For many, foodborne illness is something we associate with a bad restaurant meal or a short-lived stomach bug. But as we move through middle age and beyond, food safety becomes less about inconvenience and more about protecting our health and resilience. With that in mind, we share how adopting a few consistent habits can help significantly lower your risk.
Why Risk Rises as We Age
As food safety expert Dr. Donald Schaffner explains: “Our immune systems decline in their effectiveness as a natural consequence of aging, making us more susceptible to many illnesses, including foodborne ones.” Dr. Schaffner, Department Chair, Distinguished Professor and Extension Specialist in Food Science at Rutgers University, is known globally for his research on quantitative microbial risk assessment, predictive food microbiology, and notably, for debunking the “five-second rule” in a widely cited study that showed bacteria can transfer from surface to food in less than one second.
Starting in midlife, several age-related changes may occur that impact how your body handles germs. Digestion may slow, which gives bacteria more time to grow; stomach acid may decrease which reduces a natural defense; and the immune system often begins to decline between ages 50 and 60. Additionally, chronic conditions and medications that suppress immunity can add to vulnerability.
“While absolute risk increases with age, people can change their relative risk by making safer choices in the foods they consume, and by being vigilant about the proper steps for food handling,” says Schaffner.
The Germs That Matter Most
Foodborne illness is common in the U.S., with 48 million cases reported annually, most often caused by norovirus, Salmonella, and E.coli. Of particular concern is Listeria, which unlike most bacteria, can continue to grow slowly in the refrigerator.
Dr. Schaffner notes: “A unique thing about this microorganism is that it can grow slowly at 40°F or below, so even properly refrigerated foods can become unsafe over time.”
Protect yourself from these common pathogens
Top risk for adults
Typical sources
How to prevent
Listeria in refrigerated ready-to-eat foods
Deli meats/hot dogs, refrigerated pâtés/spreads, some soft cheeses, smoked seafood
For higher-risk adults, avoid deli meats/hot dogs or reheat to 165°F/steaming; respect use-by dates and when in doubt, throw it out.
Undercooked ground meats (STEC E. coli)
Burgers, meatballs, meatloaf; cross-contamination
Cook ground meats to 160°F; use a thermometer.
Norovirus from hands and surfaces
Ready-to-eat foods handled after cooking, shared platters, some produce
Wash hands 20 seconds; keep sick food handlers out of the kitchen; clean surfaces.
Raw/undercooked oysters (Vibrio)
Raw oyster bars, undercooked shellfish
Adults with chronic illness (especially liver disease) should avoid raw oysters; choose cooked shellfish.
Use pressure canning for low-acid foods; don’t rely on boiling-water canners.
Beyond Raw Milk: The Bigger Picture
Raw, or unpasteurized milk has received attention in recent headlines, with claims of probiotic benefits and decreased allergenic potential. While there are no controlled human studies to substantiate these claims, the science is clear that unpasteurized milk can carry harmful pathogens such as Listeria, Salmonella and Campylobacter. Pasteurization, used for more than a century, kills these bacteria without reducing milk’s nutritional value, making it the safer choice for adults over 65, people with chronic illness, those on immunosuppressive medications, pregnant women, and young children.
But that’s just one piece of the larger food safety picture. “Risk isn’t limited to a short list of ‘dangerous’ foods,” maintains Dr. Schaffner. “It’s important that older adults realize they are at increased risk of food poisoning from all foods, and so should take special care to follow proven best practices when preparing meals – clean, separate, cook and chill.”
Clean. Wash hands with soap and water for at least 20 seconds before and after handling food. Clean utensils and surfaces frequently. Rinse fruits and vegetables under running water.
Separate. Keep raw meat, poultry, seafood, and eggs away from ready-to-eat foods. Use separate cutting boards if possible.
Cook. Use a food thermometer, and remember that color is not a reliable guide. Cook poultry and leftovers to 165°F, ground meats to 160°F, and whole cuts to 145°F (with rest time).
Chill. Refrigerate perishable foods within two hours (one hour if it’s above 90°F). Keep your refrigerator at 40°F or below.
