Hey bessies, Hello Sunshine.
Today on the bright side, the Surgeon General just released an advisory that links alcohol to seven different types of cancer.
So what does that mean for all of us?
Substance abuse expert doctor Rachel Saco Adams is here with everything we need to know before taking our next sip.
Ooh, and we can't wait to break it all down for y'all. It is Wednesday, February fifth. I'm Simone Voice.
I'm Danielle Robe and this is the bright side from Hello Sunshine, Simone. It's a new month, which means it's time for a new pick for Reese's Book Club.
Yes, and February's RBC pick is Isola by Allegra Goodman. So Isla has been described as an epic of love, faith and defiance, and it tells the story of Marguerite, who is an heir to a fortune and she becomes orphaned and soon finds herself on this expedition with her guardian. But things take a turn when Marguerite is accused of betrayal and winds up punished and abandoned on any island. We will be speaking with author Alegra Goodman about this
book later this month. So be sure to stay tuned for that conversation.
I just saw Reese Witherspoon post that this is one of her favorite historical fiction reads yet, and you can imagine how much Reese reads, so for her to say this, I just really want.
To read this book. Yeah that's high praise. Yeah, high praise.
Right.
Okay, Simon, are you a dry January girl?
You know I have done dry January in the past. I found it to be so transformative. I actually stopped drinking for about two years because of Dry January. Wow, I felt so good. I was like, I don't really need this in my life anymore. Eventually I worked it back in in moderation, and that's where I'm at now. I've been on vacation for a few days and I've had some drinks with friends, and yeah, just moderation.
How about you? One month turned into twenty four that's wild. Yeah.
Yeah.
I kind of go in phases sometimes.
I if I'm like going out more, I like to to have a glass. But I've been working a lot lately, so so alcohol has not been on my mind. But the idea of drinking and how it affects us has been on my mind because the Surgeon General's Office released a pretty shocking advisory about alcohol consumption and cancer risk on January third, and a lot of us understand that
there are risks associated with drinking. I certainly never thought of alcohol as a superfood, but I was really surprised to learn about the direct link that they found between alcohol and seven different types of cancer mouth, throat, breast, liver, and colon cancers. And this warning got everybody talking because I think we all don't know exactly what the true risks are, what we should be worried about, how to
manage the risk when we do drink. There's just like a lot of questions left up in the air.
For sure.
And the thing is, so many social, professional, even romantic situations revolve around drinking. I was just talking about this with my friend because I was just at a conference and we went to one of those conference mixers and just impulsively, instinctually, I just needed to have a drink in my hand because it made me feel, I don't know, maybe like I was a part of something or kind of assuage some like it kind of helped me with
my social anxiety a bit. So I think this is really an opportunity to rethink our relationship with alcohol, particularly if you're in the thirty five to forty year old age group as a woman, because that age group is at the highest risk for binge drinking and alcohol use disorder, which is actually something that I just learned. So today we're bringing it all down with doctor Rachel Saco Adams.
She is a substance abuse researcher with a focus on alcohol and she's also a professor at Boston University School of Public Health.
Yeah, I'm so curious to see what she has to say.
We have so many questions, so let's bring her in, Doctor Rachel Seico Adams.
Welcome to the bright Side.
Thank you for having me.
Rachel. We are so glad that you are here.
You are an essential voice on the podcast today because we've been wanting to get a deeper understanding of the Surgeon General's advisory about alcohol consumption and the link to cancer. Everyone is freaking out about this. What is the top line takeaway that we should be paying attention to.
I think the Surgeon General's guidance essentially sums up something that we've known for a while, but I think is not common knowledge in the United states is that alcohol is a carcinogen. There's a causal link between alcohol consumption and seven different types of cancers. And I think that information, unfortunately, is new for a lot of people, and it's also feels scary.
This feels like a real turning point, or it feels like we've reached a critical mass in awareness around this, because obviously we all know that alcohol is not good for us. You know, we drink it for various different reasons, to help with social awkwardness, to celebrate. It's become this
huge celebratory aspect of our culture. And so I'm I'm sitting here listening to you share these findings, and I'm just thinking about how this could really reshape society if people actually start to pay attention to this, right.
I think for a long time, most people when they think about risks from alcohol, they think about the more immediate risks of like I'm not going to feel well, I'm going to feel sick the next day, i might have a hangover. You know, we all think of the obvious risk of developing addiction. But I think a lot of us think if we can just control the way we drink, or we can handle our liquor we drink reasonably, that's not going to happen to me. So those are
the things that people have been very focused on. Even in the addiction research world, we've been focused on, you know, preventing injuries, preventing you know, reducing harm from sexual assaults or car accidents. There hasn't been as much attention on risk for developing cancer, which I think a lot of people might think is like a downstream risk, but I think most people actually didn't even know that it's a potential risk associated with alcohol use.
