At some point during the next few weeks or months, the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) will, as they do every five years, publish the new edition of their Dietary Guidelines for Americans. It is expected that they may amend the 2020 advisory which recommended a maximum consumption of two drinks per day for men and one for women.
The authors’ task will not have been made any easier by the publication within weeks of two apparently contradictory reports. In December, the influential US National Academies of Sciences, Engineering, and Medicine (NASEM) declared that “No conclusions could be drawn when comparing the risk of colorectal cancer for moderate alcohol consumers versus lifelong non-consumers, nor could an association be made between moderate alcohol consumption and oral cavity, pharyngeal, esophageal, or laryngeal cancers.”
On January 3rd, however, the US Surgeon General’s Summary of Evidence of The Causal Relationship Between Alcohol Consumption and Cancer, included all four of these among its list of cancers whose risk is raised by drinking alcohol. The Surgeon General also included liver, and colorectal cancer, about which NASEM had stated “No conclusions could be drawn when comparing the risk… for moderate alcohol consumers versus lifelong non-consumers.” The only area in which the Surgeon General and NASEM agree is about the link between alcohol and breast cancer.
Is it worth it?
People who take the trouble to read the Surgeon General’s advisory carefully will discover what the increased risk actually represents. Women who consume less than one drink a week have an 11% chance of getting breast cancer during their lifetime compared to 15% for those who consume one or two drinks per day. Some may consider that 4% increase, to be a risk worth taking in return for the pleasure of a lifetime of moderate drinking. Others may take a different view.
Crucially, for the industry, the Surgeon General proposes a number of “actions we can take today to begin reducing alcohol-related cancers in the U.S”. These include “updating the existing Surgeon General’s health warning label… to include a warning about the risk of cancer… [and making] the warning label more visible, prominent, and effective in increasing awareness about cancer risks”.
The authors of the new Dietary Guidelines for Americans will also note the Surgeon General’s proposal that recommended limits for alcohol consumption by “reassessed” to account for the latest evidence on alcohol consumption and cancer risk.
Unsurprisingly, perhaps, the Surgeon General makes no acknowledgement of the NASEM authors’ findings that moderate male and female drinkers have a lower risk of cardiovascular mortality. And that, compared with never consuming alcohol, consumption of two drinks per day for men or one for women, is associated with lower all-cause mortality.
