Think Responsibly: The Risks and Benefits of Alcohol & You

A place to get your questions answered from McDougall staff dietitian, Jeff Novick, MS, RDN.

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Think Responsibly: The Risks and Benefits of Alcohol & You

Postby JeffN » Wed Jul 30, 2014 7:17 pm

Think Responsibly: A Closer Look at the Risks & Benefits of Alcohol
Jeff Novick, MS, RDN

Since alcohol is often promoted as healthy and even as a healthy beverage and has even made some of the lists of super foods...,

http://www.doctoroz.com/slideshow/dr-oz ... ue&page=11

... let's take a closer look at the risks vs benefits of alcohol and put it all in perspective.

First, let’s clarify some definitions. While there is some variance in these definitions and recommendations around the world, most are in agreement with the following.

What Constitutes A Drink?

A “drink” is considered to be:

- 1.5 oz of hard liquor
- 5 oz of wine
- 8-9 oz of malt beverage
- 12 oz of beer

Light Drinking:
- averaging <1 drink/day and < 7 drinks/week

Moderate Drinking:
- For Women:
- - <1 drink/day, < 7 drinks/week

— For Men:
- - < 2 drinks/day, < 14 drinks/week

with no more than 2 drinks on any given day for either men or women.

Heavy/Excessive Drinking:
- For Women:
- - > 1 drink/day, > 8 drinks/week

- For Men:
- - > 2 drinks/day, > 15 drinks/week

Binge Drinking:
> 4 drinks for women and > 5 drinks per men in a 2 hour period

Heavy, excessive and binge drinking are never recommended as excess alcohol consumption is the 3rd leading cause of lifestyle related deaths in the USA.

Proposed Benefits:
- The main benefit we hear in regard to alcohol, and especially red wine, is that it can lower our risk for heart disease in several ways. Studies have shown that the moderate consumption of alcohol, and not just red wine, appears to lower the risk for heart disease. In addition, it also appears to lower the risk for diabetes, hypertension, stroke and dementia.

NOTE: Remember, most all of these proposed benefits come from observational studies, which, while of value, can never prove causation and at best, only a casual association. As we know with many other items (nuts, olive oil, etc) that have been discussed in detail here, these associations are often the result of a healthier lifestyle and not due to any one of these individual items in particular. Even the best observational studies, do not have that ability or power.

Potential Risks
- The World Health Organization classifies alcohol as a Category 1 carcinogen. The reason is, the consumption of alcohol can raise your risk for cancer of the mouth, throat, esophagus, stomach, liver, colon and breast. It also increases the risk for liver disease, motor vehicle accidents, unintentional accidents, injuries, violence and drownings.

The question is, does the proposed benefit of moderate drinking outweigh the risk?

Risk vs Benefit
- The greatest benefit is for older men and in regard to heart disease.

- The greatest risk is to women and in regard to breast cancer. Even light drinking, a level thought to have little risk, has been shown to raise a women’s risk for breast cancer. A recent review of over 100 studies found that light drinking was responsible for about 5,000 of the breast cancer deaths each year.

- Those who benefit the most are also those who live an unhealthy lifestyle. If you do not smoke, are active (about 30 minutes most days) and ate just one serving of fruit or vegetables a day, there appears to be no benefit.***

- We know that even without alcohol, a healthy lifestyle of 1) not smoking, 2) being at a healthy weight, 3) being active, and 4) eating a healthy diet can eliminate over 90% of heart disease, type 2 diabetes, hypertension and stroke and about 70% of cancers.

Does the risk outweigh the benefit?

- This is really a question that can only be answered on a personal and individual case by case basis by someone in a conversation with their health care professional that takes into account their current lifestyle and all of the above information.

Considering that alcohol consumption is the 3rd leading cause of lifestyle related death in the USA, and that we can already eliminate most all of the risk for all of the conditions alcohol is supposed to help with, it is hard for me as health care professional to recommend any amount of alcohol as a preventative measure. So, I don’t and if you don’t drink, don’t start.

However, if you do drink, stay below the recommended amounts for light drinking and speak to your health care professional about your own personal risk/benefits.

Most importantly, remember, following a healthy lifestyle, even without any alcohol, gets you all the benefit without any of the risk.

In Health
Jeff


***Who benefits most from the cardioprotective properties of alcohol consumption--health freaks or couch potatoes? J Epidemiol Community Health. 2008 Oct;62(10):905-8. doi: 10.1136/jech.2007.072173.

Abstract
BACKGROUND:
The cardioprotective properties of moderate alcohol consumption, compared with abstinence or heavy drinking, are widely reported, but whether the benefits are experienced equally by all moderate drinkers is less well known.

AIMS:
To examine the association between average alcohol intake per week and the incidence of fatal and non-fatal myocardial infarction during 17 years of follow-up for 9655 men and women without prevalent disease in the general population; and to test whether the level of cardioprotection differs according to subjects' other health behaviours (healthy, moderately healthy, unhealthy) at entry to the study.

METHOD:
A longitudinal, British civil service-based cohort study, baseline in 1985-8.

RESULTS:
A significant benefit of moderate drinking compared with abstinence or heavy drinking was found among those with poor health behaviours (little exercise, poor diet and smokers). No additional benefit from alcohol was found among those with the healthiest behaviour profile (> or =3 hours of vigorous exercise per week, daily fruit or vegetable consumption and non-smokers).