The advisory outlines a number of ways alcohol causes cancer. For example, I read that it can alter levels of hormones in the body, and that change in hormone levels can cause cancer. Is that correct?
Yes, So specifically for breast cancer, what they think is one of the contributing risk factors is that alcohol consumption can alter your hormone levels, specifically estrogen, and that is known to increase risk for breast cancer. So specifically that I think is playing a role in development of breast cancer.
Is there any amount that is tolerable for the human body? Is there any amount that is like if you stay within this range, you're going to significantly reduce your risk of cancer.
So this gets at the Surgeon General's report, so I think we should talk more about this specifically. The US dietary guidelines right now for the past years have recommended did no more than one drink per day for women and no more than two drinks per day for men, and they have essentially there's been a reason to believe that if you stay within these limits that your risk for developing adverse health problems will be you know, that's
sort of the safe level. I think what we're learning now and what supported the development of this report, is that there is no actual safe level of alcohol use. So any level of alcohol use is associated with an increased risk for cancer, specifically three kinds breast cancer, throat and mouth cancer. However, what I think is the good news is that the less alcohol you have, your risk is lowered for those types of cancer. So it's not
like any or none. Essentially that the more alcohol you consume your risk for these types of cancers may increase. I could talk in numbers which might illuminate the risk. So for women over their life, the absolute risk developing breast cancer is eleven and one hundred, so eleven and one hundred women will develop breast cancer.
For women who are.
Drinking two or more drinks per day, that increases for fifteen women out of one hundred would be diagnosed with breast cancer. So the risk is increasing slightly. However, I think any woman who's evaluating how they want to take this information and use it to make choices about their alcohol use also would want to consider family history and other factors that might affect the risk for breast cancer, such as density of breast age, family history.
Again, why are we just talking about this now?
I have some different ideas on that. I mean, I think that from what I've learned that the data supporting alcohol being associated with increased risk for breast cancer has been known since the nineteen eighties. I think since then there's been mounting evidence to support this information. However, it's first of all, it's not information that's welcomed. People don't
really want to know this. This is a story that is upsetting, and it's in relation to a substance that's legal and that is part of our culture and all sorts of happy and sad rituals and customs. And I think that being able to share information like this in a way that is believable requires decades of really strong
research to support it. So I think the evidence has been coming out over the past several decades, and now it's strong enough that the Surgeon General would make this recommendation to add these warning labels to alcoholic beverages.
You said something earlier, Rachel, that I think we have to just we have to drive home this point. Up until now, up until the findings of this study, we were under the assumption that, you know, maybe about one drink a day was acceptable. But now after this, any amount of alcohol is carcinogenic.
I think that within the five past five or ten years, we've known this information and it has been discussed, but I think it's not been talked about so definitively. And I think the fact that this report came out making this recommendation for warning labels really sort of changes the game. And it's drawing a lot of attention to the issue. And part of it is that perhaps the information was there, but it just wasn't being focused on enough.
Yeah, I was interested to learn about the difference between men and women developing a risk in cancer. Women who have one drink a day have a nineteen percent risk of developing cancer, whereas men who have one drink per day have an eleven percent risk of cancer. What is the difference. Where's the disparity.
It's the link to breast cancer.
So, because breast cancer is one of the types of cancers that's known to be causally associated with alcohol use breast answer just affects women predominantly, so that therein lies why this is probably more serious for women, the stakes are higher.
Wow.
So, Rachel, when we talk about how alcohol affects us at different ages, what does this study tell us about the relationship between alcohol and aging for women?
We know that your risk for developing breast cancer increases as you age, and it also increases for women who haven't had children by age thirty.
Wait, what really something about being pregnant does something to lower cancero us.
Yes, there are just different things that affect your hormones that can affect development of breast cancer. So as you age, you're just more likely to be identified as someone with breast cancer as you get older. I mean, one thing we're learning is that as you age, your body sort of processes alcohol slower. So that might be why when you're in your thirties and forties, you're like, oh, why is it that when I'm having one drink now, I already feel really tipsy.
I don't feel well.
