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This commentary refers to ‘Urinary tartaric acid as a biomarker of wine consumption and cardiovascular risk: the PREDIMED trial’, by I. Domínguez-López et al., https://doi.org/10.1093/eurheartj/ehae804 and the discussion piece ‘Urinary tartaric acid and cardiovascular disease risk’, by A. Ortiz, https://doi.org/10.1093/eurheartj/ehaf760. We concur with Dr Ortiz1 regarding the gut microbial metabolism of tartaric acid, a biomarker of wine consumption associated with lower risk of cardiovascular events.2 Scientific interest in tartaric acid dates to 1850s, when Louis Pasteur identified two enantiomeric forms: (+)-tartaric acid and (−)-tartaric acid.3 He also observed a microbial preference for the (+)-enantiomer, which is the enantiomer produced by grapes and most likely found in urine, underscoring the stereoselectivity of microbial metabolism.3 More recently, tartaric acid has been linked to gastrointestinal benefits, including modulation of faecal bile acid composition and short-chain fatty acid production. This raises questions about the extent to which tartaric acid is absorbed and excreted, and whether it is really a reliable biomarker linked to health outcomes. In a randomized crossover trial, we found a clear dose–response relationship with wine intake and urinary tartaric acid, with ∼18%–20% of ingested tartaric acid excreted.4 ROC curve analysis in a free-living population demonstrated high discriminatory ability,5 and a one-year sub-study of the PREDIMED trial found a consistent correlation between urinary tartaric acid levels and self-reported wine consumption.5 These findings support urinary tartaric acid as a reliable biomarker for wine intake.
Lamuela‐Raventós et al. (Tue,) studied this question.