How demographic changes in Brazil impact health and excessive alcohol use

Population aging, an unprecedented global phenomenon, has become a major public health concern, significantly impacting disease epidemiology and placing a burden on healthcare systems. A recent study revealed that in 2017, 51% of the global burden of disease in adults was age-related, especially cardiovascular diseases and neoplasms [1]. Aging can lead to progressive loss of physical, mental and cognitive integrity, resulting in impaired functions and greater vulnerability to disease and death.

Using data from 2000 to 2020, the study "Demographic shifts and health dynamics: Exploring the impact of aging rates on health outcomes in Brazilian capitals" [2] investigated the relationship between demographic changes, particularly population aging, and health outcomes in Brazilian capitals. The study explores how population aging and other socioeconomic variables influence health indicators, such as mortality from chronic non-communicable diseases (NCDs) and hospitalizations for “primary care sensitive conditions” (PCSC), that is, health conditions that can be treated in basic health units and which, if they are not available, can lead to hospitalization; a common example of PCSC is hypertension.

The results showed that among men, population aging rates were associated with greater occurrences of excess weight and diabetes, while in women, several factors, including smoking, excessive alcohol consumption, hypertension, diabetes and obesity, were associated with higher rates of population aging.

The increase observed in population aging rates in all Brazilian regions, mainly in the South and Southeast, reflects an intense demographic transformation. Capitals with a greater aging population also have higher rates of mortality from NCDs and hospitalizations from  PCSC. Health inequalities between Brazilian capitals are also increasing, with poorer cities experiencing worse health outcomes.

This trend reflects global patterns already highlighted by the United Nations, indicating potential strains on public health and healthcare systems as populations age. Implementing public health policies aimed at meeting the needs of the elderly population is a major challenge in this scenario. With the expansion of the elderly population, there will be an increase in demand for health services. Social security systems may also face pressure as the disparity between workers and retirees widens. Political preparation is essential to face these issues. Investments in preventive health care for seniors, along with workforce development initiatives, can help alleviate the impact of an aging population.

References:

Chang, A. Y., Skirbekk, V. F., Tyrovolas, S., Kassebaum, N. J., & Dieleman, J. L. (2019). Measuring population ageing: An analysis of the Global Burden of Disease Study 2017. The Lancet Public Health, 4(3), e159–e167. https://doi.org/10.1016/S2468-2667(19)30019-2

Are the brains of men and women differently affected by alcohol and stress?

A new study looks at how the brains of men and women diagnosed with alcohol use disorder respond to stressful stimuli and triggers for alcohol consumption. The differences found are surprising!

Stress is an aggravating factor for alcohol consumption and significantly affects mental health. In this sense, drinking to deal with negative emotions should be considered a warning sign, as it increases the chances of problems with alcohol. In cases where alcohol is already a problem, any stress or trigger, such as seeing images of people drinking, can increase the risk of binge drinking.

Seeking to understand how biological sex can affect these aspects, researchers at Yale University carried out a survey of 77 participants (46 men and 31 women) diagnosed with disorders associated with alcohol use. These participants were asked to view 3 types of images while “mapping” of the brain activity of these individuals was carried out (a technique called “functional magnetic resonance imaging”). After this mapping, patients were monitored for eight weeks regarding their daily alcohol consumption.

The main objective of the research was to evaluate how different “maps” of brain activity were associated with days of heavy drinking over the following eight weeks. And indeed, the researchers found some significant differences: for example, among women, a lower level of brain activation in a region called the anterior cingulate cortex was found to be correlated with more days of heavy drinking. This finding was not observed in males, who, in turn, had a higher level of activation in brain regions known as the hypothalamus and hippocampus.

All of these regions are important components of the brain reward system, and are linked to drug addiction. Such results lead researchers to point out the possibility that alcohol consumption among female and male people occurs due to the activation of different regions of the reward system, highlighting the need to search for different therapeutic strategies according to the sex of the patient. Although more studies are needed to reach a more solid conclusion on the subject, these results contribute to a general trend in the health sector to provide more individualized therapeutic care, taking into account not only disorders, but various characteristics of the individual, such as gender and age.

