“Deep Links Between Alcohol and Cancer Are Described in New Report“
September 18, 2024, by Roni Caryn Rabin.
Dr. Catena’s Response:
The recent New York Times article, “Deep Links Between Alcohol and Cancer Are Described in New Report,” presents a complex issue in a manner that may lead to some misunderstanding. While the article raises important points about alcohol consumption and health risks, it appears to conflate information about light to moderate drinking with data on general alcohol consumption. As both a physician and a vintner, I believe it’s crucial to provide a balanced perspective that accurately informs the public about the potential risks of excessive alcohol consumption and binge drinking, while also acknowledging the nuanced findings of reputable medical research. For instance, a 2022 study published in The Lancet noted that for adults over 40, consuming small amounts of alcohol may offer certain health benefits, such as reducing the risk of cardiovascular disease, stroke, and diabetes.
It’s important to consider the full spectrum of scientific evidence when discussing such a complex topic. For example, it has long been known that alcohol – especially consumption above the U.S. guidelines of two units per day for men and one for women – is associated with an increased risk of certain cancers; however, reputable studies have also found associations between greater alcohol consumption and lower rates of certain cancers, including thyroid cancer and non-Hodgkin lymphoma. It is also well established that there are no health benefits to exceeding guidelines or binge drinking; on the other hand, there is extensive research suggesting that light-to-moderate wine consumption might mitigate the risk of cardiovascular disease, which is the leading cause of death globally.
If the science appears somewhat contradictory, it’s because alcohol’s impact on health is highly complex. Much more research is needed, especially large, long-term studies that include diverse populations.
Current estimates of both cardiovascular benefits and health risks are based on observational studies, which are not the most reliable because they struggle to distinguish between confounding factors and causality. Furthermore, much of the research used to support assertions that there is “no safe level” of alcohol consumption is too nuanced to be accurately captured in a headline.
For example, the Times report references a study based on the UK Biobank, stating that “moderate and light drinkers experienced more cancer deaths than occasional drinkers.” But the same data shows that low/moderate drinkers without pre-existing health or socioeconomic challenges saw no increase in mortality, and that wine-preference consumption with meals was protective against cancer deaths in some populations.
The Times report states that a recent JAMA Network study “found that moderate and light drinkers did not benefit from a reduction in heart disease.” But a previous study published in the Mayo Clinic, which used the same Biobank data, did find significant cardiovascular benefits in low/moderate drinkers who did not binge drink (https://pubmed.ncbi.nlm.nih.gov/34218856/).
The Times report also states that “drinking alters gut bacteria, which can play a role in the growth and spread of cancers.” That assertion implies causality, which is beyond the scope of a non-academic publication. It also overlooks existing literature linking a healthy microbiome to the Mediterranean diet, which includes moderate wine consumption (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359750/).
Most scientific experts in the field of alcohol and health believe that the current data presents a moment of equipoise, where the evidence on health benefits and risks of moderate drinking is fairly balanced.
Since much of the data is observational, it is crucial that a randomized controlled trial be conducted (such as the ongoing study in Spain on the Mediterranean diet with or without wine). However, when public health organizations like the WHO base “no safe level” positions on a biased review of the data, ethics committees may halt such studies and, by extension, deny public policymakers and the public at large access to critically important information about the potential benefits or risks of moderate alcohol consumption in diverse populations.
The Times has a long, well-established track record of reporting on complex scientific and medical issues in a way that is balanced, measured, and nuanced. It did this recently in a report on hormone replacement therapy for menopausal symptoms noting that while it “carries risks, to be sure, as do many medications that people take to relieve serious discomfort, dozens of studies since 2002 have provided reassurance that for healthy women under 60 whose hot flashes are troubling them, the benefits of taking hormones outweigh the risks.”
Until the medical and scientific research provides us with a much more detailed portrait of alcohol’s impact on health, I urge the Times to resist leaving its readers in a state of disenchantment with alcohol. Putting aside any health benefits, responsible consumption of alcoholic beverages provides humanity with incalculable artistic, emotional, social, and cultural pleasures, and the science simply isn’t there to suggest the risks outweigh these benefits.
In Defense of Wine 
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