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<b>Medical Disclaimer:</b> The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. All content contained on or available through this web site is for general information purposes only. The editors of Brewing Forward assume no legal responsibility for the accuracy of information contained on or available through this web site, and such information is subject to change without notice. Always seek the advice of your doctor or other qualified health provider regarding a medical condition.
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During [[beer production]], large quantities of hot liquids are handled, especially during [[mashing]] and wort [[boiling]]. Brewers should be careful. All vessels and auxiliary equipment (e.g. hoses) should be checked for stability before they are used. Wearing heat-resistant gloves and suitable work clothing is recommended. Remember to close appropriate valves before filling a vessel with hot liquid.


The harmful effects of heavy drinking have been well described; beverages with high alcohol content are not good for human health.<ref name=yangao>Yang D, Gao X. [https://www.sciencedirect.com/science/article/abs/pii/S0924224421001552 Research progress on the antioxidant biological activity of beer and strategy for applications.] ''Trends Food Sci Technol.'' 2021;110:754-764.</ref> However, the effect of an intermediate amount of drinking is more complex and needs further study. This issue involves the possible probiotic effects associated with non-alcoholic ingredients in beverages such as beer. Some clinical trials have suggested that moderate consumption of beer is good for human health, mainly due to antioxidants, anti-inflammatory effects, and reduced risk of cardiovascular disease. Increasing anti­ oxidant activities (AOX) of foods and beverages consumed by people is an effective way to improve human health.
The harmful effects of heavy drinking have been well described; beverages with high alcohol content are not good for human health.<ref name=yangao>Yang D, Gao X. [https://www.sciencedirect.com/science/article/abs/pii/S0924224421001552 Research progress on the antioxidant biological activity of beer and strategy for applications.] ''Trends Food Sci Technol.'' 2021;110:754-764.</ref> However, the effect of an intermediate amount of drinking is more complex and needs further study. This issue involves the possible probiotic effects associated with non-alcoholic ingredients in beverages such as beer. Some clinical trials have suggested that moderate consumption of beer is good for human health, mainly due to antioxidants, anti-inflammatory effects, and reduced risk of cardiovascular disease. Increasing anti­ oxidant activities (AOX) of foods and beverages consumed by people is an effective way to improve human health.


In general, the evidence suggests a J-shaped curve relationship between alcohol consumption and cardiovascular disease (CVD) morbidity and mortality, indicating that moderate drinkers are at lower risk than abstainers and heavy drinkers [2].<ref name=borsol>Boronat A, Soldevila-Domenech N, Rodríguez-Morató J, Martínez-Huélamo M, Lamuela-Raventós RM, de la Torre R. [https://www.mdpi.com/1420-3049/25/11/2582 Beer phenolic composition of simple phenols, prenylated flavonoids and alkylresorcinols.] ''Molecules.'' 2020;25(11):2582.</ref> Other more specific studies observed that cardiovascular protection was only observed with moderate consumption of fermented alcoholic beverages containing [[phenolic compounds]] such as wine or beer. The protective effect was not observed following moderate consumption of spirits.
In general, the evidence suggests a J-shaped curve relationship between alcohol consumption and cardiovascular disease (CVD) morbidity and mortality, indicating that moderate drinkers are at lower risk than abstainers and heavy drinkers [2].<ref name=borsol>Boronat A, Soldevila-Domenech N, Rodríguez-Morató J, Martínez-Huélamo M, Lamuela-Raventós RM, de la Torre R. [https://www.mdpi.com/1420-3049/25/11/2582 Beer phenolic composition of simple phenols, prenylated flavonoids and alkylresorcinols.] ''Molecules.'' 2020;25(11):2582.</ref> Other more specific studies observed that cardiovascular protection was only observed with moderate consumption of fermented alcoholic beverages containing [[phenolic compounds]] such as wine or beer. The protective effect was not observed following moderate consumption of spirits. In the specific case of beer, low-to-moderate consumption (up to one drink/day in women and two drinks/day in men) reduces the risk of CVD and represents no harm in relation to major chronic conditions [3,4]. Evidence suggests that beer’s beneficial health effects result from an additive effect between beer’s alcohol content and beer’s phenolic compounds [5]. its alcohol content is lower compared to other popular alcoholic drinks. Therefore, its low alcohol content together with its phenolic composition suggest beer to be a potential trigger of positive health effects while minimizing the detrimental effects associated with alcohol consumption. The phenolic compounds have been associated with relevant biological activities such as antioxidant, anti-inflammatory, antidiabetic and estrogenic activities.
