Current Research on Alcohol Consumption, Heart Disease and Cancer

Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

Alcohol consumption as it relates to the impact on heart disease and cancer has been a hot topic for many years. Many people want to believe that the consumption of red wine is protective and for some even therapeutic for cardiovascular disease. Unfortunately strong peer reviewed studies show the contrary. In fact the evidence is so overwhelming that even a small amount of alcohol is outright dangerous!

Many misinformed people have thought the consumption of alcohol (red wine for some) increased HDL-C, had vasodilatory properties and anti-platelet activity (it thins your blood). For some die hard recreational alcohol consumers the mention of red wine brings dreams of beneficial antioxidants like resveratrol and vitamin E. Well, it turns out none of those things are true.

Many of the studies cited by proponents of limited alcohol consumption were subject to selection bias. Unfortunately for lovers of recreational alcohol the current and most rigorous research show the total opposite to be true. More and more powerful studies now show that even small amounts of alcohol can increase your risk for cardiovascular disease like coronary artery disease, heart failure, atrial fibrillation, hypertension, fatty liver, and aneurysms.

A meta-analysis published in 2018 in The Lancet (The Lancet publishes the best science from the best scientists worldwide, providing an unparalleled global reach and impact on health) looked at 599,912 drinkers with over 5.4 million person years of follow up. They found that all-cause mortality increased at 100g per week of alcohol.

Alcohol intake was also with a higher risk of stroke, coronary disease, heart failure, fatal hypertensive disease, and fatal aortic aneurysm. Those who reported consuming more than 100g/week and up to 350g/week had a shorter life expectancy by age 40, by 6 months and up to 5 years for those who consumed the most.

Now for those who claim they consume minimal amounts of alcohol the news is not good. A study published in March of 2023 found that people who drank 25 to 44 g per day of alcohol had a small risk of all-cause mortality. The risk became more significant for those who drank 45 to 64 g or more per day. There were larger risk for mortality among female drinkers compared to female lifelong nondrinkers. The World Heart Federation examined all the data and studies on CVD and alcohol consumption and determined that no amount was safe in terms of cardiovascular disease, cancer risk, and other causes of mortality.
Good summary in the below reference on alcohol by World Heart Federation alone is pure gold.

The World Heart Federation unites the diverse cardiovascular community to bring cardiovascular health to the forefront of the global health agenda – a global community of heart foundations, scientific societies and patient organizations, united in our mission to achieve heart health for everyone.

If you want to optimize your heart and brain health, avoid alcohol or keep it to the bare minimum.

Alcohol Consumption and Cancer

There is a strong scientific evidence that alcohol drinking can cause several types of cancer. The US Department of Health and Human Services lists consumption of alcoholic beverages as a known human carcinogen. The evidence shows that the more alcohol a person drinks the higher his or her risk of developing an alcohol-associated cancer. Even those who have no more than one drink per day have a modestly increased risk of some cancers. Based on data from 2009, an estimated 3.5% of cancer deaths in the United States (about 19,500 deaths) were alcohol related.

The following are the most researched between alcohol consumption and the development of the following types of cancer:

  • Head and neck cancer
  • Esophageal cancer
  • Liver cancer: Heavy alcohol consumption is associated with approximately 2-fold increased risks of two types of liver cancer (hepatocellular carcinoma and intrahepatic cholangiocarcinoma)
  • Breast cancer: Pooled data from 118 individual studies indicates that light drinkers have a slightly increased risk of breast cancer, compared with nondrinkers.
  • Colorectal cancer: Moderate to heavy alcohol consumption is associated with 1.2- to 1.5-fold increased risks of cancers of the colon and rectum compared with no alcohol consumption 
Current Research on Alcohol Consumption, Heart Disease and Cancer

In addition to the above alcohol related cancers evidence is accumulating that alcohol consumption is associated with increased risks of melanoma and of prostate and pancreatic cancers. A strong peer reviewed study that included data from more than 1,000 alcohol studies and data sources, as well as death and disability records from 195 countries and territories from 1990 to 2016, concluded that the optimal number of drinks to consume per day to minimize the overall risk to health is zero. 