References:

Radoman, M., Fogelman, N., Lacadie, C., Seo, D., & Sinha, R. (2024). Neural correlates of stress and alcohol cue-induced alcohol craving and of future heavy drinking: evidence of sex differences. American journal of psychiatry, 181(5), 412-422.

Alcohol consumption and risk of dementia

Study analyzes the impact of alcohol consumption on regions of the brain and the impact on the development of dementia.

Recently, several media outlets published a study showing the main risk factors for the development of dementia, with harmful alcohol consumption, air pollution and diabetes being the three main ones. The study, carried out by researchers at the University of Oxford, and published in the journal Nature Communications, presents a sophisticated methodology for analyzing a United Kingdom database, the UK Biobank, already used in other studies published by CISA.

The study, published in March 2024, analyzed the effect of risk factors on a set of brain regions with greater vulnerability to the aging process and dementia. In total, 15 risk factors for dementia were investigated, such as diabetes, blood pressure, cholesterol level, weight, smoking, air pollution, socialization and alcohol consumption. To carry out this investigation, an analysis of the genome of around 40 thousand people was carried out through the UK Biobank.

Seeking to identify the risk factors associated with the degeneration of a brain network known as LIFO, the authors first investigated the natural reduction of gray matter (a region containing neurons) presented by the 40,000 biobank data. This LIFO network is associated with important cognitive functions such as attention, working memory and other cognitive functions. After that, along with genetic analysis, the researchers compared the results of the LIFO network degeneration with data from participants about the modifiable risk factors mentioned above, important for the development of dementia.

The authors point out that this study reveals both genetic and modifiable risk factors associated with one of the most fragile regions of the brain for aging and the development of dementia. The authors conclude that the findings pave the way for new research on aging.

References:

Manuello, J., Min, J., McCarthy, P., Alfaro-Almagro, F., Lee, S., Smith, S., ... & Douaud, G. (2024). The effects of genetic and modifiable risk factors on brain regions vulnerable to ageing and disease. Nature Communications, 15(1), 2576.

Gout and alcohol consumption

How can alcohol consumption affect Gout?

According to the Brazilian Society of Rheumatology (1), gout is an inflammatory disease that mainly affects the joints and occurs when the level of uric acid in the blood is above normal levels (hyperuricemia). As alcohol consumption is one of the risk factors for this disease, recent research (2) sought to analyze the association between alcohol consumption and damage caused by gout, especially the formation of “tophi”. These are skin nodules that generally form around joints, such as the knees, elbows and fingers.

In this Chinese study, more than 500 patients diagnosed with gout were studied, and it was sought to evaluate the association of gout with the frequency of consumption, as well as the quantity, time and type of alcoholic beverage consumed. To compare consumption patterns, the researchers separated three groups: abstainers, moderate drinkers and excessive drinkers. In general, excessive drinkers are those who consume more than 5 alcoholic drinks per week.

The researchers found significant associations between the consumption pattern and the appearance and severity of tophi resulting from gout. Compared to abstainers, people who drank excessively had a higher proportion of tophi, with greater size and quantity. Excessive consumption increases the chance of detecting tophi by 79%. Furthermore, long-term drinking, defined as consumption for more than ten years, increased the chances of detecting tophi by 96%; finally, the drinking of distilled beverages more than doubled the chances of detecting gout tophi.

Given these data, the authors concluded that long-term, excessive alcohol consumption and distilled beverages were predictors for the development of severe gout, with the appearance of tophi. Furthermore, for people who already have tophi, the authors conclude that any amount of alcohol (even moderate) leads to the worsening of the condition, with the appearance of more tophi.

References:

1. Sociedade Brasileira de Reumatologia. Doenças reumáticas: Gota. 2022. Disponível em: https://www.reumatologia.org.br/doencas-reumaticas/gota/
2. Han, L., Li, R., Lu, J., Ren, W., Ning, C., Pang, J., ... & Li, C. (2023). Association of the quantity, duration, and type of alcohol consumption on the development of gouty Tophi. Arthritis Care & Research, 75(5), 1079-1087.