CONCLUSION:
The cardioprotective benefit from moderate drinking does not apply equally to all drinkers, and this variability should be emphasised in public health messages.
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Re: Think Responsibly: The Risks and Benefits of Alcohol & Y

Postby JeffN » Wed Jul 30, 2014 7:19 pm

Alcohol & Cancer - What's The Risk?
Jeff Novick, MS, RDN

We always hear about the potential benefit of alcohol but do not often hear about the risk associated with it. However, over the past decade and especially during the past five years, more and more research has shown that alcohol is linked to cancers of the mouth, throat, esophagus, liver, colon and breast.

Recently, the Canadian Medical Association Journal published an articles that said that the current guidelines for sensible drinking are not adequate for the prevention of cancer. That said the reason is because they do not take the dose-response relationship between alcohol consumption and cancer risk into consideration new guidelines based on scientific evidence are needed.

Lead researcher of the article, Paule Latino-Martel, of the French National Institute for Agricultural Research said, "There is no level of alcohol consumption for which cancer risk is null. On the whole, alcohol is considered an avoidable risk factor for cancer incidence and, more generally, for the global burden of disease."

She also said, "The only recommendation the World Health Organization has constantly promoted for alcohol consumers is 'less is better.'"

In Health
Jeff
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Re: Think Responsibly: The Risks and Benefits of Alcohol & Y

Postby JeffN » Wed Jul 30, 2014 7:22 pm

Previous discussions...

Alcohol: It's Good For You If It's Not Bad For You
viewtopic.php?t=10763

Alcohol, Breast Cancer, and Postmenopausal Women
viewtopic.php?t=6680

Related Articles...

Light alcohol drinking and cancer: a meta-analysis
http://annonc.oxfordjournals.org/content/24/2/301.long

Alcoholic beverages are known human carcinogens.
http://www.cancer.org/cancer/cancercaus ... arcinogens

No Amount of Alcohol Is Safe
http://www.saspen.com/literature-1/meds ... ol-is-safe

Alcohol consumption guidelines inadequate for cancer prevention, analysis finds
http://www.sciencedaily.com/releases/20 ... 131316.htm

A single sip of a strong alcoholic beverage causes exposure to carcinogenic concentrations of acetaldehyde in the oral cavity.
http://www.sciencedirect.com/science/ar ... 1511002365

Moderate alcohol consumption during adult life, drinking patterns, and breast cancer risk.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3292347/

Epidemiology and pathophysiology of alcohol and breast cancer: Update 2012.
http://alcalc.oxfordjournals.org/conten ... gs011.full
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Re: Think Responsibly: The Risks and Benefits of Alcohol & Y

Postby JeffN » Thu Aug 27, 2015 7:37 am

Light to moderate intake of alcohol, drinking patterns, and risk of cancer: results from two prospective US cohort studies
BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h4238 (Published 18 August 2015)
Cite this as: BMJ 2015;351:h4238

http://www.bmj.com/content/351/bmj.h4238

Full text
http://www.bmj.com/content/bmj/351/bmj.h4238.full.pdf

Abstract
Objectives
To quantify risk of overall cancer across all levels of alcohol consumption among women and men separately, with a focus on light to moderate drinking and never smokers; and assess the influence of drinking patterns on overall cancer risk.

Design
Two prospective cohort studies.

Setting
Health professionals in the United States.

Participants
88 084 women and 47 881 men participating in the Nurses’ Health Study (from 1980) and Health Professionals Follow-up Study (from 1986), followed until 2010.

Main outcomes and measures
Relative risks of cancer.

Results
19 269 and 7571 (excluding non-advanced prostate cancers) incident cancers were documented among women and men, respectively, over 3 144 853 person years. Compared with non-drinkers, light to moderate drinkers had relative risks of total cancer of 1.02 (95% confidence interval 0.98 to 1.06) and 1.04 (1.00 to 1.09; Ptrend=0.12) for alcohol intake of 0.1-4.9 and 5-14.9 g/day among women, respectively. Corresponding values for men were 1.03 (0.96 to 1.11), 1.05 (0.97 to 1.12), and 1.06 (0.98 to 1.15; Ptrend=0.31) for alcohol intake of 0.1-4.9, 5-14.9, and 15-29.9 g/day, respectively. Associations for light to moderate drinking and total cancer were similar among ever or never smokers, although alcohol consumption above moderate levels (in particular ≥30 g/day) was more strongly associated with risk of total cancer among ever smokers than never smokers. For a priori defined alcohol related cancers in men, risk was not appreciably increased for light and moderate drinkers who never smoked (Ptrend=0.18). However, for women, even an alcohol consumption of 5-14.9 g/day was associated with increased risk of alcohol related cancer (relative risk 1.13 (95% confidence interval 1.06 to 1.20)), driven by breast cancer. More frequent and heavy episodic drinking was not further associated with risk of total cancer after adjusting for total alcohol intake.

Conclusion
Light to moderate drinking is associated with minimally increased risk of overall cancer. For men who have never smoked, risk of alcohol related cancers is not appreciably increased for light and moderate drinking (up to two drinks per day). However, for women who have never smoked, risk of alcohol related cancers (mainly breast cancer) increases even within the range of up to one alcoholic drink a day.


