i am s mad about pharmaceuticals; using the word RISK as if it tells anhone anything. Can taking a drug loweryour risk of a heart attack?
why can't we be fair about what that means?
WOW! Here is yet ANOTHER thing that can cause an increase in cancer. These days just about everything we eat or drink can cause an increase in cancer, but we don't let that stop us. Now, I'm to young to drink alcohol, but I know that a 1.04% risk of cancer (if you're a light drinker) would not stop me from something that I enjoy doing. The increase in cancer caused by many foods is not high enough to stress over, or to stop us from doing things we enjoy.
1
And for Gods sake, don't add any dihydrogen monoxide to you're mixed drink - it's a killer.
1
Good point Tony Dietrich, the booze is likely better than much of the water.
An important question comes to mind when reading this article. Why did Mr. Carroll choose to cite the article by Jin et al., (2013) instead of the more recent research articles such as Bagnardi et al., 2015 and Cao et al., 2015? The Jin et al., (2013) article did not control for classification bias. That is, in most of the older research on alcohol and health whichw as used in the Jin et al. study, people were divided into abstainers, light, moderate and heavy drinkers. Former drinkers were grouped in with abstainers and in many studies, former drinkers made up the majority of the abstainers. The problems is that most former drinkers who are now abstainers are so because they developed an alcohol abuse/dependence problem, developed health conditions requiring them to abstain, or are on medication that does not permit them to drink. The majority of abstainers therefore are suspected to be individuals who are experiencing poor health and in doing so, make light to moderate drinkers appear healthier. If people are light drinkers, they are probably more likely to be health conscience as well and maybe more likely to adhere to healthy diets and regular exercise programs. The harms of alcohol far outweigh the benefits of alcohol - if there are any benefits at all. If everyone adhered to light drinking (less than one drink per day) there would certainly be less health issues associated with alcohol. Unfortunately, this is not the case.
4
99.9% of people don't know that moderate drinking is 1 drink a day for women and 2 drinks a day for men.
Notice that was omitted in this article. It is rarely mentioned in articles expounding the benefits of moderate drinking.
Most people think moderate drinking is 2-5 drinks most nights a week. Moderate drinking NEVER means drinking more than the 1 or 2 drinks per night depending on whether you are a woman or man. So, that means a total of 7 drinks/week maximum for women and 14 drinks/week maximum for men.
Many people who think they drink moderately would consume their weekly maximum within a 3 day period.
Don't tell me about the positive benefits of drinking moderately.
Alcohol abuse and alcoholism costs this country billions of dollars a year in productivity on the job, and untold heartache in households across the country.
I believe in people's right to consume alcohol, but we shouldn't be spouting the benefits of alcohol consumption when it is causing so much damage to our society.
If you want the benefits of the antioxidants in red wine, drink concord grape juice.
Do we spout the benefit of other drugs? Alcohol is a drug, even though it is legal.
5
thank you for explaining basic epidemiology to people instead of being another uneducated and obnoxious journalist failing to interpret science. My initial reaction to this article's headline was very negative, as I am sick of reading things like:
"Coconut oil and saturated fats cause heart disease!"
I would add one more piece of advice.
#6) pay attention to who funds the study and how many studies they funded that were never published
6
As Joe Jackson said musically with a groove, “Everything Gives You Cancer.” https://youtu.be/WsQyru5ACmA
4
We are getting better and better at treating cancer, but failing miserably at preventing cancer. I can't help thinking it's the unregulated pesticides, which are in almost everything we eat. Me? I'm going to blame it on the wine.
1
Makes about as much sense as blaming it on the boogey man or a political party.
Plenty of cancer before there were pesticides, no?
What pesticides are unregulated, btw?
1
@Cooofnj: Actually, cancer is a modern disease that spiked after the onset of industrialized agriculture -- so yes indeed, our modern use of pesticides/herbicides/other chemicals like hormones and antibiotics in our "farm factory" culture may very well be the culprit behind our skyrocketing cancer rates.
Or, because of better public health measures, better medicine, and better availability of food, people are living longer to an age at which cancer develops -- just another take on a correlation that does not prove or even indicate causation.
1
I was under the impression that the greatest risk associated with alcohol consumption was related to recidivism for survivors of estrogen based breast cancer. This article does not speak to cancer survivors and in particular breast cancer survivors, who I understood were the ones at greatest risk from alcohol consumption. I wish it did.
1
One last thought: the great comedian Totie Fields has this epitaph on her gravestone: "I should of had the cheese cake"
2
That would be "should've" but otherwise right on.
1
Kudos, Aaron, on a well-organized, primer for proper perspective when interpreting medical studies.
(If I can reiterate and summarize two major points:
1. Always consider both relative and absolute changes to risk; and
2. Always draw your cost/benefit-analysis circle widely around ALL of the effects.)
Well done.
A votre sante!
12
I just dont get why anyone has to have a drink a day (light drinker) when there is nothing nutritional in alcohol. Its SUGAR and DIES. Same for WINES. Those grapes turned to sugar. Its like drinking “sugar soda’s”, “smoking”, “taking drugs”. Our bodies are not a machine that can be clean or parts replaced. Our organs continually work very hard to keep us alive and we need to treat our bodies with care. Its full of organs, chromosomes, cells, so ingesting anything that’s not going to keep those organs, chromosomes, cells etc working then DONT ingest it. You learn to walk on this sidewalk and look before crossing the street. Well same mind set should be about how to treat your body. You only get one body.
3
So, you’re recommending a return to prohibition? Do you similarly recommend banning sugar? After all, hasn’t it lead to an obesity epidemic, and a dramatic rise in type two diabetes, especially in children?
A glass or two of wine is far healthier than the processed garbage that people consume.
By the way, you’re wrong about wine. During fermentation, the sugars become alcohol, so there’s actually very little sugar in wine.
I’ll raise a glass to you this evening.
14
A glass of wine always enhances a meal for me especially if I am eating pasta. That would be my reason for light drinking.
9
Good wine is one of the great pleasures of life. It tastes wonderful, enhances food, stimulates conversation, affords a pleasurable buzz. It's also, possibly, good for you (see, the French paradox). If life were only about sustaining the body, rather than feeding the spirit, I suppose one could subsist on Soylent Green alone. In the end, no one gets out alive, no matter how healthy a life you life. My intention is to enjoy every second, not merely "exist".
8
Thank you for this corrective article. When I read the first article, simply reporting the scociety’s findings, which included only relative risk comparisons, I immediately submitted a comment arguing for the inclusion of absolute risk as an additional basis for evaluating the effects of alcohol. When I looked for my comment, I found the entire article had disappeared. I presume this article is a replacement for it. It gives a much better description of the cancer risks associated with alcohol consumption. Thank you again.
8
This item lead me to a second glass of wine: what's "light" drinking versus "moderate" drinking. Heavy drinking, I assume, is a gallon each day.
3
I was just looking up the heaviest drinking countries in the world and wondering if their rates of cancer are really any higher than ours in the US. I wonder too whether drinking correlates with people's perceived happiness quotient or whether it causes more woe. It was interesting to learn that the US is not even at the top of the heaviest drinking country list! So let's focus on the things that are really killing us like the French fries and donuts.
9
Very nice clarification about this topic, which I feel was not presented to the public very well in the original NYT article. Thanks you.
5
I'm sure Gary Schwitzer and Health News Review will give the NY Times good marks for "unpacking" ASCO's alarming news.
Thanks for the solid reporting.
5
Life is a sexually transmitted disease that is universally fatal
20
I am so going to use your statement if you don’t mind.
2
This is one of the most ridiculous articles I've ever read!
Please explain
5
One thing that frustrated me about the original article is that it wasn't clear what the baseline was; a 500% increase from a really low rate is much different than a moderate rate...etc. I think it written to be a lot more scary than necessary and at a certain point, I just gave up.
1
I do not understand the logic of adding absolute risks to estimate the total risk of contracting cancer. This assumes that there are no cross correlations, i.e., the risk of developing cancer does not depend on the other lifestyle choices the study subjects made. A proper study (pretty difficult to do) would require studying four different cohorts. Let us say that we are studying 45 year old males who have the same racial, income and prior disease profile as the average American male. Some of them eat broccoli, others do not. Now let us say that eating broccoli and drinking alcohol have a strong negative correlation, so that eating broccoli may or may not not confer any benefit by itself, but it does counteract increase in risk of contracting cancer by drinking alcohol. So, what should a 45 year old male who does not drink alcohol and does not eat broccoli do? There can be millions of such theoretical choices that can not be answered easily. Translating results from a risk assessment study to a recommendation for an individual is not possible, especially when added risks are small.
4
Subtracting the attributable risk for smoking from that for alcohol is not accurate (if that indeed is what Dr. Carroll did).
Attributable risk as defined in epidemiology doesn’t have a limit of 100% for the sum of all risk factors (see Modern Epidemiology, 2nd edition, ed by Rothman and Greenland, page 13), but for each factor. The upper limit for the sum of two factors is 200%.
I would question the diets of those in the study. If it is mainly processed foods, meats and little plant based foods, plus alcohol - wouldn't that impact one's chances?
1
Two points in this article confirm the point of view that is incocnsistent with generally acceptd medical opinion: !)Using numbers to play hocus pokus and to then dismiss alcohol consumption as not that much of an issue for contributing to cancer. 2)AND then to top it off, to point out that identifying foods that contribute to cancer leads to people rationalizing that too many things contribute to cancer and will therefore not bother to make any adjustments to their habits. Not a balanced view but rather the expression of someone who has a controversial idea to promote.
2
Ok, but isn’t equally irresponsible to put out a press release saying that alcohol can lead to cancer, knowing that people won’t read past the headline?
3
Well let me see I may have to subsist on nothing.
The air is bad, the water is bad, the food is bad, too much exertion is bad.
Can't trust any stats/studies anyway they all seem funded by companies.
I would be MORE worried about the sugar content people consume than a glass of wine or two -
Now that is a problem!
12
Exactly. Sugar is far more dangerous, and we see the rates of type two diabetes rising each year, especially children, yet we’re putting out studies to try to take the enjoyment out of a glass or two of wine.
2
Every time I read one of these studies a certain song comes to mind - Joe Jackson’s “Everything Gives You Cancer” from the Night & Day album. It says it all.
4
What is super annoying about these articles is that they always come, as they do in this case, with a list of "policy recommendations" that always involve more taxpayer money, more regulations, more bureaucracy and centralized control of private decisions. But then that is the kind of people who go to the professional association meetings and join the task forces to write these things up. All soviet commissars by temperament.
