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Role of wine in the (Mediterranean) diet
Greece vs. Germany

Traditionally, wine has been an integral part of meals, and cross-cultural studies have reported a significantly lower risk (20-60%) of cardiovascular disease (CVD) in Mediterranean regions where wine is a daily staple of the diet and lifestyle.

The complex relationship between light-to-moderate alcohol consumption (20-30g of alcohol daily) and CVD mortality is reflected in an U-shaped curve. Total mortality rates are generally slightly lower among moderate drinkers than among abstainers. Scientific studies are increasingly demonstrating that wine has numerous other positive effects: Moderate wine drinkers are less likely to develop diabetes and diabetics who consume wine moderately have a lower risk of CVD. Moderate drinking may also contribute to better accumulated bone mineral density and thus, reduces the risk of osteoporosis. The rates of Alzheimer's Disease and dementia are lower among moderate wine drinkers than abstainers. The mechanisms by which moderate wine consumption decreases CVD include the increase of HDL-cholesterol levels, modification of haemostatic factors, coagulation and fibrynolysis and decrease of platelet aggregation. Findings that wine drinkers are at a decreased risk of mortality from CVD compared to non-wine drinkers, suggest that substances present in wine are responsible for a beneficial effect on the outcome, in addition to that from ethanol.
Wine contains many different types of polyphenolic antioxidants which support the action of alcohol by inhibiting LDL-oxidation. Although there is a biological effect of alcohol, differences in lifestyle can also partly account for the relation between wine/alcohol consumption and CVD. Moderate drinkers tend to smoke less than other groups and hypertension is inversely related to alcohol consumption. In addition, wine-drinking populations tend to have a healthier diet and different drinking patterns than those who consume other alcoholic beverages.
Does the type of wine make a difference? More polyphenolic substances are found in red wine and the reported health benefits have been mainly associated with red wine. In Greece and Germany, white wine is the wine that is consumed the most. Some studies demonstrated that the total quantity of antioxidants is not the critical factor but the quality and type of polyphenolic compounds.
Is the wine or the wine drinker responsible for the positive health effects? Wine comsumption has been decreasing in Southern Europe whereas it has been increasing in Northern Europe. In the 1960s, consumption of wine was more than 3 times higher in Greece (41.9 l/person/yr) than in Germany (12.3 l); now, Germans (23.9 l/p/yr) are catching up in terms of wine consumption with the Greek people (34 l/p/yr). Other significant differences from the original traditional Mediterranean diet are found in most Mediterranean countries, showing a Westernization of dietary habits. Will this change affect the CVD risk profile? The risk factors, drinking patterns and lifestyle of a Mediterranean country like Greece will be compared with a Northern European country like Germany.

U.G. Fradera, C. Stein-Hammer, Deutsche Weinakademie, Germany
Y. Kotseridis, Agricultural University of Athens - KEOSOE, Greece

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