Risk and benefits of beer and nonalcoholic beer moderate consumption on cardiovascular system

Abstract

Beer is by far the most widely consumed alcoholic beverage in the world. Moderate alcohol consumption in general has been inversely associated with incident cardiovascular disease in observational studies. However, it has been suggested that fermented beverages such as red wine and beer may confer greater protective effects than spirits owing to their higher polyphenolic content. Polyphenols are secondary plant metabolites that are not essential for short-term health status, however there is increasing evidence that long-term intake may reduce the incidence of chronic diseases such as cancer, type-II diabetes, cardiovascular diseases and neurodegenerative diseases. Beer phenolic profile is very diverse, most of the beer polyphenols come from malt, and the rest come from hops used during brewing. However, although hop polyphenols in beer are found in low concentrations, they are very specific to beer since they are not detected in other foods. Most techniques used in assessing the diet followed by individuals are based on self-reporting questionnaires, which are liable to systematic bias by factors such as age, gender, social desirability and approval.

In this thesis, we aim to evaluate whether regular and moderate beer and non-alcoholic beer consumption may reduce cardiovascular disease risk. To assess beer intake one of the main objectives of this thesis was to find a reliable biomarkers of beer consumption, and for this purpose we developed and validated a new method to determine hops polyphenols (prenylflavonoids). We evaluated the effects of ethanol and the phenolic compounds of beer on classical and novel cardiovascular risk factors with an interventional nutritional trial with participants at high cardiovascular risk. Moreover, in a large, multicenter, randomized, parallel group we performed a prospective study aimed at assess the differential associations of wine, beer and spirit consumption with all-cause mortality and incidence of cardiovascular events.