Evidence suggests “one or fewer drinks per day” may elevate the risk for cancers.
January 6, 2025
The US Surgeon General has issued an advisory recommending updates to alcoholic beverage labels to include warnings about the risks of cancer.
The document, titled Surgeon General’s Advisory on Alcohol and Cancer Risk, addressed the “direct link” between alcohol consumption and an increased risk of cancer.
According to the advisory, alcohol is the “third leading preventable cause” of cancer in the US, following tobacco use and obesity.
It underscored that alcohol consumption contributed to cancers of the breast, colorectum, oesophagus, liver, mouth, throat, and voice box, regardless of the alcohol type.
Cancer risk increases with alcohol intake, and evidence suggests that even low levels—such as “one or fewer drinks per day” —can elevate the risk for breast, mouth, and throat cancers, according to a statement from the Surgeon General’s office.
Dr Murthy called for revising the Surgeon General’s health warning labels on alcohol-containing beverages to include information about cancer risks.
This advisory also emphasised the need to reevaluate recommended limits for alcohol consumption based on the latest research to account for cancer risks.
Dr Murthy said: “Alcohol is a well-established, preventable cause of cancer responsible for about 100,000 cases of cancer and 20,000 cancer deaths annually in the US – greater than the 13,500 alcohol-associated traffic crash fatalities per year in the US – yet the majority of Americans are unaware of this risk.
“This advisory lays out steps we can all take to increase awareness of alcohol’s cancer risk and minimise harm.”
The release also urged public health professionals and community groups to emphasise alcohol consumption “as a leading modifiable cancer risk factor” and improve education efforts to raise public awareness.
The surgeon general advised people to consider the link between alcohol consumption and increased cancer risk “when deciding whether to drink or how much to have”.
The action comes in response to a 2020 letter addressed to Dr Murthy by the Center for Science in the Public Interest, American Institute for Cancer Research, Consumer Federation of America, and US Alcohol Policy Alliance, urging an update to alcoholic beverage labels to include cancer warnings.
In May 2023, Ireland became the “first” country in the European Union to mandate health labelling on alcoholic drinks with the law anticipated to take effect from 22 May 2026.
The Canadian Centre on Substance Use and Addiction (CCSA) issued new guidance in 2023, warning that no level of alcohol consumption is risk-free and recommended a maximum of two drinks per week.
Evidence suggests “one or fewer drinks per day” may elevate the risk for cancers.
January 6, 2025
The US Surgeon General has issued an advisory recommending updates to alcoholic beverage labels to include warnings about the risks of cancer.
The document, titled Surgeon General’s Advisory on Alcohol and Cancer Risk, addressed the “direct link” between alcohol consumption and an increased risk of cancer.
According to the advisory, alcohol is the “third leading preventable cause” of cancer in the US, following tobacco use and obesity.
It underscored that alcohol consumption contributed to cancers of the breast, colorectum, oesophagus, liver, mouth, throat, and voice box, regardless of the alcohol type.
Cancer risk increases with alcohol intake, and evidence suggests that even low levels—such as “one or fewer drinks per day” —can elevate the risk for breast, mouth, and throat cancers, according to a statement from the Surgeon General’s office.
Dr Murthy called for revising the Surgeon General’s health warning labels on alcohol-containing beverages to include information about cancer risks.
This advisory also emphasised the need to reevaluate recommended limits for alcohol consumption based on the latest research to account for cancer risks.
Dr Murthy said: “Alcohol is a well-established, preventable cause of cancer responsible for about 100,000 cases of cancer and 20,000 cancer deaths annually in the US – greater than the 13,500 alcohol-associated traffic crash fatalities per year in the US – yet the majority of Americans are unaware of this risk.
“This advisory lays out steps we can all take to increase awareness of alcohol’s cancer risk and minimise harm.”
The release also urged public health professionals and community groups to emphasise alcohol consumption “as a leading modifiable cancer risk factor” and improve education efforts to raise public awareness.
The surgeon general advised people to consider the link between alcohol consumption and increased cancer risk “when deciding whether to drink or how much to have”.
The action comes in response to a 2020 letter addressed to Dr Murthy by the Center for Science in the Public Interest, American Institute for Cancer Research, Consumer Federation of America, and US Alcohol Policy Alliance, urging an update to alcoholic beverage labels to include cancer warnings.
In May 2023, Ireland became the “first” country in the European Union to mandate health labelling on alcoholic drinks with the law anticipated to take effect from 22 May 2026.
The Canadian Centre on Substance Use and Addiction (CCSA) issued new guidance in 2023, warning that no level of alcohol consumption is risk-free and recommended a maximum of two drinks per week.
