Cocktails cause cancer… or do they?

I don’t need to tell you that there’s a lot of questionable health advice out there. I’ve devoted a lot of time to busting medical myths about “bad guys” like butter, meat, and salt.

Most of the time, what the mainstream calls “controversial,” I call a closed case. The facts are there for anyone who’s interested in them. And what it usually boils down to is a bunch of so-called “experts” refusing to admit that they were very, very wrong about more than one recommendation.

Still, there are a few subjects on which the jury truly does remain out. And I’d like to address one of them today. That is, drinking alcohol — and more specifically, how it does or doesn’t harm your health.

Suffice it to say that there are a lot of conflicting ideas — and just as much conflicting advice — about how much alcohol, if any, is acceptable. I was taught the “Goldilocks” approach in medical school — namely, that too much alcohol isn’t good, but too little isn’t good either.

This always struck me as sensible. After all, I think we can all agree that drinking too much isn’t good for you. But the confusion rises once you begin to ask where, exactly, we should be drawing the line.

A recent review purports to set the record straight on this matter. But its conclusions aren’t exactly music to moderation advocates’ ears.

According to this review, epidemiological evidence makes a strong case against alcohol as a direct cause of seven different cancers — including cancers of the oropharynx, larynx, esophagus, liver, colon, rectum, and breast. And, they claim, results suggest that the list is probably even longer than that.

None of this is news, of course. We’ve known for some time now that alcohol abuse can contribute to the development of cancer.

But the lead study author claims that the real issue here is awareness. She says that industry-funded findings are afforded equal credibility in reporting on the subject. And that the language used by experts and the media muddies the waters and downplays the reality of this causal connection in public messages.

For the record, I won’t argue with this gripe. Truer words about most things medical have never been spoken. But here’s the thing…

This review cites expressions like “alcohol-related cancer” and “links” between alcohol and cancer as red herrings in the effort to get the truth out. But when you’re talking about epidemiological research — that is, population studies — concluding any kind of firm causality really is a sticky wicket.

That’s because epidemiology deals in correlation. And while strong enough correlations can make a very good case for causation, they simply can’t prove it.

So to suggest that drinking is comparable to smoking as a carcinogenic threat to the public is slightly disingenuous. Or at the very least, premature at this point.

For one thing, we know exactly how and why cigarettes cause cancer. But with alcohol, the mechanisms aren’t so clear. There are credible theories, of course — like that fact that alcohol easily permeates cells where it becomes acetaldehyde. (In fact, that’s precisely what causes hangovers.)

Acetaldehyde is known to damage DNA and cause cancer. So I think there’s more than enough evidence to classify binge drinking as a bona fide public health crisis — responsible, according to these estimates, for as many as 6 percent of the world’s cancer deaths.

That is a lot of cancer, no doubt. But is this enough to justify a warning that social drinking is just as harmful as excessive drinking?

Personally, I don’t think so. That’s a very large leap to make — and one that simply doesn’t have the research to support it yet. Don’t get me wrong. I’m not here to defend booze. (Though I also have no problem with anyone indulging in a cocktail or two, as long as they stick to clear spirits.)  But I will take this opportunity to point out that we know beyond a shadow of a doubt that sugar leads to more deaths worldwide than alcohol.

So, why all the publicity over a study aimed at stopping alcohol consumption… and yet still nothing more than a half-hearted push to curb sugar consumption?

All I can say is that this new era of social conservatism we seem to have found ourselves in tends to lean on belief systems over facts when making arguments. And while there’s no denying the research here, I can’t help but wonder if this draconian call for abstinence might be less about science — and more about morals — than this study author cares to admit.