 
beer can also be a source of compounds with potential toxic and pro-carcinogenic properties at higher concentrations such as carbonyl compounds and furan derivates [18].<ref name=borsol/>


Moderate beer consumption has been shown to have beneficial effects on human health, many of which are based on the redox properties of the antioxidant compounds present in beer [5,16,17]. It is known that antioxidants present in beer help to improve certain diseases, for example, moderate beer consumption is associated with an increase in bone density, cardiovascular [18] and immunological benefits and is also associated with anti-inflammatory and antioxidant properties [19]. Moderate beer intake may also exert higher protection against coronary heart disease than spirits; it has been reported that systolic blood pressure, homocysteine, and several biomarkers of inflammation decreased only after the non-alcoholic beer intervention, and these effects are likely to be attributed to the non-alcoholic fraction of the beer, mainly polyphenols [20].<ref name=marcab>Martinez-Gomez A, Caballero I, Blanco CA. [https://www.mdpi.com/2218-273X/10/3/400 Phenols and melanoidins as natural antioxidants in beer. Structure, reactivity and antioxidant activity.] ''Biomolecules.'' 2020;10(3):400.</ref>
Moderate beer consumption has been shown to have beneficial effects on human health, many of which are based on the redox properties of the antioxidant compounds present in beer [5,16,17]. It is known that antioxidants present in beer help to improve certain diseases, for example, moderate beer consumption is associated with an increase in bone density, cardiovascular [18] and immunological benefits and is also associated with anti-inflammatory and antioxidant properties [19]. Moderate beer intake may also exert higher protection against coronary heart disease than spirits; it has been reported that systolic blood pressure, homocysteine, and several biomarkers of inflammation decreased only after the non-alcoholic beer intervention, and these effects are likely to be attributed to the non-alcoholic fraction of the beer, mainly polyphenols [20].<ref name=marcab>Martinez-Gomez A, Caballero I, Blanco CA. [https://www.mdpi.com/2218-273X/10/3/400 Phenols and melanoidins as natural antioxidants in beer. Structure, reactivity and antioxidant activity.] ''Biomolecules.'' 2020;10(3):400.</ref>
Small-scale commercial beers tend to have higher levels of phenolic compounds than and large scale (macro) beers.<ref name=cargui>Carvalho DO, Guido LF. [https://www.sciencedirect.com/science/article/abs/pii/S0308814621020999 A review on the fate of phenolic compounds during malting and brewing: technological strategies and beer styles.] ''Food Chem.'' 2022;372:131093.</ref> This is partly because [[pasteurization]] and [[filtration]] are not employed in small-scale beers. Also, macro beers are usually produced using cereal [[adjuncts]] like [[maize]], which generally contribute lower levels of phenolics. Lastly, the amount and variety of hops often used for small scale "craft" beers tend to provide higher phenolic content.<ref name=sibpla>Šibalić D, Planinić M, Jurić A, Bucić-Kojić A, Tišma M. [https://link.springer.com/article/10.1007/s11696-020-01276-1 Analysis of phenolic compounds in beer: from raw materials to the final product.] ''Chem Zvesti.'' 2021;75(1):67–76.</ref> Presumably all these factors apply to home brew beer as well, although phenolic levels still vary depending on ingredients and brewing process.


Alcohol intake in the form of liquor can lead to an increase in serum homocysteine, a heart-related disease that promotes the production of oxygen free radicals and hydrogen peroxide, which can cause vascular endothelial cell damage, platelet adhesion and aggregation and promote low-density lipoprotein oxidation, leading to atherosclerosis and embolism.<ref name=yangao/> In contrast, moderate consumption of beer has not been found to increase serum homocyste­ ine, probably because beer contains vitamin B6, which can promote the catabolism of homocysteine.
Alcohol intake in the form of liquor can lead to an increase in serum homocysteine, a heart-related disease that promotes the production of oxygen free radicals and hydrogen peroxide, which can cause vascular endothelial cell damage, platelet adhesion and aggregation and promote low-density lipoprotein oxidation, leading to atherosclerosis and embolism.<ref name=yangao/> In contrast, moderate consumption of beer has not been found to increase serum homocyste­ ine, probably because beer contains vitamin B6, which can promote the catabolism of homocysteine.