Latest research on moderate drinking

Alcohol is a substance that has been present in our civilization for thousands of years and will probably continue for many more. However, an extensive body of evidence and studies has shown that there is no safe limit for alcohol consumption that is free from health risks (2–5). Much of this evidence comes from the Global Burden of Disease and Risk Factors (GBD) study (1), involving dozens of researchers around the world. Consequently, several countries began to reduce their moderate drinking recommendations, such as Australia and Canada.

In addition to the semantics of the term “moderate drinking”, it is understood that low-risk consumption is a type of alcohol use pattern that follows epidemiological parameters and is socially acceptable, such as, for example, speed limits for vehicles motor vehicles on roads (6). As rightly stated in the scientific article by Holmes et al. (2019) (7), public policy makers must balance epidemiological evidence, expert opinion and pragmatic considerations.

Due to the complexity of the topic, there are important counter-arguments against the interpretation that the only possible recommendation in this scenario would be abstinence. After all, a consumption recommendation that is not feasible would not be truly effective. For example, in an article published in the journal The Lancet Rheumatology (8), the editorial board raises some important points for the debate. In summary, the authors state that:

“The WHO [World Health Organization] warns that there should be greater education about the cancer risks associated with alcohol consumption – possibly including health warnings on alcoholic drink labels – and few would argue against better informing the public regarding the health. But the absolute risks of light to moderate drinking are small, and although there is no known safe level of consumption, it seems reasonable that the quality of life gained from an occasional drink could be considered greater than the potential harm.”

These final remarks are relevant as they recognize the risks associated with low levels of alcohol consumption, as is the case for some types of cancer, and point out that measures that inform consumers of such risks are welcome. The counterpoint made comes from the notion that the absolute risk of health problems in people who drink light to moderately is low. Furthermore, the authors point out that, potentially, the quality of life resulting from the occasional consumption of an alcoholic drink may be greater than the potential harm.

In a study from 2022 (9), the GBD group points out that, after analyzing data from 1990 to 2020, there is strong evidence that alcohol consumption recommendations should be differentiated by age group and local disease rates. For individuals aged 15 to 39 years, the proposed recommendation is 0 to 0.698 drinks per day; for individuals over 40 years of age, the recommendation is 0.114 to 1.87 daily drinks, taking into account a minimum risk of exposure. Although the authors assume that any level of alcohol consumption implies some risk of injury, based on evidence that small amounts of alcohol reduce the risk of some conditions prevalent in older ages, such as ischemic heart disease and diabetes, they conclude that small amounts of alcohol would be safe for people over 40.

There is yet another body of evidence that is emerging regarding the influence of lifestyle on the development of chronic diseases. In 2014, the World Health Organization attributed more than two-thirds of deaths worldwide (38 million) to chronic diseases. Well-established evidence shows that the incidence of cancer, cardiovascular diseases, chronic respiratory diseases and diabetes share modifiable risk factors such as alcohol consumption, body mass index (BMI), smoking, unhealthy diet and physical inactivity. A study examining the incidence of a person's first diagnosis of a chronic disease and the relationships between modifiable lifestyle risk factors (10) showed that for both sexes, not consuming alcohol was associated with a higher risk of diabetes and myocardial infarction in both sexes. Unhealthy BMI has been linked to increased risks of diabetes in both sexes and chronic obstructive pulmonary disease (COPD), lung cancer and myocardial infarction in men. Decreased daily fruit and vegetable consumption was associated with an increased risk of diabetes in both sexes, lung cancer and COPD. As chronic diseases become more prevalent with advancing age, the idea that moderate alcohol consumption is safer for people over 40 years of age, the age group in which coronary heart disease and diabetes are more common, gains reinforcement.

