Newsweek reports on 'Ozempic-Like Action' of polyphenols.

The Science Behind Muscadine Polyphenols and Their Impact on Blood Sugar.

Did you know that a little-known fruit might hold the key to managing your blood sugar levels? Muscadine, an all-American superfruit, has caught the attention of researchers for its potential impact on type 2 diabetes. Packed with powerful compounds called polyphenols, muscadines have a higher antioxidant capacity than popular superfoods like pomegranates and blueberries. 

This makes them a promising natural option for those looking to support their health and well-being.

In this article, you'll learn about the science behind muscadine polyphenols and how they affect your blood sugar. We'll explore the mechanisms of action, including how these compounds may influence insulin resistance and inflammation. You'll also discover what research says about muscadine's role in managing adult diabetes, and how it compares to other sources of beneficial compounds like resveratrol, quercetin, and ellagic acid. Plus, we'll cover recommended intake, potential side effects, and why choosing non-GMO options matters for your health.

What are Muscadine Polyphenols?

Muscadine grapes (Vitis rotundifolia) are a unique variety native to the southeastern United States, known for their thick skins, large seeds, and high polyphenol content 1. These grapes are well-adapted to the warm, humid climate of the region and have gained attention for their potential health benefits 2.

Polyphenols are secondary metabolites found in plants, and in grapes, they represent the third most abundant constituent after carbohydrates and fruit acids 2. In muscadine grapes, polyphenols are primarily concentrated in the seeds (60-70%) and skins (28-35%), with less than 10% in the pulp 2.

Types of polyphenols in muscadines.

Muscadine grapes contain a diverse array of polyphenolic compounds, including:

1. Anthocyanins: These are responsible for the red color in muscadine grape skins. The major anthocyanins found in muscadines are delphinidin, cyanidin, petunidin, peonidin, and malvidin glycosides 1. In red-skinned varieties like "Noble" and "Alachua," anthocyanin levels can range from 292.0 to 554.9 mg per 100 g dry weight 2.

2. Flavonols: Muscadine grapes are rich in flavonols such as quercetin, myricetin, and kaempferol glycosides 1 2.

3. Flavan-3-ols: These include catechin, epicatechin, and their polymeric forms (proanthocyanidins) 1. Muscadine seeds contain abundant flavan-3-ols like procyanidins (epicatechin and epicatechin gallate) and condensed tannins 2.

4. Stilbenes: The primary stilbene in muscadine grapes is resveratrol, which has been extensively studied for its potential health benefits 1. However, it's worth noting that the resveratrol content in muscadines is relatively low compared to other polyphenols 3.

5. Ellagic acids: Muscadine grapes, particularly their skins and seeds, contain large amounts of ellagic acids, including ellagic acid derivatives and ellagitannins 2.

6. Other compounds: Gallic acid, procyanidin B, and catechin gallate have also been identified in muscadine grape extracts 3.

Health benefits of muscadine polyphenols.

The high polyphenol content in muscadine grapes contributes to their impressive antioxidant capacity. In fact, muscadines have a higher antioxidant capacity than popular superfoods like pomegranates and blueberries 4. To put this into perspective, while the TEAC (Trolox equivalent antioxidant capacity) values for blueberries and blackberries range from 8.11 to 38.29 μM/g FW, muscadine grape seeds and leaves have TEAC values of 281.3 and 236.1 μM/g FW, respectively 4.

Muscadine polyphenols have been associated with a variety of potential health benefits, including:

1. Antioxidant effects: Polyphenols can help slow cell damage caused by free radicals, potentially preventing some cardiovascular diseases and types of cancers 4.

2. Anti-inflammatory properties: These compounds may help reduce inflammation in the body 1.

3. Cardioprotective effects: The antioxidant and anti-inflammatory properties of muscadine polyphenols may contribute to heart health 1.

4. Antiviral and antibacterial properties: Some studies suggest that muscadine polyphenols may have antimicrobial effects 2.

It's important to note that while these potential health benefits are promising, more research is needed to fully understand the effects of muscadine polyphenols on human health. However, the high antioxidant capacity of muscadine grapes suggests that including them in a regular diet may be beneficial to your overall health and well-being 4.

How Polyphenols Affect Blood Sugar.

