Red wine and the heart: what the trials measured

Red wine is sold to most of us as the drink that is good for the heart. The cards under this page do not back that up. The kindest results come from what is in the glass apart from the alcohol. A meta-analysis of 128 trials found that red grapes and wine lowered blood pressure, mostly in people with overweight or obesity. It counted grapes and wine together as sources of anthocyanins, the red pigments, so the drink itself was never tested on its own. When 18 smokers took turns drinking red wine, white wine and red wine with the alcohol removed, only the dealcoholised one lowered a blood marker of fat damage. In a six month randomised trial, 54 adults with type 2 diabetes who did not drink were given 150 mL of dry red wine with dinner or mineral water, and their 24-hour blood pressure ended up the same. The big Spanish data linking a Mediterranean diet that includes wine to lower heart risk stopped being statistically significant in the analyses built to avoid abstainer bias, which is what happens when non-drinkers include people who stopped because they were already ill. A 2021 review found that formal grading of the evidence did not confirm a heart benefit either. Against all of this stands one plain statement from the WHO Regional Office for Europe: about half of the cancers alcohol causes in its region occur in people who do not drink heavily.

The numbers, per 100 g

What your body absorbs

• In a randomised crossover trial in 12 healthy men, 750 mL of red wine supplied about as much quercetin (14-16 mg) as 50 g of fried onions, yet plasma quercetin after wine was lower than after onions. — 12 healthy men, each drink or food for 4 days, 3-day washout (n = 12) Evidence B source
  Plasma quercetin lower after wine than after onions (P < 0.05), not different from tea
• In a randomised crossover study in 6 healthy men drinking 500 mL, the red wine anthocyanin malvidin-3-glucoside was poorly absorbed, and plasma exposure tracked the dose (68 mg from wine, 117 mg from grape juice). — 6 healthy men, single 500 mL servings of red wine, dealcoholised red wine and red grape juice (n = 6) Evidence B source
  AUC 288 nmol x h/L red wine, 214 dealcoholised, 662 grape juice
• In 437 patients with coronary heart disease, higher wine ethanol intake correlated with higher serum iron (r = 0.21) and ferritin (r = 0.23). — 437 consecutive patients with coronary heart disease, Lyon Diet Heart Study (n = 437) Evidence C source
  Spearman r = 0.21 for iron, 0.23 for ferritin, 0.31 for GGT

What cooking and storage change

• In a randomised crossover study in 10 healthy volunteers eating 250 g of turkey with 200 mL of red wine, soaking the meat in wine after heating cut the absorbed oxidised-fat product malondialdehyde by 75%, and soaking before heating prevented its rise. — 10 healthy volunteers, three test meals (n = 10) Evidence B source
  Plasma MDA rise after meat alone 160 nM, reduced 75% with wine after heating, fully prevented with wine before heating

What it does to your health

• A meta-analysis of 128 randomised trials found that red grapes and wine, as anthocyanin sources, significantly lowered blood pressure, while cholesterol fell less with grapes than with nuts and berries. — 128 randomised clinical trials of berries, red grapes or wine, nuts and pomegranate (n = 128 trials) Evidence A source
  Blood pressure significantly reduced by berries and red grapes or wine, effects mostly in people with overweight or obesity
• A meta-analysis of 88 human intervention studies with 2890 participants found that red wine, like fruit, vegetables and tea, raised plasma non-enzymatic antioxidant capacity, and chocolate and fruit juices did not. — 88 studies, 122 interventions, 2890 participants (n = 2890) Evidence A source
  Plasma antioxidant capacity increased with red wine, effect about three times larger in people with risk factors

Safety, limits and interactions

• In a randomised crossover study in 12 healthy men, 250 mL of red wine raised cisapride exposure to 115% of the water value (not significant), against 151% for grapefruit juice, although one participant's exposure doubled with wine. — 12 healthy men, single 10 mg dose of cisapride (n = 12) Evidence B source
  AUC 115% and Cmax 107% of water with red wine (both not significant), one participant doubled
• The WHO Regional Office for Europe states that about half of alcohol-attributable cancers in its region occur in people who do not drink heavily. — WHO European Region Evidence E source
  About half of alcohol-attributable cancers occur below heavy drinking
• In pooled cross-sectional data from 16760 US adults, wine was one of seven foods linked to higher serum urate, although the whole diet explained 0.3% or less of urate variation against 23.9% for common genetic variants. — 16760 US adults of European ancestry without gout or kidney disease, five cohorts (n = 16760) Evidence C source
  Wine associated with raised serum urate, diet scores explain up to 0.3% of variance

What people believe that the data does not support

• In a randomised crossover trial in 18 male smokers drinking each beverage for 2 weeks, dealcoholised red wine lowered plasma F2-isoprostanes, a marker of lipid oxidation, and red or white wine containing alcohol did not. — 18 male smokers, 2 weeks per beverage, 1-week washout (n = 18) Evidence B source
  Plasma F2-isoprostanes fell with dealcoholised red wine (p < .05), no fall with alcoholic wines
• In a cross-sectional analysis of 75 Portuguese adults aged 55-85 at high dementia risk, a Mediterranean diet score that counted wine as harmful was linked to better MMSE scores (p = 0.043), and the original score that rewards wine showed no link. — 75 adults aged 55-85 at raised dementia risk, 84% women, Porto (n = 75) Evidence C source
  Reversed-wine score associated with MMSE (p = 0.043), original score not associated
• The EU register lists the claim that red wine polyphenols help vascular functions as non-authorised, so it may not be used on food labels in the EU. — EU food labelling Evidence E source
  Claim not authorised