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The health benefits of barley β-glucans include reduction of blood cholesterol and glucose and weight loss by increased satiety, and therefore, the control of heart disease and type-2 diabetes (Baik & Ullrich 2008). However, new findings revealed that cereal grains also contain many health-promoting components such as vitamins, minerals, essential fatty acids, phytochemicals and other bioactive food components, which include phenolic compounds (Dykes & Rooney 2007).<ref name=simhor>Šimić G, Horvat D, Dvojković K, et al. [https://www.agriculturejournals.cz/web/cjfs.htm?type=article&id=144_2016-CJFS Evaluation of total phenolic content and antioxidant activity of malting and hulless barley grain and malt extracts.] ''Czech J Food Sci.'' 2017;35(1):73–78.</ref>
The health benefits of barley β-glucans include reduction of blood cholesterol and glucose and weight loss by increased satiety, and therefore, the control of heart disease and type-2 diabetes (Baik & Ullrich 2008). However, new findings revealed that cereal grains also contain many health-promoting components such as vitamins, minerals, essential fatty acids, phytochemicals and other bioactive food components, which include phenolic compounds (Dykes & Rooney 2007).<ref name=simhor>Šimić G, Horvat D, Dvojković K, et al. [https://www.agriculturejournals.cz/web/cjfs.htm?type=article&id=144_2016-CJFS Evaluation of total phenolic content and antioxidant activity of malting and hulless barley grain and malt extracts.] ''Czech J Food Sci.'' 2017;35(1):73–78.</ref>


Beer has a higher nutritional value than other alcoholic beverages, because of its minerals and essential nutrients such as potassium, magnesium, calcium and sodium.<ref name=soliva>Solgajová M, Ivanišová E, Nôžková J, Frančáková H, Tóth Ž, Dráb Š. [https://www.jmbfs.org/80_jmbfs_solgajova_2014_fs/?issue_id=3039&article_id=29 Antioxidant activity and polyphenol content of malt beverages enriched with bee pollen.] ''J Microbiol Biotech Food Sci.'' 2014;3(3):281–284.</ref>
Beer has a higher nutritional value than other alcoholic beverages, because of its minerals and essential nutrients such as potassium, magnesium, calcium and sodium.<ref name=soliva>Solgajová M, Ivanišová E, Nôžková J, Frančáková H, Tóth Ž, Dráb Š. [https://www.proquest.com/openview/0a0ccd3ae387c2d4a4db31f29bec1614/1 Antioxidant activity and polyphenol content of malt beverages enriched with bee pollen.] ''J Microbiol Biotech Food Sci.'' 2014;3(3):281–284.</ref>


Among dietary antioxidants, phenolics are by far the most abundant in common human diets. Epidemiological studies have suggested associations between the consumption of phenolics-rich food and the prevention of many human diseases associated with oxidative stress (2-5). On the basis of their daily intake, which greatly exceeds that of other antioxidants (i.e., vitamin E, vitamin C, β-carotene), phenolic compounds may be a major factor in assuring the antioxidant potential of the diet and may contribute to maintaining the endogeneous redox balance in humans.<ref name=piafor>Piazzon A, Forte M, Nardini M. [https://pubs.acs.org/doi/abs/10.1021/jf101975q Characterization of phenolics content and antioxidant activity of different beer types.] ''J Agric Food Chem.'' 2010;58(19):10677–10683.</ref>
Among dietary antioxidants, phenolics are by far the most abundant in common human diets. Epidemiological studies have suggested associations between the consumption of phenolics-rich food and the prevention of many human diseases associated with oxidative stress (2-5). On the basis of their daily intake, which greatly exceeds that of other antioxidants (i.e., vitamin E, vitamin C, β-carotene), phenolic compounds may be a major factor in assuring the antioxidant potential of the diet and may contribute to maintaining the endogeneous redox balance in humans.<ref name=piafor>Piazzon A, Forte M, Nardini M. [https://pubs.acs.org/doi/abs/10.1021/jf101975q Characterization of phenolics content and antioxidant activity of different beer types.] ''J Agric Food Chem.'' 2010;58(19):10677–10683.</ref>
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Oxidative stress is involved in the pathology of several human diseases, such as atherosclerosis, diabetes, neurodegenerative diseases, ageing, and cancer [1]. Dietary antioxidants can counteract the negative effects of oxidative stress. Polyphenols are the most abundant dietary antioxidants, due to their presence in all fruits and vegetables [1]. Polyphenol intake can be several hundreds of milligrams per day, up to 1 g/day, depending on dietary habits [2] and, in particular, in wine, coffee, beer, chocolate, and tea consumption; and it largely exceeds that of other antioxidants, such as vitamin E, vitamin C, and β-carotene [3]. Among polyphenols, phenolic acids account for about one-third of the total intake, while flavonoids account for the remaining two-thirds of the total intake [2]. Epidemiological studies have suggested associations between long-term consumption of polyphenols-rich foods and prevention of oxidative stress-related diseases such as cancer, cardiovascular diseases, diabetes, inflammation, and degenerative diseases [1,4–6].<ref>Nardini M, Foddai MS. [https://www.mdpi.com/1420-3049/25/11/2466 Phenolics Profile and Antioxidant Activity of Special Beers.] ''Molecules.'' 2020;25(11):2466.</ref> In addition to the most familiar products, special beers produced with the addition of fruits, spices, or natural food during the fermentation process, have been becoming very popular throughout the world, responding to requests for new gustatory, olfactory, and visual stimuli from consumers. During re-fermentation and maturation of special beers, flavors and bioactive compounds, such as carotenoids and polyphenols, are extracted from fruits, spices, and natural food added to beer. Recently, the addition of fruits during the fermentation process has been reported to significantly increase the content of bioactive compounds and the antioxidant activity of beer [13]. Despite many studies describing the raw materials and the effects of technological processes, little is known about the healthy compounds and nutritional quality of commercially available beers [14–16].