I appreciate the information being available, but wish the experts would stop it at that and leave my freedom alone.
2
Not scary until your best friend who drank 1-2 glasses of wine daily dies one month prior to her 42nd birthday. The risks are real - cut back on the wine and cocktails for the long term. Eat, drink and be wary.
2
Exactly the kind of misguided comment this article was meant to, politely, discourage. We're not living our lives in this paranoia you embrace.
20
My heart grieves for your friend; however, one person does not a study or conclusion make. Correlation is not causation. I am, again, sorry for your loss.
16
I’m sorry for your loss.
What did this person eat? How active was this person? What diseases ran in her family?
I’m guessing that your friend enjoyed her 42 years more because of a glass or two of wine, while these contributed in no way to her death.
6
Health News Review is a web site that evaluates news coverage of medicine and recommends improvements. They had a column about this very story, including the New York Times coverage:
https://www.healthnewsreview.org/2017/11/alcohol-cancer-500-increase-ris...
Alcohol and cancer: What does a ‘500% increase’ in risk really mean?
"Unlike at NBC, the Times offers a mechanism for readers to push back against imbalanced stories — and a number of smart readers pointed out the problem with the Times’ risk descriptions..."
And finally:
"Aaron E. Carroll, writing on the New York Times’ Upshot blog, has a nice breakdown of some of the numbers in the ASCO report and what they mean in absolute terms." https://www.nytimes.com/2017/11/10/upshot/health-alcohol-cancer-research...
Health News Reviews has a checklist of questions that a health news story should answer. https://www.healthnewsreview.org/toolkit/
3
I love my wine so this comment is in no way self-serving, I'd love to interpret this latest ASCO statement the way you have. Unfortunately this statement and all the many underlying studies done globally do support both a causative relationship between alcohol and breast cancer and a linear relationship of its consumption and risk with breast cancer. I can't speak to the other forms of cancer, but I have searched high and low for a medical study to tell me that it's OK to consume wine if one has concerns about breast cancer, but there are none.
It probably would have been prudent for your piece to define light and heavy drinking because as you note light drinkers increase their risk only very slightly. But speaking in terms of women, a light drinker is one that has 1-2 glasses a week which in my books is basically a non-drinker. Given that all studies say that breast cancer risk goes up in a linear fashion for every single drink you have per week above none, then it may not take long to get into higher numbers of risk. A heavy drinker, which you note still carries a relatively low risk, is defined for women as having 8 drinks a week. That's not a whole lot more than the often cited heart health benefits of having one glass a day. And it's a far cry from what most of us would consider to be heavy drinking I think.
13
I have been reading this nytimes author for some time now. Are we sure that the the opinions he writes are coherent with the same principles and values the nytimes asks the readers help to promote in its daily mission?
Don't drink water! Drink alcohol!
These advises could be even acceptable in an ideal world where people eat correctly and exercise systematically.
In the contemporary social and public health American context, these are finally the subliminal messages many nytimes readers will embrace enthusiastically. Because these are the words they love to hear.
1
This is not an apologia for drinking. It's a thoughtful context-provider. Thanks to the NYT for this quality work.
14
This article makes clear that "Truth In Advertising" rules would be beneficial if applied to news articles, reports of clinical studies, drug claims, assertions related to "organic", "gluten free", "fat free" (and all the other fad claims with which we are assailed), and every other form of conveyance for risk increase or decrease information.
Inane notifications such as "Sodium Free" or "Cholesterol Free" - - on a bottle of (allegedly) "Natural Spring Water" would be eliminated.
If absolute risk data were listed FIRST, we might waste far less time reading articles such as the one which precipitated this hullabaloo!!
2
Well, thanks for this.
Eagerly awaiting the next health study that will cause needless worry and mass confusion.
2
I guarantee it will involve whole wheat and oat bran causing artery blockages that can easily be cleared by the ingestion (to immediately nullify) of cheese cake and port.
4
WineFolly dot com has posted a doctor's analysis of the study: "Wine vs Breast Cancer Update (2017)." Interesting read which includes findings of supplemental, unpublished data, not included in the original study, that breaks out the affects of different types of alcohol.
Very well done! It's so difficult trying to explain medical statistics to the public, & you have done a superb job. Thank you, Doctor!
5
Ask you doctor how much they drink. Your doctor considers you a heavy drinker if you drink more than your doctor. There are virtually no heavy drinkers. Cheers!
4
"A Link Between Alcohol and Cancer? It’s Not Nearly as Scary as It Seems."
But I knew that - without even reading the blurb.
2
I guess the UpShot article is the good cop to the alcohol causes cancer bad cop article in last week's health section. That it caused such an uproar that this UpShot piece was felt necessary shows how people do not like to hear that an activity they enjoy, drinking alcohol in this case, is bad for you.
I wonder how many of the most vehement deniers of alcohol's role in causing cancer feel the opposite way when it comes to the science of humans causing climate change?
1
Well done Dr. Carroll. Thanks.
2
A direct quote from the ASCO study.
"In total, ASCO estimates that 5% to 6% of new cancers and cancer deaths globally are directly attributable to alcohol."
From Harrison's Principles of Internal Medicine 16th edition.
Drinking 1.5 drinks /day increases risk in women by a factor of 1.4
Suppose over her lifetime a woman has a risk of 8% of developing cancer.,
Drinking 1.5 drinks /day increases that lifetime risk to 11.2%
Drinking more than 1.5 drinks /day would increase the lifetime risk to more than 11.2%.
Is that increase from 8% to 11.2% significant. That is for the individual woman to decide.
The increase in the risk of cancer from alcohol use for a particular site in the body may be relatively small.
But there are many different sites [organs] in the body so the cumulative risk for all sites is larger than Carroll estimates.
While I agree with Carroll that people should not panic I find his attitude that since the rate of alcohol related cancer deaths is small compared to all deaths disturbing.
Gun nuts argue that since there are only about 10,000 gun homicides out of 2.6 m deaths /year, then we should do nothing about gun safety measures.
Whether people drink alcohol and how much or little is their business but they should know the relative risks.
I am concerned that this article may minimize the risks.
7
1.5 drinks /day increases the risk of breast cancer in women by a factor of about 1.4
What I don't know and what would be interesting to know is this.
Suppose a woman has a first degree relative who had breast cancer or suppose a woman has a gene associated with a risk of breast cancer.
Is this woman's risk of breast cancer increased by more than a factor of 1.4 if she drinks or is there no difference in risk.
3
As has been pointed out, it's good to note the health benefits of light-to-moderate alcohol intake, which just might offset the apparently very small cancer risk. Meanwhile the death rate remains the same as it ever was: One to a person. Don't you just love statistics? Thanks so much for this article.
7
The "health benefits of light-to-moderate alcohol intake" have not been established. Just because there is an association demonstrated in research does not mean that one thing causes the other. For example, former very heavy drinkers who are now sober may be included in the "no alcohol intake" group of a study. The "light drinkers" may have better health outcomes because it does not include that group of former heavy drinkers, who, while currently sober, may experience deleterious effects in the future due to that heavy drinking from the past. But that is just one hypothesis.
5
Good comment. I perhaps should have said "....possible health benefits..." or some such.
1
The article that the author has linked to with the words "these protective factors may be greater..." primarily finds this to be true for drinkers older than age 65; the main finding of the study is that the purported health benefits of light drinking don't hold up well for young people, while the risks remain similar. "Drinking at the royal colleges’ recommended limit increases risk [of death] by 9% in women aged 16-24 and by 23% in men aged 16-24. For government limits these figures are 15% and 32%, respectively". In the abstract, the authors state their primary finding as follows: "Substantially increased risks of all cause
mortality can occur even in people drinking lower than recommended limits, and especially among younger people." Tell me again about the perils of cherry-picking data?
2
Statistics are groups of people and averages among them. You do not cherry pick but you also have to now about statistical averages, etc. Some among statistical groups score high some low and there are those in the middle. Then the results are averaged. So statistics are not absolute but show a trend that should be taken into consideration. Also groups should not be mixed with individuals. The author is right. Those who do not know statistics should learn first then make comments.
3
Thanks, Gabriel. You explained perfectly the huge risks of such kind of consolatory and much hopeful articles.
1
All causes of mortality? For young adults, that disproportionately includes accidents and violent crimes. No one is going to say that risks of both aren't greatly enhanced by irresponsible drinking.
1
My biggest pause as I absorb this data is the clinical definition of "light" consumption of 1 daily serving for a woman and 2 daily servings for a man. This doesn't feel "light" to me-it sounds chronic. I think of light as a few drinks a week perhaps a glass of wine with dinner once or twice a week. How do translate the data to that level of usage? I think that would be useful for many/most truly moderate or "light" drinkers.
2
The definition of light drinking seems to be pretty standard across studies, as it should be for research purposes. I would define 1-2 drinks a week as "occasional" consumption in the medical/scientific world. There has to be some norms in order for researchers to be able to compare information.
4
Wow! An apologetic for alcohol use, an activity that is unnecessary, provides no personal or societal value except for habit, and is clearly destructive to many lives and families. Mind boggling...I think I'll have another drink.
10
If you want to have a conversation about alcohol and risk, then let's talk.
Alcohol causes 100% of drunk driving fatalities. In 2015, 10,265 people died in alcohol-impaired driving crashes, accounting for nearly one-third (29%) of all traffic-related deaths in the United States.
Alcohol is the most commonly used addictive substance in the United States: 17.6 million people, or one in every 12 adults, suffer from alcohol abuse or dependence. How many lives have been detroyed directly or indirectly because of alcohol addiction? Countless.
And yes, no matter how you bend the facts, alcohol also increases the risk of cancer. So go ahead and rationalize your need for an alcohol high all you want. It's arguably THE most dangerous drug. Period. Cheers!
10
You must still be a member of the temperence movement. I'll have a dry martini, thank you, and toast that our paths never cross.
MOST of us, by a wide margin, are responsible drinkers.
As long as mankind has been here, distilled or fermented beverages have been part of human culture.
That YOU can't handle it, is your business. Do not impose your position on the rest of us.
15
"alcohol also increases the risk of cancer."
And LIFE increases the risk of death. Go figure.
3
A simple statistic: being alive puts you at a 100% chance of eventual death. At to what will cause that death, a myriad of reasons with various probabilities, all of them well below 100% come over the horizon. Spending your life worrying about something that has a 0.06% chance of causing your ultimate demise is a waste of energy.
32
I so appreciate this analysis. But I have a question. The original November 7 article stated that the paper in question said there was a "causal" relationship between alcohol and cancer. (I went back and re-read it to be sure.) This analysis says that the research states a correlation between the two. Which is correct? Did the original news story report it wrong? Or did this analysis? There's a big difference between causal and correlation, which is why the original news story shocked me so.
