Enjoyed your views immensely, and appreciate your perspective although I am not wholly in agreement.
But I won't here further argue the point that when we look at the balance of all the evidence, as I have argued, when critically appraised and systematically review, with each study subject to a methodology assessment with an associated derived methodological quality metric, the facts bear out that there is no safe level of alcohol consumption - all forms being shown equal, whether beer, wine or hard drinks - as WHO and the new ASCO Guideline document (along with my own research on this issue), via well-known mechanisms including upregulation of aromatase, with consequential elevation of estrogen levels, oxidative stress with increased formation of DNA adducts, elevated exposure to acetaldehyde, epigenetic modifications secondary to altered methyl transfer, and decreased retinoic acid concentrations that pathologically influence the cell cycle.
From these considerations, I have counseled in agreement with the best evidence to date that the only alcohol consumption pattern to remain safe is what I call the celebratory pattern: consumption that is neither regular nor predictable (but not "binge" level) but rather episodic when reserved for comparatively rare occasions of celebration (major holidays, anniversaries, etc.). If the pattern is on some describable schedule (X glasses every week, etc.) then it is not celebratory.
But more constructively, and leaving aside here the reasons for the oft-stated - but mis-stated - perception that "moderate" drinking incurs minimal risk, like any risk factor, alcohol consumption-related risk - both for the development of a cancer, and for it's recurrence - is subject to modulation by individual and other modifiable variations and factors. This may not remove the elevated risks but helps serve to countervail their cumulative impact. I will here highlight just one such countervailing factor, namely fiber consumption which has been demonstrated, using data from the massive European Prospective Investigation into Cancer and Nutrition (EPIC) database, to modulate the association of breast cancer risk and alcohol intake, as revealed earlier this year by Isabelle Romieu of the International Agency for Research on Cancer (IARC) and colleagues. High intake of fiber (defined as in excess of 24.2 grams/daily) reduced BC risk to 1.02 (not significant), down from the 5.7% increased risk associated with low fiber intake (<18.5 g/day).
Couple this with optimal dietary patterns approximating the Modified Cretan Mediterranean Diet (especially as to oleic acid consumption via olive oil), a committed balance of regular aerobic but also resistance/strength exercise, and optimal nutritional supplementation as warranted by evidence-based data (especially for Vitamin D3 above deficiency and insufficiency levels approximating >= 66 ng/ml on the standard 25(OH)D blood test), and avoidance of environmental and light pollution, among other healthful lifestyle interventions, and aggregated risk can be dramatically and positively modulated. Those who elect to continue to enjoy moderate alcohol intake (I am a "non-alcoholic beer" man myself - friends rib me that I may have to join "Non-Alcoholics Anonymous") are well advised to leverage these countervailing factors to reduce the excess risk that may be incurred.
Thanks again Khevin for your most thoughtful piece!
Director, Medical Research, No Surrender Breast Cancer Foundation (NSBCF)
Oncology Reviewer, Current Oncology
Society for Integrative Oncology (SIO)
Member, European Association for Cancer Research (EACR)
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