[Red wine in medicine: panacea, fashion or ... risk factor?]

Red wine has been a subject of much interest of professionals representing different fields of medicine. However, most of scientific studies have been searching for the reason of so called French paradox, which means that in France and other mediterranean countries the morbidity and mortality due to ischaemic heart disease is significantly lower than in other developed countries, in spite of relatively high consumption of fat and saturated fatty acids. The cardio-protective mechanism of red wine, although incompletely understood, is connected on one hand with the presence of ethanol which increases high-density lipoprotein cholesterol (HDL) and inhibits platelet aggregation, and on the other hand with the presence of polyphenols that have desirable biological properties. These include flavonoids, phenolic acids and stilbenes which are reputed to have antioxidant, vasorelaxing and antiplatelet properties. There is a considerable body of evidence indicating that regular consumption of red wine at moderate doses (200-400 ml a day) exerts a protective effect against ischaemic heart disease, other cardiovascular diseases, and perhaps diabetes, osteoporosis or some cancers. But, since alcohol intake involves a potential danger (risk of dependence, alcoholism, many organic diseases, migraine, allergies) medical recommendations of red wine consumption should be formulated very carefully.