21
Oh my word. I intend to continue to live a happy life, indulging myself in the short time I have left, instead of worrying whether I can live to a really old age by refraining from simple pleasures and be grumpy. As the top comment here noted, life causes death.
20
I hope you can continue to live a happy life, but don’t be so sure either indulging or refraining will guarantee this. You have less control than you think, but one thing is for sure, if cancer is part of your future, no matter how short or long that future is, you will experience some unhappiness.
Most nutrition studies are flawed by observational biases and inaccurate reporting. Case-controlled studies are better and double-blinded studies, while the gold standard, are expensive, time consuming and take years to complete. No one is going to fund them. Compared to smoking, car accidents and aging, the association of alcohol and cancer seems minor. People have been consuming fermented products, cheese and dairy, meat (even smoked and cured meats) for millennia. They have not been consuming pounds of refined sugars and industrial foods for the same period of time. Eat wisely, in moderation and don't abuse alcohol. Never smoke. Exercise modestly. Wear your seat belt. Don't worry too much. Don't waste your money on supplements and fads. You will probably live a long time.
26
Dr. Carroll, thank you for writing such a clear article about the nuances of health research!
8
This article made so much sense already as I read it. And then got to the end and saw my old friend, Dr. Aaron Carroll, had written it. So of course it makes sense. Well-explained as always, Aaron.
7
You made my day! Hope you’re doing well.
5
People who have risk factors for cancer such as first degree relatives who had cancer might want to limit their drinking.
Smoking and alcohol use together increase risk of certain cancers.
If you can not stop smoking reduce your use of alcohol.
According to Harrison's Principles of Internal Medicine 7 or more drinks per day increases the risk of many cancers by a factor of 5.
4
Forgot to mention.
From Harrison's:
4 drinks /day increases risk for oral and esophageal cancer by a factor of 3.
2
"What can we do about this? We could make simple changes to have a better understanding of risk so that each new proclamation doesn’t send us into a tizzy:...."
Send into a tizzy? This whole article sends me into one of those. The author seems to imply that the Five Changes (also called the Five Rules),while not being applied to the study of wine, are being followed with other foods and drugs.
My argument is that though the language is mostly that of the Pharmaceutical Industry and other claimers to scientific method, in actuality, no industry sells relative risk (rather than absolute risk) more than Big Pharma. If 4 in a million were reduced to 2 in a million, that would in dharma-speak be a 50% risk. Big Pharma knows the rules and uses them to its own advantage.
So please, yes, let's not let them take away the enjoyment of our wine: at least not until we've looked into the Five Changes. But bigger please: let's make them apply the Five Rules before recommending one single prescription drug to 1/4 of our population. StatinVictims.com
7
No, I don't think an occasional cocktail is a huge risk factor. However, on a chronic basis perhaps it is risky because ethanol is toxic to human tissues. It can have an acute effect as alcohol poisoning. It has a chronic effect also, but the numbers have not shown exactly how that works.
Also, I would have to think there is a big qualitative difference in the effects of distilled spirits, as opposed to wine and beer. The alcohol in a martini must have more of an effect on the epithelium of the esophagus than the dilute alcohol in a glass of pinot noir.
Go easy on liquor. Even before this raft of scare headlines, has not that been the sensible position?
7
Aaron
Thank you for an excellent article...even more impressive given that your employer regularly dishes up faux science stories...usually on topics bashing GMOs or extolling organic...without a scientific basis.
Thanks you for keeping us grounded with facts and sound analysis.
3
What’s important is that the New York Times made the announcement of the American Society of Clinical Oncology known to the general public, even providing a link to the document. Journalistic comments are entertaining and may act as a teaser to the original report. But the latter, written by competent professionals whose only vested interest is that they are committed to public health, is irreplaceable if you want a good understanding of the issue.
Mr Carroll’s article is so misleading that I find it suspect. The beverage industry is so rich and influent that it would not be surprising that they rejoin in some form to ASCO.
A moderate drinker doubles his risk of cancer to the oesophage. Mr Carroll may frame this risk whichever way he wants, yet the statistical information remains. Cancer is such a thing that we should give the correct information to everyone, in plain terms. If, individually, you consider that this is not a big deal, good luck ! Note however that multiplying cancer risks by a factor due to alcohol, the aggregate cost to society (insurance, public expenses) is multiplied by that same factor, with an absolute certainty.
5
As Dr. Carroll states, there are diseases other than cancer, some of which show a positive correlation with light alcohol usage, so the cost to society may very well increase if every light drinker eliminates alcohol consumption.
I will add that if we all live longer, social security benefits may bankrupt America.
I used to read every source of every study discussed in the Times and, in each and every instance, there was so much myopia on the part of professionals in the specialty, I lost interest. My best example is the bisphonates, those bone preservers. The Times prints an article where doctors insist we women have to take them to prevent bone fractures, but when I delve into the topic I see clear evidence that although bone density "appears" to improve on scans, it's not improvement that actually increases strength. The number of fractures has not decreased, and, in rare instances, the entire jaw bone can be destroyed if you take these medicines.
Confused, I go to my doctor armed with analyses and data, she looks at me sheepishly and says, "yeah, we used to hand those pills out like candy, but we don't anymore. We figured, well it can't hurt, but so many women had such pain they couldn't exercise, and if there's anything that keeps you strong, it's exercise. They are effective in some cases, but not as a prophylactic."
There's benefit to reading the data, but there's even more value in a little common sense perspective.
Thanks, Dr. Carroll.
7
It shows how a single study, hyped by hysterical hyperbole & distortion of baseline statistics can frighten people unnecessarily. For example, imagine a headline that says "Eating carrots can double your chances of getting Fulminating Billious Keratoma." Most people would stop eating carrots. If 1 in 10 normally contracted FBK, then the odds go up to 2 in 10, & it's wise to stop eating carrots. If, however, FBK was so rare that only 1 in 100,000 contracted it, then eating carrots would increase the incidence to 2 in 100,000 - only the most paranoid hypochondriacs would stop eating carrots.
The importance here is that sensationalist never give the baseline we need to understand the real risk (1 in 10 vs 1 in 100,000).
In addition, the original study ignores other effects of light & moderate drinking that may heavily outweigh a fractional increase of cancer risks. Study after study agree that the people who drink one or two drinks a day have a longer lifespan than do heavy drinkers & tea-totalers. So, stopping drinking may fractionally increase a chance at getting cancer at the expense of other effects far more likely to affect your lifespan.
Most Americans are mathematically illiterate when it comes to statistics - especially partial statistics. If 9 broke men are sitting in a shelter & Bill Gates walks in - what's the average wealth of the 10 men? What is the median wealth? Average is the most intentionally misused statistic we have, short of omitting baseline numbers.
9
I'm just completely skeptical of any medical headline I see any longer. I usually try to get to the original link because the real data is never as sexy nor significant as portrayed in the media, even with decent science reportage.
Cigarettes, opioids, smoked or charred meats all have obvious carcinogenic potential. The Ames test showed the potential carcinogenicity of all kinds of things and I'm surprised that someone doesn't dredge that up and make a "study" saying one of these cause cancer, then 6 months later come to the opposite conclusion.
The genetic and environmental components that lead to cancer are complex and there aren't a lot of ways to draw a direct line between cause and effect.
That said, when you go to the doctor for a physical and they ask how much alcohol you consume, rumor has it that they never really believe you and assume your intake is higher than you say it is. So how does that play into a study of the link between alcohol intake and cancer? Hmm...
2
Find me a heavy drinker who doesn't think they are a moderate drinker. Most of the problems caused by heavy drinking, regardless of what you call it, are worse than cancer.
5
A little breath of rationality in the great Trumpian desert is welcome. Too much of anything is bad for you- not exactly a surprise, but better than getting cancer from drinking the water in New Orleans.
4
Thank you for this article. To relieve the stress of DJT and his band of miscreants' daily outrages I go to the gym several times a week for an hour or so and consume several glasses of wine each week. At nearly 60, I was unsure if my body would be able to handle a daily workout without injury. Not having the occasional glass of wine may have increased my chance of a cardiac event due to the stress. Whew!
!
4
Grateful the #s were clarified! I bet a lot of readers assumed that a 4% increase meant drinking that glass of wine with dinner means a 4% chance of getting cancer.
Real clickbait news--and entirely misleading.
Instead, it means a relative risk of 1.04, a 4% increase from 1.0.
9
As I aged, like most of my friends, climbed on the treadmill of so called preventative medicine. Prescribed on average 5 daily mediations, plus OTC supplements. Constant scheduled test, both invasive and evasive. Through this vortex I call it, Physicians usually find something to treat and that involves close follow up and more testing. Of course we should listen to our Physicians, if we can afford a lot of care, and the cost of medications. With that said, and like this Cancer analysis, it turns many into hypochondriacs. Catch a conversation for folks over 50, and you'll hear all about their meds and their treatments, causing considerable stress. I pay a lot of attention to the genetics of my family line and parents.
12
Right - folks are often scared by numbers, which if explained in full are not so scary at all. Another factor seldom discussed is whether changes in behavior change risk. If, for example, a person was a heavy drinker in his/her twenties or thirties, but then dropped to moderate or light in their 40s-60s, are they still at increased risk? This matters in several ways: 1) if changing behavior can improve risk, then there is motivation to do it; 2) if one is 'doomed' for long past behavior as a young adult, folks essentially read the study as 'it's too late for you, sorry bub'; 3) if changing behavior does not improve risk, then education must be focused on the young before it is 'too late.'
20
Also, you can't just isolate one "risk" from a behavior. Often, as in this case, the benefits of a drink a day far outweigh the fractional risk of increased cancer. For one thing, a glass of wine or a cocktail ever evening helps lower the incredible stress most of us face in our daily lives. Stress is a major factor in deaths by heart attack & stroke. It ends up that, if only studies of cancer increase & stress decrease are considered, the evidence comes down overwhelmingly in favor of having one or two drinks a day. It is no advantage to significantly increase your odds of a premature death by heart disease or strokes to avoid an infinitesimal increase in the possibility of getting cancer.
4
Agree Anne. Now smoking dope is becoming in vogue and legal, so like Liquor governments can tax. I see little or nothing from the Medical profession if this is un-healthy. So the younger the folks are the more they indulge.