Polyphenols, a diverse group of phytochemicals found in plant-based foods, have gained attention for their potential to influence carbohydrate metabolism and blood sugar control. These compounds, which include flavonoids, phenolic acids, proanthocyanidins, and resveratrol, are abundant in foods such as tea, coffee, wine, cocoa, cereal grains, soy, fruits, and berries 5. Research has shown that polyphenols may have a positive impact on blood sugar levels through various mechanisms.

Inhibition of carbohydrate-digesting enzymes.

One of the primary ways polyphenols affect blood sugar is by inhibiting enzymes responsible for carbohydrate digestion. Specifically, polyphenols have been shown to inhibit α-amylase and α-glucosidase, two key enzymes involved in breaking down complex carbohydrates into simple sugars 5.

Studies have demonstrated that a wide variety of polyphenols, including flavonoids (anthocyanins, catechins, flavanones, flavonols, flavones, and isoflavones), phenolic acids, and tannins (proanthocyanidins and ellagitannins), can inhibit these enzymes in vitro 5. This inhibition slows down the rate of carbohydrate digestion, which in turn blunts glucose spikes after meals 6.

For example, research has shown that diacylated anthocyanin and anthocyanin extract from purple sweet potato reduced blood glucose and insulin responses to maltose administration in rats 5. In human studies, consuming berries (150 g of purée made from bilberries, blackcurrants, cranberries, and strawberries) with sucrose resulted in a different postprandial glycemic response compared to a control without berries 5.

Reduced glucose absorption.

Polyphenols can also affect blood sugar levels by reducing glucose absorption in the intestine. Several flavonoids and phenolic acids have been shown to inhibit glucose transport proteins, such as SGLT1 and GLUT2, which are responsible for glucose uptake in the small intestine 5.

Research has demonstrated that chlorogenic, ferulic, caffeic, and tannic acids, as well as quercetin monoglucosides, tea catechins, and naringenin, can inhibit SGLT1-mediated glucose transport 5. Additionally, quercetin, myricetin, apigenin, and tea catechins have been found to inhibit glucose transport by GLUT2 5.

These effects have been observed in both animal and human studies. For instance, when healthy subjects consumed glucose with apple juice (which contains polyphenols such as chlorogenic acid and phloridzin), their plasma glucose concentrations were significantly lower at certain time points compared to a control drink 5.

Increased insulin sensitivity.

Polyphenols may also improve blood sugar control by enhancing insulin sensitivity and glucose uptake in insulin-sensitive tissues. Some studies have shown that polyphenols can activate insulin receptors and stimulate glucose absorption in these tissues 7.

For example, tea polyphenols at a dosage of 1/10 (w/w) of tea polyphenol/starch have been shown to activate insulin receptors and glucose absorption in insulin-sensitive tissues 7. This increased glucose uptake can help reduce blood sugar levels.

Additionally, certain polyphenols have been found to enhance insulin-mediated glucose uptake in vitro. Compounds such as epicatechin, epigallocatechin-3-O-gallate (EGCG), grape seed-derived procyanidins, and extracts from bitter melon, blueberry, canna indica root, and black soybean have demonstrated this effect 8.

In conclusion, polyphenols affect blood sugar through multiple mechanisms, including inhibiting carbohydrate-digesting enzymes, reducing glucose absorption, and increasing insulin sensitivity. These effects contribute to attenuated postprandial glycemic responses and improved insulin sensitivity, making polyphenols a promising natural approach to supporting healthy blood sugar levels.

Mechanisms of Action.

Muscadine polyphenols have a complex impact on your body's metabolic processes, particularly in relation to blood sugar control. To understand how these compounds work, let's explore three key mechanisms: AMPK activation, reduced inflammation, and improved gut microbiome.

AMPK activation.

AMPK (AMP-activated protein kinase) is a crucial enzyme that acts as a cellular energy sensor. When activated, AMPK reconfigures your metabolism, turning on energy-producing pathways and shutting down energy-consuming ones 9. This activation has several beneficial effects:

1. Improved glucose uptake: AMPK activation enhances the translocation of GLUT4 glucose transporters to cell membranes, increasing glucose uptake in your muscles and other tissues 9.