Let’s start with some simple facts. Alcohol is a toxin. Alcohol is a factor in1: 30% of suicides 40% of fatal burn injuries 50% of fatal drownings 50% of homicides 65% of fatal falls 29% of fatal road traffic accidents Globally, alcohol is responsible for 3 million deaths per year; in the United States, it is the third leading cause of preventable death23. It is hard to see the upside when you see these figures. So let’s go a little deeper. First off, I drink alcohol. Not a lot. But I do drink. So any comments made here are not some puritanical position on alcohol but reflections on the data that exist in the literature. Multiple studies have demonstrated that excess alcohol consumption, usually defined as consuming greater than 2 to 4 drinks per day, is associated with worse outcomes and a greater likelihood of dying when compared to someone who drinks less than 2 to 4 drinks per day4. Alcohol Dosing and Total Mortality in Men and Women: An Updated Meta-analysis of 34 Prospective Studies. Arch Intern Med.2006
In the study shown above, females start to accrue an increased risk at greater than two drinks per day on average and males at greater than four drinks per day.
These findings shouldn’t come as a surprise to anyone.
Surprisingly, on average, individuals who consume less than two drinks per day appear to have better outcomes than those who do not drink at all. This is where things start to get a little counterintuitive, and the story of alcohol being beneficial for you starts to appear.
This relationship is known as a ‘U’ shaped curve where those in the middle have the best outcomes, and those on the edges have worse outcomes. A kind of ‘Goldilocks’ relationship; “Not too hot. Not too cold. Just right.”
How might we explain this?
Enter the darling of the 1990s, Resveratrol. This compound in red wine spawned the mantra that red wine was ‘good for your heart’. This was based on research that suggested that it might reduce cholesterol levels, among other things.
But to consume the levels of Resveratrol tested in some of the animal studies that demonstrated benefit, you would have to drink 40 litres of wine…… Per day.
Not exactly a feasible strategy. Even with the best will in the world.
Let’s look at a more plausible explanation.
Data on alcohol consumption and outcomes are almost always based on observational data, not randomised controlled trials. This means that other factors or ‘confounders’ may explain the difference between the groups, not the alcohol consumption alone.
When you look at the trials that suggest a benefit of modest alcohol consumption, you will often find that this group tend to exercise more, smoke less, be in a higher socioeconomic bracket etc. This is referred to as a ‘healthy user bias’ and is likely to explain the difference between the groups.
Most trials try to correct or adjust for these confounders, but in truth, it is very hard to do. A recent publication looked at this problem and attempted to (as much as possible) correct for these ‘healthy user’ bias factors and then compare outcomes between alcohol consumption groups. The results were a little more in line with what we might expect.
Those in the lowest alcohol consumption category had the best lifestyle factors overall. When these healthy factors were corrected for, any benefit seen with modest alcohol consumption disappeared. What remained was a linear relationship between alcohol consumption and coronary artery disease5. Much more what you might expect.
Association of Habitual Alcohol Intake With Risk of Cardiovascular Disease. JAMA Netw Open. 2022
Research like this and other studies is where the more recent media reports of ‘any’ alcohol being bad for you have come.
So, alcohol is a toxin. But, as Paracelsus notes:
“The dose makes the poison.”
Even water consumed to excess can be lethal.
We know that excess alcohol consumption is harmful. But I don’t think there was any great uncertainty around that point.
The key takeaway is that modest alcohol consumption is unlikely to be ‘beneficial’ to you. As much as you loved the idea that red wine was good for your heart, we can say with reasonable confidence that this is not the case.
The real question we need to answer is whether consuming modest amounts of alcohol is considerably worse for you when it comes to heart disease and death from any cause.
Based on the literature to date, it seems that the incremental risk for modest amounts of weekly alcohol consumption is likely to be small. But that doesn’t mean there are no downsides.
Sleep
One of the main reasons I significantly reduced my alcohol consumption was its effect on my sleep. If I drink more than one drink, I find that the quality of my sleep gets worse. I am much more likely to wake in the middle of the night and feel the effects the following day. But that’s just my personal experience.
Although alcohol is likely to make you fall asleep faster, it impacts your sleep quality6. Additionally, alcohol also reduces the percentage of REM sleep a person gets overnight7.
A workaround for me is to consume any alcohol during the daytime, so my sleep is unlikely to be affected, and if I am going to have a drink, I make sure it is worthwhile. I.e. I am with friends, or it is a high-quality drink. No more drinks on airplanes for me. Mainly because you lose about 30% of your sense of smell and taste in a pressurised cabin and therefore you are less likely to enjoy your drink8. Why do you think they serve you tomato juice and the fact that you think it’s tolerable?!
Humans have been consuming alcohol as far back as the ancient Egyptians, and some evidence suggests the Chinese were consuming alcohol as far back as 7000 B.C. So I don’t see alcohol disappearing any time soon.
The question we all need to ask is:
How much are we realistically drinking on a daily or weekly basis &
Is it likely to be doing us harm?
