervention studies strongly suggest that polyphenol supplementation protects against the development of degenerative diseases, especially in the elderly. In this review, we present data on the biological effects of plant polyphenols in the context of their relevance to human health, ageing and the prevention of age-related diseases.
A comprehensive review of the benefits of drinking craft beer: Role of phenolic content in health and possible potential of the alcoholic fraction
2023, Current Research in Food Science
Currently, there is greater production and consumption of craft beer due to its appreciated sensory characteristics. Unlike conventional beer, craft beers provide better health benefits due to their varied and high content of phenolic compounds (PCs) and also due to their alcohol content, but the latter is controversial. The purpose of this paper was to report on the alcoholic fraction and PCs present in craft beers and their influence on health. Despite the craft beer boom, there are few studies on the topic; there is a lot of field to explore. The countries with the most research are the United States > Italy > Brazil > United Kingdom > Spain. The type and amount of PCs in craft beers depends on the ingredients and strains used, as well as the brewing process. It was determined that it is healthier to be a moderate consumer of alcohol than to be a teetotaler or heavy drinker. Thus, studies in vitro, with animal models and clinical trials on cardiovascular and neurodegenerative diseases, cancer, diabetes and obesity, osteoporosis and even the immune system suggest the consumption of craft beer. However, more studies with more robust designs are required to obtain more generalizable and conclusive results. Finally, some challenges in the production of craft beer were detailed and some alternative solutions were mentioned.
Moderate beer consumption and metabolic health: A comprehensive review from the lipoprotein perspective
2022, Journal of Functional Foods
Citation Excerpt :
The alcohol content in beer is also important when considering this beverage impact in lipid profiles as a cardiovascular risk. For example, after traditional beer intake, an increase of HDL main proteins was found, but when the beer was alcohol free, apoAI and apoAII levels were reduced (Chiva-Blanch et al., 2015). Recent evidence suggests that not only lipoprotein levels and distribution are important in assessing cardiovascular risk, but also lipoprotein quality is essential.
Beer intake is part of our society lifestyle but still a controversial topic due to the lack of consensus regarding its effects on our health. Regarding cardiovascular disease, research needs to consider the amount consumed but also drinking thresholds, frequency of drinking, age and gender of consumers, lifestyle, or non-alcoholic components of beers. Nevertheless, epidemiological evidence points to healthy effects of low or moderate beer consumption and even a protective action for cardiovascular risk and diabetes, discouraging heavy intakes without any exception. Beer components include alcohol and phenolics, both of which alter high- or low-density-lipoprotein levels and their oxidation status in blood. This review aims to highlight the importance of the metabolic mechanism by which beer components may influence lipid profile in terms of quantity and functionality, modulating cardiovascular risk. This is a major challenge for our society in light of the remarkable impact of cardiovascular diseases in all-cause mortality.

View all citing articles on Scopus

¹: Present address: Cardiovascular Research Center (CSIC-ICCC), C/Sant Antoni Mª Claret 167, 08025 Barcelona, Spain.

Copyright © 2014 Elsevier B.V. All rights reserved.