alcohol, breast cancer, and postmenopausal women

[ncyg46]

we are retired, retarded, whatever you want to call it and I sure feel that my couple of beers are much healthier (stresswise) than the water in the southwest or in most of the country...and if Dr. McDougall can have a beer with his burrito, so can I. I don't drink sugar sodas or diet sodas, haven't really found anything that I like except the iced tea to go that I use in my water bottles. Open to suggestions besides plain water....

When they tell me that the immigrant workers are being conscientious about using the 5 porta potties that are now attached to each worker bus, and the happy California cows are not doing their thing in our groundwater then I will not feel so bad about drinking it again....I mean we have to breathe the air, drink the water, cook the food...what are the options? i can't drink the water here, too much sodium or alkaline in it.....we buy our drinking water, reverse osmosis and use it for our cooking. Dishes and showers with regular water is local water. At least you don't have to keep your mouth closed while showering like back east in Florida from the chlorine!!

[Nettie]

I don't drink sugar sodas or diet sodas, haven't really found anything that I like except the iced tea to go that I use in my water bottles. Open to suggestions besides plain water....

Something that was suggested in one of the forums was 1 or 2 ounces of some kind of juice, in a glass of cold club soda or carbonated water. We tried it with cranberry juice, and we really like it. I generally avoid juices, but my husband drinks quite a bit, so this was a good compromise for him. Really refreshing.

Nettie

[ncyg46]

i have some carbonated water, was going to try lime in it....sounds good, will try it! still like my beer!

[JeffN]

An older study, but confirming the other recent ones. This is not new news, it just never gets much media attention.


David B. Thomas
Environmental Health Issues
Environmental Health Perspectives Supplements Volume 103, Number S8,
November 1995

Abstract

This is a review of the epidemiological literature on alcohol and risks of
various cancers.

Alcohol has consistently been related to risks of squamous cell carcinomas of the mouth, oral pharynx, larynx, and esophagus in multiple studies of varying design. The joint effects of alcohol and smoking are greater than additive, and are probably multiplicative, suggesting biological synergism. All major types of alcoholic beverages have been causally implicated in the genesis of these diseases. The influence of alcohol on risks of upper aerodigestive tract cancers may be greater in persons with marginal nutritional status than in better-nourished individuals. Alcohol also has been associated with an increased risk of adenocarcinomas of the esophagus, gastro-esophageal junction, and gastric cardia, but the relationship is not as strong as for squamous cell esophageal carcinomas. Alcohol and tobacco account for over 80% of the squamous carcinomas of the mouth, pharynx, larynx, and esophagus in the United States. Risks of cancers of the distal stomach, pancreas, colon, and rectum have not been consistently related to alcohol, although possible relationships between beer drinking and rectal cancer and between heavy use of alcohol and pancreatic cancer warrant further study. Studies of alcohol and liver cancer, in which the confounding influence of hepatitis B was considered, have yielded inconsistent results and should be replicated. An association between heavy alcohol use and breast cancer has been observed in most studies, even after controlling for known risk factors for breast cancer, and additional investigations of this issue are warranted.

[tiranda]

Hi Nettie

You can read my thoughts on the chocolate studies here.

http://www.drmcdougall.com/forums/viewtopic.php?t=6010


In Health
Jeff

I went to that topic and found this:

[quoting JeffN]
If someone wanted to include some cocoa, the safest way might be to find some pure cocoa powder that is not processed with alkali (like Hershey's powder) and use a TB or 2 /day. You can add it to hot water with your sweetener of choice (go easy) and have a hot cocoa, or add it to your non dairy milk.
[ end quoting Jeff N]

My actual question relates to the phrase "some pure cocoa powder that is not processed with alkali (like Hershey's powder)..."

Are you saying Hershey's is an example of cocoa not processed with alkali, or that it is an example of alkalai processed cocoa and you should find a purer one.

It's probably obvious to everyone else.

thanks for your help.

[JeffN]

Are you saying Hershey's is an example of cocoa not processed with alkali,

Yes. Hershey's is pure cocoa that is not processed with alkali

In Health
Jeff

[tiranda]

Thanks!

[JeffN]

Impact of diet on breast cancer risk.
Lof M, Weiderpass E.
Curr Opin Obstet Gynecol. 2009 Feb;21(1):80-5.
PMID: 19125007

Abstract

Purpose of review: Breast cancer is the most common female cancer in Western Europe and North America, and becoming an increasing problem in developing countries such as India and China. We review recent studies (published 1 January 2007-31 August 2008) on the impact of diet on breast cancer risk.

