The latest critique from ISFAR considers research linking alcohol consumption and other cancer risk factors

The latest critique from ISFAR considers research linking alcohol consumption and other cancer risk factors

It has been shown in most studies that moderate drinkers - especially those who generally consume wine - tend to have other 'moderate' lifestyle factors. For example, they tend to be better educated, of higher socio-economic status, and generally are more active and eat a healthier diet than non-drinkers.

One exception, however, is cigarette smoking, which tends to be more common in drinkers than in abstainers.

Epidemiologists studying alcohol and health are always striving to adjust appropriately for other lifestyle factors, attempting to assure that the difference in health outcomes among subjects relates to their drinking, and not to associated lifestyle factors.

In a recent study, investigators related alcohol consumption to a large number of socio-demographic and lifestyle factors that relate to the risk of cancer. They report that several factors were associated with alcohol consumption =10g/d in both genders: older age, smoking, higher socio-demographic category, higher income, and less healthy dietary intakes. Other factors were associated with alcohol consumption differently for men and women.

The authors then report that the total number of such factors was higher among consumers of =10g/d of alcohol than among abstainers or lighter drinkers. They conclude: “The multiplicity of deleterious lifestyle behaviours combined with alcohol drinking must be taken into account in cancer-prevention efforts. Gender-specific medical advice for people with personal or family history of alcohol-related diseases, including cancer, should be strengthened.”

While ISFAR forum reviewers found the data presented in this paper to be of interest, they did not believe that simply adding up all adverse risk factors provided useful information for the prevention of cancer.

It is well known that smoking is a major risk factor for certain cancers and, in almost all studies, alcohol consumers are more likely to be smokers; hence, drinkers should certainly be advised about the dangers of smoking.

On the other hand, by simply summing the number of factors into a total score, the authors included a number of risk factors for which there is less of a scientific basis for their effect on cancer risk (for example, the intake of supplements). Such factors should not be afforded the same weight as smoking as risk factors for cancer. 

Further, this study was carried out among computer-literate volunteers, so it may have limited relevance for the general population.

There have been extensive data showing that 'healthy' and 'unhealthy' lifestyle factors tend to cluster: For example, light-to-moderate drinkers tend to be leaner and eat a healthier diet than non-drinkers or heavy drinkers, as shown in this study. However, the prevention of chronic diseases relates to a large number of behaviours, and alcohol consumption cannot be considered as an isolated factor.

Current epidemiologic data suggest that the combination of not smoking, being physically active, eating a healthy diet, avoiding obesity, and, unless contra-indicated, regularly consuming small amounts of an alcoholic beverage, together make up what can be defined as a 'healthy lifestyle'.

To read the full critique, click here.

These critiques are published by just-drinks with the permission of ISFAR.