References:

Cholesterol Truths-Mohammend Alo DO, FACC (Soon to be released)
https://www.thelancet.com/article/S0140-6736(18)30134-X/fulltext (copy and paste link)
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802963
//www.functionalmedicineuniversity.com/WorldHeartFederation.pdf
https://pubmed.ncbi.nlm.nih.gov/22910838/
https://pubmed.ncbi.nlm.nih.gov/26286216/
https://pubmed.ncbi.nlm.nih.gov/29112463/
https://pubmed.ncbi.nlm.nih.gov/21307158/
https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet
https://www.cancer.gov/news-events/cancer-currents-blog/2023/cancer-alcohol-link-public-awareness
https://www.cancer.org/cancer/risk-prevention/diet-physical-activity/alcohol-use-and-cancer.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590626/
https://www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health
https://www.mdanderson.org/cancerwise/does-alcohol-cause-cancer.h00-159383523.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6705703/
https://www.thelancet.com/article/S1470-2045(21)00279-5/fulltext (copy and paste link)
https://pubmed.ncbi.nlm.nih.gov/27842506/
https://pubmed.ncbi.nlm.nih.gov/30146330/

** Always consult with a physician or healthcare practitioner with significant integrative or functional medicine training before starting any of the above recommendations.

You can find a qualified and certified functional medicine practitioner by going to: www.FunctionalMedicineDoctors.com

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Grisanti and his functional medicine community. Dr. Grisanti encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. Visit www.FunctionalMedicineUniversity.com for more information on our training in functional medicine. Look for practitioners who have successfully completed the Functional Medicine University’s Certification Program (CFMP) www.functionalmedicinedoctors.com.

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Considering Keto?

Read this First…

Re-posting information from a blog post by Dr. Michael Greger, MD at his non-profit website, NutritionFacts.org.

“When we don’t eat enough carbohydrates, our body is forced to burn more fat, which can be misconstrued as increasing the rate of net fat-mass reduction. However, on a keto diet, our fat intake also increases.

The “carbohydrate–insulin model of obesity,” a theory put forth by low-carb advocates, suggests that decreased insulin secretion (whether from a keto diet or a less intense form of carb restriction) would lead to less fat storage such that even if more fat were consumed, less would stick to your frame.

The Nutrition Science Initiative (NuSI) was formed by Gary Taubes, author of the controversial “What If It’s All Been a Big Fat Lie?” article arguing in favor of the Atkins diet. In response, some of the researchers Taubes cited to support his thesis accused him of misrepresenting their words and being “incredibly misleading.” NuSI got $40 million in funding to sponsor research to validate the carbohydrate–insulin model that more body fat could be lost on a keto diet. In fact, the researchers found that body fat loss slowed on a ketogenic diet.

If looking only at the numbers on a scale, a keto diet would seem to be effective. More pounds were lost on a keto diet compared to a typical diet, but the rate of body fat loss slowed by more than half and most of the loss was water weight. It’s thought that less fat is burned on a keto diet because, without the preferred fuel of carbs, the body starts burning more of its own protein, so a keto diet causes less fat mass loss and more fat-free mass loss—i.e., loss of more lean mass. The leg muscles of CrossFit trainees on a keto diet shrunk in thickness by 8 percent, for instance. The study participants began burning more fat on the keto diet, but they were eating so much more fat that they ended up retaining more fat in their bodies, despite the lower insulin levels, which is “diametrically opposite” to what the keto crowd predicted.

In light of this, the Nutrition Science Initiative effectively collapsed, but, according to tax returns, not before Taubes and his co-founder personally pocketed millions of dollars.”

This was from a blog post authored by Dr. Michael Gregor.

Have a heart… brush your teeth!

This is often the message referring to halitosis (aka “bad breath”) and its relationship to poor dental hygiene. While valid, this post is actually about relationship between dental care and the leading cause of death in the United States – Heart Disease.

You may have heard that tooth infections, left untreated, do more than hurt your mouth and jaw… that they can result in infections that compromise heart valves and contribute to heart attacks and strokes! But it has been established that if you aren’t regularly brushing and flossing, you are asking for heart disease EVEN IF YOU DON’T HAVE PERIODONTAL DISEASE OR TOOTH ACHES/INFECTIONS!

According to a recent study published in August 2024 in the journal Circulation, there is an “association of a gut microbiota composition characterized by increased abundance of Streptococcus spp and other species commonly found in the oral cavity with coronary atherosclerosis and systemic inflammation markers….”

Translated:
Streptococcus anginosus, Streptococcus oralis and Streptococcus mutans do more than just make for ugly teeth and bad breath. When these bacteria are allowed to flourish in the mouth, 1) they mess up the balance with “good” bacteria and when the immune system kicks in to battle them, they escape into the blood stream to colonize our arteries and 2) they trigger low-grade systemic inflammation that contributes to artery plaques in the heart and throughout the body.

These plaques inhibit the normal function of the lining of the arteries, and they eventually impede the flow and set the stage for pieces to dislodge causing strokes and heart attacks!!!