Editorial
Light or moderate drinking is linked to alcohol related cancers, including breast cancer
BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h4400 (Published 18 August 2015)
Cite this as: BMJ 2015;351:h4400

http://www.bmj.com/content/351/bmj.h4400

Another good reason to think before you drink

Using data from two large cohort studies in the United States, Cao and colleagues1 examine the question of whether light to moderate drinking is associated with an increased risk of cancer. This question is important for a variety of reasons related to public health and alcohol policy. Cancer is one of the major causes of death globally,2 and cancer risks are frequently cited in arguments about formulating thresholds for low risk drinking guidelines.3 For instance, when Canadian guidelines were reformulated recently in 2011, in part based on the argument that consumers would not accept strict guidelines, cancer risk at low doses of alcohol use was introduced into the public health debate.4

Cao and colleagues found that in women, light to moderate drinking was associated with an increased risk of cancers with an established link to alcohol consumption—that is, cancer of the colorectum, female breast, oral cavity, pharynx, larynx, liver, and oesophagus.5 The increased risk was driven mainly by breast cancer. Similar findings emerged for light to moderate male drinkers who had ever smoked. No significant association was found in men who never smoked, or in women outside the relation with breast cancer. Also, no association was found …


Article

Medscape Medical News > Oncology
A Drink a Day May Boost Risk for Certain Cancers
Roxanne Nelson
August 21, 2015

http://www.medscape.com/viewarticle/849 ... 4955&faf=1
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Re: Think Responsibly: The Risks and Benefits of Alcohol & Y

Postby JeffN » Wed Sep 02, 2015 9:24 am

Alcohol consumption and breast cancer risk by estrogen receptor status: in a pooled analysis of 20 studies.
Int J Epidemiol. 2015 Aug 28. pii: dyv156. [Epub ahead of print]

http://www.ncbi.nlm.nih.gov/pubmed/26320033

BACKGROUND:
Breast cancer aetiology may differ by estrogen receptor (ER) status. Associations of alcohol and folate intakes with risk of breast cancer defined by ER status were examined in pooled analyses of the primary data from 20 cohorts.

METHODS:
During a maximum of 6-18 years of follow-up of 1 089 273 women, 21 624 ER+ and 5113 ER- breast cancers were identified. Study-specific multivariable relative risks (RRs) were calculated using Cox proportional hazards regression models and then combined using a random-effects model.

RESULTS:
Alcohol consumption was positively associated with risk of ER+ and ER- breast cancer. The pooled multivariable RRs (95% confidence intervals) comparing ≥ 30 g/d with 0 g/day of alcohol consumption were 1.35 (1.23-1.48) for ER+ and 1.28 (1.10-1.49) for ER- breast cancer (Ptrend ≤ 0.001; Pcommon-effects by ER status: 0.57). Associations were similar for alcohol intake from beer, wine and liquor. The associations with alcohol intake did not vary significantly by total (from foods and supplements) folate intake (Pinteraction ≥ 0.26). Dietary (from foods only) and total folate intakes were not associated with risk of overall, ER+ and ER- breast cancer; pooled multivariable RRs ranged from 0.98 to 1.02 comparing extreme quintiles. Following-up US studies through only the period before mandatory folic acid fortification did not change the results. The alcohol and folate associations did not vary by tumour subtypes defined by progesterone receptor status.

CONCLUSIONS:
Alcohol consumption was positively associated with risk of both ER+ and ER- breast cancer, even among women with high folate intake. Folate intake was not associated with breast cancer risk.
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Re: Think Responsibly: The Risks and Benefits of Alcohol & Y

Postby JeffN » Thu Sep 17, 2015 12:21 pm

Press Release

Harmful alcohol use linked with increased risk of alcohol-related cancers and injury
THE LANCET
16-SEP-2015

http://www.eurekalert.org/pub_releases/ ... 091515.php

A new study of alcohol use in countries of all income levels shows that current use increases the risk of alcohol-related cancers and injury, with no reduction in risk of mortality or cardiovascular disease overall. The research, published in The Lancet, supports health strategies to reduce harmful alcohol use, especially in low-income countries (LICs).

Alcohol consumption is proposed to be the third most important modifiable risk factor for death and disability. However, alcohol consumption has been associated with both benefits and harms, and previous studies were mostly done in high-income countries. This new study investigated associations between alcohol consumption and clinical outcomes in a prospective cohort of countries at different economic levels in five continents. The data came from 12 countries participating in the Prospective Urban Rural Epidemiological (PURE) study, a prospective cohort study of individuals aged 35-70 years. The high-income countries (HICs) were Sweden and Canada; upper-middle-income countries (UMICs) were Argentina, Brazil, Chile, Poland, South Africa, and Turkey; lower-middle-income countries (LMICs) were China and Colombia; and LICs were India and Zimbabwe.

The study included 114 970 adults, of whom 12 904 (11%) were from HICs, 24 408 (21%) were from UMICs, 48 845 (43%) were from LMICs, and 28 813 (25%) were from LICs. The median follow-up was 4·3 years and current drinking was reported by 36 030 (31%) individuals. Although current drinking was associated with a 24% reduced risk of heart attack, there was no reduction in risk of mortality or stroke, and current drinking was associated with a 51% increased risk of alcohol-related cancers--meaning those of the mouth, oesophagus, stomach, colorectum, liver, breast, ovary, and head and neck--and a 29% increased risk of injury in current drinkers. For a combination of all reported outcomes, there was no overall benefit from current alcohol use. High alcohol intake and heavy episodic drinking were both associated with significant increases in risk of overall mortality.