Recent findings: Recent studies have focused on the controversial association for dietary fat and breast cancer as well as the role of newer aspects such as glycemic index, dietary patterns and diet-gene interactions. Evidence that some of the associations may be modified by oestrogen and progesterone receptor status has been presented. Still, only alcohol intake, being overweight and weight gain have shown consistent and strong positive associations with breast cancer risk. The reasons for the null or weak associations often observed regarding diet and breast cancer might be several. For example, there may be no causal association, or existing associations may be masked by measurement error, timing of dietary exposure and differences according to tumour characteristics or diet-gene interactions.

Summary: Numerous epidemiological studies on diet and breast cancer have been published during our review period. Still, only alcohol intake, being overweight and weight gain have shown consistent and strong positive associations with breast cancer risk.

[Garden]

I am posting a link to an article below; but the main point is that alcohol can interfere with folate/folic acid; the deficiency of which is the real issue in terms of the link between breast cancer and alcohol.

http://www.huffingtonpost.com/elizabeth ... 67597.html

With all the dark green veggies McDougallers eat, I can't seem the harm in a daily glass or two of good wine. I also take a B Complex, plus folic acid, as well as Milk Thistle.

Good wine and good fresh starch based food are two of life's greatest pleasures in my opinion.

Garden

[JeffN]

Greetings.

Welcome to the forum and thanks for the link.

However, this is one area will there will always be mixed info. Why? Simple. Alcohol, while it may have some potential benefit in relation to certain diseases like heart disease, it also has known health risks. So, many studies try to sort through this and figure out where the cut-off levels are and at what level the benefits outweigh the risks and what other factors may also either increase risk (obesity, exercise) or decease risk (folate, vit e, )

The recent studies i posted in this thread confirm the known relationship between alcohol and breast cancer in women. This is not a new story. The new information was that in this study it seemed that there was an increased risk with any amount of alcohol consumed by women. In addition, having 3 or more drinks everyday increased their risk similar to smoking cigarettes.

Previously it was though that if women consumed 4 or less drinks a week, there was no increased risk for breast cancer. Some studies said there was no risk if they consumed 7 or less drinks a week. In addition, several studies have shown that, either way, this increased risk is negated by consuming adequate folate. However, this is not a universally accepted conclusion or fact (see below) nor will it ever be that simple.

Alcohol is a known carcinogen, increasing the risk of many cancers. in addition, death from injuries, violence, suicide, poisoning, cirrhosis, and possibly hemorrhagic stroke are all related to alcohol use also.

The often touted benefit of alcohol is that moderate consumption reduces your risk for several diseases including heart disease, diabetes, Alzheimer's and may increase longevity.

We always here about the French Paradox. How the French eat as much if not more saturated fat and cholesterol then we in American do, but don't suffer the amount of heart disease we do because they are protected by the red wine they drink. There is no French Paradox. They may have fewer heart attacks, but they suffer more of almost every alcohol related illness and do not live any longer. This has been addressed in this forum

Some will argue that the benefit of alcohol only reduces the risks from diseases that we can virtually eliminate through other lifestyle factors (ie., diet) that do not have the risks of alcohol, so why add in a known carcinogen. And, there are those who argue that alcohol, in and of itself, confers health benefits above and beyond just reducing certain risk factors.

In my opinion.. people should not drink. What would be better is to first do everything they can to ensure optimal health through proper diet, exercise and lifestyle. Alcohol does not have to part of this. You can dramatically decrease your risk for many of the causes of premature death through a healthy alcohol-free diet and lifestyle.

If someone doesn't drink, they shouldn't start, especially if they have had problems in the past.

If they decide to drink, then research suggests that they should limit the amount of alcohol to no more than the equivalent of 1/2 a drink a day for women and no more than 1 drink a day for men. And, consuming more than 1-2 drinks at any one time is not healthy either. In addition, realize there may be some increased risk for certain cancers even at these levels
In Health
Jeff


American Journal of Clinical Nutrition, Vol. 83, No. 4, 895-904, April 2006

Folate intake, alcohol use, and postmenopausal breast cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

Background: Several epidemiologic studies suggest that higher folate intakes are associated with lower breast cancer risk, particularly in women with moderate alcohol consumption.

Objective: We investigated the association between dietary folate, alcohol consumption, and postmenopausal breast cancer in women from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial cohort.