Only you can answer that question.
The only way to be certain you are doing no harm is to eliminate alcohol entirely. But life is full of risks, some of which we can control, some we cannot.
And some risks are worth taking.
Want to eliminate all road traffic accidents worldwide?
Simple.
Ban cars.
But at what cost?
The risks of driving are a risk most of us are willing to take.
Mokdad, A.H.; Marks, J.S.; Stroup, D.F.; and Gerberding, J.L. Actual causes of death in the United States, 2000. JAMA 291(10):1238–1245, 2004. Erratum in JAMA 293(3):298, 2005.
Centers for Disease Control and Prevention (CDC). Alcohol and Public Health: Alcohol-Related Disease Impact (ARDI). Annual Average for United States 2011–2015 Alcohol-Attributable Deaths Due to Excessive Alcohol Use, All Ages.
Alcohol Dosing and Total Mortality in Men and Women: An Updated Meta-analysis of 34 Prospective Studies. Arch Intern Med.2006;166(22):2437–2445. doi:10.1001/archinte.166.22.2437
Biddinger KJ, Emdin CA, Haas ME, et al. Association of Habitual Alcohol Intake With Risk of Cardiovascular Disease. JAMA Netw Open. 2022;5(3):e223849. doi:10.1001/jamanetworkopen.2022.3849
Britton, A., Fat, L.N. & Neligan, A. The association between alcohol consumption and sleep disorders among older people in the general population. Sci Rep10, 5275 (2020). https://doi.org/10.1038/s41598-020-62227-0
Ebrahim IO, Shapiro CM, Williams AJ, Fenwick PB. Alcohol and sleep I: effects on normal sleep. Alcohol Clin Exp Res. 2013 Apr;37(4):539-49. doi: 10.1111/acer.12006.
Burdack-Freitag, Andrea & Bullinger, Dino & Mayer, Florian & Breuer, Klaus. (2010). Odor and taste perception at normal and low atmospheric pressure in a simulated aircraft cabin. Journal für Verbraucherschutz und Lebensmittelsicherheit. 6. 95-109. 10.1007/s00003-010-0630-y.
According to the most recent ONS statistics, from 2018, liver disease is consistently among the top three causes of death each year among women aged 39-45 Binge Drinking and Me is on
The relationship between alcohol consumption and menstrual cycle: a review of the literature:
Abstract
Alcohol use affects men and women differently, with women being more affected by the health effects of alcohol use (NIAAA, 2011). Yet, a dearth of information investigating the alcohol use in women exists (SAMSHA, 2011). In particular, one dispositional factor hypothesized to contribute to alcohol consumption in women is the menstrual cycle. However, only 13 empirical papers have considered the menstrual cycle as related to alcohol consumption in women. These studies fall out with somewhat mixed findings suggesting that the premenstrual week is associated with increased, decreased, or no change in alcohol consumption, likely due to methodological differences in menstrual cycle determination and measures of alcohol consumption. These methodological differences and possible other contributing factors are discussed here with recommendations for future research in this area. Understanding the contribution of the menstrual cycle to alcohol consumption is one step in addressing an important women’s health concern.
Keywords: Alcohol consumption, Menstrual cycle, Women, Women’s health
Moderation is key when it comes to alcohol. People who drink a lot of alcohol tend to have very high triglycerides. That can be a concern because elevated triglyceride levels can increase your risk for diabetes, pancreatitis and stroke.
Wondering if you need an alcohol detox? Learn how to detox your liver from alcohol use, and how long it could take.
Of all your body’s organs, your liver takes the biggest hit when it comes to alcohol. Even if your relationship with drinking consists of occasional social drinking with friends or occasionally over-indulging in wine and cocktails during the holiday season, alcohol can still leave its mark. And it’s a mark that can be hard to reverse.
That’s why many of us wonder if a month of avoiding drinking is enough to “reset” your liver back to normal. It’s true that taking a break from alcohol for any amount of time will be beneficial overall, with some research showing that liver function begins to improve in as little as two to three weeks. But a full detox is needed for the most benefit, and how much time that takes depends on a variety of personal factors.
“It depends on how much damage has already been done,” explains liver specialist Christina Lindenmeyer, MD. “And if there are any complications related to the damage.”
Dr. Lindenmeyer explains what happens to your liver from prolonged and moderate alcohol use, and what a detox process would look like.
How alcohol impacts your liver
Your liver has enzymes that work like special tools to help metabolize (break down) different toxins that enter your body, such as alcohol.
In the short term, alcohol is processed through your liver in about an hour. Essentially, feeling “drunk” is when your liver becomes too overwhelmed to properly process alcohol, so it overflows temporarily into your bloodstream. This is what causes you to feel light-headed or tipsy after multiple alcoholic drinks.