The authors also identified differences between countries of different income levels in risk for a combination of all clinical outcomes analysed in the study (ie, mortality, cardiovascular disease, stroke, heart attack, cancer, injury, and admission to hospital). For higher-income countries (HICs/UMICs combined), current drinking was associated with a 16% reduced the risk of this combined outcome, while for lower-income countries (LMICs/LICs combined) current drinking was associated with a 38% increased risk.

Lead author Dr Andrew Smyth of the Population Health Research Institute, McMaster University, ON, Canada says: "Our data support the call to increase global awareness of the importance of harmful use of alcohol and the need to further identify and target the modifiable determinants of harmful alcohol use."[1]

Co-author Dr Salim Yusuf, Director of PHRI and President of World Heart Federation, adds: "Because alcohol consumption is increasing in many countries, especially in LICs/LMICs, the importance of alcohol as a risk factor for disease might be underestimated. Therefore, global strategies to reduce harmful use of alcohol are essential."

Writing in a linked Comment, Dr Jason Connor of the Centre for Youth Substance Abuse Research, University of Queensland, and Professor Wayne Hall of the Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, QLD, Australia and National Addiction Centre, Kings College London, UK, say: "More than sufficient evidence is available for governments to give increased public health priority to reducing alcohol-related disease burden in low-income and middle-income countries. This should be done by implementing the most effective population policies to discourage harmful drinking--namely, increasing the price of alcohol and reducing its availability, especially to younger drinkers, and preventing the alcohol industry from promotion of frequent drinking to intoxication."



MASS MEDIA ARTICLE

Alcohol Ups Mortality and Cancer Risk; No Net Benefit
Veronica Hackethal, MD
September 24, 2015

http://www.medscape.com/viewarticle/851459

Drinking alcohol does not result in a net health benefit and, in fact, increases the risk for alcohol-related cancers by 51%, according to a study of almost 115,000 people from 12 countries.

It also showed that heavy drinking increases the risk for death by 31% to 54%, and that the highest rates of harmful alcohol use are seen in the lowest-income countries.



STUDY

Alcohol consumption and cardiovascular disease, cancer, injury, admission to hospital, and mortality: a prospective cohort study
Smyth, Andrew et al.
The Lancet

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00235-4/abstract

Summary
Background
Alcohol consumption is proposed to be the third most important modifiable risk factor for death and disability. However, alcohol consumption has been associated with both benefits and harms, and previous studies were mostly done in high-income countries. We investigated associations between alcohol consumption and outcomes in a prospective cohort of countries at different economic levels in five continents.

Methods
We included information from 12 countries participating in the Prospective Urban Rural Epidemiological (PURE) study, a prospective cohort study of individuals aged 35–70 years. We used Cox proportional hazards regression to study associations with mortality (n=2723), cardiovascular disease (n=2742), myocardial infarction (n=979), stroke (n=817), alcohol-related cancer (n=764), injury (n=824), admission to hospital (n=8786), and for a composite of these outcomes (n=11 963).

Findings
We included 114 970 adults, of whom 12 904 (11%) were from high-income countries (HICs), 24 408 (21%) were from upper-middle-income countries (UMICs), 48 845 (43%) were from lower-middle-income countries (LMICs), and 28 813 (25%) were from low-income countries (LICs). Median follow-up was 4·3 years (IQR 3·0–6·0). Current drinking was reported by 36 030 (31%) individuals, and was associated with reduced myocardial infarction (hazard ratio [HR] 0·76 [95% CI 0·63–0·93]), but increased alcohol-related cancers (HR 1·51 [1·22–1·89]) and injury (HR 1·29 [1·04–1·61]). High intake was associated with increased mortality (HR 1·31 [1·04–1·66]). Compared with never drinkers, we identified significantly reduced hazards for the composite outcome for current drinkers in HICs and UMICs (HR 0·84 [0·77–0·92]), but not in LMICs and LICs, for which we identified no reductions in this outcome (HR 1·07 [0·95–1·21]; pinteraction<0·0001).

Interpretation
Current alcohol consumption had differing associations by clinical outcome, and differing associations by income region. However, we identified sufficient commonalities to support global health strategies and national initiatives to reduce harmful alcohol use.
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Re: Think Responsibly: The Risks and Benefits of Alcohol & Y

Postby JeffN » Sat Jan 09, 2016 7:14 am

New alcohol guidelines debunk health myths from light drinking

https://www.rsph.org.uk/en/about-us/lat ... 58CD83B14D

8 January 2016

RSPH welcomes the introduction of new alcohol guidelines by the Chief Medical Officer, Dame Sally Davies. The new guidelines, which follow the first review for over 20 years, includes a reduction in the recommended intake for men from 21 units to 14 units per week, the same limit as women, and also, recommends that drinkers spread their weekly units evenly over three or more days. The new guidelines place the UK below the world average for weekly alcohol intake for both men and women.

Over the past decade, rates of alcohol consumption have slowly declined. In 2005, when alcohol consumption peaked, 19% of adults stated that they do not drink at all, increasing to 21% by 2013. Similarly, in 2005, 18% of adults stated that they binge drink at least once per week, decreasing to 15% by 2013. These statistics, however, belie the concerning behaviours within the drinking population, namely the greater propensity of middle age and older people to drink on a daily basis and the continuing burden of alcohol-related disease.