2. Enhanced fatty acid oxidation: By stimulating the breakdown of fats, AMPK helps reduce lipid accumulation in your liver and muscles 9.

3. Increased insulin sensitivity: AMPK activation can improve your body's response to insulin, helping to maintain stable blood sugar levels 9.

Interestingly, obesity has been associated with reduced AMPK activation, which may contribute to alterations in glycolysis, insulin sensitivity, and hepatic lipid metabolism 9.

Reduced inflammation.

Chronic inflammation plays a significant role in the development of type 2 diabetes and other metabolic disorders. Muscadine polyphenols have demonstrated potent anti-inflammatory effects:

1. Inhibition of inflammatory mediators: Polyphenols can prevent the expression and secretion of inflammatory mediators in your body 10.

2. Reduction of oxidative stress: By donating electrons or hydrogen, phenolic compounds like flavonoids can slow down or inhibit inflammatory processes 10.

3. Modulation of inflammatory pathways: Grape polyphenols, especially resveratrol, can reduce inflammation by decreasing Nitric Oxide (NO) inactivation through antioxidative enzymes 10.

Studies have shown that subjects who consume higher amounts of flavonoid-rich foods have lower cardiovascular disease risks, which may be attributable to reductions in inflammation and oxidative stress 10.

Improved gut microbiome.

The gut microbiome plays a crucial role in your overall health, including blood sugar regulation. Muscadine polyphenols can positively influence your gut microbiome:

1. Reduction of reactive oxygen species (ROS): Dietary polyphenols can reduce the content of ROS in your intestines, creating a more favorable environment for beneficial gut bacteria 11.

2. Support for beneficial bacteria: By reducing ROS, polyphenols may benefit anaerobic and microaerophilic gut bacteria, such as Akkermansia muciniphila, which has been associated with anti-diabetic effects 11.

3. Improved intestinal health: Dietary interventions with grape polyphenol extracts have been shown to improve various intestinal health parameters 12.

Research has demonstrated that obesity and Western-style diets can lead to gut microbiome dysbiosis, which is associated with the development of cardio-metabolic diseases. Interventions with grape polyphenol extracts have been shown to modulate several microbial, inflammatory, and metabolic factors, reducing poor health outcomes associated with Western diet intake 12.

In conclusion, muscadine polyphenols work through multiple mechanisms to influence your blood sugar levels. By activating AMPK, reducing inflammation, and improving your gut microbiome, these compounds can have a significant impact on your metabolic health. As research continues, we may uncover even more ways in which these powerful plant compounds support your overall well-being.

Research on Muscadine Polyphenols and Diabetes.

As you explore the potential benefits of muscadine polyphenols for managing diabetes, you'll find that research in this area is ongoing and promising. Scientists have conducted various studies to understand how these compounds might influence blood sugar levels and related health issues. Let's take a closer look at some of the key findings from both animal studies and human clinical trials.

Animal Studies.

Animal studies have provided valuable insights into the potential effects of muscadine polyphenols on diabetes-related conditions. One notable study focused on the impact of a muscadine grape skin/seed extract supplement (MGES) on hypertension-induced cardiac damage and oxidative stress 3.

Key findings from this study include:

1. MGES showed potential in preventing hypertension-induced cardiac damage and oxidative stress.

2. The supplement increased endogenous myocardial SOD1 and catalase protein, activity, and mRNA in both normotensive and hypertensive rats. This suggests an enhanced ability to scavenge toxic free radicals 3.

3. Co-administration of MGES prevented the upregulation of downstream markers of oxidative stress, such as MDA, 4-HNE, and urinary 8-OHdG 3.

These results indicate that MGES may serve as a medical food to protect the heart from hypertension-induced diastolic dysfunction, which is partly caused by excessive reactive oxygen species production 3.

Another study examined the effects of muscadine grape supplements (MGS) with high polyphenol content on oxidative stress 13. The researchers found that:

1. MGS typically contain ground dried skin and seed of the grape, which are rich in polyphenols.

2. The high concentrations of polyphenols in the seed and skin are the primary basis for their widespread use as a nutritional supplement 13.

These animal studies suggest that muscadine polyphenols may have potential benefits for managing diabetes-related complications, particularly in terms of reducing oxidative stress and protecting heart function.