Therefore, it is reasonable to think that the new guidelines, based on the premise that there is no safe level of alcohol consumption, should not be interpreted as a recommendation of abstinence for all people, or that it would no longer be possible to talk about moderation. For some populations, the recommendation remains zero alcohol, as in the case of pregnant women, drivers, and people who, due to some health condition, cannot ingest the substance. However, for people who do not have these limitations, new research, in addition to pointing to the fact that there are risks involved in all consumption patterns (which are exponential in high levels), also indicates that the risk of consumption should be considered based on other variables, such as age and factors associated with lifestyle. In any case, there is still a need for more studies that can support public policies to guide the population that wants to drink and stay healthy.

References:

1. Gratacós-Ginès, J., Bruguera, P., Pérez-Guasch, M., López-Lazcano, A., Borràs, R., Hernández-Évole, H., Pons-Cabrera, M. T., Lligoña, A., Bataller, R., Ginès, P., López-Pelayo, H., & Pose, E. (2024). Medications for alcohol use disorder promote abstinence in alcohol-associated cirrhosis: Results from a systematic review and meta-analysis. Hepatology (Baltimore, Md.), 79(2), 368–379. https://doi.org/10.1097/HEP.0000000000000570
2. Addolorato G., Mirijello A., Barrio P., Gual A. Treatment of alcohol use disorders in patients with alcoholic liver disease. J. Hepatol. 2016;65:618–630. doi: 10.1016/j.jhep.2016.04.029.
3. O'Shea, R. S., Dasarathy, S., McCullough, A. J., Practice Guideline Committee of the American Association for the Study of Liver Diseases, & Practice Parameters Committee of the American College of Gastroenterology (2010). Alcoholic liver disease. Hepatology (Baltimore, Md.), 51(1), 307–328. https://doi.org/10.1002/hep.23258
4. Jonas, D. E., Amick, H. R., Feltner, C., Bobashev, G., Thomas, K., Wines, R., Kim, M. M., Shanahan, E., Gass, C. E., Rowe, C. J., & Garbutt, J. C. (2014). Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis. JAMA, 311(18), 1889–1900. https://doi.org/10.1001/jama.2014.3628
5. Addolorato, G., Leggio, L., Ferrulli, A., Cardone, S., Vonghia, L., Mirijello, A., Abenavoli, L., D'Angelo, C., Caputo, F., Zambon, A., Haber, P. S., & Gasbarrini, G. (2007). Effectiveness and safety of baclofen for maintenance of alcohol abstinence in alcohol-dependent patients with liver cirrhosis: randomised, double-blind controlled study. Lancet (London, England), 370(9603), 1915–1922. https://doi.org/10.1016/S0140-6736(07)61814-5

What are the main treatments for alcoholism?

There are several treatment options for recovering from alcoholism, but it is necessary to obtain medical advice to identify which is most suitable for the patient.

Alcohol dependence is a complex condition that affects millions of people around the world, harming the physical and mental health of the person with this condition, as well as their interpersonal relationships. However, despite the harmful effects of alcoholism, recovery is possible when the process is carried out through appropriate treatment.

But what types of treatment are available for people diagnosed with alcohol dependence?

Although some believe that treatment is only possible through Alcoholics Anonymous or by controlling alcohol consumption at home, there are other options that are offered in different settings and that can be highly effective.

Main treatment options

Psychotherapeutic treatment

Psychotherapy is important in the treatment of alcoholism because it addresses underlying emotional issues, allowing us to understand what leads the addict to abuse alcoholic beverages and learn how to deal with problems without resorting to these substances. Furthermore, it is a fundamental aid in preventing relapses and creating a sober and healthy life plan. Counting on the aid of a therapist can help develop strategies for coping with the disease.

Among psychotherapeutic treatments, Cognitive Behavioral Therapy (CBT) is usually highly recommended for disorders related to alcohol abuse, as it emphasizes the relationship between thoughts, behaviors and emotions. Through CBT, it is possible to deconstruct preconceived thoughts, such as “I'm just going to drink a little, then I'll stop” or “if I don't drink, I won't be able to relax”, among others.