The new guidance reflects a greater understanding of some of the health risks associated with alcohol. Research has shown that alcohol is a factor in the development of over 60 medical conditions, including heart disease, stroke and some cancers, with men bearing the brunt of alcohol-related harm (men account for roughly 65% of alcohol related deaths). It is of concern that approximately 1 in 20 of all new cancers in the UK are caused by alcohol consumption. And while consumption has been declining, well over half (59%) of local authorities in 2014 reported seeing a rise in alcohol-related hospital admissions. The new guidance advocates a level of drinking at which the risks to health are lower, rather than a safe level of drinking alcohol.

Shirley Cramer, Chief Executive of RSPH, stated that:

“Excessive alcohol consumption causes untold harm to the public through alcohol-related disease and associated social problems, costing an estimated £21 billion each year. Considerable progress has been made in recent years to educate the public and encourage healthier behaviour, but further action is required.

We welcome the new guidelines as a means of moderating alcohol consumption which will in turn have health benefits for the public. The new guidelines reflect the modern reality of alcohol availability and consumption, and critically, reinforce the message that alcohol should be viewed as a product for occasional consumption rather than a diet staple. As well as lowering the recommended amount of alcohol people should consume, we welcome the guidance to spread the amount over three or more days, to counter bingeing.

The new guidance needs to be accompanied by action on all fronts, including clearer health information on alcohol, such as calorie labelling and further investment in alcohol and educational programmes. For example, we need to do more to increase public understanding of alcohol units –only around 1 in 4 people knew 1 unit was “less than a small glass of wine” with around half of people wrongly thinking 1 glass of wine equalled 1 unit. Efforts should also be made to lower the default strength and serving size for alcohol served in pubs and bars.”



Alcohol Use and Breast Cancer: A Critical Review. Alcoholism: Clinical and Experimental Research, 2016; 40 (6): 1166 DOI: 10.1111/acer.13071

https://onlinelibrary.wiley.com/doi/abs ... acer.13071

Abstract
The objective of this study was to outline the biological pathways of alcohol-attributable breast cancer, the epidemiological risk relationship between alcohol consumption and breast cancer, and the global burden of breast cancer incidence and mortality attributable to alcohol consumption, with a focus on light drinking. First, the literature regarding the biological mechanisms of how alcohol affects the risk of breast cancer was reviewed and summarized. Second, a search of meta-analyses that evaluated the risk relationship between alcohol consumption and breast cancer was conducted. Last, the burden of alcohol-attributable breast cancer incidence and mortality was estimated by means of a Population-Attributable Fraction methodology. Data on alcohol consumption were obtained from the Global Information System on Alcohol and Health, and data on cancer incidence and mortality were obtained from the GLOBOCAN database. Alcohol consumption affects breast cancer risk through the alteration in hormone levels and the associated biological pathways, the metabolism of ethanol resulting in carcinogens, and the inhibition of the one carbon metabolism pathway. The systematic review found 15 meta-analyses on the risk relationship between alcohol consumption (also light consumption) and the risk of breast cancer. All but 2 of these analyses showed a dose–response relationship between alcohol consumption and the risk of breast cancer. An estimated 144,000 (95% confidence interval [CI]: 88,000 to 200,000) breast cancer cases and 38,000 (95% CI: 2,400 to 53,000) breast cancer deaths globally in 2012 were attributable to alcohol, with 18.8% of these cases and 17.5% of these deaths affecting women who were light alcohol consumers. All levels of evidence showed a risk relationship between alcohol consumption and the risk of breast cancer, even at low levels of consumption. Due to this strong relationship, and to the amount of alcohol consumed globally, the incidence of and mortality from alcohol-attributable breast cancer is large.

(17.5% of 38K deaths is 6,650 deaths a year from breast cancer due to light drinking, </= 1 drink a day)


MM Article
Science Daily - News
June 1, 2016

Even light drinking may increase breast cancer risk
https://www.sciencedaily.com/releases/2 ... 084655.htm
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Re: Think Responsibly: The Risks and Benefits of Alcohol & Y

Postby JeffN » Fri Jul 22, 2016 5:33 am

Study

Connor, J. (2016) Alcohol consumption as a cause of cancer. Addiction, doi: 10.1111/add.13477

http://onlinelibrary.wiley.com/doi/10.1 ... 13477/full

Abstract
Background and aims
There is increasing research evidence about the causal role of alcohol in cancer, accompanied by unclear and conflicting messages in the media. This paper aimed to clarify the strength of the evidence for alcohol as a cause of cancer, and the meaning of cause in this context.

Methods
Recent epidemiological and biological research on alcohol and cancer was reviewed and summarized, drawing upon published meta-analyses identified from the Medline database and the archives of the International Agency for Research on Cancer. More recent epidemiological studies not included in these publications were also reviewed. A brief description of the nature of causal inference in epidemiology was used to frame discussion of the strength of the evidence that alcohol causes cancer, and contrast this with the case for a protective association of alcohol with cardiovascular disease.