1
Doctor Daniel Amen has a spect scan poster out of case histories of people who drink alcohol smoke tobacco and marijuana and even caffein. The spect scans show a terrible toxic look to the brain with deep holes in the brain. People in America did not believe the written warnings from scientists since 1964 so look at these photos from Doctor Amen. The holes signify violence and aggression. Nurses and doctors have studied this in school and know it is true. Alcohol is not a health food and should have a warning on bottle will cause cancer.
1
To Daniel Kalista: People entranced by Dr. Amen's multitude of claims might consider reading Quackwatch: https://www.quackwatch.org/06ResearchProjects/amen.html
9
As the comedian Chris Rock once observed:
Aquarius - You're Gonna Die!
Capricorn - You're Gonna Die!
Gemini - You're Gonna Die TWICE!
Can we just accept this fact and calm down?
Waiter? Oh, Waiter!
23
Is there anyone reading this article who hasn’t had the bejesus scared out of him or her because of some announced cancer risk?
13
Bartender.
Same again please.
11
Alcohol won't give you cancer? Congratulations! Guess you're off the hook!
Alcohol will, of course, kill three times as many people as guns will this year, and next year, and the year after. According to the CDC, 90,000 dead. And it will, of course, cause untellable, incalculable quantities of daily harm in the form of mangled DUI victims, battered women, abused, neglected, and orphaned children, broken families, and ruined careers.
No doubt freely available alcohol is convenient and pleasurable for you, much like freely available guns and ammo are convenient and pleasurable for law-abiding gun hobbyists. But at what cost? Next time you're about to raise a glass of wine, or raise your voice to howl for gun control, pause and give some thought to all the harm caused by freely available alcohol in this country.
8
I agree with another commenter that "freely available" alcohol causes many horrific problems unrelated to cancer.
But please consider that Prohibition of alcohol hugely energized organized crime in America. Not a good idea.
By the way, neither is Prohibition of street drugs, which is creating a permanent underclass of people with prison records; killing thousands of Americans outright because they never know how strong a given quantity of an unregulated substance might be (or what it's cut with); flooding our Mexican border with drug purveyors; and financing gangs in every city.
10
One glass of a nice red Merlot with dinner every day is NOT going to add to that total. Comparing guns & alcohol is a logical fallacy as the two are no more related to each other than apples & locomotives.
Mostly overuse of alcohol kills off the drinker. Driving under the influence of serious alcohol consumption is a danger to others as well, & we are steadily increasing penalties against it.
Having guns for hunting, recreational range shooting, or competitive shooting is often considered harmless, but ALL gun ownership raises dangers. The gun you keep at home is most likely to be used for a family member's suicide (the most common form of gun death). Accidents with home guns are the second largest cause of gun deaths. Family or social disputes rank third. Criminal use of guns is a comparatively lower rate than any of the above. Remember the recent article about the long-time NRA firearms instructor who shot himself in the leg while holstering his pistol. Remember the teenage girl whose father bought her boyfriend a semi-auto pistol as a high-school graduation present. When the father handed the gun to the boy, it went off, killing the father's daughter.
If you stacked up every gun death in the country & every death directly or indirectly related to overuse of alcohol on one side of the scale, & put tobacco-related deaths on the other side, tobacco is by far a worse killer. It just takes a long time, allowing companies to profit for decades before their drug kills you.
3
Prohibition of marijuana started in 1936 as a way to target the black & Hispanic populations that more commonly used it. You might not be able to arrest a person just for being black or Hispanic (in most cases), but by leaving alcohol legal and criminalizing marijuana, you allowed the white yacht club clientele to enjoy too many martinis while throwing poor blacks & Hispanics in jail & taking away their future right to vote.
Marijuana prohibition was still minor stuff in the 1960s, where most marijuana was smuggled from Mexico by amateur individuals & groups looking to make a little profit. Many deals were done with a handshake. There wasn't enough money in it to attract the criminal gangs. However, after Nixon created the DEA & cracked down on pot with increased arrests & longer sentences, the value of marijuana increased, as did its cost. Since then, cartels have replaced the "gentlemen pirates" & we have seen many murders & the wholesale corruption of border guards, police, judges, & federal agents by the cash-rich cartels.
Yet, it is still as easy - even easier - to get marijuana in states with even the most draconian laws against it than it was before the criminals began to see smuggling it (or growing it domestically) as profitable enough to become involved. Thus it is whenever prevention & jail are attempted as solutions to personal social issues.
4
Funny, just recently, there was a study published that showed that even moderate drinking reduces your cognitive abilities significantly over time.
https://www.theguardian.com/society/2017/jun/06/even-moderate-drinking-c...
7
There are an endless number of studies. Once, a study found saccharin (Sweet & Low) to be dangerous & aspartamine (Equal) to be safer. After many additional studies, we now accept that saccharin is safer & aspartamine - especially in hot foods (like coffee) is significantly more dangerous. Never stand or fall on a single or even handful of studies as many are flawed or misinterpreted. Go with the entire body of knowledge determined to date about a subject & be ready to change your mind when new evidence changes the equation.
5
If you ignore 10 things with one chance in 1000 of killing you, the chances are 1 in 100 that one will get you--an uncomfortable number when your life is at stake. If you ignore 100 things...
Still only a one percent chance Richard i.e. there's a 99% chance whatever it is will NOT kill you. Our bodies are not nearly as fragile as they are made to seem by the outpouring of ads for this or that vitamin, supplement or antioxidant, almost none of which do nothing but fill the pockets of their manufacturers. Life is filled with uncertainties and we are all going to die. I would rather enjoy the good things in moderation and if I die sooner, so be it.
5
If you stand with one leg in a bucket of dry ice and one leg in a bucket of burning charcoal briquets - you will be, on average, comfortable. Be careful how you oversimplify & misuse the sophisticated mathematical science we call statistics.
If you ignore 10 things with one chance in 1000 to kill you, you have to be assured that ignoring one might not counteract the dangers of another, leading to no more risk than not ignoring them - or possible less risk. Ignoring the trivial additional risk (only established in 1 study that I bet you haven't analyzed or determined isn't affected by totally unrelated conditions) of additional cancer through drinking a glass of wine is also ignoring the well-proven stress relief that a glass of wine at the end of the day provides, lowering your likelihood of premature heart attacks & strokes. So, it is not so simple or simplistic as your innumerate "analysis" tries to present it. Go study statistics for a couple of years & then come back & we'll have a reasonably intelligent discussion. Meanwhile, try to learn chi-square analysis, regression to the mean, Bayesian & stochastic math so you will start to have a baseline for your statistical "analysis."
Take the Monty Hall problem. He offers you a choice of 3 doors. Behind 2 are goats. Behind the other is a car. You choose door 1. He opens door 3 to show a goat & asks you whether you want to stay with door 1 or change to door 2. Which do you do, what are your odds if you stay or switch?
1
I have a glass of wine every night with dinner. Red wine is good for the heart. However, with chicken or fish I still have a glass of white wine.
Many supplements, including those not prescribed, are helpful to an average person's health.
1
"Depending where you look, you can find evidence that says that nearly everything we eat is both associated with higher rates of cancer and lower rates of cancer."
Make two columns. In column A, list every supplement or vitamin you can think of. In column B, every malady. Mix and match and do Google searches as follows: "A cures B." I guarantee that, in 90+% of cases, you will find dozens to thousands of pages making that claim. It is possible that you will find as many affirmative responses if you search for "A causes B" where A is some variety of food.
Sounds like a big waste of time to me.
1
So, far, studies show that, whatever you eat, drink, or breath, you have a 100% chance of dying ;) though I intend to live forever if it kills me!
1
The NYT should apply some of this statistical real world rigor to its near-daily "reporting" on the opioid epidemic, in which as many as 5% of prescriptions were misused, nearly all by people who were already addicts to something, of which 1% went on to very cheap and available heroin, which, along with mixing multiple drugs and alcohol, accounts for nearly all drug death from overdose. As with alcohol, that bad 1% shouldn't make anyone want to make anyone withhold historically effective inexpensive pain medication from the 95-95% who never abused anything. . . Oh. . .wait. . .
14
Right now, it appears from numerous studies that most opioid addicts became addicted when using prescription Oxycodone concoctions (like OxyContin) legitimately for pain. They developed a dependence & continued to use it. The switch to heroin came usually as a result of no longer being able to score oxycodone prescriptions or the fact that, today, after decades of the "war on drugs" heroin & it's profoundly more potent & dangerous synthetics, Fentanyl & analogues like Carfentanyl (an elephant analgesic 10,000 times stronger than morphine) are easier to get & considerably cheaper than prescription synthetic morphine (Demerol or Dilaudid) or synthetic codeine analogues like the oxycodiene drugs.
1
Looks like more of an old wives tale rather then any reasonable scientific fact or real findings. In today's world the biggest ever cause to cancer and there are some 200 plus so named are caused by pure simple chemical pollution of this planet and life. It is just pure simple toxicity in all kinds of gases, liquids, foods, fuels like used for rockets, radiation etc. The bottom line issue is that cancer is the biggest ever money makers as far as medical care and mankind is not too concerned about stopping cancer to occur in the first place. For close to 50% of all medication and processes to cure and eliminate cancer are totally ineffective and the side effects kill more people then the cure..
To that end I am at this age 78 is dying of stage four prostate cancer that is deeply metastasized into my bone structure.
6
Cancer has been around for eons, Winemaster2. Indeed the dinosaurs probably had it. With the exception of a few (asbetos causing mesotheliomas and aniline dyes causing bladder cancer) most of the increase in the perceived rate of cancer since the industrial revolution is due to better detection, not an increase in the number of cases. We are not as fragile as many would have us believe e.g. vitamin and supplement makers and the more hysterical elements of the environmental movement, both of which make money on the issue. Everyone develops some cancerous cells all the time but our immune systems generally do an excellent job of finding and killing them before things get out of hand. For example, you may have had some cancerous prostate cells 40 or 50 years ago but your immune system kept them at bay until, unfortunately they got out of control more recently. I am truly sorry to hear of your illness. Hope that you are not in too much pain (bone mets really hurt) and that, if you are, are getting appropriate narcotics (and perhaps Marinol or medical marijuana) and taking them. At this point you should have absolutely no worry about getting addicted
2
When, during college, I worked a side job at Massachusetts General Hospital, I read the notes of an anatomy given in a lab by a pathologist at the start of the 20th century. The pathologist was conducting the autopsy of what he termed a very rare form of death that, he assured his students, they would likely never see in their practices - lung cancer!
So, how much of lung cancer is caused by pure tobacco & how much by the 150 or such additives companies put into their product to make it burn more evenly, taste better, even addict faster? Has anybody ever done a study between pure tobacco & modern additive-rich cigarettes? I'd be interested to see the results.
