Skip to main content

Update on wine and breast cancer

With breast cancer awareness month upon us again, it’s fair to ask what we have learned about prevention and treatment, and for wine drinkers, it remains a confusing picture. It’s clear that heavy alcohol consumption increases risk, not so certain whether moderation – especially wine – is all that bad; it might even be good. On one hand, the message from the medical community is unambiguous: any level of drinking increases the odds of developing breast cancer. On the other hand, at moderate levels of drinking, cancer risk is extremely difficult to measure with confidence, even more so with wine. Here’s why I think a daily glass or two of red wine with dinner is still a healthy choice:
  •   A recent study from the University of California San Diego[1] looked at survival and recurrence after breast cancer treatment, finding that light drinking had no correlation. Moderate alcohol intake was “protective against all-cause mortality” in non-obese women.
  •   There appears to be no breast cancer risk of drinking in premenopausal women, according to a very large European study involving more than 66,000 women followed for 15 years.[2] In postmenopausal women, the risk became clear at more than 2 drinks per day, but as with other studies this was seen mostly in overweight subjects.


How red wine might protect against breast cancer

  •     In order to confirm a possible correlation between alcohol and breast cancer, a plausible cause-effect relationship needs to be demonstrated. The prevailing idea is that alcohol elevates estrogen levels via enzymes called aromatases. Aromatase inhibitors (AIs) are commonly prescribed for prevention of cancer recurrence, and interestingly red wine contains natural AIs. A clever study[3] from the Women’s Heart Center at Cedars Sinai in Los Angeles tested the idea that wine could be an anti-cancer agent by assigning women to have an 8-oz glass of either red or white wine daily for a month, while monitoring hormone levels. The two groups then switched from red to white or vice-versa. The researchers concluded that red wine is a natural AI in premenopausal women, providing an explanation for its possible protective effect. The strength of this particular study is that drinking was carefully measured and consistent, rather than reliance on self-reported questionnaires.


  •               This pattern of regular, moderate, exclusive consumption of red wine is unfortunately not typical in modern society, making it increasingly difficult to suss out from population studies whether their risk profile is distinct. The best evidence is still from a 2008 study in southern France, with a population of consistent wine drinkers.[4] There was a clear J-shaped curve, with an unequivocal benefit to moderate drinking. It was the nondrinkers most likely to get breast cancer.
   

Why we should make the pink ribbons red

We would do well to remember that despite all the fear and publicity around breast cancer, heart disease remains far and away the biggest threat to women’s health. Even if there was a risk of breast cancer from wine – a debatable supposition – it is almost certainly cancelled out from the benefits to heart health. Let’s make the pink ribbons red.




[1]Low to moderate alcohol intake is not associated with increased mortality after breast cancer.
Flatt SW1, Thomson CA, Gold EB, Natarajan L, Rock CL, Al-Delaimy WK, Patterson RE, Saquib N, Caan BJ, Pierce JP. Cancer Epidemiol Biomarkers Prev. 2010 Mar;19(3):681-8.
[2] Alcohol consumption and breast cancer risk subtypes in the E3N-EPIC cohort.
Fagherazzi G1, Vilier A, Boutron-Ruault MC, Mesrine S, Clavel-Chapelon F. Eur J Cancer Prev. 2015 May;24(3):209-14.
[3] Red versus white wine as a nutritional aromatase inhibitor in premenopausal women: a pilot study.
Shufelt C1, Merz CN, Yang Y, Kirschner J, Polk D, Stanczyk F, Paul-Labrador M, Braunstein GD. J Womens Health (Larchmt). 2012 Mar;21(3):281-4.
[4] Patterns of alcohol (especially wine) consumption and breast cancer risk: a case-control study among a population in Southern France.
Bessaoud F1, Daurès JP. Ann Epidemiol. 2008 Jun;18(6):467-75.

Comments

Popular posts from this blog

How globalization of drinking habits threatens the French paradox

It seems that the more studies we see on the relationship between wine and health, and the larger they are, the more contradictory the results. Headlines summarizing comprehensive international studies declare the French paradox dead, and all alcoholic beverages are equally detrimental. I think there is an overlooked explanation for this: over the past several decades, convergence of drinking patterns around the world has separated wine from its role as a daily part of a meal. Globalization has commoditized our views about drink, toppling it from its role as a culturally specific emblem. Global convergence of drinking There are several recent reports summarizing the trend,[i],[ii],[iii]and it applies for both developed and developing countries. Since the early 1960s, wine’s share of global alcohol consumption has more than halved, declining from 35% to 15%. Beer and spirits have taken up the slack, with beer gaining 42% and spirits adding 43%, both large gains. The bigger story howeve…

Wear red and DRINK red for women’s heart health

This Friday Feb 2nd is the annual “wear red” day in Canada and the U.S. to raise awareness for women’s heart health. Why only a day for the number one threat to women’s health? Women are 5 times more likely to succumb to heart disease than breast cancer, which gets a whole month (October.) Another contradiction is that the advice women hear about prevention of breast cancer is the opposite of what you can do to lower the risk of heart disease: a daily glass of wine. Even one drink a day raises your risk of breast cancer, we are told, ignoring the overriding benefits of wine on heart health. Drink red wine to live longer Here’s why I think women should also “drink red.” For starters, wine helps de-stress and celebrates life. Stress is a factor in heart disease, and if that were the only way wine helped it would be worth considering. But the medical evidence is also strong: a daily glass of red wine helps raise the HDL “good cholesterol” levels, which lowers the risk of cardiovascular p…

Which types of wine are the healthiest?

I am often asked after lecturing on the healthful properties of wine which type is best to drink. Since much of the discussion has to do with the polyphenol antioxidants from the skins and seeds of the grape, red wine is the first criterion since it is fermented with the whole grape rather than the pressed juice. This allows for extraction and concentration of these compounds, familiar ones being resveratrol and tannins. But beyond that, which varietals have the highest concentrations?


According to the Roman philosopher Pliny the Elder, “The best kind of wine is that which is pleasant to him that drinks it” but modern science expects more specifics. (The point of course is that if you have a wine that you enjoy you are more likely to drink regularly and therefore reap the benefits.) But there are several difficulties in singling out certain wines for their healthful properties. Which compounds to measure? Are we talking about heart health or the whole gamut? Is it the varietal of the …