Pharmacological treatment

In addition to psychotherapeutic interventions, there are medications that can assist in treatment, reducing the desire to drink and anxiety, and relieving withdrawal symptoms when the person stops or reduces alcohol intake.

Three drugs, approved by the Food and Drug Administration (FDA), are used as the basis of treatments: disulfiram, naltrexone and acamprosate.

• Disulfiram is an enzyme inhibitor that causes adverse effects such as nausea, vomiting and even seizures if used in conjunction with alcohol consumption. Thus, it causes the addict to create an aversion to alcoholic beverages due to these effects.
• Naltrexone acts as an antagonist at opioid receptors, reducing the pleasurable effects of alcohol, cravings and feelings of euphoria caused by the substance.
• Acamprosate acts by reducing glutamate-induced calcium uptake, suppressing conditioned responses to alcohol and alleviating withdrawal symptoms.

It is important to emphasize that these medications should always be used under medical advice.

Mutual aid groups

Mutual aid groups, such as Alcoholics Anonymous (AA), are popular among those who want recovery and are a good way to get support, especially for people with spiritual inclinations or those who cannot afford medical treatment or are unable to access public treatments.

Family therapy

Alcohol dependence affects not only the alcoholic, but everyone around them, which is why the family can also – and should – resort to therapeutic support in order to better understand the disease, its symptoms and consequences, as well as receive guidance on the best way of dealing with the addict and his/her dependency.

Often, the family “gets sick” with the person with alcohol dependence, which is why family support is essential so that everyone can get support to better understand the disease and deal with the condition throughout the recovery process.

It is worth remembering that the family plays a very important role in treatment and recovery, as it is they who will help the alcoholic to adhere to and remain in treatment, as well as to overcome difficulties and establish a new lifestyle.

Physical activity

According to research (1), practicing physical activity can reduce the risk of mortality and reduce imbalances caused by alcohol, such as changes in sleep, muscle weakness, irritability and low self-esteem. Furthermore, practicing sports provides more interaction and contact with other people, which can help prevent relapses.

How to identify the best treatment option?

Just as there are a diversity of treatment options, there are also different profiles of people with alcohol dependence, which is why seeking help from medical professionals is the best way to identify the disease and be redirected to the most appropriate treatment. These professionals are the ones who will be able to carry out a detailed and multidisciplinary assessment to understand the alcoholic's profile, consumption patterns, whether the dependence is due to emotional, physical or interpersonal problems, and other issues.

This means that when it comes to treatment, there is no single option that fits everyone, and what works for one patient may not work for another.

References:

Referências:

1 Hallgren, M., Vancampfort, D., Giesen, E. S., Lundin, A., & Stubbs, B. (2017). Exercise as treatment for alcohol use disorders: systematic review and meta-analysis. British journal of sports medicine, 51(14), 1058–1064. https://doi.org/10.1136/bjsports-2016-096814

Rangé BP, Marlatt GA. Terapia cognitivo-comportamental de transtornos de abuso de álcool e drogas. Rev Bras Psiquiatr. 2008;30(SUPPL. 2):s88-s95. doi:10.1590/S1516-44462008000600006

National Institute on Alcohol Abuse and Alcoholism (NIAAA). What to Know about Alcohol Treatment. https://alcoholtreatment.niaaa.nih.gov/what-to-know

Are alcoholism medications safe for people with cirrhosis?

A recent study analyzed the use of medications for alcohol use disorder in patients with cirrhosis, as the safety and effectiveness of these medications in this population is scarce.

A recent study analyzed the use of medications to promote alcohol abstinence in patients with alcohol dependence and cirrhosis [1]. Through research encompassing several studies, it was possible to assess whether the medications reduced consumption or promoted abstinence and whether there was safety in terms of side effects for people with liver problems.

The liver, the main organ responsible for alcohol metabolism, suffers damage due to excessive consumption, characterizing alcoholic liver disease. This can range from asymptomatic changes, such as fatty liver (hepatic steatosis), to alcoholic hepatitis and alcoholic cirrhosis. Early diagnosis and abstinence are fundamental in the treatment strategy for alcoholic liver disease, especially in the early stages, where there is still no irreversible damage and liver decompensation [2].