BTW, I'm profoundly sad to hear of your terminal condition. in 1997, at age 49, I was diagnosed with stage 3+ colon cancer. After radiation, 2 surgeries, & extensive chemotherapy, I was given a 5% chance of surviving 5 years before liver cancer (the usual secondary cancer for colon cancer) killed me. After 5 years of remaining cancer-free, colon cancer patients are declared not in remission, but totally cured. The cancer had metastasized into the first 4 of the 5 guard lymph nodes the surgeon removed. I beat the odds and it is now 20 years later & my health has never been better. But, for that 5 years I lived with the same fears that you are now going through, though I had lived much less of my life & was acutely aware of how much of it I had to lose. I wish you comfort & consolation from your family & loved ones.
2
Beartooth, smoking has been around for centuries if not thousands of years but there was probably a lower prevalence of lung cancer because modern sanitation, clean water and sewage disposal along with medical advances in the 20th century simply allowed more smokers to live long enough to get cancer.
To any sane person it did not seem very scary in the first place. For years, we’ve seen headlines first touting, then later warning against eating this or that. (And sometimes the cycle then starts again.)
Ultimately, we will all die of something. In the meantime — screaming headlines and click bait aside — eating and drinking moderately makes sense for most people.
10
Much disease, particularly a growing number of cancers, the predilection for them is largely or entirely genetic or the result of genetic mutation.
They say that, in basketball, you can teach all of the skills, but you can't teach "quick." That is a genetic inheritance of either fast-twitch or slow-twitch leg muscle fibers.
To a large extent, your potential life span is determined by genetic factors, and no amount of careful eating & exercising can extend it (though bad practices can shorten it). In both sides of my family of Russian Jewish peasants, the average life span runs from late 90s to mid 100s. My mother's maternal grandmother was born 3 years after the Civil War & I sat on her couch with her & watched Neil Armstrong step onto the moon. She lived 105 years. My uncle, her grandson, just dies at 97.
When George Bernard Shaw was asked what he attributed reaching 90 year old to, he said he never ate meat, smoked tobacco, or drank alcohol. When Winston Churchill was later asked the same question, he noted that he ate red meat every day, started his incessant drinking with wine or brandy at breakfast, and smoked cigars all day long.
Go figure...
2
Precisely. Crossing busy streets increases your chances of being hit by a moving vehicle. What are the odds?
The reality is, if you live long enough, you're likely to get some kind of cancer. Cancer is a catch-all term for random cell growth, and there are many different kinds and causes.
5
Mainly the issue is gut health, thus, the immune system.
7
The author of this article obviously has an agenda too. Here are recommendations from his book: Eat meat several times a week: Its effects are negligible for most people, and arguably positive if you’re 65 or older.
Have a drink or two a day: In moderation, alcohol may protect against cardiovascular disease without much risk.
Enjoy a gluten-loaded bagel from time to time: It has less fat and sugar, fewer calories, and more fiber than a gluten-free one.
Eat more salt: If your blood pressure is normal, you may be getting too little sodium, not too much......
6
We all have agendas, Charles. At least Dr. Carroll's is to give medically sound advice based on data and not the profit motive. His advice sounds pretty good to me. Indeed I have followed it for many years before his book.
4
The overall health and social costs of alcohol consumption and abuse should be enough to encourage limited use even without this new report.
7
A hundred times over for tobacco!!!!
2
This research seems flawed. Look up alcohol consumption by country and cancer rates by country. The two do not correlate. According to Wkipedia, Belarus has the highest rates of alcohol consumption. According to the world cancer center, Denmark has the highest rates of cancer. Someone can go over the numbers themselves. The point is that if there was a correlation, then one would expect to see countries with high rates of alcohol consumption also have high rates of cancer.
11
I'm happy to see this more balanced article, but still believe that publishing the first article was not consistent with the ideal of "All the news fit to print." The news in the first article should have been that a reputable journal was publishing incomplete and misleading science. Why does no one infer from the earlier study that uncontrolled by FDA alcohol containing mouth wash products recommend gargling for 30 seconds a day may be the larger risk for mouth and esophagus cancers?
3
The truth is that the science, the actual science, just does not back up the beliefs by some that even moderate drinking is some sort of health hazard.
Of course, many will insist that alcohol is practically poison regardless of the science. These people would have also been steadfast believers in leeches.
5
In Blue Zones where people live unusually long lives, they are mostly daily drinkers. Also, the poems of water drinkers do not endure, at least according to Homer.
19
"Go thy way, eat thy bread with joy, and drink the wine with a merry heart; for God now accepteth thy works."
-Ecclesiastes 9:7
Nicely written article, thank you, Doctor.
10
Thank you. I’m relieved that I️ can still drink wine while I️ wait for Trump’s term to end! (This from a conservative, no less)
19
Really good article that puts things into perspective. It comes down to picking your poison, or rather choosing which way youd prefer to die. Heart disease, even though it is more common, seems less awful than having to deal with, say, mouth or esophageal cancer and all the horrific surgery that involves -- losing your lower jaw, voicebox, etc. At least with an understanding of what the statistics mean, people can make a choice.
1
I am not entirely sure, but I think that increased risk was linked only to estrogen-sensitive breast cancers. In any case, when I asked my oncologist if I should avoid alcohol, she looked at me and said, “after what we’ve put you through ( surgeries, chemo) we are not going to deny you the pleasures of an occasional drink.” So I hugged her.
15
You have given us a great gift! Reminding all of us to remember that ranges of numbers, (representing "light" to "heavy" drinking,over unspecified time) representing meanings of processes (disease and health) and outcomes (imminent death and unknown life expectancy)all take place within the complexities of known,currently unknown because of gaps in needed information which is generalizable in a range of conditions, and is adequately understood, and unknowables.That covers a great deal in a run on sentence.Then there is the avoided 100% reality of interactions between ever present uncertainties, unpredictabilities, randomness ( as lack of necessary information and not as "happenings"),lack of total control,notwithstanding levels and qualities of our "doings," and unexpected outcomes,whatever our expectancies.
What's the numerical, and existential,risk(s) of being impacted, or not, by some or any of this?Does "risk potential" change if the drinking cohort is willfully blind, deaf and ignorant about selected conditions in their daily life?Or, is acutely aware?Looking and seeing? Listening and hearing?Going beyond data-cherry-picking, post-derived-knowing, to created understandings.While being committed to continuing to question implications and consequences re necessary operating conditions.Being sensitive, for example, to the toxicity of "failure blindness."The risk of death after birth is 100%.What is the risk of experiencing a fulfilled life in between; wine drinking or not?
4
The real message is : ASK YOUR DOCTOR.
I am a cancer survivor. I want to reduce my chances of recurrence to be as low as possible. I should not drink at all.
People who already at risk for certain cancers should not drink.
I know many cancer survivors who do drink. I hope this news motivates them to have a calm and science driven discussion with their doctors to discuss what is best for them.
Everything comes with risk. I for one am glad The NY Times published the first article because it is getting people thinking about alcohol.
As someone who has been through one year of debilitating chemo during which I could not work. The short term pleasure of a glass of wine is not worth the added risk of cancer.
12
The risks associated with small amounts of alcohol, a standard sized drink or two a week, are, as stated in the opinion piece, very very small, and are indeed offset but some benefits, including the social ones of enjoying time with friends. However, most people drink too much and fail to recognize this -- when a couple of drinks per week become one or more drinks virtually every day the picture looks very different. And binge drinking, 3 or more drinks in any given sitting, does marked, immediate damage to the brain and liver, damage which is cumulative. Moreover, alcohol interacts with most drugs, with cigarette smoke and with many environmental toxins. The risks aren't additive; the cumulative effects are typically exponential. Each additional risk factor multiplies the effects of every other. Finally, much attention recently has been paid to the biome, healthy microbial communities in our mouths and guts. Alcohol messes big time with these, which is one of the reasons why oral cancer is much more common in drinkers, even light ones, than in non-drinkers. No one needs alcohol. So saying a little likely won't hurt is an awful lot like saying the occasional cigarette won't hurt. Both are (mostly) true, but a prudent person would neither smoke nor drink. No one would do so in the absence of enormous social and marketing pressure.
20
I can't wait to see all those health nuts in the hospital dying of nothing.
1
I understand that one drink a day carries as much of a risk for breast cancer as hormone replacement therapy. So why not carry some stories which talk about the upsides to HRT. It also could do good for a lot of women and also decreases the risk of some cancers as well as raising the risk of others. It can prevent osteoporosis, depression, insomnia and perhaps heart disease.
6
Death is inevitable and life is full of multiple ways one could possibly die. Self inflicted death and disease can be avoided with discipline and lifestyle backed by the best science. Whether there is a link between excessive alcohol consumption and cancer; moderate and occasional consumption of red wine, probably has no links. Most alcoholic drinks have preservatives. Each gram of alcohol consumption equals 7 calories, more than protein and carbs and less than fat. Excessive beer and wine consumption can add to calories and contribute to obesity which is linked to cancer. Addiction to alcohol and excessive drinking could cause liver cancer, contribute to painful gout, worsening of diabetes, inebriation, serious consequences of driving under the influence of alcohol, loss of self control or aggressive behavior. So cancer is not the only scary thing about alcohol, there are are a number of adverse links to alcohol, except 70% ethanol (chemical name for alcohol) which is an excellent disinfectant and antiseptic when not consumed by mouth or injected through the veins. I would not promote any other use of alcohol than as a disinfectant. Life without alcohol is not something to be feared or looked down upon. Trump supposedly does not drink alcoholic drinks and for a 71 year old, he is in decent physical health. Wonder what the red beverage in his glass was when he recently proposed a toast in Japan. South Korea and China. I assume it was red grape juice. To your health. Cheers.
2
"Trump supposedly does not drink alcoholic drinks and for a 71 year old, he is in decent physical health." His mental health? Clearly indecent.
4
Trump loves fast food, however.
4
"Of course, this means that 96.5 percent of cancer deaths are not attributable to alcohol."
Most deaths aren't attributable to cancer at all. Most deaths attributable to alcohol aren't cancer related. So we shouldn't worry about it.
There are 7.6 million cancer deaths each year in the United States so that means at 3.5%, 26, 600 cancer deaths are attributable to alcohol. So that once a day drink is a lot more likely to be your demise from cancer than you are to die at the hands or terrorists or mass shooters.
Of course, 3.5% actually underestimates the risk. According to he NYT article:
"ASCO researchers reviewed earlier published studies and concluded that 5.5 percent of all new cancers and 5.8 percent of all cancer deaths worldwide could be attributed to alcohol".