Keep these bugs at bay by doing what your momma taught you… :

  1. Brush your teeth at least twice a day,
  2. Floss at least once a day,
  3. Pay particular attention to the back molars (just because they are the hardest to reach and most likely to get neglected),
  4. Consider a WaterPik style jet flosser, and
  5. Get regular dental checkups and cleanings.

No go thank your Momma and give her a hug and a kiss.

90 Days

I welcome the opportunity to help you with any areas where you need help, but the one change that I believe will have the most profound impact on your health is your diet. This is because, directly or indirectly, improving your diet will improve just about all other concerns. What I would like you to consider is changing how you eat. I would like you to switch to a whole food plant-based diet (the acronym for this mouthful is WFPB). No, not permanently!!! Just for a short time. Consider it a 3 month experiment. Just try it for a short time and I believe that you will feel at least 80% better, no matter what your current condition is. And then you will be informed. You will know what it took. You will know what it felt like. You will know how easy or hard it was (it’s not hard). You will know how expensive it is (it actually costs a LOT less). And you will know EXACTLY what the trade-offs were. 

And then you can choose to go back to what you were doing before. Easy Peasy. No harm, no foul. Limiting your commitment to 3 months is psychologically easier than “changing forever”. You can do this and you really will be better for it, even if you decide it’s not for you in the long run. 

But, please don’t think you can do this without learning a little first. Don’t just start eliminating foods willy nilly or you will risk failing. Learn a little so you can be successful at it for 3 months. Just 3 months! That is all I’m asking. There really isn’t any good reason not to try it. 

If I have convinced you, or even if you are not convinced yet, but just curious… start with a video by Dr. Michael Gregor, MD of his presentation called “How Not To Die”. You can go to it by clicking the link below the picture (if your copy of this is digital) or you can find it on YouTube.com by searching for “How Not To Die Dr. Michael Greger, MD ”. Pretty catchy title, yes? You will know you are seeing the video you want when you scroll down the search results and see this preview picture:

How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers

Side note: I picked this video because it is NOT a propaganda video. 

  • Yes, the animal meat industry has severe climate impacts but this video does not include Jane Goodall and doesn’t even mention it.
  • Yes, the animal meat industry treats livestock horrifically, but this video has no PETA contributors and doesn’t even broach the subject.
  • Yes, the worldwide fishing industry is decimating the oceans but that is not in this video.

This video is really just about what a WFPB diet will do to help you get and stay healthy. If nothing else, you will better understand what your vegetarian and vegan and WFPB friends are doing and why.

If you are not convinced yet, please watch this shorter video by Dr. Neal Barnard, MD. Search on YouTube.com for “Why Go Vegan? Barnard”. Yes, another “why” video, but it is helpful to get another perspective and explanation and Dr. Barnard really has invested a lot of energy into helping you with free tools and information for beginners on the “how” part of this experiment including the first link in the additional resources listed below. The video you are looking for has a preview image that looks like this:

The Health Benefits of Going Vegan with Dr. Barnard | The Exam Room Podcast

If you have doubts about the ability to get the nutrition you need to perform at a high level, you do not need to worry. In fact, I think that you will find this next video fascinating. It is available with a Netflix subscription or an Amazon Prime subscription (among others), but if you don’t have access via subscription, click on the cover image below to view this YouTube link to a great synopsis with the added benefit of an authoritative assessment of the program’s strengths and weaknesses. :

Game Changers Review on YouTube

Finally, here are some resources for you that will make things easier:

  • https://forksoverknives.com has a lot of recipes, a meal planner subscription service which is cool, and a lot of other great information. 
  • https://tedshealthclub.com is a site created by a friend of mine who is not a health practitioner but who experienced his own life-changing transformation and, in the process, he gained an amazing library of practical advice and “how-to” knowledge. He has a wonderful way of communicating that does not go over people’s heads  or come off as “too teach-y”.
  • https://nutritionfacts.org/ is a great informational website by Dr. Greger

Vitamin B-12 Supplementation is REQUIRED

A deficiency of vitamin B-12 (aka Cobalmin) is very serious and causes severe health conditions that masquerade as any of a multitude of psychological, neurological, gastrointestinal, immmune related (and many many other organ system) abnormalities. From coma to psychosis, from bleeding tongue to skin lesions from head to toe, from tingling and numbness in your hands to loss of muscular control. Vitamin B-12 is absolutely vital.

If you never, or rarely eat animal products AND you are not supplementing with Vitamin B-12… it is just a matter of when, not if, you will develop symptoms of B-12 deficiency. This vitamin is not produced by humans or animals, for that matter. Instead, it is produced by microbes and we would have picked it up in ages past from water, or incompletely washed food.