I'm sort of you know, you're feeling very differently than you might have felt in college when you had a couple drinks. What is happening is that your liver is metabolizing the alcohol slower and it's staying in your body longer. Another thing to think about in terms of alcohol use for women in their thirties and forties is this is like sort of the prime of reproductive age or even even in your twenties, and we know that alcohol can you know, any level of alcohol is potentially harmful for
developing fetus. So if women are thinking about being pregnant or trying to conceive, you know, alcohol during any phase of pregnancy can lead to fetal alcohol spectrum disorder risks. It can increase risk for a miscarriage. So it's just important to think about that, you know, as you're consuming alcohol, if you're thinking about trying to get pregnant.
And what about menopause, can you tell us about what happened when we drink alcohol during menopause and how that affects cancer risk.
When women are premenopausal are going through menopause, we know that alcohol can really make symptoms worse of that process, so it can increase hot flashes, night sweats, disrupted sleep, irritability,
changes in mood. That time is a time where your hormones are naturally changing a lot, which increases your risks for cardiovascular disease, osteoporosis, weight gain, and it's believed that if you're consuming a lot of alcohol, you're going to have a harder time storm managing your weight, which can also contribute to development of those other conditions.
Do the long term health effects of alcohol differ for occasional drinkers or heavy drinkers.
Yes, for sure. I mean your risk is higher the more you drink. So if you're someone who's consuming alcohol every day, or you drink three four times a week, but you're having four or five drinks on each occasion, your risks are much greater in terms of adverse health outcomes, and also your risk for developing cancer is higher.
We've got to take a quick break, but we'll be right back to wellness Wednesday with doctor Rachel Sego Atoms And we're back with doctor Rachel Sego Atoms. I know that you've done some really insightful research on alcohol and millennial women. What have you discovered about the ways that we consume alcohol, how alcohol is marketed to us, and how this whole dynamic has really evolved over time.
So I've done a lot of thinking and work with colleagues thinking about the way alcohol is sort of portrayed to us as women of what i'll call middle age, So you know that spans millennials and you know some
Gen xers as well. But I think that there's been a real shift over the past decade or so in terms of first social media coming onto the scene and what social media has created a place where we sort of are able to talk about alcohol a lot and share information, and alcohol is presented in social media from our peers and used as you know, it's lots of jokes, lots of memes.
Emmy wine culture, mommy wine, the signs at hobby lobby and home goods. I mean, mommy wine culture is inescapable.
It is, And so we've done some thinking about like, is there any potential risk of that. I mean, it's meant to be a joke, it's meant to be funny, but it's also promoting this this idea that women who are struggling, perhaps with motherhood and it's like exhausting and tiring and hard and feels isolating, that what we should do at the end of the day is you know, turn to a glass of wine and that that's going to make our problems. That's going to make us feel better.
We deserve it and it's going to help. And in fact, like a woman in that situation who's struggling and rightly so, exhausted and tired and stressed, alcohol probably will make that night in the next morning harder because alcohol disrupts sleep, Alcohol can increase feelings of anxiety or depression. Alcohol can make you more irritable. So you know, once in a while, that's fine, probably, but if that's what you're doing repeatedly,
that's that's not going to be helpful. So we've thought a lot about just those messages and how we need to try to bring in different, different information into the conversation.
I think we.
Can't ignore the alcohol marketing and how there's been a real shift and an explosion of products really that are targeting women. There's pink drinks, you know, rose has become extremely popular. We talk about rose all day. We have low calorie selzers and products and drinks that are all new, and those are targeting women predominantly, and all of that I think is playing a role in exposure. And I think that you know, people ask me a lot like
how is it different than forty fifty years ago? Like women there were social pressures to use alcohol then too, But I think when you think about what's happening with social media and marketing today, those are some new factors that have come in that have potentially really changed things.
Yeah.
Completely, As a mom who is very intimately familiar with that feeling of like I have no one to talk to, no one cares about me and my needs, I'm gonna I'm on the verge of a breakdown in those moments, the cheaper, easier fix is, you know, a glass of wine or you know, whatever it may be that might be unhealthy, because unfortunately, the healthier fix, like let's say, hiring a mental health professional to talk to them, that's so much more expensive than you know, attend dollar bottle
of wine. So I feel like we need to just get our priorities and check and provide women who are struggling with some of these things that you're talking about with resources that can actually help us.
Yeah, and I think one of the things we can
do is help each other out. So I think that part of this and part of what's so helpful about this new Surgeon General report is we can start talking about it a little bit more, and we can start thinking about our friends and our peers and know that, you know, maybe one of the best things we can do is when we're when we're together, when we're holding a social gathering and event that we can just normalize like we're going to have, you know, we'll have alcoholic drinks,
but we're also going to have some fun non alcoholic drinks and just acknowledging that, like people might not always want to have a journey and that's okay. But if we don't like put it out there that this is a choice and we all have like the right and we maybe should be reflecting on our alcohol use, then it's just going to kind of continue where you go to an event, you go out to dinner with your friends and everybody's ordering drinks and you feel really awkward if you're not.
