What Does The Surgeon General's Warning On Alcohol Actually Mean? (And How Much Should You Freak Out?)

A big news story last week was the decision by the US Surgeon General, Vivek Murthy, to add a warning to alcohol identifying it as a key contributor to cancer. But what does this actually mean? How concerned should you be, and what steps can you take to reduce your own risk?

First things first- alcohol was first classified as a Class 1 Carcinogen way back in 1988. The International Agency for Research on Cancer (IARC) uses this classification when there is strong evidence that an agent is carcinogenic to humans. This evidence can come from epidemiological studies or from animal studies combined with evidence that the agent acts like a human carcinogen. For the record, other Class 1 Carcinogens include cigarettes, hormonal birth controls, air pollution and processed meats.

So Why The Warning Now?

As Murthy said;

“The science has been building for years, creating greater and greater certainty about more and more types of cancer. But what is clear is that while people know, for example, about the link between tobacco and cancer and other health risks and cancer, less than half of people in America know that alcohol is, in fact, connected to cancer risk.” So, to be clear, this is not new science- this is a recognition that the science was not well known or publicized and a desire to increase awareness around the dangers of alcohol.

How Exactly Is Alcohol Linked To Cancer?

Alcohol has been linked in multiple studies to seven different types of cancer: oral cavity, larynx & pharynx (throat), esophagus, liver, colorectal and female breast. It’s link is defined through a few different pathways:

• Hormonal alterations- Alcohol throws off a range of hormones including (but not limited to): cortisol, testosterone, thyroid, insulin and estrogen. It increases levels of estrogen while decreasing progesterone, which both contribute to an increased risk of breast cancer.

• Breaks down into acetaldehyde- A big word for a little toxin. You can blame acetaldehyde for just about everything you feel when you drink, from a flushed face to lightheadedness and nausea and when you drink too much your body can’t keep up and this toxin builds up in your body. It’s a key player in the cancer connection- it can permanently damage DNA, leaving you susceptible to cancer- causing mutations.

• Increasing risk of absorption of other carcinogens- Alcohol alters the cells in your mouth and increases their absorption rate- so if you’re then throwing in some “social” cigarettes, processed food, or other cancer causing agents, they’re going to be more readily absorbed and cause even more damage.

• Increases all over oxidative stress- When your body’s breaking down alcohol it actively increases oxidation while also limiting your body’s ability to eliminate oxidative stress. Chronic oxidative stress has been linked to a host of diseases like diabetes, cancer, Alzheimer’s, atherosclerosis, rheumatoid arthritis and more.

Despite this evidence, there’s still so much misinformation around alcohol, let’s dive into a few of the big rumors:

“But they drink every day in Europe and they’re not as unhealthy as us”

Let’s clear something up- Europe has an exponentially higher rate of cancer, and higher death rate from cancer, than the US. Full stop. Just because you don’t personally know anyone in Europe with cancer does not mean that it’s not happening there, and they have some sort of health fountain of youth. Europe accounts for about 10% of the global population yet carries 25% of the cancer rate. Obviously this cannot be directly linked to just alcohol use, but it is enough to shoot down that excuse.

“But I thought red wine is good for my heart”

God bless marketers (used to be one). They sure know how to take one point and roll with it to sell something. The whole “red wine is good for you” thing came from a study (funded by the alcohol industry) looking at the impact of a component of red wine called resveratrol, which has been shown to have antioxidant and anti-inflammatory benefits which is good for your health. They key point here? You need about 100 to 500 mg of resveratrol to get the effects- and that glass of red wine? It has about 1mg of it. So you’d need about 100 to 500 glasses of wine a day to get enough resveratrol but I think we can all see the downsides of that strategy.  

"But my uncle Kyle drank every day and lived to be 96"

Go uncle Kyle! Listen- these are risk factors. No you are not automatically going to develop cancer if you have a bottle of wine. We all know someone who smoked into their 80's (hell, the oldest living woman on record smoked until she was 117, then went on to live to 123). They are rare exceptions. You can be exposed to every risk factor in the world and never get sick, or you can be exposed to one and it can derail your life. The point is to minimize risk because you never know- and you're not Uncle Kyle (or Jeanne Calmet).

So What Can I Do?

Like any risk, alcohol’s are cumulative- that means the more you drink, and the more you are exposed to other risk factors, the higher your risk is going to be. Luckily, this is pretty much in your control- here’s a few basic steps you can take to decrease your risk:

1. Manage your intake- There is no “safe” amount of alcohol, but it is completely ingrained in our society and it’s going to be hard to avoid it entirely. If you are going to drink consider limiting your intake. Rather than instantly grab a beer after work limit your consumption to special occasions and take breaks throughout the year.

2. Reduce the overall stress on your body- Again this a cumulative burden. Be aware of how many toxins your body is exposed to daily and aim to reduce your overall exposure. This means avoiding pesticides, BPAs, fragrances and other inorganic substances so that when you are exposed to something (like alcohol) your body takes less of a hit.

3. Support your body- Load up on antioxidants like citrus fruits and bell peppers to reduce overall oxidative stress. Give your liver some love with foods like broccoli, turmeric, beets, garlic and leafy greens. Be aware of the nutrients that alcohol depletes- magnesium, vitamin B, zinc, vitamin D and calcium are the big ones- and work these into your diet and consider supplementation if you drink regularly.

   
   

The Surgeon General’s warning is designed to raise awareness, and that’s a good thing! For a generation that was raised on TV shows and ads featuring booze (or worse, things like “Mommy wine culture”) it’s good to have the veil pulled back a little bit- but nothing here is new. Like any toxin it comes down to minimizing exposure, and minimizing impact by understanding the risks and “controlling the controllables.”