Dietary proanthocyanidins: occurrence, dietary intake, bioavailability, and protection against cardiovascular disease

The French have one of the lowest incidences of coronary heart disease in the Western world despite a diet with a relatively high fat content. This phenomenon that has puzzled researchers worldwide for more than a decade is known as the 'French paradox' and has been linked to the high consumption of red wine in France. Red wine is rich in the complex polyphenols, the proanthocyanidins, and these compounds have recently attracted attention as potential cardiac-protective compounds. The present review summarizes the literature on proanthocyanidins with focus on their chemical structure, the occurrence, the daily intake from foods, the bioavailability and metabolism, and the evidence for a protective effect against cardiovascular diseases.