Design: Dietary data were collected at study enrollment between 1993 and 2001. Folate content was assigned on the basis of prefortification (ie, pre-1998) databases. Of the 25 400 women participants with a baseline age of 55–74 y and with complete dietary and multivitamin information, 691 developed breast cancer between September 1993 and May 2003. We used Cox proportional hazard models with age as the underlying time metric to generate hazard ratios (HRs) and 95% CIs.

Results: The adjusted HRs were 1.19 (95% CI: 1.01, 1.41; P for trend = 0.04) for women reporting supplemental folic acid intake ≥400 µg/d compared with subjects reporting no supplemental intake. Comparison of the highest with the lowest quintile gave adjusted HRs of 1.04 (95% CI: 0.83, 1.31; P for trend = 0.56) and 1.32 (95% CI: 1.04, 1.68; P for trend = 0.03) for food and total folate intake, respectively. Alcohol consumption was positively associated with breast cancer risk (highest compared with lowest quintile: HR = 1.37; 95% CI: 1.08, 1.76; P for trend = 0.02); the risk was greatest in women with lower total folate intake.

Conclusions: Our results do not support the hypothesis that high folate intake reduces breast cancer risk; instead, they suggest that a high intake, generally attributable to supplemental folic acid, may increase the risk in postmenopausal women. However, our results confirm previous studies showing positive associations between moderate alcohol consumption and breast cancer.



American Journal of Clinical Nutrition, Vol. 87, No. 3, 734-743, March 2008
Plasma folate, vitamin B-6, vitamin B-12, and risk of breast cancer in women1,2,3

Background: B vitamins such as folate, vitamin B-6, and vitamin B-12 are coenzymes that are important for DNA integrity and stability. Deficiency in these B vitamins may promote tumor carcinogenesis.

Objective: We prospectively evaluated plasma concentrations of folate, pyridoxal 5-phosphate (PLP; the principal active form of vitamin B-6), and vitamin B-12 in relation to breast cancer risk.

Design: We included 848 incident cases of invasive breast cancer identified as of 31 March 2004, and 848 individually matched control subjects from 28 345 women in the Women's Health Study aged ≥45 y who provided blood samples and had no history of cancer and cardiovascular disease at baseline in 1993. Logistic regression controlling for matching factors and other risk factors for breast cancer was used to estimate relative risks (RRs) and 95% CIs. All statistical tests were 2 sided.

Results: Plasma concentrations of folate, PLP, and vitamin B-12 were not associated with overall risk of breast cancer. Women in the highest quintile group relative to those in the lowest quintile had multivariate RRs of 1.42 (95% CI: 1.00, 2.02) for plasma folate (P for trend = 0.21), 0.91 (95% CI: 0.63, 1.30) for plasma PLP (P for trend = 0.48), and 1.29 (95% CI: 0.92, 1.82) for plasma vitamin B-12 (P for trend = 0.18). However, higher plasma folate concentrations were moderately associated with an increased risk of developing premenopausal breast cancer (P for trend = 0.04) and for developing estrogen receptor (ER)–positive or progesterone receptor (PR)–positive breast tumors (P for trend ≤ 0.06). Conversely, an inverse association was seen between plasma PLP and postmenopausal breast cancer (P for trend = 0.04).

Conclusions: Data from this study suggest that B vitamins, including folate, vitamin B-6, and vitamin B-12, may confer little or no reduction in overall risk of developing breast cancer. The observed positive associations of folate status with risk of developing premenopausal breast cancer and ER-positive or PR-positive tumors are unexpected. Additional research is needed to elucidate the role of folate in breast cancer development.

[Suebee]

Regarding mouth and throat cancers--what part does Listerine (high alcohol) play in getting that? I always thought it was crazy to use something that strong in one's mouth. Any ideas?

[JeffN]

Regarding mouth and throat cancers--what part does Listerine (high alcohol) play in getting that? I always thought it was crazy to use something that strong in one's mouth. Any ideas?

They have been linked to throat cancer and I beleive they lowered their alcohol content as a result of the studies. However, I am not sure that has made them entirely "safe."

For those with existing throad and mouth cancers, they are instructed to avoid oral hygiene products that contain alcohol.

In Health
Jeff


Rev Saude Publica. 2008 Jun;42(3):471-9. Oral health, hygiene practices and oral cancer.

