Life Extension Magazine December 2011
Link Between Alcohol and Cancer Death
By Michelle Flagg
By Michelle Flagg
Those who consume no alcohol are at higher risk of heart attack and ischemic stroke. Yet many of us drink more alcoholic beverages than is safe.
Problem drinking is defined as 12-15 drinks a week by the National Institutes of Health.1
Yet according to the latest research, alcohol in more moderate amounts can be deadly.
In one of the largest analyses of its kind, a 2011 epidemiological study of eight Western European countries revealed that drinking alcohol accounted for 1 out of 10 cancer cases in men and 1 in 30 for women, who tend to drink less.2
These included colorectal and breast cancer, along with cancers of the upper gastrointestinal tract and liver. Cancer incidence was not confined to heavy drinkers. Even those who had one to two drinks a day were at risk.
How could this happen?
You won't hear this from most doctors, but the body converts alcohol into a DNA-destroying metabolite called acetaldehyde. It is a compound sufficiently dangerous to be officially classified as a carcinogen by the International Agency for Research on Cancer.3-8 The good news is that specific nutrients many Life Extension® members already take have been shown to neutralize the cancer-causing effects of acetaldehyde before they take hold.
In this article, a scientifically validated, comprehensive anti-alcohol nutritional regimen is detailed. You will discover how acetaldehyde interferes with biological and cellular processes to induce functional and metabolic abnormalities that lead to cancer.
You will also learn nutrient interventions that operate via multiple pathways to protect against alcohol's most dangerous effects when taken before or after you drink.
When you drink alcohol, some of it converts to a metabolite called acetaldehyde, which is a highly reactive molecule that causes cancer through a variety of mechanisms. Acetaldehyde is also a primary factor involved in unpleasant next-day aftereffects of excess ethanol ingestion.9
Acetaldehyde binds to DNA, causing mutations that can initiate cancer development.5,10.11 It produces reactive oxygen species (ROS) that lead to inflammation, promoting tumor development once a cancerous cell has formed.7,8 Acetaldehyde impairs cells' natural antioxidant defense systems, making them still more vulnerable to cancer-causing oxidant damage.8 It depletes cells of vitamin B6, further impairing cells' abilities to battle oxidation.12 And acetaldehyde interferes with folic acid, blocking cells' natural DNA repair mechanisms and further promoting cancer growth.13
The most effective strategy for reducing alcohol-related cancer risk is to cut back alcohol consumption.14
But alcohol occupies a complicated place in today's health consciousness. It provides some definite benefits to cardiovascular health when used in small to moderate amounts.15 And, for many, alcohol produces both psychological and biological dependency, making it difficult to simply quit drinking.16 In addition, much of our social interaction occurs with some levels of alcohol.
Fortunately, there are proven nutrients that afford powerful antioxidant protection, while others directly interfere with acetaldehyde production in liver cells. Still others can restore the body's waning stores of essential nutrients.
Together these effects can help you lower your cancer risk if you choose to consume alcohol.
One of the best and most general ways to fight the acetaldehyde-induced oxidative stress that follows alcohol consumption is to assure that one has an adequate regular intake of key antioxidant vitamins.17 (See Table 1) In general, the higher the intake of these vitamins, the lower the risk of most cancers.18,19 Alcohol drinkers are especially vulnerable to this effect: the combination of high alcohol intake and low antioxidant vitamin intake increases the risk of colon cancer more than 6-fold.20,21
Treatment with antioxidant nutrients and vitamins can protect delicate DNA from cancer-inducing damage and reduce the inflammation that promotes cancer development in people who use alcohol chronically.22,23 A 2010 Harvard study demonstrated that intakes of vitamins A, C, and E from food alone did not reduce colon cancer risk.24 When intakes from supplements were included, the risk dropped by 19% for vitamin C intake and by 22% from vitamin E.24 The same study demonstrated a 12% decrease in cancer risk from multivitamin and folate supplementation. Similar effects have been demonstrated for other cancer types, including a variety of brain tumors.25
Selenium is an essential dietary component for human life, and it has been shown to be protective against cancer.26 It is a vital constituent of the so-called selenoproteins that are necessary for proper antioxidant and DNA repair function of several important intracellular systems.26 Selenium deficiency leads to increased DNA damage and increased likelihood of cancer in laboratory animals, whereas dietary selenium reduces formation of pre-cancerous tissue.27,28
In humans, low selenium status is associated with increased risk of colon cancer.29 Selenium levels tend to be reduced in people who drink alcohol regularly.30 That is especially concerning because selenium deficiency is a major risk factor for liver cancer; conversely, people with the highest levels of selenium in their tissues have a 50% reduction in their risk of this cancer.31
Glutathione and N-Acetyl Cysteine (NAC)
Oxidative stress combined with acetaldehyde causes a profound impairment of the body's natural antioxidant systems, by depleting stores of a compound called glutathione.32 Restoring cellular healthy glutathione levels, therefore, seems to be a natural strategy to prevent alcohol-related cancers.