"For women, just one alcoholic drink a day can increase breast cancer risk, according to a report released in May from the American Institute for Cancer Research and the World Cancer Research Fund that was cited by ASCO."
Of course not all those women die.
The real question is how important it is to you to have that drink. I suspect, there are a lot of people out there who will be reassured by this effort at confirmation bias. I would love to see the same kind of response when science tells us chocolate and red wine are good for us.
6
No one gets out alive. My mother died of lung cancer at a young age of 62. She never smoked or drank and she ate healthy and exercised daily. Her four brothers also died of various cancers when they were in their 60s as well. They simply possessed the gene and/or propensity for cancer.
My mother always said, "everything in moderation". So, enjoy that glass of wine or high ball, slice of pie or scoop of ice cream. I would rather live a fuller life with the foods and coffee I enjoy instead of worrying about or scrutinizing every bite I eat. I stopped lamenting about the past and worrying about the future a long time ago because either extreme will result in losing sight and enjoyment of today.
30
Best advice of all. Thank you.
1
This article is a little loose with the data itself.
Most heart disease and diabetes are caused by diet; they’re not inevitable conditions offset by light drinking. In terms of diabetes risk, you’re much better off as a non drinker with a balanced diet than pursuing an average American plus alcohol.
It’s great to highlight the benefits of drinking less but the problem is most drinkers intake way more than the medical definition of light drinking. The article fails to mention that, or the range of other non-cancer illnesses that are linked to the average alcohol intake.
And let’s not forget the fatalities on our roads, the increased domestic violence, increased incidence of depression all linked to alcohol consumption.
I’d suggest people read this article with a grain of salt and stop looking for excuses that cover up our problem with alcohol.
20
"...the problem is most drinkers intake way more than the medical definition of light drinking." And what peer reviewed, adequately powered study did you get this pronouncement from, or is it merely your opinion stated as fact? As Daniel Patrick Moynihan declared: "You are entitled to your own opinions, not your own facts." By your lights we should return to Prohibition. That went well.
1
You say “Don’t focus on any one disease while ignoring others.”?
The author ignores all research into the damaging impact of alcohol on health, criminality and a host of social problems to prop up the idea that it might have a therapeutic benefit on a handful of conditions that would be better treated by changes in diet.
Our diabetes and heart disease epidemic is not caused by people forgoing a light drink. It’s our sedentary sugar coated lifestyle.
The issue with alcohol is most drinkers don’t stop at one. Heroin is relatively benign in small doses too. To downplay the havoc our drinking culture is causing on our bodies and communities is reckless beyond measure.
10
Heroin is not “Benign in small doses”. It causes physical dependence in any dose very quickly. Comparing alcohol use to heroin use is just silly.
2
Women with estrogen-positive breast cancer do need to be very careful with alcohol intake. Excessive intake of alcohol will generate estrogen, a binder that allows breast cancer cells to grow. So, while it is true that alcohol intake may not have that much of an impact on cancer rates in the aggregate, this particular group should exercise caution with respect to quantity and frequency of alcohol use.
10
What is of greatest significance when determining "risk" is the health status of the person drinking alcohol. If for example a person has had cancer, alcohol is considerably more concerning given its sugar content and thus potential to activate dormant cancer cells. Other glucose related diseases from an excess of dietary carbohydrates, can over time create AGE's or 'advanced glycation end products', which in turn can initiate both inflammation and the stimulation of cells to proliferate (potential cancer), as well as autoimmune responses, diabetes being one of them. Another person whose body experiences a high daily aerobic exercise component handles alcohol quite differently than a couch potato. And so on.
7
This is an absolute fallacy. There is no sugar in most alcohol, including beer and spirits, and very little in beer. There are some carbs in beer, but not very many and the glycemic index is extremely low. Eat a balanced meal with your beer and the chances of any dangerous elevation of your blood sugar disappears.
Most of the calories in alcoholic drinks come from the alcohol itself. Mixers are a different story if you use juice or soft drinks.
But this is another misguided post on the evils of alcohol and it is incorrect.
4
Since a sizable portion of the public are cancer survivors, it was unfortunate that in an article on cancer and alcohol, no mention was made of the well-established fact that alcohol intake increases the risk of metastasis of cancers. Most rational cancer survivors who are aware of that link avoid any level of alcohol consumption, for good reason.
21
Sorry Ed, this is not a "well-established" fact except in animal models of cancer. The evidence for it is slim to none in humans. See review from 2015 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590626/, which also reports that modest increases in risk of cancer associated with alcohol is true for only some cancers (esophageal, laryngeal, pharyngeal, stomach, colorectal, liver, pancreas, lung, prostate, breast, central nervous system, and skin cancers) while it is lower for the blood cancers (leukemia, lymphoma etc) and for kidney cancers. The increased risk of alcohol for esophageal, laryngeal and stomach cancers is highly confounded by smoking. Light alcohol consumption (1 per day for women, 2 for men) lowers the risk of cardiovascular disease, a far larger cause of death than cancer.
3
"...modest increases in risk of cancer associated with alcohol is true for only some cancers (esophageal, laryngeal, pharyngeal, stomach, colorectal, liver, pancreas, lung, prostate, breast, central nervous system, and skin cancers)..."
That'a pretty long list "for only some cancers", but if you feel the need to defend alcohol consumption, go right ahead.
1
A glass of brown a day turns that frown upside-down.
9
Headlines like: "Study shows even 1 drink per day can increase a woman's risk of breast cancer" is exactly why science is under assault in this country. We need more thoughtful artickes (like this) and less hype designed for sharing and clicks.
55
No, science is under assault because of underfunded schools, evangelicals in government and oil companies funding dodgy research. People don’t understand the numbers.
8
Not to mention that the pursuit of eyeballs by the media leads to hyperbolic and misleading headlines.
1
Science is not under assault in this country because of a few poorly articulated articles. Science is under assault in this country because science is contrary to the anti-environmental and anti-public health practices that deep pocket interests like the coal industry and pesticide industry want to pursue, and those interests have captured politicians, especially Republican politicians, and because medieval religious groups insist on irrational interpretations based on false premises to drive their misogynist and mostly anti Christian agendas like their war on women's rights and women's right to control over their won body, their war against the poor and unfortunate waged by supporting right wing reactionary Republicans (almost all in office today, the sensible moderate Republicans driven out of office long ago) and their hypocritical insistence on creationist beliefs while being perfectly happy to accept the benefits of modern medicine based on evolution. Follow the money and Talibanistic right wing religious sects of any faith and you will know why science and common decency are both under assault today. And frankly, the people leading the war on science mostly do not read the NYTs, getting their hodgepodge of half truths and out right lies from right wing talk radio and Fox/aka "fake" news.
1
Sigh of relief.
12
I really appreciate the number crunching and analysis in this article. Even as a science writer myself, it's easy to think "everything causes cancer" sometimes!
The thing that's really high on my wish list, study-wise, is a multivariate analysis of various known or strongly suspected carcinogens occurring together - to suss out synergistic effects. For example, for a light-drinking vegetarian, the risk of cancer could be X. But if the same person lives in Mumbai, with all that air pollution the alcohol raises the risk to 3X.
The possible permutations are endless, but it would be good to start somewhere. (I know combinations and synergies do get tested, but we hear less about them than isolated factors - with good reason.)
24
Interestingly, for report on cancer and alcohol consumption, the well-established fact that alcohol increases the risk for metastasis (the spread) of existing cancers was not mentioned. This is of particular import to people who have been successfully treated for cancer, but are susceptible to return of the cancer, which always begins in imperceptible amounts of cancerous cells.
After reading this report, they would be under the impression that moderate drinking will "protect" them from return of the cancer.
17
This was an extremely well-written piece that used data properly and in so doing put some proper perspective on the sensationalism of the earlier article to which it refers.
As someone who did research and stats for many years, I have always thought that a lot of medical research is ill-conceived, doesn't take other factors into play and draws conclusions out of thin air.
Thanks for the rationality.
82
After I finished chemo for stage three breast cancer, my oncologist said exercise, eat healthily and drink moderately, and ENJOY your life. And that’s it. Next.
154
"... my oncologist said exercise, eat healthily and drink moderately, and ENJOY your life." - elizabeth
As a cancer survivor I recommend leaving out the 'drink moderately' part of this equation, unless you want to revisit the chemo ward.
2
The risk of cancer recurrence from alcohol is minimal to nonexistent for humans (see 2015 review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590626/). The ballyhoo comes almost entirely from animal model studies where the cancer is transplanted or induced, hardly the human situation. Do what you like but this cancer survivor plans to continue to have the life I have left enjoying my daily wine or scotch or occasional beer.
8
Not sure what constitutes a survivor in your book - it's been 9 enjoyable years for me so far. Best wishes on your journey.
1
Thank you for this.
It would really help to remind everyone, in simple every day terms and definitions, what moderate drinking is. The new British guidelines recommend no more than 14 "units" per week but it takes extra research and cross-referencing to figure out what that is in glasses of wine, mugs of beer, shots of whiskey.
And then we get into the issue of portion sizes. Some glasses and mugs actually dispense twice the recommended volume.
10
Wine glasses have indeed gotten larger. In a very lovely very upscale restaurant ( prix fixe $105 per person before drinks ) I actually had to beg for a water glass for my wine. This was not because I was so worried about the amount ( I was not driving ). It was because I am older, have quite bad arthritis and small hands.
I could not comfortably hold the glass. So these vague measurements are not helpful when it is wine.
I also think that the number of wine drinkers writing in to defend themselves is notable. Liquor drinkers know it is bad for them and are seldom commenting here. Beer drinkers , and I am one, pretty much think that it is good for us except for the calories .
I took statistics in grad school . I am not too worried about the increased risk of esophogeal cancer . I am willing to admit to the ongoing weight gain issue though.
7
Beer is good for me, except for the calories, which is why I don't eat ice cream.
2
There's a lot of carbon in alcohol. It's therefore a potent source of "carbs."
Do you have evidence for the liquor statement? I don't drink it so I have no dog. . . The one longevity study I recall regarding the Leisure World senior community found some alcohol was good, but the type of alcohol didn't matter. Whiskey. . .beer. . . wine. . . all the same. We just don't have a whiskey culture here in the US of A.
What took me aback about this study was the way "heavy drinking" was defined. Eight drinks a week or more for a woman is "heavy drinking"? So if I had a glass of wine every evening and added a beer on Saturday afternoon, I would be a heavy drinker, despite never having caught a buzz.