Human Clinical Trials.

While animal studies have shown promising results, human clinical trials are essential to determine the effectiveness and safety of muscadine polyphenols for managing diabetes in people. Unfortunately, the available information on human clinical trials specifically focused on muscadine polyphenols and diabetes is limited in the provided factual keypoints.

However, some general observations and considerations for human studies include:

1. Safety and efficacy concerns: Although grape seed supplements are considered a potential therapeutic approach to maintain health, there are safety and efficacy concerns that need to be addressed in human trials 13.

2. Variability in supplement composition: The content and concentration of polyphenolic compounds in grape supplements can vary depending on factors such as:

   • The ratio of skin, seed, and pulp included in the supplement

   • Cultivar differences

   • Environmental factors like soil type, water availability, and weather conditions

   • Manufacturing processes and quality control 13

3. Need for standardization: There is limited information on the precise identity and concentration of individual phenolics in commercially processed muscadine grape supplements. This highlights the need for standardization and quality control in supplement production 13.

4. Potential for further research: The results from animal studies support the need for further clinical assessment of commercial MGES for the treatment of patients with hypertension or those at high risk of developing hypertension, to prevent cardiac damage due to increased blood pressure 3.

To fully understand the effects of muscadine polyphenols on diabetes in humans, more comprehensive clinical trials are needed. These trials should address factors such as optimal dosage, long-term safety, and efficacy in managing blood sugar levels and related complications.

As research continues, it's important to remember that while muscadine polyphenols show promise, they should not be considered a replacement for conventional diabetes treatments. 

Always consult with your healthcare provider before incorporating any new supplements into your diabetes management plan.

Comparing Muscadines to Other Polyphenol Sources.

When you're looking for natural sources of polyphenols to support your health, muscadine grapes stand out as a nutritional powerhouse. These grapes, native to the southern United States, offer a unique profile of beneficial compounds that sets them apart from other polyphenol-rich foods. Let's compare muscadine grapes to other well-known sources of polyphenols to understand their distinctive qualities.

Grapes.

Muscadine grapes (Vitis rotundifolia) have a higher antioxidant capacity and a different phenolic profile compared to European grape varieties (Vitis vinifera) 3. The concentration of polyphenols in muscadine grapes is particularly high, with the skins and seeds containing the most significant amounts 14.

Key differences between muscadine and other grape varieties include:

1. Polyphenol content: Muscadine grapes have higher concentrations of polyphenols compared to other grape varieties 13.

2. Compound profile: While muscadines contain lower levels of resveratrol, they are rich in other beneficial compounds such as ellagic acid, tannins, anthocyanins, and flavonoids 3 14.

3. Antioxidant capacity: Muscadine grapes have a higher antioxidant capacity than many other fruits, including some varieties of grapes 14.

4. Seedless varieties: Interestingly, seedless muscadine grapes have been developed that maintain similar phytonutrient profiles to their seeded counterparts 15.

Berries.

While berries are often celebrated for their high polyphenol content, muscadine grapes offer a unique alternative. Here's how they compare:

1. Antioxidant capacity: Muscadine grapes have a higher antioxidant capacity than popular superfoods like blueberries 14.

2. Polyphenol diversity: Like berries, muscadines contain anthocyanins, which give them their purple-red color. However, muscadines also offer a broader range of polyphenols, including ellagic acid, which is found in some berries like pomegranates 14.

3. Flavonoid content: Muscadines contain flavonoids such as quercetin, which is a more potent antioxidant than vitamin C, vitamin E, or beta carotene 14.

Tea.

Tea, particularly green tea, is renowned for its high polyphenol content and health benefits. Here's how muscadine grapes compare:

1. Cardiovascular benefits: Both muscadine grape extracts and green tea have shown potential benefits for cardiovascular health. Green tea has been associated with improved cardiovascular outcomes and reduced all-cause mortality, partly due to its high phenolic content 3.

2. Unique compounds: While green tea is rich in epigallocatechin-3 gallate (EGCG), muscadine grapes offer a different set of polyphenols, including ellagic acid and anthocyanins 3 14.

3. Antioxidant properties: Both muscadine grapes and tea possess strong antioxidant properties, but their mechanisms of action may differ due to their distinct polyphenol profiles 3 14.