When to Call Us
Seek medical advice promptly if you’re in a high-risk group or if your symptoms are severe, such as bloody diarrhea, severe abdominal pain, signs of dehydration or fever with stiff neck or confusion.
A final word: with a thermometer in your drawer, a refrigerator set at the right temperature, and a few mindful habits, you can safely enjoy one of life’s greatest pleasures for decades to come.
Seasonal allergies affect about one in four American adults, and if you’re among them, you know the routine: weeks of sneezing, congestion, itchy eyes, sinus pressure, and disrupted sleep. The immune system mistakes harmless pollen for a threat, triggering a cascade of histamine and inflammatory chemicals that can feel relentless.
The good news is that allergy science keeps advancing. The past year has brought meaningful updates, including a first-ever FDA approval for a serious sinus condition, along with clearer guidance on what works best and when to start treatment.
How Common are Seasonal Allergies, and are They Getting Worse?
Roughly 25.7% of American adults have been diagnosed with seasonal allergies, with the highest rates among those in their 40s, 50s, and early 60s (27.9% in the 45–64 age group), according to the American College of Allergy, Asthma and Immunology (ACAAI). All told, an estimated 106 million American adults and children live with allergies or asthma.
Many patients are surprised to develop new symptoms in midlife or to find that allergies they once managed easily are now significantly worse. Pollen seasons are starting earlier and lasting longer in many parts of the country, and the data backs that up.
Neeta Ogden, MD, director of the Allergy, Asthma and Sinus Center, and ACAAI spokesperson, explains why.
In the past we would see a decline in allergy symptoms in parallel with a less reactive immune system that comes with age. But with soaring pollen counts at levels we haven’t seen in prior decades, the immune insult is so extreme that it’s almost as if some reactivity is inevitable. This is leading to new onset allergy symptoms for the first time in your 50s or 60s, or continued allergy later in life even when we would have expected it to dissipate.
If your allergies seem new, or newly intense, you’re not imagining it.
What Works: The Foundation of Good Allergy Care
Nasal corticosteroid sprays remain the gold standard for allergic rhinitis, more effective than antihistamines alone for controlling congestion and postnasal drip. Several are available over the counter:
Fluticasone (Flonase)
Budesonide (Rhinocort)
Triamcinolone (Nasacort)
These work best when used daily and consistently. It typically takes a few days to reach full effectiveness, and the doses in nasal sprays are low enough that they are not associated with the systemic effects of oral steroids.
Antihistamines—cetirizine (Zyrtec), loratadine (Claritin), fexofenadine (Allegra)—effectively relieve itching, sneezing, and runny nose, but are less effective for congestion on their own. Combining them with a nasal steroid often works better. Older antihistamines like diphenhydramine (Benadryl) cause significant sedation and are not appropriate for regular daytime use.
Combination nasal sprays that pair a steroid with a nasal antihistamine (such as Dymista or Ryaltris) show better results than either medication alone, so it may be worth considering if standard options aren’t effective.
The Timing Advantage: Why Earlier Is Better
One of the most consistently underutilized strategies is starting allergy medications one to two weeks before your typical symptom season. This matters more than many people realize, and the biology behind it is worth understanding.
“Once the allergic cascade starts and continues to receive input from the daily onslaught of seasonal triggers, it becomes that much harder to control or reverse,” says Dr. Ogden. “This is called allergic priming, a phenomenon where repeated, chronic exposure to an allergen like pollen causes the nasal mucosa to become hyper-responsive, leading to worse symptoms from lower levels of exposure later in the season.”
She continues: “Starting allergy medications one to two weeks before the season provides almost like a shield of armor against pollen. With earlier seasons we can’t predict when that first day of extreme pollen exposure will hit and with daily medicine on board, you can protect yourself against it.”
If you reliably develop symptoms every spring or fall at roughly the same time, discuss a pre-emptive start date with us. You can track local pollen counts at pollen.aaaai.org to time this precisely.