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I'm an MD and I would consider even 7 drinks a week too much for people, especially as they age. This article is interesting because I think it downplays the risks of alcohol too much. A lot of older people take medications and have other conditions (high blood pressure for one) that ARE affected by alcohol. For older people, alcohol also does not help with cognition, increases the risk of osteoporosis, and increases the risk of falls. In fact alcoholism rates are up for older patients.
Also, you would think from commenters on the prior article that all Americans drink but the stats are that a third of Americans do not drink at all. And the anger/ annoyance expressed by some commenters towards ASCO findings makes me think they really need to think about whether alcohol plays too large a role in their lives.
Finally a BMJ 2015 article found wealthier, more educated, active elderly are at higher risk for alcoholism than average, opposite of what people might think.
http://bmjopen.bmj.com/content/5/7/e007684.full
9
Exactly. The health science lit and standards invariably put forth levels befitting a petite Carmelite nun, rather than the rest of us in the real world.
5
The narrowing of the range parallels how MADD keeps pushing for the equivalent of a sip of alcohol to be illegal for drivers (while ignoring the huge numbers of drivers under the influence of opioids).
3
It seems like whenever you ask a doctor about some such study in the news of the indicated course of action, “Would it help?” he pauses to reflect, before responding, “Well, it wouldn’t hurt.”
2
Of course the American Society of Clinical Oncology's (ASCO) warning means little to the individual considering his/her own behaviors. It's not intended to tell individuals to change their behavior. Dr. Carroll is right, for any individual, modulating alcohol intake a bit higher or lower is unlikely to make any difference. This is a *public health* recommendation. This means it's intended to communicate the population-wide impact of society making a change. If we could shift society as a whole toward drinking less, fewer people would get cancer. The stated goals of the ASCO statement are that it informs policy, education and research. I applaud ASCO for taking a public health perspective. Too often we are stuck in an individual health/healthcare mindset.
17
I'd say it's more a matter of how MUCH we eat, rather than what we eat. Moderation is the key word, here . . .
3
The discussion is about alcohol not food consumption. Eh, what?
Then just change 'eat' to 'drink.' It's still about moderation.
I'd like to know if Aaron E. Carroll or Indiana School of Medicine have financial ties to the alcohol industry. Indiana University has made massive offshore investments to avoid taxes (see NYT Nov 8th article). Not the most reputable research funding source!
3
I am always amazed at people who think any funding to any portion of a large institution biases every professor who works there. Anyone who understands how academic research programs are structured would understand that a grant from the alcohol industry to a researcher unconnected to Dr. Carroll would have no influence on him at all -- other researcher's funds won't pay Carroll's salary, fund his students, or buy a single pipette for his laboratory.
1
Aren't moderate drinkers less likely to die because of cardio-vascular problems than is the average? Those drinkers will have to die for some other cause. Isn't the most likely of other cause cancer? Don't moderate drinkers have a higher life expectancy that non-drinkers? The moral is, if you want to increase your life expectancy, be a moderate drinker; but expect that you are more likely to die from cancer than from a heart attack or stroke.
16
Aaron Carroll apparently is balancing his joy of alcohol with the Beverage Industry’s party line on how a neurotoxic, hepatotoxic, addictive, known carcinogen can be healthful.
No thanks, my mind actually still works.
16
Did you understand a word of what he wrote?
2
You sound like loads of fun! Want to grab a drink??
We well since I already am a stage 4 cancer patient the last thing I’m going to do is stop drinking....it’s pretty much the only vice that’s open to me these days....
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"cohort study of about 6,000 people found that those who drank at least once a week had better cognitive function in middle age than those who didn’t." Offered as anecdotal evidence, I give you Donald Trump
42
Bingo. Someone drags Trump into even this article.
It's clear to me from your tone and content that you are a wise and thoughtful scientist. It is also clear from numerous stories I've seen lately that some scientists are neither wise nor truly thoughtful (thought-filled maybe).
My conclusion is that yesterday's story was not fit to print. So my question is: what was it doing in the New York Times? I guess, technically, the motto "All the news that's fit to print" is not precisely equal to "No unfit news". But wouldn't it be nice if we could trust the NYT to screen out unfit news? (I'll avoid the current buzz-phrase.)
Here's my proposal: the NYT should hire Dr. Carroll and a half-dozen similarly wise and thoughtful scientists and create a Department of Scientific Quality Control. The payoff would be enormous: think of all the wasted time, ink and anxiety that would be saved. The priceless clarity (even wisdom) gained. I for one would gladly pay $1/month more for my subscription. How 'bout you?
11
That's been done.
Health News Reviews
https://www.healthnewsreview.org/
Thank you, Dr. Carroll, for this breath of fresh air! Or I should say, fresh statistical wisdom. I worry when I read the articles about risks, and I don't want the hopelessness they sometime seem to imply to cause me to throw the baby out with the bath water. I read your articles every time, and they never fail to strike me as balanced good sense, and always help to reduce any budding cynicism the last alarmist report provoked. Moderates are hard to find these days; you're my favorite.
9
If research isn't significant, why is the NYT reporting on it?
10
I think we are all looking for the magic formula that will keep us safe from cancer. It would be great if research could give us a regime that protected us. My gynecology oncologist just told me that a good diet and exercise are just good old common sense for healthy living but are not protective. He said this from a research perspective. I didn't like the news that I can't reduce my chance of recurrence with life style choices but you can be sure that I am not going to tax any of my systems with moderate to heavy drinking, smoking or excessive sugar!
1
Of great importance I think is how most doctors use information like this ASCO report when advising patients about making meaningful improvements to their longevity and quality of life. Is Dr Carroll's POV predominant or the exception? In any event, thank you Dr Carroll for giving your readers a dose of reality.
3
What a succinct, sensible article! This is why people need to take statistics in high school. Even one year in the subject would provide enough foundation to illuminate so many of the stats-based arguments (or obfuscations) we all encounter in the news each day and as we plan our lives and try to weigh risks and alternative courses of action.
17
An introduction into the idea of chance and statistics should, and could, come much earlier than high school. It is the math skill most needed in society. [Calculations can be done on a phone, few use calculus... But we all have to consider risks.
Excellent work. Almost everyone interested in understanding such risks should read the recommendations at the end of the article.
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My mother was a heavy drinker from about age 35 till she died at age 95 from a sudden heart attack. She never had a cancer scare. Nor have I, even tho I was a heavy drinker and smoker for about 40 years.
6
Like father like son
The same "cherry picking" occurred with respect to the dire consequences that supposedly accrue to hormone replacement therapy (HRT). The main women's study (NIH?), published in the NYT a few years back, focused on increases in relative, not absolute, risks. A great hew and cry ensued. It took a Scientific American article to correct the scary implications suggested by the reported results.
3
I think the results of the HRT study were very helpful although they were carried too far. Before the study, the belief was that HRT was protective against heart disease and it was being actively pushed on all women of menopausal age - I know, because I was pushed to take it, although I had no menopausal symptoms (I know, I'm one of the lucky ones). OB/GYN offices all had glossy brochures urging their use for all women. When the study came out, this changed drastically and did result in better health outcomes for women overall, although some women then suffered needlessly from hot flashes. So a corrective was necessary, in both directions.
5
Here is a link to a starting point regarding correlations between alcohol consumption and longevity and quality of life issues: https://www.medicalnewstoday.com/articles/199398.php.
I would like to see a graph that ranks the above average cancer risks based on quality studies, corrected for variables including gender, diet, exercise, stress, economic status, etc. My guess is that the cancer risk from alcohol consumption would reside well below dozens of other cancer risk factors. The alcohol in that glass or two of wine, beer or scotch, moderately consumed, likely contributes to greater longevity from the psycho-social benefits that millions of humans derive from social drinking.
8
"Once again, we’ve been told that something we eat or drink is going to kill us." I understand that this statement was not written in total seriousness, but when discussing medical topics, it was poor journalism and poor editing on the Times' part. The increase in drinking among many segments of the population will lead to increased alcohol related cancers, not to mention liver disease and driving accidents. There is a difference in considering medical issues as public health problems and as individual medical problems. Most people taking opioids for short term pain relief will not become addicts. That doesn't mean it's not a public health problem. As a cancerphobe who greatly enjoys alcohol in many forms, the original Times story was helpful in balancing my risk-reward decisions.
4
Alcohol is not a food, it is a drug - a chemical drug. And like trans fatty acids, it is the result of taking a natural substance and putting it through an extreme level of processing - turning it into something most unnatural. Alcohol has killed millions across the world, destroyed countless individuals and families, created horrific childhoods and cost our medical care system more than almost anything else. Cancers in some is only one of the myriad of thing attributable to it.
For those preaching moderation, that is fine for you maybe - but it is a DRUG and as mentioned here, many people drink much more of it than they admit. There are many levels of alcoholism on the spectrum and it's always interesting to see people justifying their use of this drug.
From the load it puts on the liver and kidneys when the body is trying to get rid of it even in the 'moderate' drinker, to the excess empty calories, to mood changes - the justification that "a few glasses of wine are good for the heart" is just so much BS.
If you are concerned about your heart health and need to relax, go to a yoga and/or meditation class. Unnatural chemical drug use cannot be compared.
32
Well there's actually a big difference between alcohol and trans fatty acids, alcohol exists in nature in the form that we drink. All we are doing is concentrating it, but its original, 'natural' form is unchanged. Fermentation of sugars into methanol is a very common metabolic pathway among living organisms. Trans fatty acids do not exist in nature and that is why our bodies can't metabolize them properly.
37
Alcohol is a natural result of fermentation of almost any sugar source. Usually fruit. Your "extreme level of processing" takes place in nature, often on a forest floor, in combination with wildly occurring yeasts. Apes and elephants in the wild are just two of the animals that partake of alcohol.
So much for your "unnatural...chemical drug".
38
I will continue to take my chances with a cocktail, rather than risk the well-documented dangers of yoga: http://www.nytimes.com/2012/01/08/magazine/how-yoga-can-wreck-your-body....
2
If you're female, and getting old, never had children or had them late, you're exactly the demographic making up the one-in-seven, or one-in-eight women who come down with cancer--even if, like me, you exercised, ate your greens, and breast-fed three children. Cancer is commoner than the cold. Enjoy your occasional, even nightly, glass of red wine.
http://www.thecriticalmom.blogspot.com
3
There is something wrong with telling people that if they are in a demographic that is more likely to get cancer. they should go ahead and increase their chances of getting this dreadful disease, don't you think?
Here's what else we can do: demand that our media stop publishing clickbait scary headlines about minimal risks. (I noticed with satisfaction that this was the most common response in comments to the original article.) The 'well' page has become an example of what not to publish. Thank you for this corrective.