It's worth noting that muscadine grape supplements typically contain ground dried skin and seed of the grape, which were once considered waste products in grape processing. The high concentrations of polyphenols in these parts have led to their widespread use as nutritional supplements 13.

When considering polyphenol sources, it's important to remember that each offers a unique profile of beneficial compounds. Muscadine grapes stand out for their high antioxidant capacity, diverse polyphenol content, and potential health benefits. By incorporating a variety of polyphenol-rich foods into your diet, including muscadine grapes, you can take advantage of the broad spectrum of health-promoting compounds nature has to offer.

Recommended Intake of Muscadine Polyphenols.

When you're considering adding muscadine polyphenols to your diet, it's important to understand the recommended intake and the various forms in which they're available. Let's explore the dosage guidelines and the different ways you can incorporate these beneficial compounds into your daily routine.

Dosage.

Determining the optimal dosage of muscadine polyphenols can be challenging due to variations in supplement composition and individual needs. However, research provides some guidance:

1. Clinical trial dosage: A recent Phase I clinical trial used muscadine grape extract supplement (MGES) capsules at a dosage range of 320 to 1600 mg per day 3. For a 60 kg person, this is equivalent to 5.2 to 27 mg MGES/kg each day.

2. Animal study equivalent: An animal study that showed improvements in diastolic dysfunction used a dose of approximately 14 mg/kg per day for rats 3. Using allometric scaling to convert this to a human equivalent dose, it would be approximately 2.3 mg/kg per day.

3. Serving size: One serving of fresh muscadine grapes is about 1/2 cup or 16 grapes. This serving contains approximately 55 calories, 13.37 g of carbohydrates, and 3.37 g of fiber 16.

It's important to note that these dosages are based on specific studies and may not be universally applicable. Always consult with a healthcare professional before starting any new supplement regimen.

Forms (juice, supplements, etc.)

Muscadine polyphenols are available in various forms, each with its own benefits and considerations:

1. Fresh Grapes: Eating fresh muscadine grapes is a natural way to consume polyphenols. One serving (1/2 cup) provides a good source of fiber and is fat-free, cholesterol-free, and sodium-free 16.

2. Supplements: Muscadine grape supplements (MGS) are available in different forms:
   a. Capsules: Often contain ground dried skin and seed of the grape, which are rich in polyphenols 17. For example, one study used capsules containing 100% V. rotundifolia muscadine grape seed from the Noble variety 17.
   b. Dried water-extract: Some studies have found that dried water-extract MGS had the highest total phenolic content and antioxidant capacity compared to ground seed and/or skin products 13.

3. Juice: While not specifically mentioned in the provided information, muscadine grape juice is another option for consuming polyphenols.

When choosing a supplement, it's important to be aware that the content and concentration of polyphenolic compounds can vary depending on several factors:

• The ratio of skin, seed, and pulp included in the supplement 13

• Cultivar differences

• Environmental factors like soil type, water availability, and weather conditions 13

• Manufacturing processes and quality control 13

When choosing a form of muscadine polyphenols, consider your personal preferences and health goals. While fresh grapes offer additional nutritional benefits, supplements may provide a more concentrated source of polyphenols. However, it's crucial to choose high-quality supplements from reputable manufacturers to ensure you're getting the intended benefits.

Remember, while muscadine polyphenols show promise for health benefits, they should not replace a balanced diet or prescribed medications. Always consult with your healthcare provider before adding new supplements to your routine, especially if you have existing health conditions or are taking medications.

Potential Side Effects and Precautions.

While muscadine polyphenols offer numerous health benefits, it's important to be aware of potential side effects and take necessary precautions. Understanding these aspects can help you make informed decisions about incorporating muscadine polyphenols into your diet or supplement regimen.

Drug Interactions

Muscadine polyphenols may interact with certain medications and supplements, potentially affecting their efficacy or causing unwanted side effects. Here are some key points to consider:

1. Enzyme inhibition: Polyphenols can bind to proteins, including digestive enzymes, potentially affecting their function 18. This interaction may impact the effectiveness of enzyme supplements commonly used to manage digestive disorders.

