Update from the CASCADE study

WHAT IS THE CASCADEThe CASCADE study (CArdiovaSCulAr D STUDY?

The CASCADEThe CASCADE study (CArdiovaSCulAr D study (CArdiovaSCulAr Diabetes & Ethanol) is the first randomized wine study with a focus on diabetes. 224 abstainers with type 2 diabetes were randomly assigned to consume 1 glass (150 ml) of red wine, white wine or water for 2 years, on top of a Mediterranean diet that was not restricted in terms of calories.

WHAT IS THIS?

The current publication, “Wine and health- new evidence” summarizes previous findings from the CASCADEThe CASCADE study (CArdiovaSCulAr D study (see hereunder*) and shows new evidence regarding different effects in men and women that arose during the trial.

WHAT’S NEW AND WHAT DOES IT MEAN?

These results demonstrate positive effects on blood lipids, components of the metabolic syndrome, blood pressure and abdominal fat distribution. Furthermore, the current findings also show different effects of wine consumption in men and women and suggest that initiating moderate wine consumption among type 2 diabetics seems to be a safe option with regards to heart rate variability and plaque formation.

Additional conclusions were:

• Men and women metabolise alcohol differently: Women and men metabolize alcohol differently. Women have a lower alcohol dehydrogenase activity (ADH, the enzyme metabolizing alcohol in the body) than men resulting in higher blood alcohol levels after consuming similar amounts of ethanol.
• Red wine has positive effects on levels of HDL cholesterol (good cholesterol) for women: In this trial, among women consuming 150 ml of red wine/day over 2 years, the HDL levels increased significantly compared to the beginning of the study and compared to women in the white wine and water group. In men, no difference was found between the different groups.
• ApolipoproteinsApolipoproteins are proteins that bind lipids such as cholesterol and fat to form lipoproteins and t... levels increase with consumption of red wine for women: A similar difference was seen in the apolipoproteins: Women in the red wine group showed a significant increase in the apolipoprotein levels compared to men in the red wine group. The authors speculate that the beneficial effects of wine might have been more evident, if men and women had consumed different amounts of wine but ALL participants received the same, one glass of wine.
• Heart rate variabilityHeart rate variability is variation in the time interval between heart beats. (HRV) – no long-term effects found in this study: A poor HRV may predict progression of atherosclerosis. One glass of red wine did not show any long-term effects on HRV parameters in the current study.

* Previous findings from the CASCADEThe CASCADE study (CArdiovaSCulAr D study:

• Moderate wine consumption and the heart: Studies focusing on chemical/cellular factors involved in atherosclerosis, support the idea that moderate intake of alcoholic beverages may slow down atherosclerosis. Plaque formation was examined at the beginning and after two years. Individuals with the highest rate of plaques seem to profit the most from drinking red wine.
• Blood pressure: Previous evidence regarding the effect of moderate alcohol consumption on blood pressure is inconsistent. Consumption of red wine in the CASCADEThe CASCADE study (CArdiovaSCulAr D study had no effect on the 24h blood pressure.
• Moderate wine consumption and the abdominal fat: Studies have shown associations between drinking patterns and distribution of body fat. The Metabolic Syndrome is more common in non-drinkers and less common among wine drinkers. As part of the CASCADEThe CASCADE study (CArdiovaSCulAr D study, the body fat was measured at the beginning and after 2 years of the study and moderate wine consumption did not deteriorate the proportion of abdominal fat.

Note: Please note that even though the CASCADEThe CASCADE study (CArdiovaSCulAr D study is a relatively small study, it is the first trial where abstaining participants were randomized into 3 groups (red wine, white wine and water) to examine various biochemical and physiological parameters concerning moderate wine consumption.

Golan R, Gepner Y, Shai I, Wine and health- new evidence, 2018, European Journal of Clinical Nutrition, https://doi.or/10.1038/s41430-018-0309-5.

For more information about this article, read the scientific abstract here.