‘Don’t Drink Alone’ Gets New Meaning

In what may be bad news for bars and pubs, a European research consortium has found that people drinking alcohol outside of meals have a significantly higher risk of cancer in the mouth and neck than do those taking their libations with food.

Luigino Dal Maso of the Cancer Referral Center in Aviano, Italy, and his colleagues studied the drinking patterns of 1,500 patients from four cancer studies and another 3,500 adults who had never had cancer. All lived in Italy or French-speaking Switzerland.

After the researchers accounted for the amount of alcohol consumed, they found that individuals who downed a significant share of their alcohol outside of meals faced at least a 50 to 80 percent higher risk of cancer in the oral cavity, pharynx, and esophagus, when compared with people who drank only at meals. Consuming alcohol without food also increased by at least 20 percent the likelihood of laryngeal cancer. The findings appear in the International Journal of Cancer.

Roughly 95 percent of cancers at these four sites traced to smoking or drinking by the study volunteers, Dal Maso says. The discouraging news, his team reports, is that drinking with meals didn’t eliminate cancer risk at any of the sites.

Lots of heavy drinkers

For their new analysis, the European scientists divided people in the study into four groups, based on how many drinks they reported having in an average week. The lowest-intake group included people who averaged up to 20 drinks a week. The highest group reported downing at least 56 servings of alcohol weekly–or an average of eight or more per day. Cancer risks for the mouth and neck sites rose steadily with consumption–even for people who reported drinking only with meals.

For instance, compared with people in the lowest-consumption group, participants who drank 21 to 34 alcohol servings a week at least doubled their cancer risk for all sites other than the larynx. If people in these consumption groups took some of those drinks outside meals, those in the higher consumption group at least quadrupled their risk for oral cavity and esophageal cancers.

People in the highest-consumption group who drank only with meals had 10 times the risk of oral cancer, 7 times the risk of pharyngeal cancer, and 16 times the risk of esophageal cancer compared with those who averaged 20 or fewer drinks a week with meals. In contrast, laryngeal cancer risk in the high-intake, with-meals-only group was only triple that in the low-intake consumers who drank only with meals.

Alcohol can inflame tissues. Over time, that irritation can trigger cancer, Dal Maso says. He suspects that food reduced cancer risks either by partially coating digestive-tract tissues or by scrubbing alcohol off those tissues.

He speculates that the reason laryngeal risks were dramatically lower for all study participants traces to the tissue’s lower exposure to alcohol. Swallowed liquid doesn’t wash across the larynx, he points out. Any contact comes from vapors that escape a liquid being ingested.

The take-home message Dal Maso reads from his group’s data is “to consume alcohol in little amounts, and when you do–eat!”

Location, location, location

Such findings suggest why drinking in taverns and pubs may pose special risks, says Jürgen Rehm of the Addiction Research Institute in Zurich. Not only do many people in bars drink alcohol in the absence of food, but also the setting invites drinking to excess.

Scores of studies have shown that drinking moderately–generally about two drinks per day–confers a host of benefits to people’s hearts. Indeed, in a study of U.S. adults that Rehm’s team published 2 years ago, such moderate drinkers had a lower risk of death from all causes over an 11-year follow-up than those who either drank more or less than moderate amounts.

Moreover, a growing number of studies find that people who binge by downing 5 to 8 drinks in one day at least twice a month, derive little or no cardiovascular benefits normally associated with alcohol.

Next week: Binge-drinking is on the rise.

Janet Raloff

Janet Raloff is the editor of Science News for Students, a daily online magazine for middle school students. She started at Science News in 1977 as the environment and policy writer.

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