Heart disease remains the leading cause of death in the world, claiming around 17.9 million lives each year. That means it is responsible for 32% of total deaths around the globe. Most research is being done to determine effective prevention strategies against it; hence the growing interest in nutrition. Studies in epidemiology have shown that the more strictly people adhere to the Mediterranean diet, the less likely they are to develop cardiovascular disorders (CVDs).
PREDIMED is the biggest clinical study of the MedDiet’s effect and is land-marked. The MedDiet is believed to include the moderate intake of alcohol, especially wine, among its components, one of the factors that lead to the cardioprotective feature of this dietary pattern. To assess whether wine intake as measured by urinary tartaric acid, an objective and reliable biomarker is associated with a lower risk of cardiovascular disease, this study was published in the European Heart Journal.
There have always been indications that moderate consumption of wine lowers the chances of suffering from CVD in older populations. Information on wine consumption based on self-reporting always suffers measurement errors connected with subjective assessments. This study aimed to assess the relationship between urinary tartaric acid objective biomarkers for wine consumption and the rate of composite clinical CVD events.
This was designed as a case-cohort nested study within a PREDIMED (Prevention with Mediterranean Diet) trial with 1232 participants: 685 incident cases of CVD and a random sub-cohort of 625 participants (including 78 overlapping cases). Consumption of wine was measured with validated food frequency questionnaires, whereas urinary tartaric acid was measured by liquid chromatography-tandem mass spectrometry at baseline and 1 year of intervention. Weighted Cox regression models were fitted to estimate the hazard ratios (HRs) of CVD.
At the baseline, a relationship between tartaric acid and self-reporting of wine consumption existed [r = 0.46 (95% CI[confidence interval] 0.41; 0.50)]. To obtain better representations of risk patterns, five post hoc urine tartaric acid excretion categories were used. While lower CVD risk was found for concentrations of 3-12 and 12-35 ÎĽg/mL-which represent approximately 3-12 and 12-35 glasses of wine consumed per month(HR 0.62 (95% CI 0.38; 1.00), p = 0.050 and HR 0.50 (95% CI 0.27; 0.95), P =.035, respectively)-self-reported wine consumption and the risk for CVD were correlated even less.
The limitations of the research are as follows. Since the participants for this study included older, high-risk individuals with CVD living in a Mediterranean setting, results cannot be generalized to other populations. Even after the adjustment for many potential confounders, residual confounding cannot be established. The observational design of our study cannot support causation, but its prospective case-cohort design with a long follow-up enhances the reduced likelihood of reverse causation. Finally, tartaric acid determined only indirectly wine consumption while excluding other alcoholic beverages.
The authors concluded that the use of objective and reliable urinary biomarkers showed light-to-moderate consumption of wine associated with a reduced rate of clinical cardiovascular events in a Mediterranean population at high risk.
Reference: DomĂnguez-LĂłpez I, Lamuela-RaventĂłs RM, Razquin C, et al. Urinary tartaric acid as a biomarker of wine consumption and cardiovascular risk: the PREDIMED trial. Eur Heart J. 2024:ehae804. doi:10.1093/eurheartj/ehae804