The presence of alcoholic cirrhosis and its complications can alter the action of medications, impacting the safety of use and increasing side effects. Therefore, the characteristics of the medication and the way it is administered must always be considered in cirrhotic patients.

Since clinical treatment options are limited to improve liver function in patients with cirrhosis, alcohol abstinence is the most important and proven therapeutic intervention [3]. However, many patients have difficulty achieving abstinence. Medications approved for alcohol use disorder include: naltrexone, which helps reduce excessive alcohol consumption; acamprosate, which facilitates the maintenance of abstinence; and disulfiram, which blocks the body's metabolism of alcohol, causing unpleasant symptoms such as nausea and redness of the skin. Other medications, such as baclofen, gabapentin, sertraline and topiramate, are also studied [4]. Among them, only baclofen has been shown to be safe and effective in maintaining abstinence in individuals with liver disease [5].

Seeking to analyze the side effects and effectiveness of medications in patients with cirrhosis or liver disease, even with limitations due to the low level of studies found, the study indicated that the use of medications can increase the probability of alcohol abstinence by 32% compared to placebo or standard treatment. Furthermore, the safety profile of these medications was considered adequate in most studies, suggesting that they may be an alternative for the treatment of patients with alcoholic cirrhosis. However, it is important to highlight the need for more research, especially in patients with advanced liver disease, to confirm these findings and evaluate the safety of these medications in this vulnerable population [1].

Therefore, if you or someone you know is dealing with alcohol use disorder and cirrhosis, it is essential to follow medical recommendations. Appropriate treatment can significantly increase quality of life and survival.

References:

1. Gratacós-Ginès, J., Bruguera, P., Pérez-Guasch, M., López-Lazcano, A., Borràs, R., Hernández-Évole, H., Pons-Cabrera, M. T., Lligoña, A., Bataller, R., Ginès, P., López-Pelayo, H., & Pose, E. (2024). Medications for alcohol use disorder promote abstinence in alcohol-associated cirrhosis: Results from a systematic review and meta-analysis. Hepatology (Baltimore, Md.), 79(2), 368–379. https://doi.org/10.1097/HEP.0000000000000570
2. Addolorato G., Mirijello A., Barrio P., Gual A. Treatment of alcohol use disorders in patients with alcoholic liver disease. J. Hepatol. 2016;65:618–630. doi: 10.1016/j.jhep.2016.04.029.
3. O'Shea, R. S., Dasarathy, S., McCullough, A. J., Practice Guideline Committee of the American Association for the Study of Liver Diseases, & Practice Parameters Committee of the American College of Gastroenterology (2010). Alcoholic liver disease. Hepatology (Baltimore, Md.), 51(1), 307–328. https://doi.org/10.1002/hep.23258
4. Jonas, D. E., Amick, H. R., Feltner, C., Bobashev, G., Thomas, K., Wines, R., Kim, M. M., Shanahan, E., Gass, C. E., Rowe, C. J., & Garbutt, J. C. (2014). Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis. JAMA, 311(18), 1889–1900. https://doi.org/10.1001/jama.2014.3628
5. Addolorato, G., Leggio, L., Ferrulli, A., Cardone, S., Vonghia, L., Mirijello, A., Abenavoli, L., D'Angelo, C., Caputo, F., Zambon, A., Haber, P. S., & Gasbarrini, G. (2007). Effectiveness and safety of baclofen for maintenance of alcohol abstinence in alcohol-dependent patients with liver cirrhosis: randomised, double-blind controlled study. Lancet (London, England), 370(9603), 1915–1922. https://doi.org/10.1016/S0140-6736(07)61814-5

Harmful alcohol consumption and breast cancer

Understand how harmful alcohol consumption can be related to the disease.