Who this works differently for

• In a 6-month randomised trial in 54 previously abstaining adults with type 2 diabetes, 150 mL of dry red wine with dinner did not change average 24-hour blood pressure compared with mineral water. — 54 adults with type 2 diabetes who did not drink, mean age 57, 85% men, Israel, 6 months (n = 54) Evidence B source
  No difference in mean 24-h blood pressure between wine and water groups

What is still unknown

• Observational data from 7447 high-risk Spanish adults link a Mediterranean diet that includes wine with lower cardiovascular risk (HR 0.55), but the analyses least exposed to abstainer bias were not significant. — 7447 older Spanish adults at high cardiovascular risk (PREDIMED), 4.8 years for CVD, plus 23133 graduates (SUN) (n = 7447) Evidence C source
  HR 0.55 (95% CI 0.36-0.83) for CVD with MedDiet including wine, versus HR 0.84 (0.61-1.15) excluding wine
• A meta-analysis of 76 prospective cohorts tied alcohol to a 5% higher gastric cancer risk per 10 g a day, with the association strongest for beer and liquor, with no strong association reported for wine. — 76 prospective cohorts, 6316385 participants, 32758 gastric cancer cases (n = 6316385) Evidence C source
  5% higher risk per 10 g/day alcohol, strong effect for beer and liquor, no strong effect reported for wine
• A 2021 narrative review reports that meta-analyses of intervention studies link wine with better cardiovascular outcomes, but that GRADE assessment did not confirm this. — literature 2010-2021 Evidence E source
  Benefit not confirmed by GRADE

The bottom line

This page gives you no health reason to start drinking wine, or to drink more. Before the findings, know what is missing. We have no card on wine in pregnancy, on the liver, on alcohol dependence, on children and teenagers, or on how a real glass compares with the grams in these studies. That silence reflects gaps in what we have checked so far. It is no sign that those risks are small, and on each of them your doctor is the right person to ask. The plant compounds wine is praised for reach the blood poorly. Twelve men got about the same quercetin from 750 mL of red wine as from 50 g of fried onions, and less of it turned up in their blood after the wine. Six men absorbed little of the main red wine pigment, and grape juice, which carried more of it, gave more than twice the exposure. Across 88 studies red wine raised the antioxidant capacity of blood plasma, a lab reading taken from a blood sample, and none of those studies tracked heart attacks or deaths. One kitchen finding is real and small. In 10 volunteers, soaking turkey in red wine after cooking cut the oxidised fat product they absorbed from the meat by 75 percent, and soaking it before cooking stopped the rise completely. Two claims you may meet do not hold. The EU refuses to let labels say red wine polyphenols help your blood vessels. And in 75 older Portuguese adults at risk of dementia, a Mediterranean diet score that counted wine as harmful went with better memory test results, while the usual score that rewards wine showed no link. That study took one snapshot, so it cannot say which came first. Some findings are uncomfortable in both directions. Across 76 cohorts, beer and spirits went with more stomach cancer and no strong link was reported for wine, which is an observational pattern and does not cancel the WHO warning above. In 16760 American adults wine was one of seven foods linked to higher uric acid, the substance behind gout, although the whole diet explained 0.3 percent or less of the differences between people and their genes explained 23.9 percent. In 437 heart patients more wine went with more iron and ferritin in the blood, so this study gives no support to the idea that wine lowers iron stores. For medicines we hold one small study of one drug. Red wine barely changed cisapride levels on average, and in one of 12 men it doubled them, so anyone on regular medication should ask a pharmacist before assuming wine is harmless alongside it. Here our evidence runs out, for the reasons named at the top of this section.

