Wine drinkers have reduced risk of gullet cancer

The type of alcohol that people drink and their social background appears to be linked to the risk of developing BE, which occurs when heartburn or acid reflux permanently damages the oesophageal lining, according to research published in Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute.

The study called “Alcohol Types and Sociodemographic Characteristics as Risk Factors for Barrett's Esophagus”​, said that compared to the general population, people with BE have a 30 to 125-fold increased risk of developing oesophageal adenocarcinoma (EAC), which is the fastest growing cancer in the US.

It looked at 953 men and women in Northern California between 2002 and 2005 and found that people who drank one or more glasses of red or white wine a day had less than half the risk (or 56 percent reduced risk) of BE.

However, there was no reduction of BE risk among people who drank beer or liquor and the protective effect of wine did not increase with higher consumption.

Douglas A. Corley, a Kaiser Permanente, Northern California, gastroenterologist and the study's principal investigator, said. "We already knew that red wine was good for the heart, so perhaps here is another added benefit of a healthy lifestyle and a single glass of wine a day."​

One theory as to why wine reduces the risk of BE and oesophageal cancer is that the antioxidants neutralize the oxidative damage caused by gastro-oesophageal reflux disease, a risk factor for BE.

Another theory is that wine drinkers typically consume food with their wine, reducing the potentially damaging effect of alcohol on oesophageal tissue.

However, Ai Kubo, an epidemiologist at Kaiser Permanente and lead author, said: "We cannot preclude the possibility that wine drinking is a proxy for other 'health-seeking' behaviour."​

The study, which claims to be the first and largest population-based study to examine the connection between alcohol consumption and risk of BE, said that the incidence of EAC has increased by more than 500 percent in the last three decades.

The rate of increase is most predominant among Caucasian males, which the authors say suggests that environmental or lifestyle factors may play important roles.

It said that stratification by beverage type showed an inverse association for wine drinkers compared to non-drinkers. In addition, education status was significantly inversely associated with the risk of BE.

Meanwhile, those who preferred wine were more likely to have college degrees and regularly take vitamin supplements than those who preferred beer or liquor.

It concluded that there were “associations between alcohol types, socioeconomic status, and the risk of Barrett's oesophagus”. ​

But it said: “Although choice of alcoholic beverages was associated with several factors, multiple adjustments (including for ​gastro-oesophageal reflux disease or GERD) did not eliminate the association between alcohol and Barrett's oesophagus.”​

Preventing BE ​

The study is part of larger Kaiser Permanente study led by Dr Corley that looked at abdominal obesity and consumption of dietary antioxidants, fruits and vegetables in connection with BE. It found that people can reduce their risk of BE by eating eight servings of fruits and vegetables a day and maintaining a normal body weight.

Corley advised those trying to prevent BE to keep a normal body weight and follow a diet high in antioxidants and high in fruits and vegetables as it is not actually clear that treating the acid reflux will necessarily prevent someone from getting BE

The research findings were echoed by two other studies published in the same issue of Gastroenterology. Australian researchers found that people who drank wine were at a lower risk of EAC and Irish researchers found that people who drank wine were at a lower risk for oesophagitis, an irritation of the oesophagus that follows chronic heartburn and often precedes BE and cancer.

Source: Gastroenterology, March 2009, Volume 136, Issue 3, Pages 806-815“Alcohol Types and Sociodemographic Characteristics as Risk Factors for Barrett's Esophagus”​​Authors: Ai Kubo, Theodore R. Levin, Gladys Block, Gregory J. Rumore, Charles P. Quesenberry Jr, Patricia Buffler, Douglas A. Corley.