Immunotherapy: The Only Treatment That Changes the Underlying Response
Allergy shots (subcutaneous immunotherapy) remain the only therapy that can actually modify the underlying allergic response rather than just managing symptoms. The process involves regular injections of gradually increasing allergen doses over three to five years. Many patients achieve lasting relief that continues well after completing the course.
For patients in their 50s and 60s wondering whether immunotherapy is still worth pursuing, Dr. Ogden advises: “Immunotherapy remains a great option at those ages and may sometimes be better in older patients who may not do well taking medications like antihistamines. However, you have to proceed with caution in older patients who might have a more complicated medical history and make sure there are no contraindications.”
Practical considerations include the time commitment for regular injections and a small risk of anaphylaxis, which requires post-injection observation in the office. Sublingual immunotherapy (dissolving tablets placed under the tongue) is FDA-approved for certain pollen allergies as a needle-free alternative, but note that it is not approved for patients over 65.
Simple, Underrated and Very Effective: Saline Nasal Irrigation
Rinsing the nasal passages with a saline solution, using a Neti pot, squeeze bottle, or syringe, physically removes pollen, allergens, and irritants from the nose. It reduces postnasal drip and congestion, and it prepares the nasal lining so that medicated sprays absorb better. Used with sterile or distilled water once or twice daily, it has virtually no side effects and is widely recommended by allergy specialists.
First Drug Approved for Fungal Sinus Disease
Allergic fungal rhinosinusitis (AFRS) is a chronic sinus condition caused by an allergic immune reaction to naturally occurring fungi. It produces thick, sticky mucus that can fill and expand the sinuses and erode surrounding bone. The same type 2 inflammatory pathway implicated in eczema, asthma, and nasal polyps are involved, and it has a high recurrence rate even after surgery.
However, in a promising development this February, the FDA gave a green light to the first drug ever approved for this condition. Dupilumab (Dupixent) is a biologic that works by blocking specific inflammatory signals (IL-4 receptor alpha) rather than broadly suppressing the immune system. It is already approved for eczema, asthma, nasal polyps, COPD, and chronic hives. In Phase III trials, patients receiving dupilumab showed 50% improvement in clogged sinuses (opacification) after one year, and significant reductions in polyp size, congestion, and bone erosion.
“This is an exciting approval and shows the continued diversity of applications for dupilumab, especially in the setting of rhinosinusitis,” says Dr. Ogden. “For those patients it offers very significant relief for a serious condition with a 92% reduction in need for further sinus surgery or systemic corticosteroids compared to placebo, and an 81% reduction in nasal congestion. It’s pretty groundbreaking and life-changing for patients managing what can be a debilitating disease.”
If You Have Both Allergies and Asthma
Allergies and asthma frequently overlap. High pollen counts can worsen asthma symptoms and increase flare risk. Drugs such as Singulair can help manage both conditions simultaneously, though they carry a small risk of mood-related side effects in some patients.
A Word About Online Allergy Information
Be aware that although social media is filled with posts purporting new cures, it’s often inaccurate. In fact a 2026 study published in the Journal of Allergy and Clinical Immunology found that the most engaging content was often the least informed. Natural remedy claims were the most common theme, followed by promotion of IgG food panel testing, and fears about allergy medications.
A persistent example: although not supported by evidence, many believe that eating local honey can desensitize you to local pollens. The reality is that most wind-borne pollens causing hay fever are not the same pollens bees carry into hives, and the amount in honey is far too low to produce a therapeutic immune response.
Acting on misinformation can delay effective treatment, so please check with our office before spending time and money on unproven approaches.
When to See an Allergist
We can manage many straightforward seasonal allergies at our office, but will refer you to an allergist if:
Your symptoms are not adequately controlled despite standard medications
You want to identify your specific allergens through skin or blood testing
You’re considering immunotherapy to reduce long-term medication dependence
You have recurrent sinus infections, nasal polyps, or symptoms suggestive of fungal sinus disease
You experience symptoms year-round
You have coexisting asthma
Seasonal allergies are common, but prolonged suffering doesn’t have to be. With the right timing, evidence-based treatment, targeted new therapies for severe disease, and careful evaluation of your options, most patients can achieve meaningful relief. If you have questions about anything described here, please don’t hesitate to bring them to your next visit.