Oxidative stress is involved in the pathology of several human diseases, such as atherosclerosis, diabetes, neurodegenerative diseases, ageing, and cancer [1]. Dietary antioxidants can counteract the negative effects of oxidative stress. Polyphenols are the most abundant dietary antioxidants, due to their presence in all fruits and vegetables [1]. Polyphenol intake can be several hundreds of milligrams per day, up to 1 g/day, depending on dietary habits [2] and, in particular, in wine, coffee, beer, chocolate, and tea consumption; and it largely exceeds that of other antioxidants, such as vitamin E, vitamin C, and β-carotene [3]. Among polyphenols, phenolic acids account for about one-third of the total intake, while flavonoids account for the remaining two-thirds of the total intake [2]. Epidemiological studies have suggested associations between long-term consumption of polyphenols-rich foods and prevention of oxidative stress-related diseases such as cancer, cardiovascular diseases, diabetes, inflammation, and degenerative diseases [1,4–6].<ref>Nardini M, Foddai MS. [https://www.mdpi.com/1420-3049/25/11/2466 Phenolics Profile and Antioxidant Activity of Special Beers.] ''Molecules.'' 2020;25(11):2466.</ref> In addition to the most familiar products, special beers produced with the addition of fruits, spices, or natural food during the fermentation process, have been becoming very popular throughout the world, responding to requests for new gustatory, olfactory, and visual stimuli from consumers. During re-fermentation and maturation of special beers, flavors and bioactive compounds, such as carotenoids and polyphenols, are extracted from fruits, spices, and natural food added to beer. Recently, the addition of fruits during the fermentation process has been reported to significantly increase the content of bioactive compounds and the antioxidant activity of beer [13]. Despite many studies describing the raw materials and the effects of technological processes, little is known about the healthy compounds and nutritional quality of commercially available beers [14–16].
Catechins: Flavanol (+)-catechin is the third most abundant compound in hop cones possessing antioxidative and vasodilative features [43]. Flavanols catechin and epicatechin show antioxidative and anti-inflammatory properties [47]. A mixture of hop proanthocyanidins shows more pronounced antioxidative properties than individual flavanols and proanthocyanidins [43].<ref name=habkos/>


[[Styrene]], present in weissbier and other phenolic beers, is possibly carcinogenic.<ref name=langra>Langos D, Granvogl M. [https://pubs.acs.org/doi/abs/10.1021/acs.jafc.5b05606 Studies on the simultaneous formation of aroma-active and toxicologically relevant vinyl aromatics from free phenolic acids during wheat beer brewing.] ''J Agric Food Chem.'' 2016;64(11):2325–2332.</ref>
[[Styrene]], present in weissbier and other phenolic beers, is possibly carcinogenic.<ref name=langra>Langos D, Granvogl M. [https://pubs.acs.org/doi/abs/10.1021/acs.jafc.5b05606 Studies on the simultaneous formation of aroma-active and toxicologically relevant vinyl aromatics from free phenolic acids during wheat beer brewing.] ''J Agric Food Chem.'' 2016;64(11):2325–2332.</ref>


Xanthohumol is a well-known compound [40]. It has been studied as an anticancer agent, but poses many other positive properties against pathogenic fungi, malaria, and HIV-1 viruses [43]. It has chemopreventive, sedative, anti-inflammatory, and antimicrobial properties. Even though the isomer of xanthohumol—isoxanthohumol is proven to be a bit less potent than xanthohumol, it too has anti-mutagenic and antiangiogenic activity [43,44]. Another chemical compound with anticarcinogenic properties belonging to this group is 8-prenylnaringenin [45].<ref name=habkos/>
Both tyrosol (TYR) supplementation and its biotransformation into hydroxytyrosol (HT) are capable of triggering relevant beneficial effects on the cardiovascular system [30]. HT is considered one of the strongest dietary antioxidants, with anti-inflammatory, antiproliferative, antiplatelet and proapoptotic activities [32]. Therefore, beer would represent an indirect source of HT via TYR hydroxylation. Consequently, beer should also be considered a relevant source of TYR and HT, together with the traditional dietary sources of extra virgin olive oil and wine.<ref name=borsol/> Belgian strong ale, the beer with the highest concentration in TYR and HT, uses a specific and traditional yeast that could produce higher proportions of TYR [43].
