Moderate Red Wine Drinking Does Not Help Cut Women's Breast Cancer Risk.

Abstract

Shufelt et al., 1 claim that red wine drinking does not appear to increase breast cancer risk. In the corresponding news release (cedars-sinai.edu/About-Us/ News/News-Releases-2012/Moderate-Red-Wine-DrinkingMay-Help-Cut-Womens-Breast-Cancer-Risk-Cedars-SinaiStudy-Shows.aspx), it was even suggested that drinking red wine in moderation may reduce one of the risk factors for breast cancer, providing a natural weapon to combat a major cause of death among U.S. women. We disagree with the statements made in the article and press release. Regarding the experimental approach of Shufelt et al., it must be noted that the trial design was not blinded, meaning that the women were aware of the beverage type (i.e., red or white wine) they were consuming, as they were given the wine bottles to ‘‘take home.’’ The results could, therefore, be purely a result of the placebo effect, especially as the alleged health benefits of red wine (‘‘French paradox’’) have been widely communicated in the past. Even if the results of Shufelt et al. held up in a double-blinded experimental design, this still does not mean that there is any difference between red and white wine regarding breast cancer risk. The World Health Organization (WHO) International Agency for Research on Cancer (IARC), based on a careful examination of all biologic and epidemiologic evidence, came to the conclusion that for breast cancer there is an increased risk with increasing alcoholic beverage consumption regardless of the beverage type. A small increase from abstinence to drinking less than one standard drink per day, which is the equivalent of 12 g pure alcohol, was associated with elevated breast cancer risk based on a reanalysis of individual data of almost 60,000 women with the disease and more than 95,000 controls. This result corroborates other meta-analyses (for a short overview, see reference 4; details are given in reference 2). The hormone-modulated mechanism for ethanol-related carcinogenesis, which may be influenced by red wine according to Shufelt et al., is only one of several possible mechanisms. As the breast epithelium expresses class I alcohol dehydrogenase, the tissue may be susceptible to acetaldehyde, the oxidation product of ethanol. This mechanism leading to DNA adduct formation was recently confirmed in vitro. As there are no significant differences between white wine and red wine in regard to alcohol content, the acetaldehyde-related mechanism cannot be influenced by wine type as the hormone-modulated mechanism could be. For these reasons, we think that the current state of research does not allow concluding that red wine is less carcinogenic than white wine (or any other alcoholic beverage). In review of the facts and of the significant risks even at low levels of consumption, consumer communications to women should refer to the IARC and state that alcoholic beverages cause breast cancer independent of beverage type.