Our goal: to help you breathe easier, literally.
Allergy-Proofing Your Home
Reducing indoor allergen exposure can meaningfully improve symptom control alongside medication.
Bedding & Bedroom
Encase mattresses and pillows in allergen-barrier covers
Wash bedding weekly in hot water (at least 130°F) or dry on high heat
Minimize rugs, heavy curtains, and hard-to-clean decor that collect dust
Air Quality
Keep windows closed during high-pollen days; use air conditioning
Replace HVAC filters regularly; HEPA filters trap the finest particles
Vacuum weekly with a HEPA-filter vacuum (standard vacuums can disperse fine particles back into the air)
Pollen Control
Shower before bed to rinse pollen from hair and skin
Change clothes after spending time outdoors on high-pollen days
Wear sunglasses outside to reduce eye exposure
Mold & Moisture
Keep indoor humidity below 50%; use a dehumidifier if needed
Check under sinks and around appliances regularly for moisture or leaks
Pets
Keep pets out of bedrooms if dander is a trigger
Bathe dogs weekly to reduce dander (bathing cats is generally less helpful for reducing human symptoms)
A Quick Guide to Alternative Methods
Saline Nasal Irrigation
Evidence: Strong. Widely recommended as an adjunct to standard treatment. Physically removes allergens and improves medication absorption.
Acupuncture
Evidence: Modest. Some randomized trials suggest small symptom improvement but it is not a substitute for evidence-based treatment.
Butterbur
Evidence: Preliminary. Some antihistamine-like effects in small studies, but raw butterbur contains compounds toxic to the liver. Only PA-free certified products should be considered.
Quercetin and Other Supplements
Evidence: Insufficient. Lab studies are promising, but human clinical trial evidence remains limited and inconsistent.
Probiotics
Evidence: Emerging. Certain strains may modestly reduce symptoms by influencing gut-immune interactions. An active area of research, but not yet standard practice.
Dietary Changes
Anti-inflammatory diets (fruits, vegetables, omega-3 fatty acids) support overall immune health, but medical treatment may still be needed.
Note: Always consult with us before starting supplements or alternative therapies. “Natural” does not automatically mean safe, and some supplements interact with prescription medications.
From prevention to precision care, a new wave of research is reshaping what it means to protect your memory and thinking
For generations, a diagnosis of dementia or Alzheimer’s disease signaled a one-way journey of irreversible decline that slowly eroded memory, independence, and identity. Over the last decade, though, scientific understanding has expanded dramatically. Today, a combination of lifestyle interventions, biomarker testing, and targeted therapies has radically injected hope into the diagnosis and treatment of cognitive disorders in older adults. Perhaps most remarkable: research now suggests that up to 45% of dementia cases may be preventable. “Dementia is not an inevitable part of aging,” says Amy Sanders, MD, a highly respected dementia neurology expert now at Sunday Health, a preventive cognitive neurology practice.
A similar evolution occurred in cardiology decades ago. As with heart disease, which was once considered unavoidable, and oncology, where one-size-fits-all treatments have given way to precision medicine, scientific discovery is reframing what’s possible in dementia care. “This field, once static, is now full of energy and promise,” says Maria Thomas, co- founder and CEO of Sunday Health. “By focusing on prevention, early detection, and individually tailored treatments, we are moving toward a future where cognitive decline can be delayed, managed, and increasingly, prevented.”
Prevention Takes Center Stage
New drugs and diagnostics often make the news, but clinicians consistently note that managing modifiable risk factors is central to good health. For older adults, this includes new approaches to delay and/or prevent dementia. A robust body of evidence, anchored internationally by the landmark FINGER study and its counterpart, the U.S. POINTER study, shows that targeted lifestyle changes can significantly reduce cognitive decline.
