Did you read that RED WINE was good for you?

You may have seen in the news a recent report from www.cedars-sinai.edu that "Moderate red wine drinking may help cut women's breast cancer risk" and I thought we should look at the issue of alcohol and breast cancer.


Many studies have demonstrated a link between too much alcohol of any kind and breast cancers.  A literature review suggests that 3 or more drinks (45 gms of alcohol which translates to 15 oz of wine www.pubs.niaaa.nih.gov/publications) significantly increases the risk for breast cancer and perhaps having a wreck, among other things.  Furthermore, a large observational study, published last year  (jama.ama-assn.org/content/306/17/1884) of 100,000 women in the Nurses Health Study suggests that anyone drinking over 3-6 drinks per week begins to show an increase in breast cancers.  A review of the article reveals that the "drinking group" had other risks like increased tobacco use, more hormone replacement use and more with a family history of breast cancer, suggesting that  alcohol in moderation may not be the only difference between the groups.  The mechanism may be that alcohol changes the hormonal balance (estrogen, progesterone and testosterone) to favor breast cancer development and when added to other risks may enhance them.


Subgroup analysis of this study and two other studies found that folate or folic acid intake mitigates this effect of alcohol even at a dose of 300mcg per day.


So what about the newest study?  Red grape skin contains polyphenol compounds, some of which have antioxidant properties to help prevent breast cancer and the hypothesis is that the protection of the red is greater than any putative risk, particularly at a "moderate" dose.  The researchers in the Cedars Sinai study said the change in hormonal pattern suggested that RED WINE may stop the growth of cancer cells, not like other kinds of alcohol, particularly white wine.


So how many breast cancers are we talking about here.  Of course there is geographical and national variation, but an article in Cancer Causes and Control reviewing nutritional data and cancer statistics noted that the population attributable risk in the US is only 2% of all breast cancers.  Clearly being lean, moving around and exercise have more impact in the population as a whole.


Moderate alcohol use has been shown in multiple studies to prevent coronary artery disease, ischemic stroke and diabetes.  For those at risk moderate alcohol use has been shown to have a substantial survival benefit.  Factoring in these studies and pending a longterm randomized trial of alcohol on overall clinical outcome, I have some recommendations:

• If you don't drink, think twice before you start.
• If you drink, make certain your multivitamin has 400mcg folate.
• If you drink white wine, you might consider the benefits of RED.
• And the amount?  Most experts define "moderate" as 1-2 glasses (<8 oz).