Reality Health
By Dr. Sara Levine
Dear Doctor Levine,
My girlfriends drink wine every night at dinner. I keep
telling them that alcohol causes breast cancer, but they claim that
alcohol is “heart healthy.” According to them, alcohol
will prevent diabetes along with a variety of other maladies. Something
just doesn’t sound right about this. What’s a girl to
do?
Alcohol consumption in moderation may decrease the risk of a number
of medical conditions, including coronary heart disease, diabetes,
hypertension, congestive heart failure, stroke, and dementia. However,
there is a significant accumulation of medical studies that support
an association between breast cancer and alcohol intake. A recently
published study at Kaiser Permanente Medical Care Program studied
the drinking habits of 70,033 women, and found that drinking more
than three alcoholic drinks a day increased a woman’s breast
cancer risk by 30%. Even women who drank 1-2 drinks per day had a
10% higher risk of breast cancer than those who drank less than 1
drink per day.
One drink means 12 oz. beer, 5 oz. wine, 1.0 oz. of 100 proof spirits,
and 1.5 oz of 80 proof spirits. Each of these contain between 13 and
15 g of ethanol. For women, 1 drink per day is considered a moderate
alcohol intake when looking at data for decreasing risk of heart disease.
When it comes to decreasing one’s risk of breast cancer by limiting
alcohol intake, avoiding habitual daily alcohol intake is appropriate.
Your friends might find it important to know that the recent Kaiser
study found that alcohol type had no impact on risk of breast cancer
risk. Total alcohol intake was the crucial risk determining factor.
Your friends are not binge drinkers. Binge drinking is a form of
alcohol abuse and has never been shown to provide any health benefit.
Binge drinking increases one’s risk of myocardial infarction
(MI) and overall chance of dying. Even though your friends do not
drink heavily, using health as a sole reason to drink alcohol is going
a bit overboard. Even a 10% increased risk of breast cancer from such
intake is frightening. Most women are not heavy drinkers. Only 4%
of women drink more than three drinks daily. 4% seems like a small
number, but when you look at a 30% increase in breast cancer risk
in this group, this may lead to 3-5% of women developing breast cancer
due to alcohol intake alone.
An extensive review of data on 1 million individuals showed that
moderate alcohol intake was associated with an overall risk reduction
of total mortality by 18%. Other studies have shown a risk reduction
of coronary heart disease by 30-35% and of new onset diabetes by 30%.
Weighing risk versus benefit is key to interpreting this conflicting
data on a personal level. If you have first degree relatives with
breast cancer, even a 10% additional increase in breast cancer risk
will be more significant to you. If you have a genetic increased risk
for heart disease, but not breast cancer, you might feel more comfortable
drinking a glass of wine with your dinner. Drinking more than this,
however, will not confer any positive health benefit. If you choose
to drink a glass of wine nightly, you might find it helpful to take
a folate supplement. There is some evidence taking folate might reverse
the increased risk for breast cancer in those with a higher intake
of alcohol.
Alcohol intake is not the panacea that your friends describe. As
discussed earlier, even a moderate amount of alcohol might increase
one’s risk of developing breast cancer. There has not been a
randomized controlled trial of alcohol’s effectiveness at improving
overall health. Fortunately, there are quite a number of inherently
safe alternative changes that one can make to decrease health risks.
For those who drink a glass of wine nightly, a better idea might be
to consider increasing exercise time or decreasing intake of cholesterol
laden food. Obesity increases risks for heart disease and breast cancer.
This does not mean that consuming alcohol occasionally is a problem.
For those women who enjoy an occasional spirit, a more reasonable
alternative might be drinking a better wine a few times a week, rather
than making it a nightly habit. In life, it always makes sense to
pick quality over quantity.
Sincerely,
Sara Levine, M.D., F.A.A.P.
Dr. Sara Levine is board certified by both the American Board
of Internal Medicine and the American Board of Pediatrics and has
been practicing medicine for more than nine years. She graduated summa
cum laude from Case Western Reserve University and was elected to
Phi Beta Kappa. She received her M.D. from Case Western Reserve University
School of Medicine. She has completed Advanced Clinical Education
in Child and Adolescent Obesity from the University of California,
San Francisco. Dr. Levine is in private practice in Boca Raton
Please email all questions to drsaralevine@bellsouth.net
|
|
