# Wine Polyphenols and Health: Quantitative Research Literature Analysis
## 3 Results
His most highly cited paper (cited 338 times) in the current dataset was a paper focused on how red wine polyphenols and ethanol can affect gut microbiota ecology and biochemical biomarkers [35]. From this in vivo study, the authors concluded that regular and moderate red wine consumption could significantly modulate the growth of select gut microbiota in humans, highlighting possible probiotic effects associated with the inclusion of red wine polyphenols in the diet [35]. In fact, this was the first in vivo study that showed that red wine polyphenols could inhibit nonbeneficial bacteria and potentiate the growth of probiotic bacteria (such as bifidobacteria), which could be implicated in the reduction of the C-reactive protein and cholesterol-promoting health benefits in the host. Figure 4: Most productive authors. (Bibliometric data were extracted from the Scopus online database). Figure 3: Distribution of documents by type. (Bibliometric data were extracted from the Scopus online database). The second most-cited article was a review by [PERSON] et al. [36] that remarked on the evidence that not only do wine polyphenols (e.g., resveratrol, anthocyanins, flavonoids, and catechins) provide an abundance of health benefits, but also their metabolites could play a real role in cardiovascular and cancer protection [36]. Among the most recent works of [PERSON], the second most-cited author (Figure 4), some studies (reviews and clinical trials) explore the different mechanisms of the cardiovascular protective effects of polyphenols, for instance, in vascular health, stimulating the formation of vasoprotective factors (e.g., nitric oxide and endothelium-derived hyperpolarizing factor) that promote vasodilitation and prevent platelet activation [37; 38]. Moreover, the author, in a further work, marked the role of wine polyphenols in improving vascular smooth muscle function, by reducing the excessive vascular oxidative stress of pathological blood vessels, probably related to changes in the expression levels of antioxidant and pro-oxidant enzymes [39]. Interestingly, the work of [PERSON] also focalizes on the interaction of wine polyphenols and gut microbiota [40]. In this review, the authors underline how the moderate consumption of red wine could modulate quantitative and qualitative changes in oral and gut microbiota by means of some polyphenols present in this beverage. The interaction of wine polyphenols (e.g., (+)-catechin and (\(-\))-epicatechin, gallic acid) and/or their metabolites (coming from the interaction of wine polyphenols with oral and gut microbiota) leads to a modification of the gut microbiota, showing a moderately prebiotic effect and an inhibition of the pathogenic microflora [40]. For instance, [PERSON]'s most-cited work investigated [41] how the gut microbiota interacts with red wine extract, leading to the formation of a wide range of phenolic microbial metabolites coming from catabolism of the main flavonoids (e.g., flavan-3-ols and anthocyanins). While the metabolites formed from anthocyanins seemed to be quickly degraded into simpler compounds, the metabolites from flavan-3-ols (such as phenyl-\(\gamma\)-valerolactone derivatives) were stable during absorption and could be used as a possible biomarker of red wine consumption linked to in vivo health effects. Moreover, in his recent review [42], the relationship between wine consumption, diet, and microbiome modulation in Alzheimer's disease was investigated. This study highlighted that red wine polyphenols could act in a multi-target way and that wine polyphenol could modulate the composition of gut microbiota leading to brain function and Alzheimer's disease protection with significant health consequences. Figures 5 and 6 show the most productive institutions based on data retrieved from the Scopus database Institutional Assignment and Countries, respectively. Figure 5: Most productive institutions. (Bibliometric data were extracted from the Scopus online database). The most productive institution was the Universitat de Barcelona (Figure 5).