OBJECTIVE: To assess the association between oral health and hygiene practices and oral cancer. METHODS: Hospital-based case-control study in the metropolitan area of São Paulo, southeastern Brazil, from 1998 to 2002. A total 309 patients with squamous cell carcinoma of the mouth and the pharynx and 468 controls matched by sex and age were included in the study. Cases were recruited in seven reference hospitals and controls were selected in five out of the seven participating hospitals. Detailed information on smoking, alcohol consumption, schooling, oral health status and hygiene practices were obtained through interviews. Odds ratios (OR) and 95% confidence intervals (95% CI), adjusted by sex, age, schooling, smoking, alcohol consumption as well as the variables oral health status and hygiene practices were estimated using unconditional logistic regression analyses. RESULTS: The use of complete dental prosthesis was not associated with oral cancer but regular gum bleeding showed a strong association (OR 3.1; 95% CI 1.2-7.9). Those who never attended a dental visit were more likely to have oral cancer (OR 2.5; 95% CI 1.3-4.. Daily mouthwash use showed a stronger association to pharynx (OR 4.7; 95% CI 1.8-12.5) than mouth cancer (OR 3.2; 95% CI 1.6-6.3). CONCLUSIONS: Gum bleeding, no dental care, and daily mouthwash use were factors associated with oral cancer regardless of tobacco and alcohol consumption. PMID: 18470367

Am J Epidemiol. 2007 Nov 15;166(10):1159-73. Epub 2007 Aug 30. Oral health and risk of squamous cell carcinoma of the head and neck and esophagus: results of two multicentric case-control studies.

Poor oral health has been reported as a risk factor in the etiology of head and neck cancer. Data on oral health were ascertained as part of two multicenter case-control studies comprising 924 cases and 928 controls in central Europe and 2,286 cases and 1,824 controls in Latin America. Incident cases of squamous cell carcinoma of the head and neck (oral cavity, pharynx, larynx) and esophagus, as well as age (in quinquennia)- and sex frequency-matched controls, were enrolled from 1998 to 2003. Poor condition of the mouth (central Europe: odds ratio (OR) = 2.89, 95% confidence interval (CI): 1.74, 4.81; Latin America: OR = 1.89, 95% CI: 1.47, 2.42), lack of toothbrush use (Latin America: OR = 2.36, 95% CI: 1.28, 4.36), and daily mouthwash use (Latin America: OR = 3.40, 95% CI: 1.96, 5.89) emerged as risk factors for head and neck cancer, independent of tobacco use and alcohol consumption. Missing between six and 15 teeth was an independent risk factor for esophageal cancer (central Europe: OR = 2.84, 95% CI: 1.26, 6.41; Latin America: OR = 2.18, 95% CI: 1.04, 4.59). These results indicate that periodontal disease (as indicated by poor condition of the mouth and missing teeth) and daily mouthwash use may be independent causes of cancers of the head, neck, and esophagus. PMID: 17761691

Cancer Causes Control. 2001 Jun;12(5):419-29. Mouthwash in the etiology of oral cancer in Puerto Rico.
PMID: 11545457

Cancer Res. 1991 Jun 1;51(11):3044-7. Mouthwash use and oral conditions in the risk of oral and pharyngeal cancer. PMID: 2032242

[Suebee]

Wow! Thanks Jeff. Before this information, I only had a "gut feeling." Incredible! I never thought to search for this data before. I'm going to send this on to friends AND my husband!

[Garden]

Thanks for the extensive reply, Jeff. It's hard to know what the results would be for women following a McDougall type diet for many years-whether they would be so healthy and well nourished that the effect would be null. Most studies are done on women eating the SAD diet, I would think.

There are mixed messages on the subject as you say.

It's really hard for me to give up the social aspects of wine etc...plus I really do love the taste with different foods.

So...

I just saw television program on dealcoholized wines recently- (not sparkling grape juice) but wines that taste like wine, but without the alcohol. Apparently they have been around for awhile- Sutter Home makes some as well as other wine makers.

http://chefmom.com/articles/winetrend.htm

Thanks,
Garden

[gail f]

Hello,

My copy of the Wellness Letter published by U. Cal. Berkeley (August 2008 issue) stated:

Alcohol increases the risk of breast cancer substantially in women who are on hormone therapy, according to a 20-year Danish study of 5,000 postmenopausal women. Women on hormones who averaged a drink a day had a two-to-threefold higher risk than women who neither drank nor took hormones; those averaging two or more drinks a day, a fivefold increase. In women who did not take hormones, alcohol did not increase cancer risk. Previous studies suggested that alcohol raises the risk of breast cancer (slightly, in most cases)- as can hormone therapy, especially when taken long term.