"Alcohol is related to breast cancer?? I thought alcohol consumption in moderation was safe—even healthy! "
News channels recently reported on a new prospective study published by the British Medical Journal showing evidence of increased risk of developing breast cancer in women who consume “light to moderate” alcohol (5-15g, with 14g ~ 1 beer, shot, or glass of wine), or the equivalent of 1/3-1 drink daily on average. Relative risk of developing other cancers in both men and women who consumed light to moderate alcohol was not significantly increased compared to those who drank none. More research is needed to conclude why breast cancer in particular is at greater risk, but, given that 12% of women develop breast cancer in their lifetime, reducing breast cancer risk is certainly an important concern for nutritionists like me.
One of the helpful features of the new published study is that the researchers factored into statistical consideration many other variables that may influence the development of cancer, such as smoking, consumption of red meat and fruits and vegetables, age, BMI, and physical activity. Even with these potential confounders accounted for, the results showed a small but statistically significant direct relationship between the amount of alcohol consumed and the risk of developing breast cancer.
Compared to non-drinkers, women who drank less than or equal to 1 drink on average had 13% increased risk of breast cancer; those who drank 1-2 drinks had a 24% increased risk, at 2-3 drink the risk was 42% higher, and at >3 drinks/day the risk was 66% higher.
You may have heard that alcohol in moderation (no more than 1 daily drink for women and 2 for men) is beneficial to heart health. Alcohol can raise your HDL and help prevent blood clots—good things indeed! But what has been evidenced in heart health is that there is a strong “J-shaped” curve in the data, with cardiovascular disease risk dropping with a little alcohol consumption compared to no alcohol, but increasing with additional alcohol, to where anything beyond light-moderate alcohol consumption is related to greater heart disease risk than for those who abstain.
Not only is limiting alcohol to 1 drink for women and 2 for men the only way with alcohol to potentially benefit cardiovascular health, even more importantly, there are other more effective ways to receive these same benefits without the risks—through regular exercise, through maintaining a healthy weight, and through practicing good nutrition habits such as consuming adequate fruits and vegetables and limiting sodium and trans and saturated fats. For this reason, the American Heart Association does not recommend consuming alcohol for heart benefits, but does recommend that those who do choose to drink only do so in moderate amounts.
What should YOU take from this study?
1. Know that alcohol is not harmless. Acetaldehyde, a breakdown product of ethanol, is a clear carcinogen. Though drinking <1 drink for women and <2 drinks for men does not show to have any considerable increase in risk for cancers other than breast cancer, there is a clear increased risk as alcohol consumption increases. And although wine may have more antioxidants than other alcoholic beverages, alcohol is alcohol when it comes to cancer risk. Further, alcohol impairs judgment, can cause accidents (even fatalities), and can lead to physical and psychological dependence and addiction in some who drink. Alcohol has risks!
2. Assess your own intake. How frequently do you enjoy alcohol? How much do you typically drink each time? Consider that "1 drink" is equal to a 5oz glass of wine (a full wine glass is usually closer to 9oz--helpful to know if you pour at home), a 12oz glass of beer, or a single shot of liquor. Prefer cocktails? Check out this helpful cocktail calculator to see how many "drink" equivalents your favorite beverage has.
3. Make an informed decision that aligns to YOUR lifestyle and health goals. Breast cancer is a scary reality that 12% of all women face. Consuming alcohol in moderation may increase your breast cancer risk, but consuming a little alcohol may also have cardiovascular benefits. Beyond these benefits, alcohol can be enjoyable! Alcoholic beverages can taste good and make you feel good too. These are important factors in terms of quality of life that should be considered as you decide nutrition goals that are best for YOU.
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