June 2009

 

Alcohol and Women

In February of this year news came out of Britain that a “million women” study was yielding interesting research on alcohol’s effects on women. The million women study is intended to “investigate how various reproductive and lifestyle factors affect women’s health. In particular, the study looked at how hormone replacement therapy affects a woman’s breasts and other aspects of her health.” However the study also looked at “diet, childbirth, breastfeeding, vitamin and mineral supplement use, oral contraceptive use, and family history of illness”.

During the study, Dr. Naomi Allen et al, found that any amount of alcohol consumed by women led to an increased risk of certain cancers. Prior to the study, news media and researchers widely reported on the correlation between alcohol and breast cancer, however, linking low to moderate alcohol consumption to other cancers is a first.

The study included over 1.2 million middle-aged women in the United Kingdom who drank alcohol and consumed an average of one drink a day. Participants were recruited to the study between 1996 and 2001. Researchers identified cancer cases through the National Health Service Central Registries.

The women were found to have an increased cancer risk with increasing alcohol intake, especially for cancers of the breast, liver, rectum, mouth, throat, and esophagus. Based on their findings, the researchers estimated that alcohol could be to blame for 13% of these cancers in women.

• Women who drank only wine had the same risk for developing cancer as those who drank beer, spirits, or a combination of alcoholic beverages.
• Less than 2% of the women in the study regularly consumed more than three drinks a day, but each additional drink increased risk.
• Women who smoked and drank alcohol had an increased risk of oral, throat, and esophageal cancer that was greater than the risk associated with smoking alone.

The U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA) warns of alcohol’s additional harms to women, which include:

• Heavy drinking increases the risk of osteoporosis, especially in young women whose bones are still developing.
• Heavy drinking can disrupt menstrual cycles and cause reproductive difficulties, including infertility and increased risk of miscarriage.
• Drinking while pregnant can lead to fetal alcohol syndrome with its facial anomalies, and problems with growth, learning, and behaviour.
• Heavy-drinking women are more vulnerable to alcohol-induced brain damage than men.
• There are more than 150 prescription and over-the-counter medications with negative interactions with alcohol; older women can be more sensitive to these drug effects.

The U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA) shows data from its National Survey on Drug Use and Health (NSDUH) on “Alcohol Use among Pregnant Women and Recent Mothers: 2002 – 2007”

• Combined 2006 and 2007 data indicate that the rate of past-month alcohol use among women aged 15 to 44 was lower for those who were pregnant (11.6 percent) than for recent mothers (42.1 percent), who in turn had a lower rate than those who were not pregnant and not recent mothers (54.0 percent).
• Past-month alcohol use among pregnant and nonpregnant women and recent mothers aged 15 to 44 did not change significantly between 2002-2003 and 2006-2007.
• Nearly 16 percent of pregnant women aged 15 to 17 used alcohol in the past month, and they consumed an average of 24 drinks in the past month (i.e., they drank on an average of 6 days during the past month and had an average of about four drinks on the days that they drank).

For more information on fetal alcohol syndrome, please visit the Best Start Resource Centre.

The Canadian Cancer Society recommends that women who choose to drink should drink less than one drink per day (pregnant women should avoid alcohol). A drink is one 350 ml (12 oz.) bottle of beer, one 145 ml (5 oz.) glass of wine, or one 45 ml (1.5 oz.) shot of spirits. See also the Low-Risk Drinking Guidelines website for further information about comparable drink sizes.

When the million women study research was released to the media many researchers, policy makers, and senior public health workers commented on what, if any, the extenuating circumstances were for this increased risk. Some of the more popular arguments cited were: increased alcohol promotion aimed at women, increased income for women, difference in alcohol metabolism, and the mixed messages of alcohol’s positive health effects.

Below is a brief discussion of these four arguments.

Increased Alcohol Promotion

The European Centre for Monitoring Alcohol Marketing (EUCAM) recently released a report on alcohol marketing trends. One of the trends cited is the alcohol industry’s new stake in the female market [PDF]. Some of the new directions that alcohol companies have gone toward are featuring attractive men in commercials, introducing fruit-flavoured beer, introducing new, colourful packaging, advertising alcohol as a diet product, and linking brands with health concerns.

An example of this last point was seen recently when Mike’s Hard Lemonade launched their new “Mike’s Hard Pink Lemonade” on April 10, 2009 at the Toronto Metro Home Show with new partners, The Canadian Breast Cancer Network. At the time of the launch, the CBCN was to receive 25% of profits from the new product.

Several public health units and organizations found this relationship to be a conflict of interest for the CBCN as alcohol’s effect on breast cancer is widely known.

Increased income

Some social researchers have written that due to the break down of the glass ceiling, women are climbing the work ladder at a pace not seen before. These changes also include higher earning potential, higher stress, and a need to “fit in” with a largely male unit, which may include drinking after work and/or using alcohol as a coping mechanism.

Difference in alcohol metabolism

The Centre for Addiction and Mental Health (CAMH) explains that women's bodies have less water content and are less able to dilute alcohol. As a result, women are more likely to become impaired from the same quantity of alcohol. Alcohol also does more physical damage to women more quickly than it does to men.

Mixed messages about alcohol’s positive health outcomes

The mixed messages about the health effects of alcohol seemed to have spun wildly out of control. This is partly due to the media’s apparent obsession with promoting alcohol as a healthy component of one’s diet. What was and continues to be missed in the messaging is that alcohol's cardiovascular enhancing properties only benefit middle-aged men and that most women die of cancer over stroke or heart attacks. This means that the limited benefits that booze can generate will not be realized for women, nor does it matter since their main concern should be cancer.

Lastly, and probably the most important issue, is that healthy eating, and active living are a more positive lifestyle choice than alcohol consumption.

The million women study is bound to influence the work of public health practitioners and researchers dedicated to understanding alcohol’s various effects on the body. As countries and provinces decide on healthy drinking guidelines, the findings from the United Kingdom are sure to make a mark on what will be deemed “responsible, healthy alcohol intake”. Stay tuned to your national, provincial and regional health authority to see how they define “healthy drinking”.