The French have low coronary heart disease mortality with high fat consumption; this epidemiological anomaly is known as the "French Paradox" and is commonly attributed to the consumption of red wine. However, epidemiology studies have not convincingly shown a superiority of red wine vs. alcohol or other alcoholic beverages. We have used the hamster model of atherosclerosis to determine the active ingredient(s) of red wine responsible for the beneficial effect. Hamsters (nine in each group) were given a cholesterol/saturated fat for 10 weeks to induce foam cell formation. Water or 6.75% ethanol was given to the control groups. Beverages tested included red wine, dealcoholized red wine, and red grape juice, all diluted in half. Ethanol and all beverages caused a significant reduction in atherosclerosis. The combination of ethanol in red wine had the largest effect in decreasing atherosclerosis by both hypolipemic and antioxidant mechanisms. When compared with dealcoholized wine and normalized to polyphenol dose, red wine's beneficial effects can be attributed entirely to the polyphenols. Grape juice had a significant benefit at a much lower dose of polyphenols than the wines. Grape juice was calculated to be much more effective than red wine or dealcoholized red wine at the same polyphenol dose in inhibiting atherosclerosis and improving lipids and antioxidant parameters. This data suggests that polyphenolic beverages from grapes are beneficial in inhibiting atherosclerosis by several mechanisms. Grape juice or non-alcoholic red wine are an excellent alternative to red wine in this model of atherosclerosis.