Interactions of wine drinking with omega-3 fatty acids in patients with coronary heart disease: A fish-like effect of moderate wine drinking

Background: Moderate alcohol drinking and marine omega-3 fatty acids (ω3) have both been associated with low mortality from coronary heart disease (CHD). However, there is little data evaluating the interactions of wine ethanol drinking with ω3 in CHD patients. Methods: The relationships between wine drinking and marine ω3 were evaluated in a cross-sectional study in patients with CHD participating in a randomized trial testing the effect of a high α-linolenic acid (ALA, the main plant ω3) diet. Daily ethanol intake was calculated as energy and expressed as a percentage of total energy. Plant and marine ω3 in the diet were carefully evaluated in each patient in both groups. Results: Patients were classified according to their habitual consumption of ethanol. Patients in the "high ALA group" and controls ("low ALA group") were analyzed separately. Within each group, there was a progressive increase in marine ω3 levels with increased alcohol intake, with a level of eicosapentanoic acid (EPA) that increased by 50% (P < .005) and 37% (P < .05) in the low and high ALA groups, respectively. After controlling for potential confounders (including dietary EPA) in a multivariate linear model, the association between wine ethanol and EPA remained significant in the low (P < .001) and high (P < .05) ALA groups. Conclusion: In these patients with CHD, moderate wine drinking was associated with higher marine ω3 concentrations than no alcohol use. Although the data have to be confirmed in large groups, this effect of wine comparable to that of fish may partly explain the protective effects of wine drinking against CHD.