That is such a good point that women have an opportunity to come alongside one another with this information and be each other's support system.
I think so, And it's hard. I mean, we talk about peer pressure for adolescents and college students with substances with alcohol, but I think it is so real with women and women in their twenties and thirties and forties. It's hard to be the person that's going to not choose to drink because there's a lot of fears associated with that. You think that, you know, maybe your friends will think you're judging them, or that people will assume that you have a problem that you're you know, you can't.
Why is she not drinking? She might you know, is she in recovery? You might burn friendships. So it's it's not.
Easy, simone. Are you wanting to cut alcohol out entirely from your life?
No, I'm not planning to. I actually have in the past. I stopped drinking for about two years and it was great, but I found a way to work it back into my life. That feels like a healthy level of moderation for me. How about you.
I don't want to cut it out entirely either.
I think most people are probably in the same lane. As we are, so I'm curious if there is anything that people like us should really be keeping in mind in order to partake in a way that is as healthy as possible. You know.
One of the things that I started thinking about all of this was in twenty nineteen, the book Sober Curious came out by Ruby Arrington, and it's sort of I think one of the take home premises from that is just reevaluating your relationship with alcohol, which might mean you want to still continue drinking at times, but maybe not as much, and just be more thoughtful about when you
want to drink and why. So I would encourage anyone really to perhaps for a period of time keep like a journal about just record when you're drinking and why, and who you're with, if you're alone, and how you feel after if you're you know, you have any regret or you think that that was a good experience, just
to learn more about when you're drinking and why. And then I think that there's a lot of optimism about these new non alcoholic products that have entered the market and how you're starting to see them more at regular grocery stores and in restaurants and at Fenway Park in Boston, you know. I mean they have these non alcoholic beers, they have non alcoholic drinks.
They've really and they're quite good.
And they're sober bars too, they're sobertail.
You know.
That movement started really strong actually right before COVID hit, and COVID sort of like halted it pretty clearly. And then a lot of women in particular turned to alcohol during COVID for different reasons. But what I've seen is a positive thing is now some people women and men who are you know, would maybe have three four drinks in a night, are having one or two and then they're switching to the non alcoholic drink for the rest of the night.
Yeah, that's a nice option.
You know.
Just having these these types of products around in your house is a choice. So it's it's not really it doesn't have to be all or nothing for most people. And I think as you experiment and try different things over time, you might you might continue to evolve and think differently about it.
And that's all. Okay.
One of the things that I think I've seen done really well, my mom actually does it. She makes non alcoholic seltzer water really fun. She cuts up a ton of fruit and berries and like makes the glass look really enticing and fun, and so people at parties, I think, feel more comfortable holding it and drinking it because it feels like an experience right, just the way like an alcoholic Drick does. The one thing that I can tell you I've personally struggled with in this vein is the
social pressure around it all. Because when I was younger and I would go out to work drinks or even on a date and I would say, oh, I'll have, you know, a Seltzer water with lime or a diet coke or whatever it is. People would be like, oh, you're no fun, or come on, you have to have one with me. And as I've gotten older, it's gotten easier to not give in to that pressure, but I really still find it challenging if I'm being honest, because I don't want to be looked at as if I'm not fun.
Yeah, of course, I mean I think there's a few things that can help, And if you're going to meet a group, I think it helps to have something in your hand. People are uncomfortable when you're standing there with
nothing in your hand. You're like making someone else uncomfortable, which is crazy, but you know, so if you can get there first, or you have a friend that knows you're not drinking to just someone can grab you a soda, water and lime, or you know, a non alcoholic drink put in a regular glass, so maybe you're not drawing attention to the fact that what you're drinking is non alcoholic. I think that those are great things. I think the date situation can be very tricky. I've talked to friends
who the same thing. It's it's really hard to go on new dates with people and not want to order alcohol because then you think that they are making judgments about you. I've witnessed people handle that different ways, and I think what tends to work best is just honesty, being like practicing, and being more comfortable to just say, I'm getting this type of drink, and you know what,
You don't have to make an excuse. You really don't, but if you want to, you can just say, you know, I'm getting this type of drink I really like it, or I have a big meeting tomorrow.
You know you can.
You can make up a reason and the reasons are probably all true.
You can send them a link to this episode.
Yeah, one of my best friends has a joke with me. She will always be like, because I trained for a triathlon at one point, and so I really was not drinking.
