The holidays are here again—and with them, another season of cocktail parties and festive family get-togethers. So I couldn’t think of a better time to revisit a story that grabbed a whole lot of headlines this past summer.
In case you missed it, I’m talking about the recent review that put forth the following statement: Alcohol causes cancer. So, according to these researchers, quitting drinking should be right next to quitting smoking as a public health directive.
Now, I don’t need to tell you that there’s a lot of questionable health advice out there. (Consider the “controversies” surrounding butter, meat, and salt.) And what it usually boils down to is a bunch of so-called “experts” refusing to admit that they were very, very wrong about something.
Still, there are a few subjects on which the jury truly does remain out. And among them is how much alcohol, if any, is acceptable. That’s why, today, I’d like to address drinking—and more specifically, how it does or doesn’t harm your health.
A direct cause of seven different deadly cancers?
According to this recent 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, the study author claims, results suggest that the list is probably even longer than that.1
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 this researcher argues 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 the causal connection between alcohol and cancer 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 cancer threat is slightly disingenuous. Or at the very least, premature at this point.
Why alcohol and cigarettes aren’t quite two of a kind
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 it’s not hard to put two and two together here.
There are, of course, other known risks of heavy drinking. It’s a prime cause of fatty liver disease, for one—not to mention full-fledged cirrhosis and liver failure. All of which are very serious health threats, particularly if you’re overweight, obese, or struggling with blood sugar control already.
There’s also the fact that alcohol disrupts hormones in large quantities. This, in turn, interferes with glucose metabolism and bone turnover processes, promotes adrenal burnout and disrupts sleep, and creates an estrogen-dominant environment (which is equally dangerous to both men and women).
So yes, I’d say there’s more than enough evidence to classify binge drinking as a full-fledged public health crisis—responsible, according to these estimates, for as many as 6 percent of the world’s cancer deaths.
But there are also plenty of studies showing that moderate alcohol intake can actually boost your health. Take the following study featured in Clinical Nutrition back in 2013, for example.
Researchers recruited 67 men with a high cardiovascular risk and randomly assigned them to consume red wine (30g alcohol per day), non-alcoholic red wine, and gin (30g alcohol daily) for four weeks. Results showed that both of the alcohol interventions (red wine and gin) improved good HDL cholesterol levels, compared to the non-alcoholic red wine group.2
This indicates that any heart health benefits were related to alcohol. Not to the resveratrol (and other polyphenols) red wine is so famous for containing. (Both of which are incredibly good for you—but which, as I’ll explain in a moment, you’re better off getting from supplements.)
Suffice it to say, similar research supporting cigarettes is scarce (if not nonexistent).
Sugar is the biggest missing link of them all
Look, I’m not here to defend booze. The risks are real, no doubt. And no one is going to argue that heavy drinking isn’t a health hazard. 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.
It’s also hard to ignore the fact that this latest study made absolutely no distinction between different types of alcohol. There’s a huge difference in sugar content between popular drinks like beer, wine, champagne, margaritas, and whiskey sours—and a simple dry gin martini or vodka and club soda with a twist of lime.
And we know for certain from dozens of peer-reviewed, published studies that sugar leads to more deaths worldwide than alcohol.
So, why all the publicity over a single study aimed squarely at stopping alcohol consumption… and yet nothing more than a half-hearted push to reduce the consumption of added sugar?
To me, this is one of the biggest reasons to think twice before taking puritanical calls for alcohol abstinence at face value.
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 recommendation always struck me as supremely sensible. But the confusion rises once you begin to ask where, exactly, we should be setting limits. So let’s talk about that now.
Four essential survival strategies for drinkers
When it comes drinking, there are four rules of thumb you should always adhere to. Follow these guidelines, and you’ll be maximizing alcohol’s benefits, while minimizing its most serious risks:
Stick with spirits. This should speak for itself. The dangers of alcohol may be up for debate—but the lethal effects of sugar are not. Clear alcohols and sugar-free mixers (like club soda) are best. But beer, wine, champagne—and any cocktail that uses juices, sugar-sweetened sodas, or simple syrups—all deserve a hard pass in my book.
Take your B vitamins. Alcohol depletes your body’s B vitamin supply, which also hampers your ability to detoxify naturally. This contributes to the buildup of dangerous acetaldehyde, and it’s one reason why a few too many drinks can leave you wincing the next morning. Keep your bases covered by making sure you are taking at least a B100 complex. (And drinking plenty of water to stay hydrated.)
Call it quits after two. And no, I don’t mean 2 a.m. Even if your cocktails aren’t adding to your daily sugar load, your body still puts everything on hold to metabolize alcohol first. So stopping at two drinks is just plain good sense—minimizing metabolic and sleep disruptions, while limiting hangovers and keeping you from making bad decisions at the dessert table (and elsewhere). If you’re feeling “buzzed” you’ve had more than enough.
Finally, exercise. This may be the last thing you want to do the morning after a party—but it’s important. In fact, recent research confirms “hazardous” drinking raises your risk of overall and cancer-related death by nearly 60 percent and 90 percent respectively. But these effects appear to be largely reversible… simply with regular exercise. (The equivalent of about 35 minutes of brisk walking per day.)
In fact, subjects who drank moderately and also exercised had as much as a 20 percent lower risk of death compared to teetotalers.3
The moral of the story, as far as I’m concerned? You really don’t need to give up alcohol to prevent disease. But as I’ve reminded you time and again, you do need to start moving.
- Connor J, et al. Addiction. 2016 Jul 21.
- Chiva-Blanch G, et al. Clin Nutr. 2013 Apr;32(2):200-6.
- Perreault K, et al. Br J Sports Med. 2016 Aug 31.