2. Glucose uptake: Some polyphenols can decrease glucose uptake in the intestines 18. If you're taking medications to manage blood sugar levels, such as those for type 2 diabetes, consult your healthcare provider before consuming large amounts of muscadine polyphenols.

3. Blood pressure medications: While muscadine grape extract supplements (MGES) didn't affect blood pressure in animal studies, it's crucial to monitor for potential interactions with anti-hypertensive medications 3. There's a theoretical risk of unintended hypotension or other drug interactions.

4. Nutrient absorption: Polyphenols can chelate (bind) iron and other minerals, potentially reducing their absorption 18. If you have iron deficiency or are taking iron supplements, be cautious about consuming large amounts of polyphenol-rich foods or supplements.

Who Should Avoid Muscadine Polyphenols?

While muscadine polyphenols are generally safe for most people, certain individuals should exercise caution or avoid them altogether:

1. People with digestive enzyme deficiencies: If you have conditions like celiac disease, lactose intolerance, or exocrine pancreatic insufficiency, be cautious with high doses of polyphenols. They may further inhibit digestive enzymes, exacerbating your symptoms 18.

2. Individuals with iron deficiency: Due to the iron-chelating properties of polyphenols, those with iron deficiency anemia should consult their healthcare provider before consuming large amounts of muscadine polyphenols 18.

3. People taking multiple medications: If you're on several medications, especially for chronic conditions, consult your healthcare provider before adding muscadine polyphenol supplements to your regimen.

4. Pregnant or breastfeeding women: Due to limited research on the effects of high doses of muscadine polyphenols during pregnancy and lactation, it's best to consult with a healthcare provider before using supplements.

5. Individuals with alcohol dependency: If you have a history of alcohol abuse or dependency, be cautious with muscadine wine. Alcohol consumption, even in the form of muscadine wine, carries the risk of dependency and can significantly impact life expectancy 19.

It's worth noting that while these precautions are important, consuming muscadine grapes or moderate amounts of muscadine products as part of a balanced diet is generally safe for most people. However, when considering supplements or high doses, it's always best to consult with a healthcare professional.

Remember, the key to reaping the benefits of muscadine polyphenols while minimizing risks is moderation and informed consumption. By being aware of potential interactions and knowing when to seek medical advice, you can safely incorporate these beneficial compounds into your health regimen.

Conclusion.

Muscadine polyphenols have a significant influence on blood sugar control through various mechanisms. Their ability to activate AMPK, reduce inflammation, and improve gut health makes them a promising natural option for managing diabetes. The unique profile of these compounds, including high levels of ellagic acid and anthocyanins, sets muscadines apart from other polyphenol-rich foods. This all-American superfruit, with its higher antioxidant capacity than pomegranates and blueberries, offers a powerful punch of health benefits.

To wrap up, while muscadine polyphenols show great potential, it's crucial to approach their use thoughtfully. Talking to your healthcare provider before adding supplements to your routine is essential, especially if you're taking medications or have existing health conditions. By making informed choices and being aware of potential interactions, you can safely tap into the benefits of this remarkable fruit. Remember, muscadine polyphenols are just one piece of the puzzle in maintaining overall health and well-being.

References.

[1] - https://www.sciencedirect.com/science/article/abs/pii/S0955286323000451
[2] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372644/
[3] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9598776/
[4] - https://smallfruits.cals.ncsu.edu/2020/06/critical-article-muscadines-health-benefits/
[5] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2871121/
[6] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7602234/
[7] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7895753/
[8] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728631/
[9] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213547/
[10] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174578/
[11] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6181265/
[12] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10670540/
[13] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9686579/
[14] - https://hinnantvineyards.com/wp-content/uploads/2022/07/muskhealth.pdf
[15] - https://smallfruits.org/files/2021/12/2021-R-07-Final-Report.pdf
[16] - https://www.ncmuscadinegrape.org/health-benefits/
[17] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3313487/
[18] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10058246/
[19] - https://www.webmd.com/diet/muscadine-wine-good-for-you

Medical disclaimer and alert. The information in this website  is meant to supplement, not replace, advice from your doctor or healthcare provider, and is not meant to cover all possible uses, precautions, interactions or adverse effects. 

This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on this website or the pages it links to.

You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

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