**1. Alcohol and health**

Alcohol consumption is associated with several social and health risks and since 2010, the WHO conducts its global strategy to reduce the harmful use of alcohol [1–4]. In a recent review, alcohol was found to be the seventh leading risk factor for premature death in 2016, contributing to 2.8 million deaths worldwide, leading to the conclusion that no amount of alcohol is safe [5]. Other sources found that alcohol can have some beneficial health effects when consumed in low-risk drinking patterns [6–10]. Research shows that there may be a beneficial cardioprotective effect of these relatively low levels of drinking for ischaemic heart disease, ischaemic stroke and diabetes mellitus, as well as death from all causes [6–10]. Lowrisk drinking is also called "drinking in moderation" and is usually defined using standard units. The WHO recommends consuming a maximum of two standard drinks per day, with at least two days a week without alcohol, and never more than four drinks per consumption episode [4]. In Australia, a standard drink contains 10 g of pure alcohol [11]. Ethanol is found to be associated with favourable changes in several cardiovascular biomarkers such as higher concentration of high-density lipoprotein cholesterol and adiponectin, and lower concentration of fibrinogen and other haemostatic factors [12].

### **1.1 History of wine as a health food**

From earliest times wine has been used as a therapeutic agent, irrespective of a lack of clinical and scientific data for a variety of ailments [13]. It has been used as a nourishment, for diuresis and hyperthermia and as an aperient, as well as an antibacterial agent for wounds. These therapies eventually became widely adopted throughout Medieval Europe until the puritanical religious movement accredited to Oliver Cromwell spread to the east coast of North America via the Pilgrim Fathers in 1620.

These puritan movements in England and the USA eventually led to the temperance movement of the nineteenth century, which condemned alcohol in all its forms. Wine only found favour again as a medicine in the last decades of the twentieth century.
