Is drinking alcohol even safely and moderately raising your cancer risk? If the latest World Health Organisation (WHO) data is to be believed, half of all alcohol-attributable cancers in the WHO European Region are caused by “light” and “moderate” alcohol consumption – less than 1.5 litres of wine or less than 3.5 litres of beer or less than 450 millilitres of spirits per week. In other words, there is no safe limit when it comes to alcohol, the WHO clarified while releasing its statement to The Lancet Public Health. Alcohol has been classified as a Group 1 carcinogen by the International Agency for Research on Cancer decades ago. It has been linked to at least seven types of cancer, including bowel and breast cancer. Ethanol (alcohol) causes cancer as it breaks down in the body, which means that any beverage containing alcohol, regardless of its price and quality, poses a risk of developing cancer. This drinking pattern is responsible for the majority of alcohol-attributable breast cancers in women, with the highest burden observed in countries of the European Union (EU). The new WHO statement clarifies, “Currently available evidence cannot indicate the existence of a threshold at which the carcinogenic effects of alcohol ‘switch on’ and start to manifest in the human body.” Moreover, no studies can demonstrate the potential beneficial effects of light and moderate drinking on cardiovascular diseases and Type 2 diabetes outweighing the cancer risk associated with these same levels of alcohol consumption for individual consumers. “Individuals may exercise their judgement as to whether they may wish to consume small amounts of alcohol to accompany a healthy meal but they must be fully cognisant of the health risks that will accrue as alcohol levels in the blood build up,” says Dr K Srinath Reddy, distinguished professor, Public Health Foundation of India (PHFI). “The harmful effects of alcohol consumption stretch across a wide range of structural and functional dysfunction in many organs in the body. Besides cancers at different sites, cardiovascular disease, liver disease, pancreatitis and neurologic and mental health disorders, road traffic accidents and other forms of injury and violence are linked to alcohol. Even small amounts of alcohol can disturb brain function by affecting neuronal transmission. Some effects are temporary but many cause long lasting damage," Dr Reddy warns. “The belief that moderate doses of alcohol are good for cardiovascular health has been challenged in recent years. Earlier studies which promoted that belief were conducted in middle aged high fat-consuming Western populations,” he adds. Elaborating the effects of alcohol in the Indian context, Dr Reddy says, “The effects of alcohol depend on patterns of drinking (with or independent of meals, regular or binge), types of alcohol consumed and presence of other risk factors. The Mediterranean diet, for example, has a number of positive effect modifiers that counter the harmful effect of alcohol. Studies in many other populations, including in India, have not shown a cardiovascular benefit from alcohol. The increased risk of raised blood pressure and stroke is an especially worrisome cardiovascular effect. Alcohol has also been linked to serious cardiac arrhythmias (irregularities of heartbeat). Alcohol has a high calorie content (7 calories per gram) and leads to overweight and obesity, with attendant health risks. Deaths from accidents among the young are especially a major public health concern.” Prof Monika Arora, Vice-President: Research and Health Promotion, PHFI, says, “India adopted the national NCD (non-communicable disease) target of 10 per cent relative reduction in prevalence of alcohol use by 2025 against the terminology of harmful use of alcohol that was adopted by many countries. This was an informed decision because there are no safe levels of alcohol consumption for overall health. Contrary to popular opinion, alcohol increases risks of many CVDs. Recent research evidence has led to major reversals in the perception of alcohol in relation to health in general and CVD in particular. This statement by WHO is very timely and in line with recent policy briefs by international organisations like the World Heart Federation.” “If you haven’t started drinking, then don’t do so as there is no such additional benefit. But if you do like your drink, then limit intake, keep it to social drinking and stick to wine in moderation,” says Dr R M Anjana, consultant diabetologist and managing director at Dr Mohan’s Diabetes Centre in Chennai. The risk starts when you decide to have the first glass. “We cannot talk about a so-called safe level of alcohol use. It doesn’t matter how much you drink – the risk to the drinker’s health starts from the first drop of any alcoholic beverage. The only thing that we can say for sure is that the more you drink, the more harmful it is – or, in other words, the less you drink, the safer it is,” explains Dr Carina Ferreira-Borges, acting Unit Lead for Noncommunicable Disease Management and Regional Advisor for Alcohol and Illicit Drugs in the WHO Regional Office for Europe. Globally, the WHO European Region has the highest alcohol consumption level and the highest proportion of drinkers in the population. Over 200 million people in the region are at risk of developing alcohol-attributable cancer.
