Recent headlines about links between cancer and the consumption of alcohol and ultra-processed foods arrived just in time to bolster those New Year’s resolutions, whether you’re focused on Dry January abstinence, eating better or both. But the latest health findings should be a warning to make lasting lifestyle changes, local physicians say, not just temporary ones.
An advisory issued this month by Surgeon General Vivek Murthy calls for warning labels on beer, wine and liquor packaging indicating the risk alcohol poses for developing breast, colorectal, esophageal, liver, mouth, throat and voice box cancers. (Alcoholic beverages have had warning labels cautioning against drinking while pregnant, driving or operating machinery since 1989.)
“Certain chemicals are produced when we consume alcohol,” explains Saad Haque, a gastroenterologist and hepatologist at VHC Health. “Before they’re broken down by the liver, they’re directly in contact with organs such as the esophagus and the stomach. These chemicals are directly toxic to these organs. The toxicity manifests itself as inflammation, so that inflammation, over a period of time, leads to cancer.”
Although past research has suggested that drinking red wine in moderation has some cardiovascular benefits, more recent studies have questioned those findings. In addition, “Alcohol use is an unambiguous risk factor for cancer,” says Timothy Cannon, co-director of the Gastrointestinal Cancer Program and Molecular Tumor Board at Inova.
Drinking alcohol is the third leading preventable cause of cancer in the United States, after tobacco and obesity, according to the Department of Health and Human Services (HHS). Each year, about 100,000 Americans are diagnosed with alcohol-related cancers, and about 20,000 die from them. “Cancer risk increases as alcohol consumption increases,” HHS states.
Haque surmises that the surgeon general’s advisory is targeted at three constituent groups: the general public, the food and alcohol industry, and politicians. Congressional approval is required to add cancer warnings to product labels.
“He’s telling you, ‘You can’t do this. This is bad,'” Haque says. “If he’s coming up with this, you’d better take this seriously.”
Concerns About Ultra-Processed Foods
In addition to alcohol, ultra-processed foods pose another cancer risk, particularly for colorectal cancer, according to a report published last month in Gut, a gastroenterology and hepatology journal, by researchers at the University of South Florida and Tampa General Hospital Cancer Institute.
NOVA, a food classification system that categorizes edible substances based on the extent to which they are processed, defines “ultra-processed foods” as industrial formulations made entirely or mostly from substances extracted from foods (such as oils, fats, sugar, starch, and proteins) or synthesized in laboratories (think flavor enhancers, colors, and food additives intended to make the product hyper-palatable). Examples of ultra-processed foods include soda, sports drinks, instant soups and noodles, breakfast cereals and bars, and ready-to-eat packaged foods.
Those in the “ultra” category differ from “processed foods,” which NOVA defines as products manufactured by industry with the use of salt, sugar or oil. Processed products are derived directly from foods, have just two or three ingredients, and are recognized as versions of the original foods. Examples in this classification include frozen veggies, canned fish and freshly-made cheese or bread. The Mayo Clinic Health System says it’s important to consider how much processing food has undergone when making healthy dietary choices.
“If you look at the history of ultra-processed food, it comes to us after the Second World War because there was such a huge push for industrialization and making sure that food—meals-ready-to-eat and so forth—were supplied to the military forces that it then subsequently translated into the Baby Boomer generation, and then, before you know it, it became part of our diet,” Haque says.
Today, more than half of the calories adults in the U.S. eat at home come from ultra-processed foods, according to the Johns Hopkins Bloomberg School of Public Health.
And the number of people younger than 50 being diagnosed with colorectal cancer is climbing. Today, colorectal cancer is the No. 1 cause of cancer death in men younger than 50 and the No. 2 cause in women of the same age group. In the late 1990s, it was the fourth-leading cause of cancer death for both genders.
“That is totally consistent with my experience as an oncologist,” says Inova’s Cannon. “In the last three weeks, I’ve literally seen five new colon cancer patients under the age of 45. I saw one who was 28. That is much different than 10 years ago.”
Other theories about factors that could be triggering the increase include regular use of antibiotics (such as to treat acne) and microplastics in food, Cannon says, but “it only stands to reason that you’d think about food first because that’s what goes in the colon.”
Past research has linked diets high in ultra-processed foods to 32 health conditions, including kidney stones, depression and other cancers such gastric, pancreatic and breast.
“Across the board, it’s a major health risk,” Haque says. Ultra-processed foods are rich in omega-6 fatty acids, which have been linked to chronic inflammation. “Any situation where there’s long term inflammation will lead to cancer.”
Eat This, Not That
Because ultra-processed foods are hard to avoid, everyone is at risk. But it is possible to meaningfully decrease the consumption of these products through dietary changes. In fact, tests have shown that inflammation markers can start falling within three to four months with dietary adjustments, Haque says. “When…we know the inflammation is going down, it’s safe to expect cancer risk to also go down.”
However, identifying ultra-processed foods takes effort, Cannon says. “There’s not really any one label item that shows that something’s ultra-processed, but generally speaking, cookies, alcohol, processed deli meats—these usually go through the types of procedures that we would call ultra-processed.”
If you are reading labels, look short lists of ingredients with pronounceable, familiar names.
Another tip: Eat more fresh fruit and veggies—especially those high in fiber, such as raspberries and green peas. Fiber can reduce the risk of colon cancer, Cannon says.
Haque adds that enjoying in-season produce is better than buying imported items; fruit and veggies start losing their nutritional value soon after harvest. “Go to a farmers market or places where you know that there’s a direct-to-consumer effort,” he suggests.
Additionally, cook more and avoid pre-packaged meals. “Buy things that require you to process the food, not a company to process the food,” Haque says.
Ultimately, cancer risk has many genetic and environmental factors, but being intentional about what you put in your body is a good idea.
“People who have been diagnosed with cancer, they’re always thinking, ‘Have I done something to cause this?’” Cannon says. “I certainly talk to a lot of people who say, ‘Man, I wish I had eaten better. I wish I had focused more on more fruits and vegetables.’ We can’t say in any one case that their diet had to do with the cancer, because there’s a lot of ways you can get cancer, but I think anything we can do to get people eating healthier would be really useful.”