despite the interesting beer antioxidant profiles described in the present paper and in the literature, it is important to highlight the importance of a moderate consumption of beer in the context of a healthy dietary pattern, such as the Mediterranean diet [23]. Excessive beer consumption can lead to an excessive body weight, hamper pancreatic function and increase the risk of cancer due to its ethanol content and also due to the low levels of toxic compounds [17].<ref name=borsol/>
Flavonoids are commonly referred to as antioxidants because of their redox properties, which allow them to act as reducing agents, hydrogen donators and singlet oxygen quenchers. Therefore they may prevent diseases associated to cell oxidative stress, such as cancer, cardiovascular diseases, autoimmune diseases and other age-related diseases (for a comprehensive overview on polyphenols and health, see Vassallo, 2008).<ref name=fumgal>Fumi MD, Galli R, Lambri M, Donadini G, De Faveri DM. [https://www.sciencedirect.com/science/article/abs/pii/S0889157511000238 Effect of full-scale brewing process on polyphenols in Italian all-malt and maize adjunct lager beers.] ''J Food Compos Anal.'' 2011;24(4–5):568–573.</ref> Tannin molecules have been reported to have anticarcinogenic, antimutagenic and antioxidant activities. They were also reported to inhibit the growth of fungi, bacteria, and viruses (Chung et al., 1998; Khanbabaee and Van Ree, 2001). However, the ingestion of large quantities of tannins results in adverse health effects as they precipitate proteins, inhibit digestive enzymes and affect the utilization of vitamins and minerals (Szajdek and Borowska, 2008).
In moderate beer drinkers, studies showed a 20–25% reduction in fatality rate from coronary diseases and a reduction by 50% of death factor risk (Bamforth, 2002; Walzl, 2005). These beneficial effects of beer on human health is mainly related to phenolic compounds, particularly to their antioxidant activity and their bioavailability (for a comprehensive overview see Preedy, 2009). Fantozzi et al. (1998) outlined that beer contains a quantity of phenols that supply molecules which play a role in antioxidant activity in vivo. Ghiselli et al. (2000) pointed out that polyphenols in beer induced a significant increase in plasma antioxidant capacity, that the phenolic acids in plasma increase after beer intake, and that the alcohol level plays an important indirect role in the absorption of phenols. Bourne et al. (2000) observed that ferulic acid (belong to nonflavonoid group) in beer is readily assimilated by the body. Gorinstein et al. (2007) found that the antioxidant potential of beer was well correlated to flavanols and flavonoids but slightly lower referred to total polyphenols, and that beer polyphenols improve lipid metabolism and increase antioxidant and anticoagulant activities.<ref name=fumgal/>
Beer is a source of many compounds not only for human nutrition but also for human health [3]. The polyphenols in beer due to their antioxidative features could contribute together with other dietary sources of polyphenols to protection from degenerative changes in the human body and so protect from diseases by moderate beer consummation. They have anticarcinogenic and antifungicide activities [3]. There is also a group of isofl avonoids in beers whose phytoestrogenic effects are now studied [4, 5].<ref name=keljur>Kellner V, Jurková M, Čulík J, Horák T, Čejka P. [https://www.researchgate.net/profile/Vladimir-Kellner/publication/236144996_January_February_2007_32/links/00b7d5165784fc0249000000/January-February-2007-32.pdf Some phenolic compounds in Czech hops and beer of Pilsner type.] ''Brew Sci.'' 2007;60:31–37.</ref>
Many biological effects and health benefits have been associated with flavonoid consumption, although these effects may be related to their ability to modulate cell-signaling rather than their antioxidant activity (Williams, Spencer, & Rice-Evans, 2004).<ref name=quival>Quifer-Rada P, Vallverdú-Queralt A, Martínez-Huélamo M, Chiva-Blanch G, Jáuregui O, Estruch R, Lamuela-Raventós R. [https://www.sciencedirect.com/science/article/abs/pii/S0308814614012205 A comprehensive characterisation of beer polyphenols by high resolution mass spectrometry (LC–ESI-LTQ-Orbitrap-MS).] ''Food chem.'' 2015;169:336–343.</ref>