If you are vegetarian but eat eggs and dairy, you should be aware that 50% of ovo/lacto vegetarians who don’t supplement with B-12 are still deficient. In fact, among those that don’t supplement, studies have shown low B-12 levels in roughly 1/3 of the meat eaters!

So, bottom line – B-12 is CHEAP but CRITICAL! Follow the formula…

CHEAP + CRITICAL = REQUIRED

Don’t be a dummy. Supplement B-12 regardless of your diet.

Food Dyes and IBD

Inflammatory bowel diseases (IBDs)—like Crohn’s disease and ulcerative colitis—affect millions of people around the world. They cause lasting structural damage—such as inflammation, ulcers, and sores—to your gastrointestinal (GI) tract.

Until now no one could really pinpoint exact causes behind IBDs.

However a new study made an eye-opening discovery: Some very commonplace and “colorful” foods may actually TRIGGER these debilitating diseases.

For this study, researchers fed lab mice a normal diet—or a diet that included something called Allura Red AC (FD&C Red 40 or E129) for 12 weeks.

To the researchers’ surprise the Red Dye caused new inflammation in their GI tracts. It also disrupted the gut barrier. It even increased serotonin production in the gut, which, in turn, increases susceptibility to IBDs. In fact, the researchers said there’s enough evidence to suggest Allura Red AC may “trigger” IBD in otherwise healthy subjects!

These results offer a serious warning about the potential dangers of food dyes in our diet. Perhaps worst of all is the fact that we’ve known about the problems with Allura Red FC for almost 50 years! And one of the most long-standing concerns involves its effect on behavior in children—which is why many countries in Europe (including France, Germany, and Switzerland) banned it years ago.Avoiding these “colorful” foods could be instrumental in aiding patients suffering with IBD.

How to Know If Red Dye 40 Is in Food

It would be hard to determine if restaurant food contains the red dye. But on packaged food, the FDA requires food manufacturers to list ingredients, including color additives. Look for the following on packaging labels:

  • Red 40
  • Red 40 Lake
  • FD&C Red No. 40
  • Food Red 17
  • Allura Red AC

As you might have guessed, Allura Red AC is one of the most widely used food dyes in the world. You commonly find it in breakfast cereals, soft drinks, dairy products, candies, and even vitamins!

Now, since you’ll find Allura Red FC in countless products in the United States, it’s up to YOU to keep it out of your diet.

Author: Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

  • References
  • https://www.webmd.com/ibd-crohns-disease/news/20221221/study-says-food-dye-red-40-can-trigger-bowel-problems
  • https://www.medicalnewstoday.com/articles/ibd-common-red-food-coloring-may-cause-intestinal-inflammation-colitis
  • https://www.sciencedaily.com/releases/2022/12/221220112440.htm
  • https://www.diabetes.co.uk/news/2023/jan/inflammatory-bowel-diseases-could-be-initiated-by-a-common-food-dye.html
  • https://www.nature.com/articles/s41467-022-35309-y
  • https://www.sciencetimes.com/articles/31181/20210514/chronic-gut-inflammation-triggered-two-common-food-coloring.htm

The information in this post is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Grisanti and his functional medicine community. Dr. Grisanti encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. Visit www.FunctionalMedicineUniversity.com for more information on our training in functional medicine. Look for practitioners who have successfully completed the Functional Medicine University’s Certification Program (CFMP) www.functionalmedicinedoctors.com. This content may be copied in full, with copyright, contact, creation and information intact, without specific permission, when used only in a not-for-profit format. If any other use is desired, permission in writing from Dr. Grisanti is required

Do we do physicals?

I am a chiropractor and I perform physical examinations every day.

I am also a member of the National Registry of Certified Medical Examiners and so I perform commercial driver physical exams so I can complete Medical Examination Report forms (form MCSA-5875) and Medical Examiner’s Certificate forms (MCSA-5876) to allow a driver to get or maintain a commercial driving license or endorsement.

I keep getting questions about whether I can do a sports physical or an FAA Pilot physical exam or if I can complete a Physicians Health Report for a non-commercial driver because the DMV requires it. The answer is generally no, for varying reasons:

The FAA does not allow chiropractors to perform physical exams at this time.

Non-commercial driver physicals do not need to be performed by an NRCME examiner and are supposed to be performed by a primary care physician who has an established doctor-patient relationship with the driver or who is accepting the driver for such a relationship going forward.

Similarly, qualification to perform a physical sport should also be determined by a primary care doctor. I will do this for an established patient, but I generally do not offer this as a service to the general public.