A large Italian cohort study suggests that moderate wine intake, as defined within a traditional Mediterranean diet, may be associated with slightly slower biological aging in men, whereas total alcohol intake showed a different, less favorable pattern.
Moderate Wine Consumption, Defined by the Mediterranean Diet, Is Associated With Delayed Biological Aging in Men From the Moli-sani Study. Image Credit: Igor Normann / Shutterstock
In a recent study published in the International Journal of Public Health, a group of researchers examined how wine consumption patterns are linked to biological aging using biomarker-based measures.
Background
People age at different rates, with some remaining biologically younger than their chronological age (CA), while others age faster. Unlike CA, biological age (BA) determined by clinical biomarker measurements has been shown to be a more accurate predictor of future health risks and longevity. Furthermore, aging and its related pathophysiological processes may be influenced by lifestyle choices.
The Mediterranean Diet is characterized by a moderate intake of wine (as a part of the diet) and is associated with an abundance of cardiovascular health benefits; however, there are still ongoing discussions about the health benefits of wine compared to other alcoholic beverages. It is therefore critical that the relationship between wine and overall health be explored, given the rapidly growing elderly population and the need for further exploratory research to identify possible causal mechanisms.
About the study
The study analyzed data from 22,495 adults participating in the Moli-sani Study, a large population-based cohort in Southern Italy. Diet was measured using a validated Food Frequency Questionnaire (FFQ) covering habitual food and beverage consumption over the past year.
Wine intake was divided into five categories: abstainers, former drinkers, moderate according to national guidelines, moderate according to Mediterranean Diet criteria, and heavy drinkers.
BA was estimated using a Deep Neural Network (DNN), a supervised machine learning model trained on 36 circulating biomarkers reflecting multiple physiological systems, including metabolic, cardiovascular, renal, and inflammatory processes. The difference between BA and CA, referred to as Δage, was used as an indicator of biological aging, where negative values indicated slower aging.
Associations between wine consumption and Δage were evaluated using multivariable linear regression models, adjusting for potential confounders (age, sex, BMI, smoking habits, and levels of physical activity, education, medical history, and adherence to an alcohol-free Mediterranean Diet Score (MDS)).
In addition to exploring dose-response relationships using restricted cubic spline models, missing data were addressed through multiple imputation methodologies to support the robustness of results.
Study results
The study population had a mean CA of 55.6 years, while the average BA was slightly lower at 54.9 years, indicating an overall modest delay in aging. The participants fell into categories of drinking, with nearly half classified as moderate drinkers and smaller percentages as abstainers, Mediterranean moderate drinkers, or heavy drinkers.
Men who consumed wine at levels consistent with the Mediterranean Diet (approximately 125-500 mL per day) showed a modest association with slower biological aging compared to abstainers. Specifically, their Δage values were lower, indicating that they were biologically younger than their CA. The strongest effect was observed at around 170 mL/day, which is roughly one to two glasses, where biological aging was reduced by approximately 0.34 years.
Moderate wine drinking showed positive effects, whereas both minimal and maximal consumption showed similar negative or neutral outcomes. This indicates that even though moderate wine drinking likely has positive effects, excessive wine drinking cancels these effects. In addition, total alcohol from all sources had no similar results to moderate wine drinking. Therefore, when alcohol is consumed in large quantities, it is associated with accelerated BA. So, not all beverage sources of alcohol have the same effects.
Interestingly, these associations were predominantly observed in men. Women did not show significant differences in biological aging across wine consumption categories. However, the formal interaction test by sex was not significant, so the study did not establish that the association truly differed between men and women. This may be due to biological differences in alcohol metabolism, including lower activity of alcohol dehydrogenase enzymes and hormonal influences, leading to stronger physiological effects of alcohol in women even at lower doses.
Subgroup analyses showed no clear evidence that the association differed across levels of adherence to the Mediterranean Diet, suggesting that wine-component-specific properties may plausibly play a role in these observed relationships and effects. Furthermore, other elements of the Mediterranean Diet, including vegetable intake and the ratio of good to bad fats, were associated with a slower rate of aging.
It was observed that healthier people who were more active, had low body mass index, and fewer chronic conditions, were more likely to fall into moderate drinking categories, suggesting a link between healthy habits. However, the study controlled for these factors, making the findings more reliable.
Conclusion
In men, moderate wine drinking appears to affect the rate of biological aging at intake levels defined as moderate by a traditional Mediterranean Diet; however, the benefits may result from bioactive compounds, such as polyphenols, found in wine rather than from its alcohol content.
Overall, there were no significant effects for total ethanol intake in the main categorical analyses, indicating the need to consider beverage types and consumption patterns. While this study provides promising insights into healthy aging, it does not establish causation, and further long-term studies are needed to investigate how our lifestyle choices affect the aging process and inform public health policy.
Journal reference:
Esposito, S., Di Castelnuovo, A., Costanzo, S., Gialluisi, A., Pepe, A., Ruggiero, E., De Curtis, A., Magnacca, S., Persichillo, M., Casanovas-Garriga, F., Cerletti, C., Donati, M. B., de Gaetano, G., Iacoviello, L., & Bonaccio, M. (2026). Moderate Wine Consumption, Defined by the Mediterranean Diet, Is Associated With Delayed Biological Aging in Men From the Moli-sani Study. Int. J. Public Health. 71. DOI: 10.3389/ijph.2026.1609410, https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2026.1609410/full
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