Is there a safe level of alcohol consumption?
In January of 2025, the US surgeon general issued a report warning that alcohol is associated with multiple cancers.
More than half of Americans are unaware of the link between alcohol consumption and cancer. This includes many health care providers. There is still an outdated belief that a moderate amount of red wine is beneficial to cardiovascular health and has additional health benefits. The link between the benefit of alcohol to cardiovascular disease is also becoming controversial in light of more recent evidence.
I would challenge this view and state that an abundance of phytophenols and stilbenes, including resveratrol found in red wine are the source of any benefit, not the alcohol, which is a known hepatotoxin, neurotoxin, cardiotoxin, endocrine disruptor, and carcinogen.
An abundance of plant pigment-derived compounds are the good actors in red wine, providing a rich source of antioxidants and phytochemicals with positive epigenetic health effects that can be readily consumed in many other healthier sources in fruits and vegetables and botanical medicines without the accompanying risk factors of alcohol consumption.
While alcohol, like tobacco, has been a socially acceptable and even medically acceptable social intoxicant, “alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimizes health loss is zero. The widely held view of the health benefits of alcohol needs revising.”.
In other words, there is no safe level of alcohol consumption. All levels of alcohol consumption come with significant risk factors.
Which cancers are linked to alcohol consumption
“Alcohol increases risk of cancer of oral cavity and pharynx, oesophagus, colorectum, liver, larynx and female breast. There is accumulating evidence that alcohol drinking is associated with some other cancers such as pancreas and prostate cancer and melanoma.”
How does alcohol cause damage?
o Metabolic by products bind to DNA, damaging cells and fueling tumors
o Dysregulation of hormonal metabolism of estrogen
o Acts as a solvent for other environmental toxins increasing toxic exposure
o Increases inflammation
While some believe that the social aspects of alcohol consumption contribute to health and longevity, as noted in the super healthy long lived Blue Zone cultures where alcohol is part of a way of life, there is a growing interest in non-alcoholic designer beverages that serve the same social and celebratory function. In fact, one can toast with a glass of sparkling water with a splash of flavor added for conviviality and connection.
As many cancer treatments can damage heart function, I also recommend limiting alcohol intake to patients who have been treated with doxorubicin which damages the myocardium and to those patients with have arrythmia for which alcohol increases dysregulation.
I do advise all patients to avoid alcohol use as it is a known carcinogen. And if this is not something they wish to adopt as a way of lifelong term, I recommend that they refrain from alcohol use if they have known body burden of cancer, during cancer treatment and strictly for the first 2 years after completing cancer treatment. This is the period when recurrence is most common. I also recommend, if abstinence is not an option, that they limit alcohol intake to one glass a few times a year at a wedding or holiday celebration.
OutSmart Cancer patients are highly motivated to do everything that they can to contribute to a good outcome. In this patient population, particularly those patients who are looking for a health outcome and a health model, implementing the OutSmart Cancer® System starting with the OutSmart Cancer® Diet guidelines can be a reasonable first step and foundation to Getting Well, Staying Well and Living Well Beyond Cancer and to Creating a Body Where Cancer Cannot Thrive.
Selected References
(1) Griswold, Max G et al. Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 The Lancet, Volume 392, Issue 10152, 1015 – 1035
(2) Alcohol and Cancer Risk 2025, Report of US Surgeon General Alcohol and Cancer Risk 2025. Report of US Surgeon General https://www.hhs.gov/surgeongeneral/priorities/alcohol-cancer/index.htmlchrextension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.hhs.gov/sites/default/files/oash-alcohol-cancer-risk.pdf
(3) https://peterattiamd.com/alchohol-intake-and-cardiovascular-disease-risk/
(4) Biddinger KJ, Emdin CA, Haas ME, et al. Association of Habitual Alcohol Intake With Risk of Cardiovascular Disease. JAMA Netw Open. 2022;5(3):e223849. doi:10.1001/jamanetworkopen.2022.3849
(5) Bagnardi, V., Rota, M., Botteri, E. et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose–response meta-analysis. Br J Cancer 112, 580–593 (2015). https://doi.org/10.1038/bjc.2014.579
(6) Di Credico, G., Polesel, J., Dal Maso, L. et al. Alcohol drinking and head and neck cancer risk: the joint effect of intensity and duration. Br J Cancer 123, 1456–1463 (2020). https://doi.org/10.1038/s41416-020-01031-z
(7) https://www.bluezones.com/2018/09/new-study-says-theres-no-safe-level-of-alcohol/
(8) CDC Alcohol Use and Your Health https://www.cdc.gov/alcohol/index.html
(9) https://www.nytimes.com/wirecutter/reviews/best-non-alcoholic-drinks/
(10)Dulf PL, Mocan M, Coadă CA, Dulf DV, Moldovan R, Baldea I, Farcas AD, Blendea D, Filip AG. Doxorubicin-induced acute cardiotoxicity is associated with increased oxidative stress, autophagy, and inflammation in a murine model. Naunyn Schmiedebergs Arch Pharmacol. 2023 Jun;396(6):1105-1115. doi: 10.1007/s00210-023-02382-z. Epub 2023 Jan 16. PMID: 36645429; PMCID: PMC10185623.
(11)Steven K Clinton, Edward L Giovannucci, Stephen D Hursting,
The World Cancer Research Fund/American Institute for Cancer Research Third Expert Report on Diet, Nutrition, Physical Activity, and Cancer: Impact and Future Directions, The Journal of Nutrition, Volume 150, Issue 4,2020, https://doi.org/10.1093/jn/nxz268