Results
The usual epidemiological understanding of a cause is a factor that increases the incidence of a condition in the population. In the context of a body of epidemiological evidence of an association of alcohol consumption with a disease, the inference that it is a causal association requires alternative explanations of the observed finding to be judged unlikely. Even without complete knowledge of biological mechanisms, the epidemiological evidence can support the judgement that alcohol causes cancer of the oropharynx, larynx, oesophagus, liver, colon, rectum and breast. The measured associations exhibit gradients of effect that are biologically plausible, and there is some evidence of reversibility of risk in laryngeal, pharyngeal and liver cancers when consumption ceases. The limitations of cohort studies mean that the true effects may be somewhat weaker or stronger than estimated currently, but are unlikely to be qualitatively different. The same, or similar, epidemiological studies also commonly report protection from cardiovascular disease associated with drinking but a high level of scepticism regarding these findings is now warranted.

Conclusions
There is strong evidence that alcohol causes cancer at seven sites in the body and probably others. Current estimates suggest that alcohol-attributable cancers at these sites make up 5.8% of all cancer deaths world-wide. Confirmation of specific biological mechanisms by which alcohol increases the incidence of each type of cancer is not required to infer that alcohol is a cause.



Mass Media Article

Even one glass of wine a day raises the risk of cancer: Alarming study reveals booze is linked to at least SEVEN forms of the disease
By Colin Fernandez Science Correspondent For The Daily Mail
18:20 EST 21 Jul 2016,

http://www.dailymail.co.uk/health/artic ... sease.html

Alcohol causes cancer of the mouth and throat, larynx, liver and colon
Also causes bowel and breast forms but it may be responsible for others
Women who drink 2 units a day are 16% likelier to die from breast cancer
90% of people don't realise alcohol increases the risk of the deadly disease
The substance is estimated to have caused half a million deaths since 2012
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Re: Think Responsibly: The Risks and Benefits of Alcohol & Y

Postby JeffN » Tue Feb 21, 2017 4:40 pm

As an FYI, a standard drink contains about 14 grams of alcohol.

https://pubs.niaaa.nih.gov/publications ... guide2.htm

The cut-off point in this study between moderate and heavy was 112 grams a week. That equates to 1.14 drink a day or 8 a week,

In American, moderate drinking is up to 1-2 drinks per day, which, according to this study, just puts all of them at risk for Arterial aging.



Twenty‐Five‐Year Alcohol Consumption Trajectories and Their Association With Arterial Aging: A Prospective Cohort Study

https://doi.org/10.1161/JAHA.116.005288
Journal of the American Heart Association. 2017;6:e005288

Abstract

Background Emerging evidence suggests that arterial stiffness, an important marker of cardiovascular health, is associated with alcohol consumption. However, the role of longer‐term consumption patterns in the progression of arterial stiffness over time remains unclear. A longitudinal cohort design was used to evaluate the association between alcohol consumption over 25 years and subsequent changes in arterial stiffness.

Methods and Results Data (N=3869; 73% male) were drawn from the Whitehall II cohort study of British civil servants, in which participants completed repeat pulse wave velocity assessments of arterial stiffness across a 4‐ to 5‐year interval. Repeated alcohol intake measurements were used to categorize participants into alcohol consumer types, accounting for longitudinal variability in consumption. Sex‐stratified linear mixed‐effects modeling was used to investigate whether drinker types differed in their relationship to pulse wave velocity and its progression over time. Males with consistent long‐term heavy intake >112 g of ethanol/week had significantly higher baseline pulse wave velocity (b=0.26 m/s; P=0.045) than those who drank consistently moderately (1–112 g of ethanol/week). Male former drinkers showed significantly greater increases in arterial stiffness longitudinally compared to consistently moderate drinkers (b=0.11 m/s; P=0.009). All associations were nonsignificant for females after adjustment for body mass index, heart rate, mean arterial pressure, diabetes mellitus, high‐density lipoprotein, and triglycerides.

Conclusions This work demonstrates that consistently heavy alcohol consumption is associated with higher cardiovascular risk, especially among males, and also provides new insights into the potential impact of changes in drinking levels over time. It discusses the additional insights possible when capturing longitudinal consumption patterns in lieu of reliance on recent intake alone.
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Re: Think Responsibly: The Risks and Benefits of Alcohol & Y

Postby JeffN » Mon May 22, 2017 12:17 pm

Not published yet but following in the above recent trend in published data that the potential benefits have been overstated and there is harm from even small amounts...

http://www.dailymail.co.uk/femail/artic ... rence.html

Drinking half a wine bottle a week may increase risk of breast cancer recurrence
One in eight Australian women will be diagnosed with breast cancer
And alcohol has been shown to increase the risk of a diagnosis, new study says
By AUSTRALIAN ASSOCIATED PRESS
UPDATED: 11:24 EDT, 4 May 2017

Drinking just half a bottle of wine a week may increase the risk of breast cancer returning for survivors of the disease, a new study has found.

The equivalent of 60 ml of wine a day significantly increases the risk of breast cancer recurrence, research from Cancer Council Victoria has suggested.

Lead researcher Dr Anna Boltong, from the University of Melbourne, said the findings could change the guidelines on alcohol consumption to include those diagnosed with cancer.

'The current public health advice for reducing alcohol risk is an upper limit of two standard drinks per day for healthy men and women but there is no reference to people who have previously been diagnosed with cancer,' Dr Boltong said.

'These results show that as little as six grams of alcohol per day - that's just three tablespoons of wine - is associated with a modest increase in risk for women who have had breast cancer, particularly those who are post-menopausal.'