The original FINGER trial, published in The Lancet in 2015, demonstrated that a multimodal program combining diet, exercise, cognitive training, and cardiovascular risk management helped preserve memory and executive function in older adults at risk for cognitive decline. Its global expansion, the World-Wide FINGERS Network, now spans more than 60 countries. The U.S. POINTER study produced similarly compelling results. Participants who received structured lifestyle support, including personal coaching, nutrition guidance, and regular social engagement, showed greater cognitive stability and improved emotional well-being.
These findings and others have led experts to reconsider the long-held belief that dementia simply happens with age. Instead, they highlight the extraordinary adaptability of the brain. Thomas notes that prevention must start earlier than most people realize. “We’ve long understood how to protect our heart health, but attention to brain health has lagged. Today, we know the same evidence-based behaviors that support cardiovascular health also contribute directly to maintaining cognitive health,” says Thomas.
Dr. Sanders underscores this lifespan approach: “It’s never too early to think about brain health, optimally beginning in your mid-30s when cognitive aging starts. But it’s never too late either.” She points to findings from the Rush Memory and Aging Project, which showed that adults well into their 70s and 80s experienced slower cognitive decline simply by adopting new activities.
*Newly added to the 2024 per Lancet Commission report.
Brain Health Through the Lifespan
Sources: Sunday Health, Lancet
Why Lifestyle Matters: Connecting the Dots
Why do lifestyle interventions make such a difference? Today’s research paints a clear biological picture.
Physical activity increases blood flow, reduces inflammation, and promotes the growth of new neural connections.
A nutrient-rich diet helps counteract oxidative stress and supports metabolic health.
Social interaction and cognitive engagement strengthen neural networks and build cognitive reserve, defined as the brain’s capacity to withstand age-related change.
Advances in Early Detection
For decades, investigating a diagnosis of Alzheimer’s disease required invasive spinal taps or costly imaging. But recent advances, especially in biomarker testing, have changed the landscape. In May 2025, the FDA approved the Lumipulse G pTau217/β-Amyloid 1-42 Plasma Ratio, the first-ever blood test that can identify Alzheimer’s-related proteins well before symptoms appear.
Dr. Sanders cautions that its purpose is specific: “The Lumipulse test is intended for people age 55 or older who are already showing symptoms. An abnormal ratio does NOT mean someone definitely has Alzheimer’s, and a normal result doesn’t guarantee they don’t.”
Instead, the test is one tool in a broader diagnostic picture, akin to A1C (blood glucose) tests for diabetes or measuring cholesterol levels for heart disease. “There is no single test that makes a definitive diagnosis of Alzheimer’s disease,” she emphasizes.
Ideally, brain health baselines that include cognitive testing and biomarker measurements will become a standard part of preventive care. “Just as you periodically get a colonoscopy or mammogram, establishing a brain health baseline can help detect any changes early,” says Thomas.
For those with risk factors such as a family history or genetic vulnerability (e.g. the APOE gene), baselines can be particularly informative. “APOE is a risk gene, not a destiny gene,” Dr. Sanders reminds. “It’s even more reason to work on modifiable risk factors if you know you’re at increased genetic risk.”
New Therapies: A Turning Point in Treatment
Two FDA-approved monoclonal antibodies—lecanemab (Leqembi) and donanemab (Kisunla)—have demonstrated that it’s possible to slow disease progression in the earliest stages of Alzheimer’s disease. In clinical trials, these patients experienced a 25–35% reduction in cognitive decline.
“These are the first ever disease-modifying medications for Alzheimer’s,” Dr. Sanders notes.
The Lancet cautions that trial results range from modestly positive to neutral, and the real- world impact is still unfolding. Currently they are appropriate only for early-stage Alzheimer’s patients who have confirmed amyloid buildup and are not on blood thinners. But for many families, even a modest slowing of decline can translate into months or years of meaningful function.
What’s Coming Next
The treatment pipeline is expanding rapidly. New therapies target multiple mechanisms:
Tau-targeting treatments to prevent the spread of tau tangles.
Anti-inflammatory drugs to address the role of neuroinflammation.
Neuroprotective compounds to preserve neurons and synapses.
GLP-1 receptor agonists (commonly used for diabetes and weight loss) are now being studied for neuroprotective effects.
