Drinking pattern matters with regards to cancer risk
Alcoholic beverages are widely consumed worldwide and are linked to various health issues, including different types of cancer. The International Agency for Research on Cancer (IARC) classifies alcohol as a carcinogen and has identified seven cancers related to alcohol consumption. With the available evidence, the benefits attributed to alcoholic beverages on diabetes, cardiovascular disease and mortality must be weighed individually against other risks, including cancer risks. While most studies focus on the amount of alcohol consumed, research suggests that the pattern of drinking can significantly affect health outcomes. A binge drinking pattern has been associated with a significantly increased risk of cancer. In contrast, other healthier drinking patterns, such as the Mediterranean alcohol-drinking pattern (MADP), have shown statistically significant results for reduced risk of mortality.
The goal of the current study was to investigate how adherence to the MADP relates to the incidence of alcohol-related cancers, aiming to provide insights for cancer prevention strategies that consider drinking patterns, not just alcohol quantity.
The study followed 19,541 individuals from the SUN study population, which includes Spanish university graduates. They answered questions about their diet and health over time (average follow up 13 years). The researchers created a score to measure how well participants followed the MADP, which included drinking moderately, preferring wine (especially red), drinking with meals, and not binge drinking. They classified participants into groups based on their scores: low, moderate, and high adherence (*).
The main focus was on whether participants developed certain types of cancer known to be linked to alcohol. Participants reported any cancer diagnosis during follow-ups, confirmed by physicians. The cancer rates between those with different levels of adherence to the MADP were statistically analysed and adjusted for other factors like age, body weight, and lifestyle habits to ensure the results were accurate. The reference group consisted of those participants with a low adherence to MADP.
The results showed that adherence to the MADP was associated with a lower risk of alcohol-related cancers in men, while no significant benefit was observed for women.
The authors concluded that their findings suggest that health recommendations about alcoholic beverages should be different for men and women. For women, the current advice to limit alcohol remains important. For men, the study results recommend that if they choose to drink, they should consider following the MADP to possibly reduce their cancer risk. They call for more studies to confirm these findings, especially in women, and to explore the effects of the MADP in different populations.
(*) MADP score:
The moderate total alcohol consumption item was modified to better fit evidence and current recommendations on grams of moderate alcohol consumption. This score ranged from 0 to 9 points and assessed adherence to specific criteria, including:
- Moderate total alcohol consumption: 2 points for alcohol consumption of 5–15 g/day for women and 10–30 g/day for men. Intake below this range (0–5 g/day for women and 0–10 g/day for men) scored 1 point, while intake above this range (>15 g/day for women and >30 g/day for men) received 0 points.
- Preference for wine: 1 point was given if at least 75% of the alcohol consumed was in the form of wine.
- Preference for red wine: 1 point was assigned if at least 75% of the wine consumed was red wine.
- Consumption of wine with meals: 1point was scored if at least 75% of the wine was consumed during mealtimes.
- Low consumption of spirits: 1 point was given if the consumption of spirits accounted for less than 25% of the total alcohol consumption.
- Alcohol consumption spread over a week: 2 points were scored for participants in the highest quartile of the ratio of number of drinking days per week to total g/week of alcohol intake. One point was scored for participants in the third and second quartiles and zero points for those in the lowest quartile.
- Avoidance of binge drinking: 1 point was given for never exceeding five drinks on a single occasion.
