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Founded in 1970 by the "Father of Aerobics"
Kenneth H. Cooper MD, MPH

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Alcohol Intake and Cancer Risk: What are the Facts?

Posted in
Eat better

Thursday, Oct 08, 2015

It has long been known that a consistent light to moderate alcohol intake is associated with a significantly decreased risk of cardiovascular disease (CVD) when compared with the CVD risk of non-drinkers or heavy drinkers. Since CVD is the leading cause of death for both U.S. men and women (~800,000 deaths per year), the current guidelines for alcohol consumption for those who choose to drink seem reasonable. Men are allowed a maximum of 2 drinks per day, while women are allowed a maximum of 1 drink* per day. Of course, certain segments of the population (e.g., pregnant or nursing women, individuals with health problems that are made worse by alcohol) should avoid alcohol entirely. Additionally, no one disputes the fact that excessive/irresponsible/binge drinking can contribute to a myriad of health and social problems such as motor vehicle accidents, drownings, absenteeism from work, spousal and child abuse, etc.

What seems to be missing from the conversation regarding the benefits of a light to moderate and responsible alcohol intake is that cancer is the second leading cause of death among U.S. men and women (~500,000) deaths per year, and the fact that the World Health Organization’s International Agency for Research on Cancer declared alcohol a carcinogen in 1988.1 The risk is dose-dependent; the more alcohol that one consumes, the higher the risk. A cause and effect relationship has been shown repeatedly between alcohol consumption and cancers of the esophagus, mouth, pharynx, larynx, colon-rectum, liver, and female breast, and there is growing evidence of increased risk of pancreatic cancer as well. While not all of the mechanisms have been established, more than a dozen carcinogenic compounds have been identified in alcoholic beverages. These include benzene, lead, cadmium, and aflatoxins. However, the most significant carcinogen in alcoholic beverages is ethanol - i.e., the alcohol itself.

At this point, you are probably thinking (and hoping) that light drinking is not related to cancer, and that the problems listed above relate more to moderate and heavy drinkers. While it is true that the cancer risk is dependent on the amount of alcohol consumed, even light drinkers face a somewhat increased cancer risk when compared with nondrinkers. This recently came to light in a summary analysis of 222 existing studies with 92,000 light drinkers and 60,000 non-drinkers.2 Light drinkers had higher rates of cancers of the mouth and larynx (17% higher), esophagus (30% higher), and female breast (5% higher) than non-drinkers. This finding should be balanced against the fact that when people respond to questionnaires regarding alcohol intake, some will ‘underestimate’ their actual intake. Thus, some who claim to be light drinkers are actually moderate to heavy drinkers. This would artificially inflate any association between light drinking and increased cancer risk.

So, is there a happy medium somewhere for people who choose to drink alcohol? In other words, is there an amount that would yield substantial benefits in terms of cardiovascular risk reduction but at the same time would only slightly increase the risk of cancer? Based on the literature, this amount would likely be no more than 2-3 drinks per week for women, and no more than 4-5 drinks per week for men. I should mention here that non-drinkers are advised to remain non-drinkers because of the potential risk of alcohol addiction. It bears repeating that individuals with health problems that are made worse by alcohol should also abstain.

To learn more about nutrition, physical activity, healthy eating and risk of chronic disease, take our Nutrition for Health and Fitness (NHF) and/or Personal Trainer Education (PTE) courses. You need not be a health and fitness professional to take these courses; the general public is always welcome to attend any of our courses.

*1 drink is defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard liquor

 

References

Alcohol drinking.  IARC Working Group, Lyon, 13-20 October 1987. IARC Monograph Evaluation  of Carcinogen Risks. 1988:44:1-378.

Bagnardi, V., Rota, M., Botteri, D. 2013. Light alcohol drinking and cancer: a meta-analysis.  Annals of Oncology 24:301-308.

 

*A light alcohol consumption would be no more than 5 drinks per week for men and no more than 3 drinks per week for women, with no binge drinking.