And that was years ago.
And so now if I'm not drinking and we're all out together, my friend'll be like, oh, Danielle's training for a triathalone.
You can't drink.
She's always training, right.
It's like people don't yell at you if you're like, oh, I'm training for a ten k, that's right. Yeah.
I mean.
My friend said to me once and here, I am an alcohol researcher and I've been studying this for about almost twenty years. And I was going to a conference, an international conference about five years ago or something, and I said to my friend, and this was a time I was trying to just really be present and reduce my own alcohol, but realizing how uncomfortable I meet other people. And I said, you know, I don't I don't really want to drink, but it's so hard in these situations
because it's such a big part of the community. And she was like, Rachel, I just don't believe anyone should drink if you don't want to, Like, you should never drink a drink when you don't want to, and that like very simple statement was so profound to me. I thought, like, of course, of course you shouldn't drink this, Like you don't have to drink an alcoholic beverage if you don't want to.
I'm an adult, I study this, but it's hard.
And I think we can also be an advocate for the people in our friend group who aren't drinking and kind of step in and say, hey, she's you know, she's not drinking tonight, and that's her choice, Like let's move on. Yes, I think that we can kind of support our friends in that way.
It's time for another short break. We'll be right back with doctor Rachel Saco Adams and we're back to wellness Wednesday with doctor Rachel saco Atoms.
Okay, Rachel, we'd love for you to set the record straight on some common alcohol anecdotes.
Son, Will you tell.
Us if these are fact or fiction? It was conventional wisdom for a long time that a glass of red wine every day is good for your heart. Is that true? If not, why has this been so misconstrued for so long?
That is not true.
It was believed for a period of time, and the research world has struggled with this, and.
I'll explain why.
The idea that low level drinking like that was good for you has to do with the way that studies were set up. So essentially, the researchers were looking at people who drank sort of low levels of alcohol in comparing them to people who completely abstained who didn't drink any alcohol, and then looking at health outcomes like development of cardiovascular risk or other types of health outcomes mortality risk.
But the problem with that design is that a lot of the people who weren't drinking anything were already struggling with health problems, so they were a sicker population. So that made them look like it made it look like the people drinking low levels of alcohol were you know, having improved health. But in actuality, it had to do
with the comparison group. So now they've started to do studies where they're looking at, you know, the comparison group is people who drink just really infrequently, and they're realizing that those potential health benefits don't really play out anymore.
Okay, next one, Tequila is quote unquote the healthiest liquor. We've heard that it's better for you than darker liquors. Are there any forms of alcohol that are actually healthier than other ones?
No, All alcohol has the same alcohol molecule in it, so it has the same association and risk for development of these cancers, So there's no real difference. I think that's really just a myth. I mean, there's no What you should pay attention to, though, is alcohol content within drinks and sort of drink sizes. So you know, if you pay attention to this, like no more than one drink per day. For wine, that's like five ounces of wine.
But if you have an enormous wine glass and you have a very heavy pore from your friend, I mean, one glass might actually be equivalent to two glasses. So you got to think about that when you're choosing what drinks you're going to have and paying attention that, like, actually the size of the bottle or the alcohol content in the beer, for instance, does actually change the amount of alcohol you're ingesting.
How about drinking during the day is better than drinking at night because it doesn't affect your sleep, true or false?
I mean I think that for people who've drank a lot during the day, they get really tired later in the day usually and then are exhausted. It can be hard to sort. You're still metabolizing the alcohol, and you're going to go through the same processes, and you're going to be dehydrated probably around the time like you need to start going to bed regular time, So I think that you're still probably going to have interrupted sleep that evening.
Lastly, mixing alcohol is worse for you than staying with the same one all night.
I think that perhaps that is true that you might feel worse when you're mixing lots of different things together, but it also probably could have to do with the fact that you're just ingesting a lot of alcohol, and so the more different types you.
Have means you've had a lot and you just might not feel well the next day.
Doctor Seco Adams, this has been so interesting and informative.
Thank you for sharing your time and your knowledge with us.
Thanks for having me.
Doctor Rachel Saco Adams is a substance abuse researcher and associate professor at the Boston University School of Public Health.
That's it for today's show. Tomorrow, we're joined by actor Jordana Brewster to talk all about our new movie Hard Eyes. Join the conversation using hashtag the bright Side and connect with us on social media at Hello Sunshine on Instagram and at The bright Side Pod on TikTok oh, and feel free to tag us at Simone Boyce and at Danielle Robe.
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See you tomorrow, folks, keep looking on the bright side.