In the long term, prolonged alcohol use can cause severe damage to your liver. Your liver has a specific pathway that the toxins follow to be broken down, so if over time, this pathway becomes overwhelmed by too many toxins, it can affect the efficiency of your liver’s work. In other words: It can’t keep up.
Certain health concerns and diseases can arise in your liver due to long-term alcohol use, including:
If your liver has taken a hit from prolonged alcohol use, there are ways to give it — and the rest of your body — a break.
You can make the move toward detoxing your liver through these steps:
Stop drinking
The first and most important line of defense? You guessed it: Abstain from drinking. “Abstinence is the most critical intervention and treatment,” notes Dr. Lindenmeyer.
This is sometimes easier said than done, of course. If you’re a heavy drinker, you may need to wean off alcohol to let your body adjust. If you’re experiencing severe symptoms of alcohol withdrawal, be sure to talk to a healthcare provider.
If you’re more of a moderate to occasional drinker, you may find the hardest part of stopping drinking to be the social pressures. Try replacing your usual cocktail or beer with a nonalcoholic option, including many of the now popular mocktails available so you can still enjoy social time with friends without having alcohol in the mix.
Maintain a healthy diet
Another thing that will help your liver’s journey in recovery is good nutrition. There’s no miracle diet by any means, but the Mediterranean diet, for example, can help fill some of the nutritional gaps you may have due to alcohol use.
“Nutrition optimization is actually the most evidence-based and most important intervention aside from stopping drinking,” points out Dr. Lindenmeyer. This is because, for a lot of people who experience some kind of liver dysfunction, it makes them at risk of not getting enough proteins, calories or vitamins.
There are also certain foods like tea, fish and nuts that can benefit the liver’s function in many ways. Think of it as giving your liver a little boost in the right direction. “Nutrition therapy is very important in terms of feeding the liver and giving it the building blocks it needs to restore itself,” says Dr. Lindenmeyer.
How long until your liver detoxes from alcohol?
Of course, we all want a simple, achievable number for how long we should abstain from alcohol in order for our bodies to fully heal from its effects.
But the truth is,the timeline of your liver detoxing is going to depend on different factors like:
The amount of alcohol you consume.
The frequency of your drinking.
Any other health conditions you may have.
Your age.
Your weight.
“There is no ‘one size fits all’ answer,” states Dr. Lindenmeyer. “It depends on how much damage has already been done and any possible complications.”
There has been some research conducted on how abstaining from alcohol detoxifies your liver over time. A 2021 review of research notes that several studies determined that two to four weeks of abstinence from alcohol by heavy-alcohol users helped reduce inflammation and bring down elevated serum levels in the liver.
In short: A few weeks off will help. But the longer you can abstain from alcohol, the better. And if your liver has experienced long-term effects, your healthcare provider would probably recommend lifelong abstinence from alcohol to allow it to fully detox and recover.
“For patients who are left with cirrhosis after severe injury to the liver from alcohol, even one drink of alcohol is toxic to the liver,” cautions Dr. Lindenmeyer.
Should you take a break?
For many of us, alcohol becomes a casual routine associated with going out and spending time with loved ones. But if you’re drinking alcohol in excess of the recommended guidelines, you may be doing damage to your liver. It can be hard to notice at first if your body is sending you any warning signs that it’s overwhelmed.
Here are some common signs that your liver is taking a serious hit from alcohol:
It can be hard to find (or even know) the balance of how much alcohol your body is able to handle. If you’re not sure if your drinking crosses a certain line or not, try measuring your alcohol intake.
According to the U.S. Centers for Disease Control and Prevention (CDC), alcohol should be consumed in moderation, which means one drink a day for women and people assigned female at birth (AFAB), and two for men and people assigned male at birth (AMAB) — unless your doctor says otherwise. If you’re keeping up with this average (or less), the damage from alcohol is most likely minimal.
On the other hand, binge drinking is generally defined as four drinks for women and five drinks for men within a two-hour period. And even occasional binge drinking episodes can have profound effects on your liver’s health over time.
Overall, a small break from drinking like a Dry January won’t necessarily fully “detox” your liver, but if you’re prone to overindulging in alcohol, you can see small health boosts such as decreasing inflammation of the liver and increasing your energy levels with such a break.
The bottom line
Just like a broken bone or infection needs time to heal, so does an overworked liver. While this depends on the amount of alcohol you have had over the years, your liver can see partial healing within two to three weeks, but this will depend on your health history.
Depending on the extent of liver damage you have, you may need to completely abstain from alcohol in order to give your liver the best chance for recovery. Talk to a doctor about your personal history and what’s right for you.
Moderation is key when it comes to alcohol. People who drink a lot of alcohol tend to have very high triglycerides. That can be a concern because elevated triglyceride levels can increase your risk for diabetes, pancreatitis and stroke.
Healthaware 