Alcohol, diet and their interaction in colorectal and urinary tract tumors

Abstract

Alcohol consumption is one of the most important known causes of human cancer after tobacco smoking, chronic infections, and possibly obesity. For colorectal cancer, diet has shown to be one of the most significant factors, and alcoholic drinks are considered a related habit for this disease. Furthermore, a possible co-synergistic effect between high intake of alcoholic beverages and red meat - preferably eaten with heavy burn surface - become relevant in populations with a Western dietary pattern. Similarly, the occurrence of urinary tract tumors would be related to this type of dietary pattern which includes high and frequent intake of alcoholic drinks. However, a moderate consumption of red wine, together with a healthy diet, would be protective. Nevertheless, total avoidance of alcohol, although optimum for cancer control, cannot be recommended in terms of a broad perspective of public health, in particular in countries with high incidence of cardiovascular disease. Actually, the so called Mediterranean diet, which among other food products includes red wine, has been strongly related as a protective dietary habit against several types of cancer. It is interesting to note that most policies to prevent and reduce alcohol-related problems are based on external control of the behavior of consumers by using, for instance, regulations on advertising of these products, restrictions on the sale - for hours of sale, or minimum age for sale, among others - price increase, taxes, monitoring of alcohol in motor vehicle drivers, and punishments. So far, these strategies have not had a major impact on public health. Thus, we can reasonably wonder whether this is the best approach to change an individual and social practice that goes back several millennia ago in human history. Dietary practices are a complex field of study, even more in relation to cancer, an etiology recognized as multicausal. The habit of consuming alcoholic beverages is one of those practices. Consequently, epidemiological studies should consider the type of alcoholic drink, the amount consumed, and also the frequency of consumption in order to achieve valid and reliable results. Furthermore, research on alcohol intake and cancer should be analyzed from multiple theoretical and methodological approaches, and involving communities in both research and educational strategies on this issue.