A daily glass of red wine associated with lifestyle changes independently improves blood lipids in patients with carotid arteriosclerosis: results from a randomized controlled trial

Dirk W Droste, Catalina Iliescu, Michel Vaillant, Manon Gantenbein, Nancy De Bremaeker, Charlotte Lieunard, Telma Velez, Michèle Meyer, Tessy Guth, Andrea Kuemmerle, Georges Gilson, Anna Chioti, Dirk W Droste, Catalina Iliescu, Michel Vaillant, Manon Gantenbein, Nancy De Bremaeker, Charlotte Lieunard, Telma Velez, Michèle Meyer, Tessy Guth, Andrea Kuemmerle, Georges Gilson, Anna Chioti

Abstract

Background: Physical exercise and a Mediterranean diet improve serum lipid profile. The present work studied whether red wine has an effect on top of a lipid-lowering lifestyle in patients with carotid atherosclerosis.

Methods: A prospective randomised unblinded trial was performed from 2009 to 2011 in 108 patients with carotid atherosclerosis, 65% of whom were already on statin therapy with a low mean LDL of 104.9 mg/dl. Half of them were advised to follow a modified Mediterranean diet and to perform moderate physical exercise during 30 min/day (lifestyle changes) for 20 weeks. Within these two groups half of the patients were randomised either to avoid any alcohol or to drink 100 ml of red wine (women) or 200 ml of red wine (men) daily.

Results: LDL was significantly lowered by 7% in the lifestyle-changes group compared to the no-lifestyle-changes group (p = 0.0296) after 20 weeks. Lifestyle changes lowered the LDL/HDL ratio after 20 weeks by 8% (p = 0.0242) and red wine independently by 13% (p = 0.0049). The effect on LDL/HDL ratio after 20 weeks was, however, more pronounced in the non-LC group. Total cholesterol (-6%; p = 0.0238) and triglycerides (-13%; p = 0.0361) were lowered significantly by lifestyle changes after 20 weeks compared to the no-lifestyle-changes group. Lipoprotein (a) was not significantly affected by any intervention. The given results are per ITT analysis.

Conclusions: Lifestyle changes including a modified Mediterranean diet and physical exercise as well as a glass of red wine daily improve independently the LDL/HDL ratio in patients with carotid arteriosclerosis even though the vast majority of them was already on statin therapy.

Trial registration: ClinicalTrials.gov NCT01146132.

Figures

Figure 1
Figure 1
Study procedures.
Figure 2
Figure 2
Patient attrition.