Xanthohumol is a “broad-spectrum” cancer chemopreventive agent acting on all three stages of carcinogenesis. Xanthohumol and isoxanthohumol are both active ROS scavengers, while only the former is active in superoxide scavenging assays. Isoxanthohumol, 8-prenylnaringenin, and xanthogalenol may also exert chemopreventive effects [18, 61–64].<ref name=coljer>Collin S, Jerković V, Bröhan M, Callemien D. [https://link.springer.com/referenceworkentry/10.1007/978-3-642-22144-6_78 Polyphenols and beer quality.] In: Ramawat KG, Mérillon J-M, eds. ''Natural Products.'' 1<sup>st</sup> ed. Springer; 2013:2334–2353.</ref>
Prenylflavanones have mainly been studied for their estrogenic activity. Hopein is a very potent phytoestrogen. The authors recommend its application in prevention or treatment of (post)menopausal symptoms and osteoporosis [61, 63, 65]. Weak estrogenic activity has been observed for close analogs like 6-prenylnaringenin, 8-geranylnaringenin, 6,8-diprenylnaringenin, and isoxanthohumol. Prenylchalcones like xanthohumol and xanthogalenol also show low activity [66].<ref name=coljer/>
Flavonols induce cardioprotective effects, including antioxidant effects (protection against LDL oxidation) and inhibition of platelet activity and vasodilatation [48, 69], while very little information is available on their potential anticancer effects.<ref name=coljer/>
trans-Resveratrol shows an impact on platelet aggregation and vasodilatation, and through its effect on the antioxidant status, regulates gene expression and decreases the total lipid concentration (cholesterol and triglycerides) [115]. Although less potent, cis-resveratrol, trans-, and cis-piceid also improve the antioxidant activity [116, 117]. Piceid absorption is enhanced by the presence of its sugar [118]. trans-Resveratrol inhibits the initiation and growth of tumors. It inhibits cyclooxygenase, ornithine decarboxylase, and angiogenesis [119, 120]. trans-Piceid is a weaker inhibitor of ROS production [121]. As flavonoids, trans-resveratrol alters the synthesis of eicosanoids (mediators of inflammation) and decreases the leukotriene/prostacyclin ratio by modifying lipoxygenase activity [120–122]. Estrogenic activity has recently been reported for some stilbenes, especially trans-resveratrol. cis-Resveratrol appears less potent [120, 123].<ref name=coljer/>
The relationship between alcohol consumption and cardiovascular events or all-cause mortality is described as a J-shaped curve, whereby maximum benefit is achieved at a moderate consumption level (Roerecke & Rehm, 2012; Sierksma & Kok, 2012).<ref name=zapmar>Zapata PJ, Martínez-Esplá A, Gironés-Vilaplana A, Santos-Lax D, Noguera-Artiaga L, Carbonell-Barrachina ÁA. [https://www.sciencedirect.com/science/article/pii/S0023643819300039 Phenolic, volatile, and sensory profiles of beer enriched by macerating quince fruits.] ''Lwt.'' 2019;103:139–146.</ref> These benefits are additive to the beneficial effects of other healthy lifestyle factors such as non-smoking, physical activity and a healthy diet (Mukamal, Chiuve, & Rimm, 2006).
Oxidative stress reflects an imbalance between an organism’s excessive production of oxygen radicals and its reduced capacity to detoxify. Oxidative intermediates, such as OH•, O•2−, and NO•, attack cell components and cause inflammation, cancer, ageing, and metabolic diseases [1,2]. It has been commonly accepted that the prevention of oxidative stress benefits human health [3,4]. For example, the ingestion of natural plants such as vegetables, fruits, and tea [5–10] has been well identified to counteract the amount of oxidative stress that cells encounter and to reduce the incidence of diseases related to oxidative damage [11–14]. The positive effect of a phytogenic diet on human health can be mainly attributed to the abundance of bioactive flavonols with pharmaceutical properties.<ref name=gaofan>Gao Y, Fang L, Wang X, et al. [https://www.mdpi.com/416306 Antioxidant activity evaluation of dietary flavonoid hyperoside using ''Saccharomyces cerevisiae'' as a model.] ''Molecules.'' 2019;24(4):788.</ref>
it was found that the degree of the positive effects of drinking beer on health are directly associated with the content of phenolic compounds in beer, after analyzing beers with different levels of phenolics (3). Gasowski, B., Leontowicz, M., Leontowicz, H., Katrich, E., Lojek, A., Číž, M., Trakhtenberg, S., and Gorinstein, S. The influence of beer with different antioxidant potential on plasmalipids, plasma antioxidant capacity, and bile excretion of rats fed cholesterol-containing and cholesterol-free diets. J. Nutr. Biochem. 15(9):527–533, 2004.