Cancer is one of the leading death causes worldwide, responsible for approximately 10 million deaths in 2020, or almost one in every six deaths. Breast cancer is currently the most prevalent tumor worldwide. Factors that increase the risk of breast cancer include old age, obesity, harmful alcohol consumption, family history of breast cancer, radiation exposure, gynecological history (age of menarche, first pregnancy, etc.), smoking, and postmenopausal hormone therapy (1).

Excess alcohol has carcinogenic potential, that is, it can cause various types of cancer. There is epidemiological evidence that alcohol consumption increases the risk of tumors in many organs, for example, in the oral cavity, larynx, esophagus, liver, pancreas and colorectum (2). According to the Global Cancer Observatory of the International Agency for Research on Cancer (IARC), an institution part of the WHO, 4.1% of new cases in 2020 were attributable to alcohol consumption.

Effects of alcohol on breast cancer (3)

Alcohol consumption is well established as a risk factor for breast cancer. The involvement of alcohol consumption in breast cancer is a complex process that acts through several mechanisms. And although alcoholic beverages contain a variety of compounds that contribute to carcinogenesis (the process of cancer formation), alcohol itself appears to be the most important component in this case.

However, the underlying mechanisms for alcohol to be carcinogenic still need to be clarified. Potential mechanisms include: oxidative stress, cell proliferation, effects on hormones (particularly steroid hormones), and effects on carbon metabolism.

When ingested, alcohol is metabolized into acetaldehyde, classified as carcinogenic by IARC. Although the production of acetaldehyde from alcohol occurs mainly in the liver, it also occurs in breast tissues and one of the adverse effects of acetaldehyde include modifications to DNA. Hormonal effects due to alcohol consumption may also contribute to breast cancer. Consumption of alcoholic beverages increases hormone levels. One study reported that consumption of 30g of ethanol (~2.5 drinks) per day for three menstrual cycles was associated with a 28% increase in plasma estradiol and a 21% increase in plasma estrone among women aged 21 to 40 years (4). Elevated intracellular estrogen levels resulting from alcohol intake may promote cancer-related cell proliferation in breast tissue.

Different patterns of alcohol consumption may have different effects on the development of breast cancer, even when the total amount of alcohol intake is constant (5). According to IARC, the risk of developing breast cancer increases by 7 to 10% for every 10g (∼1 drink) of alcohol consumed daily by adult women. This association is observed in both premenopausal and postmenopausal women. Compared to other organs, the breast appears to be more susceptible to the carcinogenic effects of alcohol. This raises a clinical and public health concern, because almost half of women of childbearing age drink alcohol and 15% of drinkers at this age drink four or more drinks at the same time (4).

In Brazil, for example, a study carried out by FIOCRUZ (6) with more than 1,500 women under 50 years of age showed that those who consumed alcohol regularly for 10 years or more had a three times greater risk of developing breast cancer compared to teetotalers or  occasional drinkers.

Healthy habits are essential for preventing breast cancer and other diseases, so try to practice physical activity, maintain adequate body weight, adopt a balanced diet and, if you decide to drink, consume in moderation.

References:

1. OMS (2023). Brest cancer. Disponível em: https://www.who.int/news-room/fact-sheets/detail/breast-cancer.
2. Connor, Jennie. "Alcohol consumption as a cause of cancer." Addiction 112.2 (2017): 222-228.
3. Freudenheim JL. Alcohol's Effects on Breast Cancer in Women. Alcohol Res. 2020 Jun 18;40(2):11.
4. Liu, Ying, Nhi Nguyen, and Graham A. Colditz. "Links between alcohol consumption and breast cancer: a look at the evidence." Women’s health 11.1 (2015): 65-77..
5. Starek-Świechowicz, B., Budziszewska, B., & Starek, A. (2023). Alcohol and breast cancer. Pharmacological reports : PR, 75(1), 69–84. https://doi.org/10.1007/s43440-022-00426-4
6. Vieira R, Tobar JSS, Dardes R, Claudio L, Thuler S. Alcohol Consumption as a Risk Factor for Breast Cancer Development: A Case-Control Study in Brazil. Asian Pac J Cancer Prev. 2018 Mar 27;19(3):703-707.