References

    1. Amarenco P, Labreuche J. Lipid management in the prevention of stroke: review and updated meta-analysis of statins for stroke prevention. Lancet Neurol. 2009;8:453–463. doi: 10.1016/S1474-4422(09)70058-4.
    1. Goldstein LB, Bushnell CD, Adams RJ, Appel LJ, Braun LT, Chaturvedi S. et al.Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American heart association/american stroke association. Stroke. 2011;42:517–584. doi: 10.1161/STR.0b013e3181fcb238.
    1. Taylor F, Huffman MD, Macedo AF, Moore THM, Burke M, Davey Smith G, Ward K, Ebrahim S. Statins for the primary prevention of cardiovascular disease. Cochrane Database of Systematic Reviews. 2013. p. Art. No.: CD004816. DOI: 10.1002/14651858.CD004816.pub5.
    1. Genser B, Dias KC, Siekmeier R, Stojakovic T, Grammer T, Maerz W. Lipoprotein (a) and risk of cardiovascular disease–a systematic review and meta analysis of prospective studies. Clin Lab. 2011;57:143–156.
    1. Enkhmaa B, Anuurad E, Zhang W, Tran T, Berglund L. Lipoprotein(a): genotype-phenotype relationship and impact on atherogenic risk. Metab Syndr Relat Disord. 2011;9:411–418. doi: 10.1089/met.2011.0026.
    1. Muntner P, Lee F, Astor BC. Association of high-density lipoprotein cholesterol with coronary heart disease risk across categories of low-density lipoprotein cholesterol: the atherosclerosis risk in communities study. Am J Med Sci. 2011;341:173–180. doi: 10.1097/MAJ.0b013e3181f97e4a.
    1. Huxley RR, Barzi F, Lam TH, Czernichow S, Fang X, Welborn T. et al.Isolated Low levels of high-density lipoprotein cholesterol Are associated with an increased risk of coronary heart disease: an individual participant data meta-analysis of 23 studies in the asia-pacific region. Circulation. 2011;124:2056–2064. doi: 10.1161/CIRCULATIONAHA.111.028373.
    1. Demarin V, Lisak M, Morovic S, Cengic T. Low high-density lipoprotein cholesterol as the possible risk factor for stroke. Acta Clin Croat. 2010;49:429–439.
    1. Acharjee S, Qin J, Murphy SA, McCabe C, Cannon CP. Distribution of traditional and novel risk factors and their relation to subsequent cardiovascular events in patients with acute coronary syndromes (from the PROVE IT-TIMI 22 trial) Am J Cardiol. 2010;105:619–623. doi: 10.1016/j.amjcard.2009.10.042.
    1. Labreuche J, Deplanque D, Touboul PJ, Bruckert E, Amarenco P. Association between change in plasma triglyceride levels and risk of stroke and carotid atherosclerosis: systematic review and meta-regression analysis. Atherosclerosis. 2010;212:9–15. doi: 10.1016/j.atherosclerosis.2010.02.011.
    1. Trejo-Gutierrez JF, Fletcher G. Impact of exercise on blood lipids and lipoproteins. J Clin Lipidol. 2007;1:175–181. doi: 10.1016/j.jacl.2007.05.006.
    1. Brown WV, Fletcher GF, Wilson PW. Using exercise to reduce risk. J Clin Lipidol. 2009;3:360–367. doi: 10.1016/j.jacl.2009.10.006.
    1. Sola R, Fito M, Estruch R, Salas-Salvado J, Corella D, de La TR. et al.Effect of a traditional mediterranean diet on apolipoproteins B, a-I, and their ratio: a randomized, controlled trial. Atherosclerosis. 2011;218:174–180. doi: 10.1016/j.atherosclerosis.2011.04.026.
    1. Kastorini CM, Milionis HJ, Esposito K, Giugliano D, Goudevenos JA, Panagiotakos DB. The effect of mediterranean diet on metabolic syndrome and its components: a meta-analysis of 50 studies and 534,906 individuals. J Am Coll Cardiol. 2011;57:1299–1313. doi: 10.1016/j.jacc.2010.09.073.
    1. Buitrago-Lopez A, Sanderson J, Johnson L, Warnakula S, Wood A, Di AE. et al.Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis. BMJ. 2011;343:d4488. doi: 10.1136/bmj.d4488.
