Wine polyphenols in the prevention of metabolic syndrome: a critical review of multitarget mechanisms and translational perspectives

Metabolic syndrome (MetS), a major global public health concern, is characterized by lipid accumulation, glucose dysregulation, and vascular dysfunction. Moderate wine consumption-particularly red wine-has been associated with reduced risk of chronic diseases through mechanisms such as antioxidation, lipid metabolism modulation, and enhanced insulin sensitivity. The "French Paradox" suggests that polyphenols in wine may play a central role in these protective effects. This review provides a comprehensive analysis of the chemical composition, content variability, and metabolic regulatory functions of wine-derived polyphenols. The type and concentration of polyphenols in wine are influenced by grape variety, climatic conditions, and winemaking processes; red wines generally contain higher polyphenol levels due to extended contact with grape skins and seeds during fermentation. These compounds exert multi-targeted metabolic effects, including the regulation of lipid and glucose metabolism, energy reprogramming, and vascular function improvement-contributing to the prevention and management of MetS. Despite promising evidence, challenges remain in improving the bioavailability of wine polyphenols, generating robust clinical evidence, and translating these compounds into effective functional foods. This review aims to provide a scientific foundation for understanding the role of wine polyphenols in metabolic health and to inform future research and nutritional strategies for MetS intervention.