DWA symposium at the German Congress of Internal Medicine – Wine and cancer risk

The topic “Alcoholic beverages/wine and cancer risk” was at the centre of the DWA Symposium which took place in Mannheim, Germany, last April.

The symposium is organised every year in parallel with the Congress of Internal Medicine to present and discuss key topics on wine and health. Mostly physicians of internal medicine attended the Congress and the Symposium and part of the symposium will also be available as an e-learning tool of continuing education for those physicians who could not attend.

The speakers of the symposium were renowned scientists: Prof. Nicolai Worm, Munich, Prof. Ramon Estruch from the University Hospital of Barcelona, both active members of the Wine Information Council.

Prof. Nicolai Worm opened the Symposium by presenting an overview of the epidemiological evidence. His detailed analysis of the available data showed that the scientific figures do not confirm the media headlines according to which any amount of alcohol increases the risk of cancer. Furthermore, he also pointed out that the risk of cancer varies not only according to the amount of alcohol consumed during a lifetime, but other lifestyle factors also need to be considered.

One of these lifestyle factors is the diet. Several meta-analyses have indeed shown that the Mediterranean diet, which is characterized by a regular moderate consumption of wine with the meals and no misuse and abuse of alcohol, has been associated with a lower risk of cardiovascular diseases and cancer, and a lower total mortality.

While excessive consumption and alcohol misuse is linked to an increasing risk of cancer, a low to moderate intake, particularly of wine, was associated with a decreased risk for some types of cancers.

Prof. Worm further emphasized on the fact that most benefits are observed with a Mediterranean drinking patternThe Mediterranean diet, which includes moderate consumption of wine, is considered .... To give a better example, he referred to a meta-analysis with 2.1 million people, where an 11% lower cancer risk was observed when the alcoholic beverages were consumed in the frame of a Mediterranean diet.

Prof. Ramon Estruch, continued in the same lines and presented his own data from the Spanish PREDIMEDThe PREDIMED study is one of the few randomized controlled trials about the Mediterranean Diet. More... intervention trial. He explained that the excessive use of alcoholic beverages, whether occasional (binge) or continuous, is detrimental to the human being and is a major public health and social problem. In this particular setting, alcohol is carcinogenic and high alcohol intake has been linked to some types of cancer such as upper/digestive tract (oral cavity, larynx, and esophagus), lung, breast, liver, bowel and melanoma. In some studies, the relative risk of few specific cancers (colorectal, oral and breast) has been associated to light to moderate doses of alcohol consumption.

However, several other factors may influence the risk of alcohol-related cancers, among others age, sex, ethnicity, body mass index and smoking. In addition, the effects of alcohol consumption on cancer risk may vary according to the drinking pattern (daily vs. weekly consumption), socioeconomic status as well as the dietary pattern or intake of some key nutrients such as folate.

In addition, publications on this issue may share some commonly observed problems:

• Underreporting of alcohol intake may explain increased risk of certain cancers for light drinking (participants don’t answer questions regarding their alcohol intake incorrectly).
• Different effects depending on the type of alcoholic beverage consumed (wine, beer or spirits) due to the non-alcoholic components of these beverages (polyphenols).
• Drinking patterns (binge vs. regular moderate drinking).
• Dietary patterns and other lifestyle factors.

Taking these considerations into account in the PREDIMEDThe PREDIMED study is one of the few randomized controlled trials about the Mediterranean Diet. More... trial (Prevention with Mediterranean Diet) that included 7,447 high risk cardiovascular subjects who were followed-up for an average period of 5 years, two interesting observations were made. Women who followed a traditional Mediterranean diet including a moderate wine consumption and enriched with extra virgin olive oil showed a significant reduction in the incidence of breast cancer; whereas men in the same intervention group showed a lower incidence of prostate cancer.

Prof. Estruch concluded by emphasizing the important role diet has to play for cancer risk.

Prof. Kristian Rett (chair of the Scientific Board of the DWA) led a lively discussion which closed the symposium.

The more than 120 physicians who attended the symposium, appreciated the objective presentation of the scientific evidence about the sensitive subject “Alcoholic beverages/wine and cancer risk”.