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Yes - 1,2,3,4,5 - taking ethanol also increases your risks of heart disease, stroke, high blood pressure, memory and learning problems, depression, anxiety, insomnia, contraction of STD,s etc, as well as of committing or suffering any number of acts of violence, and of being involved in every shape of accident. The CDC estimates ethanol use leads to 80,000+ deaths a year; personally, I nix the bottle for the problem of thinking you,re having fun when you aren't. https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm
11
Put it on the sulfites risk label on the bottle. We know how much that changes behavior.
2
What's "heavy" drinking?
3
Just a bit more than I do, I think.
43
Dear Steve, GREAT response. A good chuckle on Saturday morning.
2
thanks for reminding us all that life is about tradeoffs and trading off enjoyment for longevity is too individual for anyone else to make our rules. As with choices about medical care near death... it is up to us to determine the value of care.
5
When I read the alcohol-cancer article in the Times yesterday, I commented that it failed to address the relative risk question. This article answers that objection perfectly. Thanks for the perspective that was missing.
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Hi
Thank you Prof. Carroll for your enlightening comments. There is no such thing as zero risk in whatever we eat or drink, including pesticide treatment of food over which we have nothing to say other than not buy it. This also applies to people who swear by so-called vegetarian diets.
Some physicians in the US refuse to acknowledge the benefits of light drinking of red wine with meals in the prevention of cardiovacular disease They prefer to operate in am ideal world where big pharma markets synthetic versions of grape seed known to prevent atheroma in humans. As a retired physician living in Europe, where common sense wine drinking is common and longevity exceeds that of the US, it does a disservice to ordinary people with no medical training to constantly trumpet the findings of some studies which seem to identify alcohol as a 'killer". Prof. Carroll's explanation of how statistics cqn be used to support extremist conclusions based simply on observattional data should be an eye-opener to the lay public.
BOB, MD
1
Prevent cardiovascular disease by eating right, keeping down cholesterol , high blood pressure and your weight and visiting your doctor regularly for testing.
No negative effects in this strategy.
1
EFM, also choose your parents wisely!
Thank you for putting this in perspective. The original article should have included this evaluation. The real concern should have been the relationship between alcohol consumption and inflammation.
6
Here's one known fact. Life is the leading cause of death. In fact, studies have show that life causes death in 100% of people. Therefore life must be avoided at all costs. Eliminate life and you will not die.
My point here is that avoiding alcohol will not ensure everlasting life. Certainly, do not drink heavily. But a glass of wine or even a half a bottle, will not lead you to your death. Death is coming no matter what you do. that's it. So ignore the asinine articles proclaiming that Alcohol, red meat, chicken, Alaskan Salmon, Catfish, Roasted vegetables, weightlifting, skateboarding, surfing the net, walking on cobble stone, may lead to your death.
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Bottoms up !!! Enjoy life .
7
One should add to that: "Everything in moderation". And to enjoy life, get lots of sleep and have a balance or stress and ambition for achievement that is right for you.
2
Slipping on the soap in the shower might be deadly too.
4
I am sure a direct correlation can be made between oropharyngeal and larynx cancer and esophageal cancer with those who habitually drink straight shots of of whiskey, rum, tequela and vodka, even if followed by so-called: "chasers." That ache in the throat the morning after is the warning sign. This correlation was observed by my late mother, a registered nurse during the post-WWII era, when shot glass drinking was the 'manly' thing to do.
3
It seems that it all comes down to the sugar content in alcoholic beverages. Sugar causes inflammation in the body and compromises the immune system. And processing too much alcohol can overwhelm the liver. Many who are not happy with their nightly wine habit have done 30-day challenges involving no alcohol, no sugar, and eating clean---and the craving for sugar and wine actually goes away. I thought I was an alcoholic because of the nightly wine routine, but really, it was just a carb/sugar addiction. Now I can have one glass of wine if out for dinner (don't have any wine on hand at home), and stop at that because I don't love the taste any more. Our bodies actually crave the good stuff, if we give them a chance. Try it and you'll see. Danette May has a good 30 day challenge.
10
Another urban myth. Dry wine and spirits actually have a relatively low carb count. The sugar in the grape or grain has been converted to alcohol. Maybe one of the reasons light to moderate drinking decreases diabetes risk is that alcohol satisfies our sugar craving without the sucrose. Ans, as illustrated above, one reason it's good to forgo both sugar and booze if you want to reset your craving for either.
7
Moderation in all things, perhaps the best and simple guidance. and while I appreciate the message in this news story, I am reflecting on news that another friend of mine just died from complications owing to Liver failure, as such I didn't this news very encouraging - the relatively weak link between cancer and alcohol is cold comfort, while I believe that the more certain and direct link between alcohol consumption and Liver disease should be the main focus of the story folks are reading about.
I'd like more news about cancer prevention on basis of active lifestyle and modified diet to avoid processed foods, reduced meat and dairy, and yes, an occasional glass of wine or mug of beer, by all means.
4
Excellent lesson on risk factors. Hoping the other NYT writers read this, and stop putting out scare stories based on minuscule actual risk factors.
140
After my new right hip surgery this past summer I was loaded with Opiods! I rejected all but some Hydrocodine in favor of wine! I shall stick with the wine. It has a long history.
72
Good to see that the time from the latest scary headline to the inevitable "not so fast" is getting shorter.
86
Having been with someone with neck cancer and the dramatic, horrible treatment (lucky to be alive from cancer now), and who drinks several every day, I think you do a disservice. Drinking a lot each day over time is also key. It's not about only how much you drink this year, it's cumulative drinking over time. And these are horrible cancers, and horrible treatments if you are lucky to survive.
21
That news scared me - thanks for your analysis.
This one's for you!
40
The NY Times and other media need to give the public more specific information about alcohol's carcinogenic property.
How many readers know that for nearly 2 decades the NIH has published a List of Known Carcinogens with alcoholic beverages on it?
See https://ntp.niehs.nih.gov/ntp/roc/content/listed_substances_508.pdf
16
Correlation and causation. Relative risk and absolute risk. The later are for serious thought, the former generates grant money for researchers and ad revenue for publishers. This perspective should have been included with the original “chicken little” story.
14
Correlations are useful indicators for where to look, and in humans are often the only ethical option
3
Science is basically finding out what we knew from the Stone Age i.e. abuse of a vice will usually give you trouble and vice in moderation is usually ok.
Every now and then science will come through with a breakthrough like with polio, heart bypass surgery, etc. etc. but for every one of these they will come up with, they will also come up with nine other useless or obvious findings and make you take a million tests and new diets and new procedures or even hurt or kill you.
The trick is to know the difference between the two.
9
The core problem here is that when the media, and, sometime, researchers, run after click bait and don't provide information in a way that is accurate and that acknowledges clearly what we know and do not know, it strengthens the ability of people to be manipulated by false information (such as claims about homeopathy) and resistant to true information (such as the safety and effectiveness of vaccines).
17
Wine drinkers generally drink more than they realize. Safe wine consumption recommendations are based on a 4 to 5 oz pour, depending on the alcohol content of the wine. Most people, including our friendly bartenders, pour a third to 50% more per glass. Your actually drinking almost 2 glasses of wine - in one pour. If you're a 2 or more glasses for "drinks and dinner" type of wine drinker, and you're actually consuming 3, 4, or more glasses, then, over time, liver disease is probable. Behavioral cancers, cirrhosis and other self induced illnesses are always regrettable. Be sure to get a blood panel/liver enzyme screening test on an annual basis if you are a daily or frequent alcohol consumer.
49
Thank you. There is some denial here among light drinkers who have the habit off daily and nightly drinking. i do not dismiss alcohol and its metabolite acetaldahyde as known carcinogens. If you are in the small increase in cancers due to your drinking it is likely due to your habit.
2
People underestimate their drinking and meat-eating, and overestimate their exercise levels!
2
Thank you for putting these risks in perspective. However, these risks are huge in comparison to the levels the government considers "acceptable" when regulating chemicals and environmental exposures. EPA, for example, routinely regulates whenever cancer risks exceed one in a million. (or at least it used to before this administration took over)
21
Thanks for the statistics refresher. I am another that follows the moderation line of thinking. The problem that I have seen is that "moderation" in alcohol progresses from a glass on Friday night to a half a bottle every night in a relatively short time period. I don't believe an 8 oz glass every night is moderate, but most regular drinkers of my acquaintance disagree.
27
I intuit that your observations on moderation are personal. How else to explain the leap from a Friday night glass of wine to half a bottle every night. I reckon that you are very aware of the amount of alcohol everyone ingests when in your company. In your opinion, how many ounces of wine constitutes moderation?
And how do we explain that in some countries a glass of wine for lunch and dinner is perfectly normal?
3
SW,
Your comment supports the author's point: life seldom offers us easy choices. Depending on multiple genetic, developmental and environmental factors, just about anything we eat or drink can have both positive and negative effects. This is especially true of alcohol, in proportion to how much we drink.
The boundaries between 'light', 'moderate' and 'heavy' alcohol consumption are fuzzy, yet the terms are useful. Relatively light drinking appears to somewhat reduce the risks of diabetes, cardiovascular disease and some cancers, while slightly increasing the risks of some other health problems. Relatively heavy alcohol use, OTOH, is clearly associated with a wide range of negative effects, in proportion to the amount of alcohol consumed. It also appears some, but by no means all, light-to-moderate drinkers are at risk of becoming heavy drinkers. Unfortunately, it's not always possible to know in advance who is more likely to become alcoholic. We are left to find out the hard way.
The bottom line is that people who live long, healthy and happy lives successfully trade off the various risks of eating and drinking with their subjective benefits, as they do the rest of life's innumerable other hazards and rewards. Regardless, success depends not only on personal responsibility, but even more on a measure of luck. *C'est la vie*!
I always appreciate perspective and relative statistics. But we also know that you can load the dice towards worse or better health with your lifestyle. Thanks for this helpful article.
26
Thank you for de-escalating the attention grabbing announcements with clear statistical analysis.
I'm a lifelong believer that moderation is the key. One drink. An occasional piece of pie.
I've lived long enough to have been told to play outside in the sun without protection, ride a bike with no helmet or knee pads, and eat eggs without worries of cholesterol- oh, but eggs have been redeemed again.
The world is not "black and white" and while there are some things that are bad for you, but demonizing everything is not the answer.
Eat well, exercise, get a good night's sleep, hug your loved ones. That's the best you can do. Oh, and if you enjoy a glass of wine with dinner, that's OK.
178