N-acetyl cysteine (NAC) powerfully replenishes glutathione levels in tissues, helping to fend off the consequences of acute oxidative stress.33,34 It is widely used in conventional medicine to fight the impact of toxic ingestions, such as acetaminophen (Tylenol®) overdose.35 Rats supplemented with NAC prior to treatment with acetaldehyde are potently protected against toxicity and death; the effect is even more powerful when combined with vitamin C and thiamine.36 Independently, NAC binds acetaldehyde directly, further preventing its damaging effects.37
Benfotiamine is a fat-soluble form of thiamine (vitamin B1).38 It is best known for its protective effects against formation of advanced glycation end products (AGEs) in people with diabetes or the metabolic syndrome.39 Since AGEs are known to play a major role in cancer formation (by promoting oxidative damage and inflammation),40 benfotiamine is finding a role in cancer prevention as well. By a separate mechanism, benfotiamine also directly prevents cell damage arising from alcohol use.41 And benfotiamine has significant antioxidant effects, preventing induction of cancer-causing DNA damage in laboratory studies.39,42
Folic Acid and SAMe
In addition to toxic acetaldehyde production, alcohol consumption depletes the body of certain important nutrients. Deficiencies of folic acid, zinc, and the sulfur-containing amino acid methionine are frequent among drinkers.6,43,44 Cells that lack these nutrients cannot suppress cancer genes called proto-oncogenes, often resulting in the initiation of a cancer.10,45 Compared with non-drinkers, men who consume more than two alcohol drinks daily have a 64% increased risk of colon cancer, while women have an 84% increase.11 But those with the highest folic acid and methionine intakes have an approximately one-third lower risk of colon cancer.11
Supplementation with folic acid, zinc, and S-adenosylmethionine (SAMe) is an effective way of preventing these widespread alcohol-related deficiencies and potentially lowering cancer risk.46-49 SAMe has additional value because, like NAC, it helps restore depleted glutathione in alcohol-damaged cells, providing additional antioxidant protection.50,51
Chlorophyllin is a water-soluble form of the green plant pigment chlorophyll.52,53 It has been evaluated as a chemopreventive agent in populations at high risk for liver cancer, one of the most common tumors known, and one that is frequently caused by ingested toxins.52-54 Chlorophyllin is a large molecule thought to bind to many carcinogens and toxins, enhancing their excretion from the body before they damage DNA.54,55 Binding to toxins in the intestine prevents their uptake, further reducing their cancer-producing effects.54 Chlorophyllin also induces important enzymes that protect against oxidants arising from toxins such as acetaldehyde, while also reducing expression of inflammatory mediators.56,57
Grape Seed Extracts
Extracts of grape seeds are known to be powerful antioxidants with health benefits on many tissues. In both animal and human studies, these extracts reduce markers of oxidative damage and enhance natural antioxidant mechanisms to protect cells and DNA from injury.58-62 Grape seed extracts have been shown to prevent alcohol-induced oxidative damage in all tissues examined in animal studies.63,64 These extracts are highly bioavailable in humans, making them especially appealing in combating the cancer-causing effects of alcohol.65,66
Silymarin (from Milk Thistle)
Silymarin is a compound extracted from the milk thistle plant. It has long been used to improve liver health and enhance excretion of toxins, particularly those that are related to alcohol toxicity. Silymarin is a powerful antioxidant and protects DNA from cancer-inducing damage, especially in alcohol-induced liver disease.22,67 It inhibits conversion of ethanol to acetaldehyde and reduces cell proliferation in laboratory models of liver cancer.68
