ChiroACCESS Article



Research Status of Resveratrol



This information is provided to you for use in conjunction with your clinical judgment and the specific needs of the patient.

Dwain M. Daniel, D.C.

  

ChiroACCESS



Published on

October 13, 2011

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Prior to the year 2000 only 180 articles on resveratrol had been indexed in PubMed.  Since 2000 an additional 4080+ articles have been indexed.  Why the major surge in interest? It could be because preliminary evidence suggests resveratrol may be an effective intervention in the prevention or treatment of Alzheimer’s disease, cardiovascular disease, cancer, diabetes, back pain and the aging process.  Granted, the evidence is preliminary but many researchers consider it very promising.  In spite of limited human studies, the lack of significant adverse effects coupled with its potential benefits and relatively low price make it a very appealing nutritional supplement to the consumer.

Resveratrol is a polyphenol molecule which is found in many plants such as grapes, peanuts and cranberries as well as others.  Based primarily on animal and in vitro studies it has antioxidant, anti-inflammatory and anti-aging effects (1). 

Potential Benefits


As mentioned above, resveratrol has been identified as having antioxidant and anti-inflammatory properties.  Both characteristics play essential roles in the maintenance of health and prevention of many chronic diseases (2-4).  

The method by which resveratrol exhibits its antioxidant properties is very complex and not well understood.  Several different mechanisms have been studied.  One study demonstrated resveratrol causes a significant decrease in malonaldehyde content in mononuclear cells which is an indication of oxidant injury (5).  Another study observed a significant decrease in DNA damage due to lipid perioxidation with the use of resveratrol (6).  Resveratrol, in its trans-form, has also demonstrated activity as a scavenger of free radicals (7). 

The mechanism by which resveratrol acts as an anti-inflammatory agent is also complex and poorly understood.  One hypothesis is resveratrol down regulates inflammatory cytokine expression by inhibiting activation of nuclear factor-kappaB (1).  Resveratrol has also demonstrated the ability to increase the anti-inflammatory cytokine IL-10 in mice (8).   Of particular interest to the chiropractic physician is a recent article in Spine relating to nucleus pulposus mediated pain.  This study concluded resveratrol reduced levels of pro-inflammatory cytokines both in vitro and in vivo.  This study was a rodent study but the authors theorize resveratrol may have a similar effect in humans (9).

Possibly the most exciting aspect of resveratrol to the consumer is the possibility of life extending properties (http://www.cbsnews.com/video/watch/?id=5037314n).  If resveratrol is an effective anti-inflammatory and antioxidant agent, the successful prevention and treatment of cancer, diabetes, Alzheimer’s disease, COPD, and cardiovascular disease would naturally extend life.   However the life extending properties that are generating the most excitement is the hypothesis that “calorie restriction” can increase life span by activating the Sirtuin 1 gene.  Activation of this gene has shown more gradual aging and increased lifespan in several species (10).  Resveratrol may be able to activate this gene without calorie restriction in man as well (11). 

Bioavailability

Concerns over the bioavailability of trans-resveratrol have been expressed in the literature.  Although resveratrol is well absorbed, it is converted to sulfated resveratrol and glucuronidated resveratrol in the small intestine and liver which limits its bioavailability (12;13).  Estimates for bioavailability of resveratrol is less than 1% (14).  As discouraging as this appears several studies have demonstrated bioavailability may be improved by several different means:
  1. Dosing with quercetin (12;13;15)
  2. Morning dosing (16)
  3. Dosing on an empty stomach (17)
  4. Repeated dosing results in an accumulation in the epithelial cells of the small intestine which may cause improved bioavailability (16).
  5. Methylated derivatives with improved bioavailability are currently being investigated (14).
It should be noted, even with low bioavailability, several human studies have demonstrated an effect of resveratrol ingestion. Two examples are studies which have demonstrated a reduction of cell proliferation in colon cancer (.5 and 1 g per day) (18) and increases in cerebral blood flow during task performance (250-500 mg per day) (19).

Conclusion


The bottom line for resveratrol, based on a recent systematic review, is there is insufficient evidence to justify routine consumption of resveratrol in humans other than in dietary sources (20).  However, based on its safety profile, low cost and possible benefits, many individuals may choose to take 250 to 500 mg daily, just in case the potential benefits are eventually shown to be real.

There are many commercial sources for resveratrol available through the internet.  The website www.consumerlabs.com routinely tests various dietary supplements and has a section on resveratrol.  This is a pay site ($33.00/year) but is well worth the price as it identifies many products that are not approved due to testing failure.
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Wuertz K, Quero L, Sekiguchi M, Klawitter M, Nerlich A, Konno S, et al. The red wine polyphenol resveratrol shows promising potential for the treatment of nucleus pulposus-mediated pain in vitro and in vivo. Spine (Phila Pa 1976 ) 2011 Oct 1;36(21):E1373-E1384.

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