The Fluid Aspect of the Mediterranean Diet in the Prevention and Management of Cardiovascular Disease and Diabetes: The Role of Polyphenol Content in Moderate Consumption of Wine and Olive Oil

Abstract

A growing interest has emerged in the beneficial effects of plant-based diets for the prevention of cardiovascular disease, diabetes and obesity. The Mediterranean diet, one of the most widely evaluated dietary patterns in scientific literature, includes in its nutrients two fluid foods: olive oil, as the main source of fats, and a low-to-moderate consumption of wine, mainly red, particularly during meals. Current mechanisms underlying the beneficial effects of the Mediterranean diet include a reduction in inflammatory and oxidative stress markers, improvement in lipid profile, insulin sensitivity and endothelial function, as well as antithrombotic properties. Most of these effects are attributable to bioactive ingredients including polyphenols, mono- and poly-unsaturated fatty acids. Polyphenols are a heterogeneous group of phytochemicals containing phenol rings. The principal classes of red wine polyphenols include flavonols (quercetin and myricetin), flavanols (catechin and epicatechin), anthocyanin and stilbenes (resveratrol). Olive oil has at least 30 phenolic compounds. Among them, the main are simple phenols (tyrosol and hydroxytyrosol), secoroids and lignans. The present narrative review focuses on phenols, part of red wine and virgin olive oil, discussing the evidence of their effects on lipids, blood pressure, atheromatous plaque and glucose metabolism.

Wine’s Phenolic Compounds and Health: A Pythagorean View

“…The debate on alcohol use and health is becoming heavily polarized: one party underscores a large amount of data in support of the J curve [ 1 , 3 ] whereas the other side dismisses such evidence and calls for total abstention [ 2 , 3 ]. In support of the former, researchers and the lay press often advocate the health benefits of (poly)phenol consumption via red wine intake and cite the vast amount of in vitro literature that would corroborate the hypothesis [ 4 , 5 ].…”

Role of Polyphenols and Carotenoids in Endothelial Dysfunction: An Overview from Classic to Innovative Biomarkers

“…Polyphenols are a large and heterogeneous group of phytochemicals generally divided into flavonoids, phenolic acids, stilbenes, and lignans, although more than 8000 different polyphenols have so far been described [ 8 ]. These molecules are produced in plants as secondary metabolites to manage environmental stresses, such as ultraviolet lights, free radicals, and uncommon temperatures, thus limiting the effects of oxidative stress.…”

Platelet Responses in Cardiovascular Disease: Sex-Related Differences in Nutritional and Pharmacological Interventions

“…Beyond these evidences, flavonoids have received particular attention for potential health benefits of fruit-and vegetable-rich diets, especially in relation to the cardiovascular 5 Cardiovascular Therapeutics system [111]. Most (but not all) epidemiological studies, indeed, greatly suggest that high intake of dietary flavonoids (approximately 200 mg/day of total flavonoids) is inversely related to CVD risk and mortality [112][113][114][115][116][117]. Nonetheless, it must not be overlooked that some of their beneficial effects may also be attributed to other bioactive constituents, (including other polyphenols, vitamins, and minerals), synergizing with flavonoids.…”