Lowering alcohol consumption and maintaining a healthy weight is known to reduce the risk of breast cancer - a disease that affects one in eight women in Australia.

However, the latest findings have the potential to change the way advice is given to cancer-stricken patients.

'People who have survived cancer should be armed with all the facts and be supported to reduce their alcohol intake and improve their health,' Dr Boltong said.

Dr Boltong will present the findings of the study at the Behavioural Research in Cancer Control Conference in Melbourne.
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Re: Think Responsibly: The Risks and Benefits of Alcohol & Y

Postby JeffN » Tue May 23, 2017 6:10 am

And this one was just published

Alcohol Consumption and Mortality From Coronary Heart Disease: An Updated Meta-Analysis of Cohort Studies
Journal of Studies on Alcohol and Drugs, 78(3), 375–386 (2017).

DOI: http://dx.doi.org/10.15288/jsad.2017.78.375
Published Online: May 21, 2017

Abstract

Objective:
Previous meta-analyses estimate that low-volume alcohol consumption protects against coronary heart disease (CHD). Potential errors in studies include systematic misclassification of drinkers as abstainers, inadequate measurement, and selection bias across the life course.

Method:
Prospective studies of alcohol consumption and CHD mortality were identified in scholarly databases and reference lists. Studies were coded for potential abstainer biases and other study characteristics. The alcohol–CHD risk relationship was estimated in mixed models with controls for potential biases. Stratified analyses were performed based on variables identified as potential effect modifiers.

Results:
Fully adjusted meta-analysis of all 45 studies found significantly reduced CHD mortality for current low-volume drinkers (relative risk [RR] = 0.80, 95% CI [0.69, 0.93]) and all current drinkers (RR = 0.88, 95% CI [0.78, 0.99]). There was evidence of effect modification by cohort age, gender, ethnicity, and heart health at baseline.

In stratified analyses, low-volume consumption was not significantly protective for cohorts ages 55 years or younger at baseline (RR = 0.95, 95% CI [0.75, 1.21]), for studies controlling for heart health (RR = 0.87, 95% CI [0.71, 1.06]), or for higher quality studies (RR = 0.86, 95% CI [0.68, 1.09]). In studies in which the mean age was 55 years or younger at baseline, there were significantly increased RRs for both former (RR = 1.45, 95% CI [1.08, 1.95]) and occasional drinkers (RR = 1.44, 95% CI [1.09, 1.89]) compared with abstainers.

Conclusions:
Pooled analysis of all identified studies suggested an association between alcohol use and reduced CHD risk. However, this association was not observed in studies of those age 55 years or younger at baseline, in higher quality studies, or in studies that controlled for heart health. The appearance of cardio-protection among older people may reflect systematic selection biases that accumulate over the life course.



Mas Media Article

A glass of red is NOT good for the heart: Scientists debunk the myth that drinking in moderation has health benefits
Daily Mail
UPDATED: 07:59 EDT, 22 May 2017

http://www.dailymail.co.uk/health/artic ... heart.html

• Previous studies imply moderate drinkers have less heart disease than abstainers
• Yet, these teetotallers frequently used to drink and cut back or quit for their health
• Nondrinkers are therefore often less healthy, regardless of their alcohol intake
• Healthy older people are more inclined to drink than people with worse health
• This gives the false illusion that moderate drinking promotes boost wellbeing
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Re: Think Responsibly: The Risks and Benefits of Alcohol & Y

Postby JeffN » Wed Jun 07, 2017 9:03 am

Research
Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: longitudinal cohort study
BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2353 (Published 06 June 2017)
Cite this as: BMJ 2017;357:j2353

Abstract
Objectives
To investigate whether moderate alcohol consumption has a favourable or adverse association or no association with brain structure and function.

Design
Observational cohort study with weekly alcohol intake and cognitive performance measured repeatedly over 30 years (1985-2015). Multimodal magnetic resonance imaging (MRI) was performed at study endpoint (2012-15).

Setting
Community dwelling adults enrolled in the Whitehall II cohort based in the UK (the Whitehall II imaging substudy).

Participants
550 men and women with mean age 43.0 (SD 5.4) at study baseline, none were “alcohol dependent” according to the CAGE screening questionnaire, and all safe to undergo MRI of the brain at follow-up. Twenty three were excluded because of incomplete or poor quality imaging data or gross structural abnormality (such as a brain cyst) or incomplete alcohol use, sociodemographic, health, or cognitive data.

Main outcome measures
Structural brain measures included hippocampal atrophy, grey matter density, and white matter microstructure. Functional measures included cognitive decline over the study and cross sectional cognitive performance at the time of scanning.

Results
Higher alcohol consumption over the 30 year follow-up was associated with increased odds of hippocampal atrophy in a dose dependent fashion. While those consuming over 30 units a week were at the highest risk compared with abstainers (odds ratio 5.8, 95% confidence interval 1.8 to 18.6; P≤0.001), even those drinking moderately (14-21 units/week) had three times the odds of right sided hippocampal atrophy (3.4, 1.4 to 8.1; P=0.007). There was no protective effect of light drinking (1-<7 units/week) over abstinence. Higher alcohol use was also associated with differences in corpus callosum microstructure and faster decline in lexical fluency. No association was found with cross sectional cognitive performance or longitudinal changes in semantic fluency or word recall.