One area that others in the brewing industry have been less than comfortable in me pursuing is that of beer (in moderation) as a component of a healthful lifestyle. The issue was not that they did not believe it to be true, but rather that the perception would be that a scientist working within the industry could not take a dispassionate approach to the matter. I have been assiduous in not using industry funds in any of this work and I have always been at pains to emphasise negatives as well as positives as I sought to (at the least) illustrate how beer is more than the equal of wine, for which beverage there seems not to have been the same reluctance to hold back 127-137. We have highlighted how wine is (incorrectly) perceived as a healthier option 138, 139. We have also highlighted the ignorance concerning matters of beer and brewing that many people have 140. There should be no let-up in the education of the drinking public. In terms of specific research on health-related issues concerning beer, then we have included studies on antioxidants 141, folate 142, minerals 143 especially silicate 144, as well as soluble fibre and prebiotics as referred to earlier. Furthermore, we have explored the gliadin content of commercial beers 145 and highlighted the merit of the enzyme prolylendoproteinase in producing gluten free beer 146. We employed an ELISA-based procedure to measure gliadin. There are those who insist that it is insufficiently sensitive and are critical of its use in beer. This area needs extensive gluten free research, including studies in conjunction with those in the medical profession. We also did not fight shy of the matter of carbohydrates in beer in relation to health, discussing the nonsense of the beer belly and the glycaemic index as it pertains to beer 147.<ref>https://onlinelibrary.wiley.com/doi/full/10.1002/jib.594</ref>
Commercial lager beer contains lower amounts of THMs than the water used for brewing.<ref>Wu QJ, Lin H, Fan W, Dong JJ, Chen HL. [https://onlinelibrary.wiley.com/doi/pdf/10.1002/j.2050-0416.2006.tb00733.x Investigation into benzene, trihalomethanes and formaldehyde in Chinese lager beers.] ''J Inst Brew.'' 2006;112(4):291–294.</ref> Could be a result of filtering?
THMs are not removed by agents used for dechlorination, only by carbon filtration.<ref>Moore N, Ebrahimi S, Zhu Y, Wang C, Hofmann R, Andrews S. [https://iwaponline.com/ws/article/21/5/2313/80665/A-comparison-of-sodium-sulfite-ammonium-chloride A comparison of sodium sulfite, ammonium chloride, and ascorbic acid for quenching chlorine prior to disinfection byproduct analysis.] ''Water Supply.'' 2021;21(5):2313–2323.</ref>
Consuming beverages with high magnesium content can help reduce risk of coronary heart disease,<ref>https://www.sciencedirect.com/science/article/pii/S0306987713004763</ref> and beer is relatively high in [[magnesium]]...
There is a well-balanced amount of minerals contained in beer. Being relatively high in potassium and low in sodium it is an ideal drink to include in diets for hypertensive patients (De Stefano and Montanari, 1996). It is low in calcium and rich in magnesium which may help protect against gall stone and kidney stone formation.<ref name=monmay>Montanari L, Mayer H, Marconi O, Fantozzi P. [https://www.sciencedirect.com/science/article/abs/pii/B9780123738912000341 Chapter 34: Minerals in beer.] In: Preedy VR, ed. [[Library|''Beer in Health and Disease Prevention.'']] Academic Press; 2009:359–365.</ref>
A large amount of potassium (500–600 mg/L) is particularly interesting for the nutritional importance of beer. Due to an osmotic effect, a high potassium content promotes the elimination of [[sodium]] and [[chloride]]s and therefore helps body dehydration and demineralization (De Stefano and Montanari, 1996). It remains in the final product and accounts for 30% of the recommended daily amount, considering 1 L of medium alcoholic beer as an acceptable daily intake.<ref name=monmay/>
{| class="wikitable"
|+ Mineral composition of beer<ref name=monmay/>
!Inorganic substances !! Amount in beer (mg/L) !! Recommended daily intake (mg/day) !! Physiological effects in humans
|-
| Phosphates || 300–400 || 1,250–1,500 ||Important constituent of bones and teeth; responsible for energy storage and transmission
|-
| Sulfate || 150–200 || – || No important effect
|-
| Nitrate || 10–80 || – || Nitrate can be converted to nitrite which is harmful to health. The amount of nitrate in beer is usually below the legal limit of 50 mg/l for drinking water and is harmless
|-
| Chloride || 150–200 || 2,500 || –
|-
| Potassium || 500–600 || 2,500 || Good for prophylaxis against heart attack; a high potassium content is diuretic
|-
| Sodium || 30–32 || 550 || Low sodium content desirable
|-
| Calcium || 35–40 || 800–1,000 || Can prevent heart diseases
|-
| Magnesium || 100–110 || 300–350 || Lowers the cholesterol level, beneficial effect on cardiac activity
|}
From a nutritional point of view, beer contains significant amounts of B vitamins, mainly folates and riboflavin, and selenium.<ref name="Siqueira">Siqueira, PB, et al. [https://www.researchgate.net/publication/49599952_O_PROCESSO_DE_FABRICACAO_DA_CERVEJA_E_SEUS_EFEITOS_NA_PRESENCA_DE_POLIFENOIS "O Processo De Fabricação Da Cerveja E Seus Efeitos Na Presença De Polifenóis (The Beer Manufacturing Process And Its Effects On The Presence Of Polyphenols)"] ''Alimentos e Nutrição Araraquara'', vol. 19, no. 4, 2008, pp. 491-498.</ref>


