U.S. Surgeon General Dr. Vivek Murthy’s new Advisory on Alcohol and Cancer Risk outlining a direct link between drinking alcohol and increased risk of developing seven types of cancer was released Friday amid a review of federal guidelines for alcohol consumption.
The move drew praise from Dr. Michael B. Siegel, professor of public health and community medicine at Tufts University School of Medicine, who said it is likely not a coincidence Murthy’s advisory came as the fight over how much alcohol the U.S. should deem safe as part of a healthy diet is being debated.
The secretaries of the U.S. Department of Health and Human Services and the U.S. Department of Agriculture are conducting an every-five-year review of dietary guidelines, including for alcohol consumption, which is due to be released later this year. With just over two weeks left before the Biden administration ends, this could be one of Murthy’s last chances to influence the outcome. Murthy didn’t directly call for changing the dietary guidelines in his advisory, however.
“My sense is that he probably got fed up, and he basically has had enough of the alcohol industry influence, and is basically just saying, that’s it. We’re gonna have science decide this, not politics. So he came out with this definitive statement, unequivocally saying that alcohol is a carcinogen and that moderate drinking is a risk factor for cancer,” Siegel said.
The dietary guidelines provide advice on what Americans should eat and drink to meet nutrition needs, promote health, and prevent disease. They are used by doctors to suggest lifestyle changes and by the federal government to determine how food assistance can be spent.
There are about 100,000 alcohol-related cancer cases and about 20,000 alcohol-related cancer deaths in the U.S. each year, the advisory states. Alcohol is the third-leading cause of cancer in the U.S., after tobacco and obesity.
While research has shown a link between alcohol and cancer, “the majority of Americans are unaware of this risk,” Murthy said in a statement.
Murthy will be replaced by a surgeon general nominated by President-elect Donald Trump after Trump’s Jan. 20 inauguration.
Dr. William Dietz, a professor at the Milken Institute School of Public Health at the George Washington University, said Murthy is using his position to draw attention to a major health issue while he can, the way previous surgeon generals waived flags about the dangers of tobacco use and obesity.
“I think he safely added alcohol to what is now the big three, which is tobacco, obesity and alcohol,” Dietz said. “It’s quite appropriate and within character of the position to use the position as a bully pulpit to call to the attention of the American public issues related to health.”
Potential benefits to heart health from moderate drinking
Murthy’s advisory comes weeks after one of the reports expected to shape the next edition of the U.S. Dietary Guidelines broke with the emerging scientific consensus that alcohol has no health benefits. Instead, the evidence review by the National Academies of Sciences, Engineering, and Medicine in December tentatively endorsed the former prevailing scientific theory that moderate drinking is linked to fewer heart attack and stroke deaths, and fewer deaths overall, compared with not drinking at all. Many scientific organizations now dispute that hypothesis, saying the harms of any alcohol outweigh any potential health benefits.
Dr. Laura Catena, a vintner and physician who divides her time between California and Argentina, said that it is important for the surgeon general speak about the health risks that come with heavy or binge drinking, but the public should look to the National Academies findings as well.
“I think it’s also important for people who drink in moderation and who drink perhaps as a way to socialize, to gather with family and friends or as a part of their cultural traditions, like I do with my family in Argentina, to know that there are positives and negatives to drinking, as was revealed in the (National Academies) report,” she said.
The National Academies report was commissioned by Congress, which provided $1.3 million for the work. Some public health experts raised concerns that the nongovernmental panel put together by the National Academies included researchers and experts with ties to the alcohol industry and failed to include many relevant studies about the harms of alcohol in their review.
“The alcohol industry has been hoping that they can get this recommendation to basically say that alcohol can be healthy for you, it can lower your risk of heart disease, and therefore, you know, it should be part of a healthy diet,” Siegel said.
A major alcohol trade group said they aren’t telling people to drink for their health.
“We do not recommend that anyone drink to achieve health benefits and urge all adults who choose to consume alcohol to consult their health provider to determine what is best for them and to follow the recommendations of the 2020-2025 Dietary Guidelines,” Amanda Berger, senior vice president for science and research at the Distilled Spirits Council, said in a statement.
Several alcohol industry associations responded to Murthy’s advisory by pointing to the existing dietary guidelines or the National Academies report.
More: For alcohol industry, surgeon general’s cancer warning is nothing to toast
The secretaries will also rely on a second analysis by a governmental committee called the Interagency Coordinating Committee on the Prevention of Underage Drinking that is expected to be completed this month. That committee is made up of experts from the Department of Health and Human Services, Surgeon General, the Centers for Disease Control and other agencies and were tasked with reviewing the health effects of moderate drinking.
For the first time, the secretaries will rely on the findings of the two reports rather than evaluating the available scientific evidence about alcohol and make recommendations.
When the U.S. dietary guidelines were last updated in 2020, the government rejected its scientific advisers’ recommendation to lower alcohol consumption. The guidelines still suggest limiting drinks to one daily for women, two for men.
In recent years, the the World Health Organization and national health agencies around the world, have issued guidance that no amount of alcohol is safe.
Tobacco-style warning labels?
Murthy also called on Congress to add cancer risk warnings on alcohol. Current label statements, which warn about drinking alcohol during pregnancy and the impact of alcohol on driving a car or operating machinery, have not been updated since 1988.
Changing the existing warnings would need the support of Congress as well as the incoming Trump administration. Trump has tapped Dr. Janette Nesheiwat, a medical director for a chain of urgent care clinics and a Fox News contributor, to be his surgeon general. The appointment requires Senate confirmation.
Nesheiwat has spoken on FOX about the benefits of reducing alcohol use. Trump has said he does not drink, and Robert F. Kennedy Jr., Trump’s pick for Health and Human Services secretary, said he has been sober for more than four decades.
This article originally appeared on USA TODAY: Why now? Surgeon general elevates alcohol consumption before term ends
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