    1. Tokede OA, Gaziano JM, Djousse L. Effects of cocoa products/dark chocolate on serum lipids: a meta-analysis. Eur J Clin Nutr. 2011;65:879–886. doi: 10.1038/ejcn.2011.64.
    1. Blum A, Merei M, Karem A, Blum N, Ben Arzi S, Wirsansky I. et al.Effects of tomatoes on the lipid profile. Clin Invest Med. 2006;29:298–300.
    1. Silaste ML, Alfthan G, Aro A, Kesaniemi YA, Horkko S. Tomato juice decreases LDL cholesterol levels and increases LDL resistance to oxidation. Br J Nutr. 2007;98:1251–1258.
    1. Sabate J, Oda K, Ros E. Nut consumption and blood lipid levels: a pooled analysis of 25 intervention trials. Arch Intern Med. 2010;170:821–827. doi: 10.1001/archinternmed.2010.79.
    1. Banel DK, Hu FB. Effects of walnut consumption on blood lipids and other cardiovascular risk factors: a meta-analysis and systematic review. Am J Clin Nutr. 2009;90:56–63. doi: 10.3945/ajcn.2009.27457.
    1. Krenz M, Korthuis RJ. Moderate ethanol ingestion and cardiovascular protection: from epidemiologic associations to cellular mechanisms. J Mol Cell Cardiol. 2012;52:93–104. doi: 10.1016/j.yjmcc.2011.10.011.
    1. Smoliga JM, Baur JA, Hausenblas HA. Resveratrol and health–a comprehensive review of human clinical trials. Mol Nutr Food Res. 2011;55:1129–1141. doi: 10.1002/mnfr.201100143.
    1. Kloner RA, Rezkalla SH. To drink or not to drink? that is the question. Circulation. 2007;116:1306–1317. doi: 10.1161/CIRCULATIONAHA.106.678375.
    1. O’Keefe JH, Bybee KA, Lavie CJ. Alcohol and cardiovascular health: the razor-sharp double-edged sword. J Am Coll Cardiol. 2007;50:1009–1014. doi: 10.1016/j.jacc.2007.04.089.
    1. Avellone G, Di GV, Campisi D, De Simone R, Raneli G, Scaglione R. et al.Effects of moderate Sicilian red wine consumption on inflammatory biomarkers of atherosclerosis. Eur J Clin Nutr. 2006;60:41–47. doi: 10.1038/sj.ejcn.1602265.
    1. Coimbra SR, Lage SH, Brandizzi L, Yoshida V, da Luz PL. The action of red wine and purple grape juice on vascular reactivity is independent of plasma lipids in hypercholesterolemic patients. Braz J Med Biol Res. 2005;38:1339–1347. doi: 10.1590/S0100-879X2005000900008.
    1. Flensborg-Madsen T, Knop J, Mortensen EL, Becker U, Makhija N, Sher L. et al.Beverage preference and risk of alcohol-use disorders: a Danish prospective cohort study. J Stud Alcohol Drugs. 2008;69:371–377.
    1. Estruch R, Ros E, Salas-Salvado J, Covas MI, Pharm D, Corella D. et al.Primary prevention of cardiovascular disease with a mediterranean diet. N Engl J Med. 2013;368:1279–1290. doi: 10.1056/NEJMoa1200303.
    1. Touboul PJ, Hennerici MG, Meairs S, Adams H, Amarenco P, Bornstein N. et al.Mannheim carotid intima-media thickness and plaque consensus (2004-2006-2011). An update on behalf of the advisory Board of the 3rd, 4th and 5th watching the risk symposia, at the 13th, 15th and 20th European Stroke Conferences, Mannheim, Germany, 2004, Brussels, Belgium, 2006, and Hamburg, Germany, 2011. Cerebrovasc Dis. 2012;34:290–296. doi: 10.1159/000343145.
    1. Arning C, Widder B, von Reutern GM, Stiegler H, Gortler M. [Revision of DEGUM ultrasound criteria for grading internal carotid artery stenoses and transfer to NASCET measurement] Ultraschall Med. 2010;31:251–257. doi: 10.1055/s-0029-1245336.
    1. von Reutern GM, Goertler MW, Bornstein NM, Del SM, Evans DH, Hetzel A. et al.Grading carotid stenosis using ultrasonic methods. Stroke. 2012;43:916–921. doi: 10.1161/STROKEAHA.111.636084.
    1. Droste DW, Keipes M. The reduction of stroke risk, risk of myocardial infarction and death by healthy diet and physical activity. Bull Soc Sci Med Grand Duche Luxemb. in press.
