Elsevier

American Heart Journal

Volume 155, Issue 1, January 2008, Pages 175-181
American Heart Journal

Clinical Investigation
Prevention and Rehabilitation
Interactions of wine drinking with omega-3 fatty acids in patients with coronary heart disease: A fish-like effect of moderate wine drinking

https://doi.org/10.1016/j.ahj.2007.08.009Get rights and content

Background

Moderate alcohol drinking and marine omega-3 fatty acids (ω3) have both been associated with low mortality from coronary heart disease (CHD). However, there is little data evaluating the interactions of wine ethanol drinking with ω3 in CHD patients.

Methods

The relationships between wine drinking and marine ω3 were evaluated in a cross-sectional study in patients with CHD participating in a randomized trial testing the effect of a high α-linolenic acid (ALA, the main plant ω3) diet. Daily ethanol intake was calculated as energy and expressed as a percentage of total energy. Plant and marine ω3 in the diet were carefully evaluated in each patient in both groups.

Results

Patients were classified according to their habitual consumption of ethanol. Patients in the “high ALA group” and controls (“low ALA group”) were analyzed separately. Within each group, there was a progressive increase in marine ω3 levels with increased alcohol intake, with a level of eicosapentanoic acid (EPA) that increased by 50% (P < .005) and 37% (P < .05) in the low and high ALA groups, respectively. After controlling for potential confounders (including dietary EPA) in a multivariate linear model, the association between wine ethanol and EPA remained significant in the low (P < .001) and high (P < .05) ALA groups.

Conclusion

In these patients with CHD, moderate wine drinking was associated with higher marine ω3 concentrations than no alcohol use. Although the data have to be confirmed in large groups, this effect of wine comparable to that of fish may partly explain the protective effects of wine drinking against CHD.

Section snippets

Methods

The Lyon Diet Heart Study is a randomized secondary prevention trial to test whether an α-linolenic acid (ALA)–rich diet may prevent cardiovascular complications after a first acute myocardial infarction.18, 19 α-Linolenic acid is the main plant ω3 and the precursor of long-chain ω3s, eicosapentanoic acid (EPA) and docosahexanoic acid (DHA), which are the main marine ω3. The patients in the experimental group were instructed to follow a Mediterranean diet rich in ALA, and no specific

Results

The data about 353 male patients were available. As previously reported,3 ethanol intake accounted for 8% of total energy intake in the low ALA group, wherein wine ethanol represented 88% of the total. The average ethanol intake in the high ALA group was 7.3% of total energy, wherein wine ethanol represented 95%. Thus, as expected in a French population, most of the ethanol consumed by the patients came from wine. There were no irregular or binge drinkers among the 353 patients included for the

Discussion

These cross-sectional data demonstrate that moderate wine drinking was associated with higher blood long-chain ω3 than no alcohol use in these patients with CHD. In fact, wine drinking was associated with a 50% increase in EPA and a 21% increase in DHA among patients with low dietary ALA. The smaller effect seen with DHA than with EPA is consistent with the known tight regulation of DHA synthesis from ALA and EPA. In the group with high dietary ALA, the increases were 37% for EPA and 10% for

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