Everything bad for you is good for you is bad for you

Suppose you are a woman who enjoys a glass of wine or two with dinner.  This is the amount of alcohol you consume most of the time, and rarely if ever do so excessively.  You don’t drive drunk, you can forgo drinking without difficulty, and drinking has caused no appreciable problems for you.  You are as typical a moderate drinker as can be found.

How should you respond to the recent report of a new study that demonstrates increased risk of breast cancer with alcohol consumption, even in moderation?  From the Times:

Some women who drink to their health may want to reconsider. A new study shows that women who routinely have even small amounts of alcohol, as few as three drinks a week, have an elevated risk of breast cancer.

The research, which looked at the habits of more than 100,000 women over 30 years, adds to a long line of studies linking alcohol consumption of any kind — whether beer, wine or spirits — to an increased risk of breast cancer. But until now the bulk of the research largely focused on higher levels of alcohol intake. The latest study is among the first to assess the effect of relatively small amounts of alcohol over long periods of time, drawing on a large population of women to provide new detail about the breast cancer risks associated with different patterns of drinking.

Based upon this one data point, it would seem that being a teetotaler is the healthiest choice a woman could make.  But the Times continues:

The rise in cancer risk from three to six drinks a week, though, was modest, and for many women may not be enough to outweigh the heart-healthy benefits of drinking in moderation.

Indeed, drinking an alcoholic beverage every day is likely to reduce the risk of heart disease.  Per the American Heart Association:

[A] large number of observational studies have consistently demonstrated a reduction in coronary heart disease with moderate alcohol consumption. Prohibiting alcohol consumption would deny a potentially sizable health benefit to people who would otherwise choose to drink.

So what’s the right decision?  Heart disease is the leading killer of women in the United States.  However, cancer is right behind it, and breast cancer is the most common cancer women get.  On the other hand, 267,000 women die annually from heart attacks, compared to just 39,520 from breast cancer.

For women with significant risk factors for one of these diseases (eg. multiple family members who have died either of heart disease or breast cancer), it makes sense to make their lifestyle choices accordingly.  A woman with a BRCA1 mutation, for example, might want to curtail her alcohol consumption.  For the vast majority of women somewhere in the middle there’s little reason to change behavior.  Teasing out the role of various different contributory factors in the development of disease for any given person is incredibly difficult, and just about everything we consume has positives and negatives.  Some things, such as smoking cigarettes, increase the risk of numerous diseases enough that any possible benefit is grossly outweighed for most of us.  Most things fall somewhere in the murky middle.  They may help a little, they may hurt a little, but in the long run it’s probably okay to enjoy them in reasonable amounts.


Russell Saunders

Russell Saunders is the ridiculously flimsy pseudonym of a pediatrician in New England. He has a husband, three sons, daughter, cat and dog, though not in that order. He enjoys reading, running and cooking. He can be contacted at blindeddoc using his Gmail account. Twitter types can follow him @russellsaunder1.


  1. Somewhere in here, the question has to be asked… do you like drinking wine? If so, that should factor in there somewhere.

    (In truth, I suspect it’s usually the overriding factor. People often pick and choose the location of the health pinball as justification for the lifestyle they would already be choosing for other reasons.)

    (Okay, maybe I’m the only one that does that. Hey. Milk chocolate has milk. Calcium!)

    • Well, yes. I assumed the women asking this question are ones who like the consumption of alcohol. If they hate it, then that’s the overriding factor in their considerations.

      • My comment was unclear. I was thinking of those who enjoy it. The thought of taking out wine from dinner, if one enjoys it, seems tragic absent rather compelling evidence. We’re always finding out new things. New dangers and occasionally new benefits.

        It’s one thing to quite smoking due to the clear and compelling link to all manner of health problems. It seems another to give up one of life’s little joys on a less-than-one-percent tacked on to the likelihood of something bad happening.

        I’m not saying such things shouldn’t be studied. I just shudder to think, based on what I am seeing, anyone without a substantial history of breast cancer giving up their wine for this. Fortunately, I think few will.

    • I can’t watch the talk right now, but I infer that it deals with flaws in medical studies. Not having the study referenced above right in front of me, I can’t speak directly to its strengths or weaknesses. It does, however, seem to have some things going for it, including a huge number of study subjects and a very long period of study,

      • Ben talks about the flaws in medical studies, yes, but he also talks about the flaws in the medical study publication process.

        Which, honestly, is a valid critique of the general science publication process, as well.

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