Conclusions
Alcohol consumption, even at moderate levels, is associated with adverse brain outcomes including hippocampal atrophy. These results support the recent reduction in alcohol guidance in the UK and question the current limits recommended in the US.



Study: Even moderate drinking might be bad for aging brains
KIM PAINTER
USA TODAY

https://www.usatoday.com/story/news/201 ... 102550952/

Here’s one more reason to think before you drink: even a modest amount of booze might be bad for aging brains.

A new study published Tuesday in the medical journal BMJ says moderate drinkers were more likely than abstainers or light drinkers to develop worrisome brain changes that might signal eventual memory loss. They also were more likely to show rapid slippage on a language test, though not on several other cognitive tests.
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Re: Think Responsibly: The Risks and Benefits of Alcohol & Y

Postby JeffN » Thu Sep 14, 2017 12:35 pm

How alcohol industry organisations mislead the public about alcohol and cancer
Drug Alcohol Rev.. doi:10.1111/dar.12596
First published: 7 September 2017
DOI: 10.1111/dar.12596

http://onlinelibrary.wiley.com/doi/10.1 ... 12596/full

Introduction and Aims
Alcohol consumption increases the risk of several types of cancer, including several common cancers. As part of their corporate social responsibility activities, the alcohol industry (AI) disseminates information about alcohol and cancer. We examined the information on this which the AI disseminates to the public through its ‘social aspects and public relations organizations’ and related bodies. The aim of the study was to determine its comprehensiveness and accuracy.

Design and Methods
Qualitative analysis of websites and documents from 27 AI organisations. All text relating to cancer was extracted and analysed thematically.

Results
Most of the organisations were found to disseminate misrepresentations of the evidence about the association between alcohol and cancer. Three main industry strategies were identified: (i) denial/omission: denying, omitting or disputing the evidence that alcohol consumption increases cancer risk; (ii) distortion: mentioning cancer, but misrepresenting the risk; and (iii) distraction: focussing discussion away from the independent effects of alcohol on common cancers. Breast cancer and colorectal cancer appeared to be a particular focus for this misrepresentation.

Discussion and Conclusions
The AI appears to be engaged in the extensive misrepresentation of evidence about the alcohol-related risk of cancer. These activities have parallels with those of the tobacco industry. This finding is important because the industry is involved in developing alcohol policy in many countries, and in disseminating health information to the public, including schoolchildren. Policymakers, academics, public health and other practitioners should reconsider the appropriateness of their relationships to these AI bodies.
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Re: Think Responsibly: The Risks and Benefits of Alcohol & Y

Postby JeffN » Wed Oct 04, 2017 4:43 pm

The relationship between drinking alcohol and esophageal, gastric or colorectal cancer: A nationwide population-based cohort study of South Korea.
Choi YJ, Lee DH, Han KD, Kim HS, Yoon H, Shin CM, Park YS, Kim N.
PLoS One. 2017 Oct 3;12(10):e0185778. doi: 10.1371/journal.pone.0185778. eCollection 2017.
PMID: 28973012

http://journals.plos.org/plosone/articl ... ne.0185778
http://journals.plos.org/plosone/articl ... =printable

Abstract

BACKGROUND:
Epidemiologic findings of low-volume alcohol consumption in relation to gastrointestinal cancers including gastric cancer are inconsistent.

METHODS:
The association between alcohol intake and esophageal, gastric and colorectal cancer risk was examined in a population-based prospective cohort of 23,323,730 adults in Korea who had undergone a biennial evaluation provided by the National Health Insurance Corporation between the years 2009 and 2012. After median 5.4 years of follow-up, 9,171 esophageal, 135,382 gastric and 154,970 colorectal cancer cases were identified. Cox regression models were used to estimate hazard ratios (HR) and corresponding 95% confidence intervals (95% CI).

RESULTS:
Light drinking as well as moderate to heavy alcohol consumption significantly increased the risks of the three gastrointestinal cancers (HR 1.51; 95% CI, 1.43-1.60; HR 1.08; 95% CI, 1.06-1.09; HR 1.12; 95% CI, 1.11-1.14) compared with non-drinkers after adjusting for age, sex, smoking, exercise, income, body mass index, and diabetes. The synergistically increased cancer risk between excessive amount of alcohol consumption and currently smoking or underweight individuals was observed only in the esophageal cancers.

CONCLUSIONS:
Light drinking including even one alcoholic drink a day is associated with increased risks of esophageal, gastric and colorectal cancer.
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Re: Think Responsibly: The Risks and Benefits of Alcohol & Y

Postby JeffN » Fri Nov 17, 2017 9:12 am

The Lancet
Volume 390, No. 10109, p2215, 18 November 2017

Editorial

Alcohol and cancer

DOI: http://dx.doi.org/10.1016/S0140-6736(17)32868-4

"The Nov 7 publication of Alcohol and Cancer: a Statement of the American Society of Clinical Oncology (ASCO) emphasises the prominence of alcohol as a proven cause of many cancers. This view is not novel and comes exactly 30 years after a working group of the International Agency for Research on Cancer determined that alcoholic beverages were carcinogenic to humans. It has been echoed by other cancer societies since then but seemingly ignored by the wider medical community and by society. The influential endorsement by ASCO provides a powerful impetus to act on decades of evidence that alcohol harms health."

read more...
http://www.thelancet.com/journals/lance ... 40-6736(17)32868-4/fulltext
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