Silymarin also stabilizes cell membranes and promotes normal liver cell regeneration.67,69 It reduces inflammatory mediators that otherwise help to promote cancer growth.67,69,70 Long-term administration of silymarin significantly increases survival time of patients with liver cirrhosis, a frequent precursor of liver cancer.69 Laboratory studies reveal that silymarin reduces tumor cell proliferation and new blood vessel growth, helping to starve tumors of vital nutrients and oxygen.69 Finally, silymarin has been shown to inhibit development of tumor metastases, helping limit spread of cancer.69
Picrorhiza kurroa is a member of the figwort family, with a long history of use in traditional south Asian medical systems.71 Picrorhiza extracts given to laboratory animals following chronic alcohol ingestion reverse most of the deleterious biochemical changes induced by alcohol.72,73 A powerful antioxidant,71 picrorhiza also has specific anti-cancer effects, inhibiting toxin-induced cancer generation and increasing life span of tumor-afflicted animals.74,75 Picrorhiza also very specifically modifies the inflammatory "master molecule" called nuclear factor-kappaB, reducing production of inflammatory cytokines that can promote tumor growth.76 That mechanism, along with others, also promotes cancer cell death by apoptosis.71,76
Barley is a fiber- and antioxidant-rich grain with a number of chemopreventive properties of particular interest in the context of cancer.77 Toxin-induced gastrointestinal tumors in mice can be prevented using extracts of barley grain or bran.77,78 A powerful cancer-suppressing protein called lunasin, first identified in soy protein, has now been discovered to be abundant in barley as well.79,80 Barley lunasin suppresses formation of tumor cell colonies and protects DNA from cancer-inducing changes.79,80 Barley grass extracts also serve a prebiotic function, modifying the intestinal environment to prevent toxin-induced colon cancers.81
Resveratrol is a versatile polyphenol derived from grapes and other plants. Like most polyphenols, resveratrol is also a powerful antioxidant and protector of DNA and mitochondria against alcohol's toxic effects.64,82,83 Even after DNA damage has occurred, resveratrol switches on essential DNA repair mechanisms to heal the injury before it can trigger cancerous change.83
But resveratrol has other unrelated beneficial health effects attained through its positive regulation of a control molecule called SIRT1. Resveratrol activates SIRT1 in vitro and produces changes that mimic caloric restriction—the best-studied mechanism to maximize life span in living organisms.84 SIRT1 switches off production of many inflammatory cytokines that contribute to cancer promotion.85 When cells are co-cultured with resveratrol before exposure to alcohol metabolites, they produce many fewer inflammatory cytokines—the result of SIRT1 activation.85 Together all of these mechanisms contribute to resveratrol's potent anticancer effects.
A landmark 2011 study revealed that drinking alcohol may account for 1 out of 10 cancer cases in men and 1 in 30 for women. Even modest alcohol consumption was found to increase risk for most forms of cancer. This occurs owing to a little-known process in which your body converts alcohol into acetaldehyde, an officially classified carcinogen.
Acetaldehyde boosts cancer risk by inflicting oxidative stress that damages DNA, prevents DNA repair, and triggers a pro-inflammatory cascade.
You can help neutralize these cancer-inducing effects through a comprehensive nutritional regimen. These include plant-based compounds like silymarin from milk thistle extract, resveratrol, grape seed extract, and barley grass. Increasing intake of specific vitamins and minerals can help you restore those depleted from your body as a result of alcohol consumption, including selenium, vitamin B6 and folic acid.
It is especially important to take nutrients like benfotiamine, N-acetyl cysteine (NAC), vitamin C and SAMe before or while ingesting alcohol. If you forget, take these nutrients immediately after alcohol ingestion.
If you have any questions on the scientific content of this article, please call a Life Extension® Health Advisor at 1-866-864-3027.
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