Another accelerating frontier: artificial intelligence. Machine-learning tools can analyze health records, cognitive patterns, and even voice changes to detect decline earlier than human clinicians can. These technologies promise increasingly personalized, predictive brain care.
As scientific understanding deepens, one theme has become clear: brain health, like heart health, requires consistent habits, early detection, and lifelong attention. With more accessible biomarkers, evolving therapeutics, and stronger evidence for prevention than ever before, the next decade promises major breakthroughs. Or as Thomas says: “The future of brain health isn’t just hopeful, it’s actionable.”
Modern medicine excels at treating disease, yet true healing can go beyond correcting an abnormal lab value or repairing an injury. It involves restoring wholeness of body, mind, and spirit. Increasingly, we recognize that spirituality is a powerful dimension of health, shaping how people find hope, strength, and meaning in moments of challenge.
What Is Spirituality?
Spirituality is broader than religion, though faith may be part of it. At its core, it involves:
A search for meaning and purpose.
A sense of connection with oneself, others, nature, or a higher power.
Transcendence, growing beyond one’s limitations.
The American Academy of Family Physicians describes spirituality as “the way you find meaning, hope, comfort, and inner peace in your life.” People express it through prayer, meditation, nature, music, art, or personal values. While religion offers structure and community, spirituality is personal, more of an inner compass guiding how you live and how you heal. Deepening this connection often brings peace, resilience, and clarity.
How Spirituality Differs from Religion
Religion
Spirituality
Shared beliefs and organized practices
Individual search for meaning and purpose
Rituals or worship
Expression through reflection, art, nature, or quiet contemplation
Community-oriented
Personal, self-directed
Research increasingly supports the link between spiritual well-being and physical health. People who describe themselves as spiritual often report lower stress, healthier behaviors, and greater life satisfaction. Regular practices such as meditation, prayer, or mindfulness have been associated with lower blood pressure, improved immunity, and better mood.
Harvard cardiologist Dr. Herbert Benson termed this the relaxation response — the body’s built-in healing mechanism triggered by calm, focused awareness. Even 10–20 minutes of quiet reflection daily can slow the heart rate, ease anxiety, and reduce pain.
Recent studies show:
Integrating spirituality into care improves well-being, resilience, and quality of life while reducing anxiety and hospital stays. (BMC Palliative Care, 2025)
Spiritual support in serious illness enhances peace and satisfaction. (JAMA Network, 2024)
“Man is not destroyed by suffering; he is destroyed by suffering without meaning.”
— Viktor Frankl
Spirituality helps people adapt to hardship, forgive more readily, and find strength in situations that cannot be changed. When illness or loss occurs, questions naturally arise: Why is this happening? What matters most? Will my loved ones be okay? Facing these questions is not a sign of weakness but of courage and self-awareness.
Tools for Exploring Your Spiritual Life
Two simple frameworks used in healthcare can help you reflect on what brings meaning, comfort, and clarity.
H — Hope: What gives you strength or peace?
O — Organized beliefs: Do you participate in a faith or spiritual community?
P — Personal spirituality: What practices nourish your spirit?
E — Effects on care: How do your beliefs guide decisions?
F — Faith, Belief, Meaning: What gives your life purpose?
I — Importance and Influence: How do your beliefs help you cope?
C — Community: Who offers belonging and support?
A — Action: What habits help you live your values?
Cultivating Spiritual Health
Spiritual growth is lifelong and doesn’t require a specific belief system, only openness and intention.
Try:
Quiet reflection or prayer
Noticing small moments of beauty
Practicing forgiveness (see ho’oponopono, below)
Staying connected with uplifting people
Celebrating simple joys
Ask yourself:
Who are the most important people in my life?
How have they affected me?
With whom do I feel most comfortable?
What is my ideal job? What if the money didn’t matter?
Where would I like to be in 10 years?
What are some goals for this year?
How can I avoid a stagnant life?
Do things happen for a reason?
What are my beliefs on life’s purpose?
What specific experiences have shaped my spiritual beliefs?
