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Dr. C.H. Weaver M.D. Updated 01/2022

Is drinking good or bad for our health? Will it help prevent certain conditions but raise our risks of others? Adding to the conversation, one study suggests that those of us who do drink alcohol—moderately or less, that is—might live longer. On the other hand research also suggests that even moderate alcohol consumption can increase the risk of breast cancer.

Most adults don't know that alcohol boosts cancer risk, yet its consumption has been found to increase the risk of seven cancers, including breast, colon and mouth cancer. Alcohol-related cancers caused about 378,000 deaths worldwide in 2016. In a recent study researchers surveyed nearly 3,900 Americans and only 1 in 4 knew that liquor increased cancer risk.10

Given the confusion, researchers have continually explored the effects of alcohol consumption on our health, and specifically on how long we live. For example, a study conducted at the University of Austin at Texas in followed adults between ages 55 and 65 over 20 years, monitoring their alcohol use (or lack of use) as well as lifespan (or risk of dying prematurely).1 They found that participants who drank moderately tended to live longer than those who drank heavily or not at all and even those who drank only a little. Specifically, non-drinkers were twice as likely to die prematurely that moderate drinkers. Moderate drinking was considered one to three drinks per day.

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More recently researchers in Sweden published results of a study on the relationship between low-to-moderate alcohol consumption and mortality.2 In a study population of middle-aged and older men and women who were followed for 15 years, the researchers found that women and men who drank lightly (a half a drink per day for women, one and a half for men) lived longer than nondrinkers: up to 17 months longer for women and up to 15 months longer for men.

Moderate or low seem to be the key words when it comes to alcohol consumption and longevity. According to a study in Texas, participants who consumed a modest amount (not too much or too little) of alcohol had the lowest risk of death. Heavy drinkers were 70 percent more likely to die than moderate drinkers, and light drinkers (those who drank fewer than one to three drinks per day) were 23 percent more likely to die than their moderate counterparts. The Swedish researchers also found that alcohol consumption beyond the modest level where they observed a benefit was linked with a rising risk of death; in other words, the more people drank in excess of the beneficial level, the shorter their lifespan.

We don’t really know why moderate drinkers are living longer. It may be that sharing wine, beer, or spirits (not excessively) can be a positive social experience, building relationships and support that contribute to our overall well-being. A little alcohol can also help reduce stress and promote relaxation. And there’s the consideration that alcohol itself may have a protective physiological effect, though this wasn’t part of this study.

Alcohol Consumption Increases Breast Cancer Risk

Women who have as few as three to six alcoholic beverages per week appear to have a slightly increased risk of breast cancer.3,4,5 Heavier drinking further increases the risk according to a study published in the Journal of the American Medical Association.6 The reasons for the relationship between alcohol and breast cancer are not well understood, but may involve alcohol’s effects on a woman’s estrogen levels. According to a study published in the Journal of the National Cancer Institute, postmenopausal women who consume an average of 10 grams or more of alcohol per day are more likely than nondrinkers to develop estrogen receptor-positive breast cancer; there was no link between alcohol intake and estrogen receptor-negative breast cancer.7

Whether low levels of alcohol also affect breast cancer risk has been less clear. To further explore the relationship between alcohol and breast cancer, researchers evaluated information from the Nurses’ Health Study. The study involved more than 105,000 women. Information about alcohol intake was collected at several different points between 1980 and 2006.

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  • Compared with nondrinkers, women who had three to six drinks per week had a 15% increase in risk of breast cancer.
  • Higher levels of alcohol intake further increased risk of breast cancer. Women who had at least two drinks per day had a 51% increase in risk of breast cancer.
  • When the researchers considered alcohol intake earlier in life (age 18 to 40) and later in life (after age 40), both time periods were important: alcohol intake during either time period increased breast cancer risk.

These results suggest that even low levels of alcohol can increase breast cancer risk, although the effect is fairly small. The researchers note that “..an individual will need to weigh the modest risks of light to moderate alcohol use on breast cancer development against the beneficial effects on cardiovascular disease to make the best personal choice regarding alcohol consumption.”

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Dietary folate may protect against the effect of alcohol and the risk of developing breast cancer.8,9 Researchers from Australia conducted a study including nearly 17,500 women to evaluate the relationship between dietary folate (found in highest concentrations in vegetables) and its effects on alcohol consumption and the risk of breast cancer. Women participating were aged 40 to 69 years; 537 eventually were diagnosed with breast cancer. Overall, women who consumed 40 grams of alcohol (roughly two glasses of wine) or more daily had a significantly increased risk of breast cancer compared to women who consumed no alcohol. There was no direct association found between dietary folate consumption and the risk of breast cancer; however, a high folate intake (400 micrograms per day) lessened the increased risk of breast cancer among women with an alcohol intake of over 40 grams per day.

The bottom line is that if you don’t currently drink, we’re not recommending that you start drinking to reduce your risk of death. You can, after all, enjoy some of the assumed benefits of alcohol, such as social interaction and stress relief, with alternatives like a coffee date or brisk walk. There are also some serious health risks associated with drinking, and it’s certainly not for everyone. But if you do drink moderately and responsibly (particularly if you’re an older adult, as in this study population), it’s possible that glass isn’t harming your health and might even be adding years to your life.

References:

  1. Holahan CJ, Schutte KK, Brennan PL, Holahan CK, Moos BS, Moos RH. Late-Life Alcohol Consumption and 20-Year Mortality. Alcoholism: Clinical and Experimental Research [early online publication]. August 24, 2010.
  2. Bellavia A, Bottai M, Wolk A, Orsini N. Alcohol Consumption and Mortality: A Dose-Response Analysis in Terms of Time. Annals of Epidemiology [early online publication]. January 4, 2014.
  3. Collaborative Group on Hormonal Factors in Breast Cancer. Alcohol, tobacco and breast cancer – collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 without the disease. British Journal of Cancer. 2002;87:1234-1245.
  4. Key J, Hodgson S, Omar RZ et al. Meta-analysis of alcohol and breast cancer with consideration of the methodological issues. Cancer Causes & Control. 2006;17:759-70.
  5. Li C, Chlebowski RT, Freiberg M et al. Alcohol consumption and risk of postmenopausal breast cancer by subtype: the Women’s Health Initiative Observational Study. Journal of the National Cancer Institute. Early online publication August 23, 2010.
  6. Chen WY, Rosner B, Hankinson SE, Colditz GA, Willett WC. Moderate alcohol consumption during adult life, drinking patterns, and breast cancer risk. JAMA. 2011;306;1884-1890.
  7. Suzuki R, Ye W, Rylander-Rudqvist T et al. Alcohol and Postmenopausal Breast Cancer Risk Defined by Estrogen and Progesterone Receptor Status: A Prospective Cohort Study. Journal of the National Cancer Institute. 2005;97:1601-8.
  8. Epidemiology, Vol. 12, No. 4, pp. 420-428, 2001).
  9. Baglietto L, English D, Gertig D, Hopper J, Giles G. Does dietary folate intake modify effect of alcohol consumption on breast cancer risk? Prospective cohort study. BMJ.
  10. https://www.ajpmonline.org/article/S0749-3797(21)00430-X/fulltext