Sources

1. wnb3-01 · RCT (crossover)
   Twelve healthy men consumed 750 mL red wine, 50 g fried onions or 375 mL of black tea, each for 4 d in random order. These supplements provided similar amounts of quercetin (14-16 mg)...The plasma quercetin concentration after the consumption of wine was lower than that after onions (P: < 0.05) and not different from that after tea
   J Nutr, 2001 · checked 2026-09-23
2. wnb3-02 · RCT (crossover)
   Six healthy male subjects were studied in a randomized cross over setting...All subject consumed 500 mL of each beverage on separate days providing the following M-3-G quantities: red wine 68 mg, dealcoholized red wine 58 mg, and red grape juice 117 mg...M-3-G is poorly absorbed after a single ingestion of red wine, dealcoholized red wine, or red grape juice
   Eur J Nutr, 2001 · checked 2026-09-23
3. wnb3-15 · cross-sectional
   Data were obtained from 437 consecutive patients. There was a positive relationship (Spearman statistics) between wine ethanol and the serum levels of iron (r = 0.21, p < 0.0001), ferritin (r = 0.23, p < 0.0001) and GGT (r = 0.31, p < 0.0001)
   Nutr Metab Cardiovasc Dis, 2001 · checked 2026-09-23
4. wnb3-05 · RCT (crossover)
   Three meals of 250 g turkey cutlets supplemented by water (A); soaked in red wine after heating plus 200 ml of red wine (B); or soaked in red wine prior to heating plus 200 ml of red wine (C) were administered to 10 healthy volunteers...after (B) there was a 75% reduction in the absorption of MDA (P<0.0001). However, after (C), the elevation of plasma MDA was completely prevented
   FASEB J, 2008 · checked 2026-09-23
5. wnb3-11 · meta-analysis
   A meta-analysis of 128 randomized clinical trials was conducted to investigate the effects of berries and red grapes/wine as sources of anthocyanins and of nuts and pomegranate as sources of ellagitannins on a range of cardiometabolic risk biomarkers...Blood pressure was significantly reduced by the two main sources of anthocyanins, berries and red grapes/wine
   Int J Mol Sci, 2018 · checked 2026-09-23
6. wnb3-12 · meta-analysis
   For the analysis, eighty-eight studies were included, reporting a total number of 122 interventions and involving 2890 subjects. There was overall evidence of the effectiveness of fruit, vegetables, dietary patterns based on plant foods, red wine and tea in increasing plasma NEAC. No changes were found for chocolate and fruit juices.
   Br J Nutr, 2013 · checked 2026-09-23
7. wnb3-06 · RCT (crossover)
   cisapride 10 mg with 250 mL grapefruit juice, red wine (cabernet sauvignon), or water in a randomized 3-way crossover study in 12 healthy men...Cisapride AUC and C(max) with red wine were 115% (difference not statistically significant) and 107% (difference not statistically significant), respectively, of those with water...One subject had a doubling in cisapride AUC and C(max) and a decrease in norcisapride/cisapride ratios with red wine
   Clin Pharmacol Ther, 2001 · checked 2026-09-23
8. wnb3-10 · agency position
   However, around half of all alcohol-attributable cancers in the WHO European Region occur among people whose alcohol consumption does not meet the definition of heavy drinking.
   WHO Regional Office for Europe, No level of alcohol consumption is safe for our health, 4 January 2023 · checked 2026-09-23
9. wnb3-13 · pooled cross-sectional
   Seven foods were associated with raised serum urate levels (beer, liquor, wine, potato, poultry, soft drinks, and meat (beef, pork, or lamb))...In comparison, 23.9% of variance in serum urate levels was explained by common, genome wide single nucleotide variation
   BMJ, 2018 · checked 2026-09-23
10. wnb3-04 · RCT (crossover)
    Eighteen male smokers consumed, in random order, red wine, white wine, or dealcoholized red wine, for two weeks with one week washout between beverages...Plasma F2-isoprostanes (p < .05) decreased significantly with dealcoholized red wine but not with the alcohol-containing beverages
    Free Radic Biol Med, 2001 · checked 2026-09-23
11. wnb3-08 · cross-sectional
    MEDAS-R was positively associated with better MMSE performance (p = 0.043) and showed a borderline association with the MoCA (p = 0.051), but not with the ACE-R score (p = 0.356). No association was found between MEDAS-O and cognitive function
    Nutrients, 2025 · checked 2026-09-23
12. wnb3-09 · register entry
    POL-HC-7784 Polyphenols derived from red wine Total red wine polyphenols help vascular functions that contribute to a healthy cardiovascular system. Non-authorised
    EU Register on nutrition and health claims, claim POL-HC-7784, snapshot 2026-09-21 · checked 2026-09-23
13. wnb3-03 · RCT
    Fifty-four type 2 diabetes, alcohol abstainers were randomized to consume 150 ml/dinner dry red wine or mineral water...After 6 months of intervention, the average 24-h BP did not differ between the wine and water groups
    Am J Hypertens, 2016 · checked 2026-09-23
14. wnb3-07 · cohort analysis
    For good compliers with MedDiet (including wine), the HR for CVD was 0.55 (95% CI 0.36-0.83)...Additionally, analyses least vulnerable to threats of abstainer bias were not significant and neither were multiplicative interaction terms for the wine item in the questionnaire
    Eur Heart J, 2026 · checked 2026-09-23
15. wnb3-14 · meta-analysis of cohorts
    Seventy-six prospective cohort studies were eligible and included in the analysis...a strong effect of alcohol consumption, particularly beer and liquor but not wine, on gastric cancer risk was observed compared with nondrinkers...5% per 10 g/day increment of alcohol consumption
    Eur J Cancer, 2015 · checked 2026-09-23
16. wnb3-16 · narrative review
    Our narrative review has shown that in meta-analyses of intervention studies, consumption of chocolate and wine was positively associated with the beneficial outcomes associated with the cardiovascular system. In contrast, the assessment with the GRADE (Grading of Recommendations Assessment, Development and Evaluation) scale did not confirm this phenomenon.
    Nutrients, 2021 · checked 2026-09-23