Benefits
Cholesterol and insulin resistance markers
A pooled analysis of 17 randomized trials (651 people) found resveratrol lowered insulin resistance scores overall. In people with metabolic syndrome it also lowered fasting glucose, LDL cholesterol and total cholesterol. Results varied between groups of people, and these are blood markers rather than heart outcomes.
Blood sugar markers
A pooled analysis of 11 randomized trials (388 people) found resveratrol lowered fasting glucose, insulin, HbA1c and insulin resistance in people with diabetes, but had no significant effect in people without diabetes. The trials were small, and resveratrol is not a replacement for diabetes care.
Blood pressure readings
A pooled analysis of 17 randomized trials found no significant overall change in systolic or diastolic blood pressure. Significant drops appeared only in subgroups taking 300 mg/day or more and in people with diabetes, and the systolic effect was larger in people with a higher BMI.
C-reactive protein, an inflammation marker
A pooled analysis of 35 randomized trials found resveratrol lowered CRP and high-sensitivity CRP by a small amount (about 0.3 to 0.4 mg/L). Effects were clearer in trials lasting 10 weeks or longer and, for CRP, at 500 mg/day or more. The trials covered people with a range of health conditions.
Pain and well-being after menopause
In a two-year crossover trial in 125 healthy postmenopausal women, 75 mg twice daily lowered a combined pain score and improved somatic menopausal symptoms and general well-being compared with placebo. These were secondary outcomes; the trial's main outcome, cognition, was reported separately.
Bone density in postmenopausal women
In the same two-year trial, 12 months of resveratrol versus placebo increased bone mineral density at the lumbar spine and femoral neck and lowered a bone breakdown marker (CTX) by about 7%. Gains were larger in women with poorer bone markers at the start. The women did not have osteoporosis, and actual fractures were not counted.
SIRT1 and calorie restriction research
Resveratrol became famous for apparently activating SIRT1, an enzyme linked to the effects of calorie restriction. A later laboratory study found this activation appeared only with a fluorescent-tagged test substrate, not with natural substrates. A 30-day trial in 11 men with obesity reported some calorie restriction-like metabolic changes, but no longevity benefit has been shown in people.
Mechanism of action
SIRT1 activation (disputed)
Resveratrol was proposed to activate SIRT1 directly. A laboratory study found it activated SIRT1 only when the test substrate carried a fluorescent tag, not with natural substrates, so any effect on SIRT1 in the body is likely indirect. In a small human trial, muscle SIRT1 and PGC-1α protein levels rose after 30 days.
AMPK activation
In the 30-day trial in men with obesity, resveratrol activated AMPK in muscle and improved muscle mitochondrial respiration on a fat-derived fuel. AMPK is a cellular energy sensor that helps cells take up glucose and burn fat.
Estrogen receptor and circulation effects
Resveratrol can act as a phytoestrogen. The investigators of the two-year postmenopausal trial proposed that it improves circulation, possibly through estrogen receptors in blood vessel walls, and found that gains in femoral neck bone density tracked with better blood flow.
Clinical trials
Meta-analysis of 17 randomized controlled trials comparing people with metabolic syndrome with healthy people with or without obesity. (Sergi et al. 2020, Arch Med Sci Atheroscler Dis)
651 participants across 17 trials.
Resveratrol significantly lowered HOMA insulin resistance overall. In people with metabolic syndrome it significantly lowered glucose, LDL cholesterol and total cholesterol. The authors noted some differences between the populations studied.
Meta-analysis of 11 randomized controlled trials in people with and without diabetes. (Liu et al. 2014, Am J Clin Nutr)
388 participants across 11 trials.
In participants with diabetes, resveratrol significantly lowered fasting glucose, insulin, HbA1c and HOMA insulin resistance. In participants without diabetes, there was no significant effect on any blood sugar measure. The authors called for more high-quality studies.
Systematic review and meta-analysis of randomized controlled trials; 17 trials reported blood pressure. (Fogacci et al. 2019, Crit Rev Food Sci Nutr)
Adults across 17 randomized trials.
Resveratrol did not significantly change systolic blood pressure (about -2.5 mmHg) or diastolic blood pressure overall. Significant reductions appeared only in subgroups using 300 mg/day or more and in people with diabetes. Resveratrol was fairly well tolerated, with no serious adverse events in most trials.
Meta-analysis of 35 randomized controlled trials (24 measuring high-sensitivity CRP and 11 measuring CRP). (Gorabi et al. 2021, Phytother Res)
Participants with a range of inflammatory conditions across 35 trials.
Resveratrol lowered high-sensitivity CRP by about 0.40 mg/L and CRP by about 0.31 mg/L. Effects were clearer in trials of 10 weeks or longer, and doses of 500 mg/day or more lowered CRP but not high-sensitivity CRP.
Randomized, double-blind, placebo-controlled crossover trial of 150 mg/day resveratrol (resVida) for 30 days; one co-author worked for DSM Nutritional Products, which supplied the resveratrol. (Timmers et al. 2011, Cell Metab)
11 healthy men with obesity.
Resveratrol lowered sleeping and resting metabolic rate, activated AMPK and raised SIRT1 and PGC-1α protein in muscle, and improved muscle mitochondrial respiration. Liver fat, blood glucose, triglycerides and inflammation markers fell, and systolic blood pressure and HOMA insulin resistance improved. The trial was very small and short.
24-month randomized, double-blind, placebo-controlled, two-period crossover trial of 75 mg resveratrol twice daily; pain and well-being were secondary outcomes. (Thaung Zaw et al. 2020, Menopause)
125 healthy postmenopausal women.
Resveratrol reduced a composite pain score (P < 0.001), especially in overweight women, and improved somatic menopausal symptoms (P = 0.024) and general well-being (P = 0.010). The pain improvement was associated with better blood vessel responsiveness in the brain.
Bone outcomes from the 24-month randomized, double-blind, placebo-controlled crossover RESHAW trial of 75 mg resveratrol twice daily. (Wong et al. 2020, J Bone Miner Res)
Postmenopausal women without overt osteoporosis.
After 12 months, resveratrol versus placebo increased bone mineral density at the lumbar spine (+0.016 g/cm2) and femoral neck (+0.005 g/cm2) and lowered the bone resorption marker CTX by 7.24%. Gains were larger in women with poorer bone markers at the start and in those also taking vitamin D plus calcium.