Due to its antioxidant capacity and low alcohol content, beer is able to improve plasma antioxidant activity, reducing the risk of coronary artery diseases without presenting the negative aspects produced by high doses of ethanol. Therefore, due to beer has a high concentration of antioxidant compounds, its moderate consumption is capable of positively influencing the plasma lipid level and its anticoagulant capacity.<ref name="Siqueira"/>
Beer is considered a source of folates and otherB vitamins, such as [[niacin]], pyridoxine and cyanidesnocobalamin, in addition to being cited as an important sourceselenium and have a diuretic effect, due to the high ratiopotassium / sodium. 6Hops are considered an herb with propertiesmedicinal products, used as an antibiotic and anti-inflammatory. Ostudy of the properties of some compounds present in thehops revealed bioactive effects in a large part of theirmetabolites. 23The antioxidant properties of phenolic acidsgives them the ability to prevent cancer due to theirability to scavenge free radicals, which cause oxidationthe DNA of cells. Arimoto-Kobayashi 4 reviewed liver and lungs of rats, revealing which componentspresent in beer are able to protect the body againstagainst the genotoxic effects of heterocyclic amines.Several compounds were isolated from beer andsubmitted to in vivo tests , with the objective of studying theirability to prevent the occurrence of degenerative diseasessuch as cancer, and cardiovascular disease. Amongthe isolated compounds, prenylflavonoids andalpha acids. The xanthohumol chalcone, together withits isoxanthohumol isomer, formed during processingare prenylflavonoids found in greater con-focusing on beer. Xanthohumol has been identified asthe main agent in cancer prevention, due to itshigh antioxidant capacity, besides presenting propertiesanti-estrogenic, anti-inflammatory, anti-angiogenic activities,inhibition of DNA polymerase and the ability to controlproliferation of cancer cells. 17Epidemiological studies indicate that consumptionmoderate alcohol consumption is inversely related to thecardiovascular diseases, presenting a lowermortality rate among those who consume beveragesmoderately alcoholic, mainly wine and beer,compared to individuals who do not consume these drinksor those who consume too much. Epidemic studiessuggest a relationship between foods rich inpolyphenols and the prevention of some diseases, like cancer,cardiovascular disease and inflammation.<ref name="Siqueira"/>
On average, beer contains 2–6 g/L peptide, which mainly originates from the cereal grains.<ref>Han Y, Wang J, Li Y, Hang Y, Yin X, Li Q. [https://www.sciencedirect.com/science/article/abs/pii/S0308814615005993 Circular dichroism and infrared spectroscopic characterization of secondary structure components of protein Z during mashing and boiling processes.] ''Food Chem.'' 2015;188:201–209.</ref>
Beer contains about 500 mg/L of proteinaceous material.<ref name=steiner>Steiner E, Gastl M, Becker T. [https://www.researchgate.net/profile/Elisabeth_Wiesen/publication/226773564_Protein_changes_during_malting_and_brewing_with_focus_on_haze_and_foam_formation_A_review/links/56bc4bc508ae2481ab6aeeba.pdf Protein changes during malting and brewing with focus on haze and foam formation: a review.] ''Eur Food Res Technol.'' 2011;232:191–204.</ref>
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*https://www.homebrewtalk.com/threads/having-an-allergic-reaction-to-dry-hops.655275/
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*Piendl, A., and Biendl, M. Physiological significance of polyphenols and hop bitters. Brauwelt Int. 18:310-317, 2000.
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*Costanzo, S.; Di Castelnuovo, A.; Donati, M.B.; Iacoviello, L.; de Gaetano, G. Wine, beer or spirit drinking in relation to fatal and non-fatal cardiovascular events: A meta-analysis. Eur. J. Epidemiol 2011, 26, 833–850.
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*[https://onlinelibrary.wiley.com/doi/full/10.1002/jib.5 Phenolic acids from malt are efficient acetylcholinesterase and butyrylcholinesterase inhibitors]
*Galati G, O’Brien PJ. 2004. Potential toxicity of flavonoids and other dietary phenolics: significance for their chemopreventive and anticancer properties. Free Radic Biol Med 37(3):287–303.
*Laughton, M. J.; Evans, P. J.; Moroney, M. A.; Hoult, J. R. C.; Halliwell, B. Inhibition of mammalian 5-lipoxygenase and cyclo-oxygenase by flavonoids and phenolic dietary additives: Relationship to antioxidant activity and to iron ion-reducing ability. Biochem. Pharmacol. 42:1673–1681; 1991.
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*[https://link.springer.com/article/10.1007/s00217-018-3098-0 Beer as a potential source of macroelements in a diet: the analysis of calcium, chlorine, potassium, and phosphorus content in a popular low-alcoholic drink]
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*https://pubs.acs.org/doi/abs/10.1021/jf104421q Fate of pesticides during beer brewing


==References==
==References==