    1. Mente A, de Koning L, Shannon HS, Anand SS. A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Arch Intern Med. 2009;169:659–669. doi: 10.1001/archinternmed.2009.38.
    1. Ministère de la Santé. Le plaisir de bien manger et d'être actif! Luxembourg; 2011. .
    1. Powell KE, Paluch AE, Blair SN. Physical activity for health: what kind? How much? How intense? on top of what? Annu Rev Public Health. 2011;32:349–365. doi: 10.1146/annurev-publhealth-031210-101151.
    1. Damasceno NR, Perez-Heras A, Serra M, Cofan M, Sala-Vila A, Salas-Salvado J. et al.Crossover study of diets enriched with virgin olive oil, walnuts or almonds. Effects on lipids and other cardiovascular risk markers. Nutr Metab Cardiovasc Dis. 2011;21(1):S14–S20.
    1. Mursu J, Voutilainen S, Nurmi T, Rissanen TH, Virtanen JK, Kaikkonen J. et al.Dark chocolate consumption increases HDL cholesterol concentration and chocolate fatty acids may inhibit lipid peroxidation in healthy humans. Free Radic Biol Med. 2004;37:1351–1359. doi: 10.1016/j.freeradbiomed.2004.06.002.
    1. Elkind MS, Sciacca R, Boden-Albala B, Rundek T, Paik MC, Sacco RL. Moderate alcohol consumption reduces risk of ischemic stroke: the Northern Manhattan study. Stroke. 2006;37:13–19. doi: 10.1161/01.STR.0000195048.86810.5b.
    1. Wilkins K. Moderate alcohol consumption and heart disease. Health Rep. 2002;14:9–24.
    1. Pereira MA, Swain J, Goldfine AB, Rifai N, Ludwig DS. Effects of a low-glycemic load diet on resting energy expenditure and heart disease risk factors during weight loss. JAMA. 2004;292:2482–2490. doi: 10.1001/jama.292.20.2482.
    1. Singh RB, Rastogi SS, Niaz MA, Ghosh S, Singh R, Gupta S. Effect of fat-modified and fruit- and vegetable-enriched diets on blood lipids in the Indian Diet Heart Study. Am J Cardiol. 1992;70:869–874. doi: 10.1016/0002-9149(92)90729-I.
    1. Avellone G, Di GV, Campisi D, Alonzo G, Gambino L, Avellone G. et al.[Effects of two Sicilian red wines on some cardiovascular risk factors] Ital Heart J Suppl. 2004;5:382–388.
    1. Rifler JP, Lorcerie F, Durand P, Delmas D, Ragot K, Limagne E. et al.A moderate red wine intake improves blood lipid parameters and erythrocytes membrane fluidity in post myocardial infarct patients. Mol Nutr Food Res. 2011;56:345–351.
    1. Chiva-Blanch G, Urpi-Sarda M, Ros E, Valderas-Martinez P, Casas R, Arranz S. et al.Effects of red wine polyphenols and alcohol on glucose metabolism and the lipid profile: a randomized clinical trial. Clin Nutr. 2012;32:200–206.
    1. Budzynski J, Klopocka M, Swiatkowski M, Pulkowski G, Ziolkowski M. Lipoprotein(a) in alcohol-dependent male patients during a six-month abstinence period. Alcohol Alcohol. 2003;38:157–162. doi: 10.1093/alcalc/agg045.
    1. Kervinen K, Savolainen MJ, Kesaniemi YA. A rapid increase in lipoprotein (a) levels after ethanol withdrawal in alcoholic men. Life Sci. 1991;48:2183–2188. doi: 10.1016/0024-3205(91)90152-2.
    1. Clevidence BA, Reichman ME, Judd JT, Muesing RA, Schatzkin A, Schaefer EJ. et al.Effects of alcohol consumption on lipoproteins of premenopausal women. A controlled diet study. Arterioscler Thromb Vasc Biol. 1995;15:179–184. doi: 10.1161/01.ATV.15.2.179.
    1. Holme I, Urdal P, Anderssen S, Hjermann I. Exercise-induced increase in lipoprotein (a) Atherosclerosis. 1996;122:97–104. doi: 10.1016/0021-9150(95)05761-7.
    1. Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, Ghali WA. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ. 2011;342:d671. doi: 10.1136/bmj.d671.

Source: PubMed

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