Am I a good person?
And remember: At any given moment, you have the power to say this is not how the story is going to end.
Adapted from a presentation by Uday Jani, MD, Shore View Medical Care
The Four Things That Matter Most
The ancient Hawaiian practice of ho’oponopono — “to make right” — offers a simple yet profound way to restore balance and resolve conflict. While this tradition has been taught for generations, many people were introduced to it more recently through mentions in popular culture, including a storyline in medical drama “The Pitt.” Its appearance there reflects a growing public curiosity about approaches that support emotional healing and connection. Modern teachers such as Dr. Ihaleakalā Hew Len and palliative care expert Dr. Ira Byock have helped bring ho’oponopono into therapeutic care.
Using these healing words in daily life can help people release burdens, improve emotional well-being and resolve interpersonal difficulties with integrity and grace:
I am sorry. Acknowledging hurt without guilt or shame.
Forgive me. Letting go of regret and emotional burdens.
Thank you. Gratitude for both challenges and blessings.
I love you. Extending unconditional love to yourself and others.
Our year was off to a sobering start with the advisory on alcohol and cancer risk issued by the Surgeon General in January. The key points, which were concerning, and for at least half of Americans, seemingly unknown until now, included:
A direct link was reported between alcohol consumption and higher risk for cancers of the breast, colorectum, esophagus, liver, mouth, throat (pharynx), and voice box (larynx).
Four pathways were posited: 1) As it metabolizes, alcohol breaks down into acetaldehyde, a chemical which damages DNA in multiple ways. This can cause a cell to begin growing uncontrollably and create a cancerous tumor. 2) Alcohol induces oxidative stress, damaging DNA, proteins, and cells, and increasing inflammation. 3) Alcohol may alter hormone levels, which can play a role in development of breast cancer. 4) Carcinogens from other sources, especially particles of tobacco smoke, can dissolve in alcohol, making it easier to be absorbed into the body, and increasing risk for mouth and throat cancers.
Citing a 2019 survey showing that just 45% of Americans recognize alcohol as a risk factor for cancer, a strong recommendation was made to raise awareness by updating the current warning label on alcoholic beverages.
There is no doubt that the Surgeon General can greatly influence recognition of a health issue, as evidenced by the landmark 1964 report on the risks of tobacco, laying the groundwork for public regulations in the decades to follow. Then, 42% of Americans smoked, now just 11% do. The impact of the current alcohol advisory may not be as profound, but it is significant for several reasons.
While the science behind the advisory is not new, as alcohol-related cancer risk has been noted previously by many healthcare organizations, it has grown increasingly stronger over the years. Particularly for women who drink, recent studies have added to the mounting evidence of their higher risk of developing breast cancer, as well as increased susceptibility to liver disease, cardiovascular disease, and neurotoxicity compared to males. A more widespread public campaign with prominent warnings on alcohol-containing products will help underscore these findings.
The advisory may also add impetus to the cultural shift around alcohol use that’s been occurring over the last decade. As noted, the percentage of Americans who agreed that 1-2 drinks per day is bad for one’s health is low at 45% in the most recent Gallup poll but still reflects a marked improvement compared to 26% in 2016. Most promisingly, the younger generation is leading the charge, with 65% of adults aged 18 to 34 agreeing that alcohol consumption negatively affects health vs. 38% on average of their elders.
Highlighting the risk of disease associated with alcohol requires a more nuanced approach than tobacco, where no consumption is considered safe. Instead, alcohol consumption is viewed along a continuum where risk for most people remains relatively low at 2 standard drinks or less per week, and moderately low at 3 to 6 standard drinks per week – yet fully acknowledging that individual risk is determined by a complex interaction of biological and environmental factors. As long-time researchers wrote in the Harvard Public Health Journal, while heavy drinking is indisputably harmful at every age, the data may not justify sweeping statements about the effects of moderate alcohol consumption. They point to research with mixed results e.g. studies showing decreased mortality, lower risk of cardiovascular disease in moderate drinkers, and a widely cited UK study of one million women that reported higher rates of breast cancer among drinkers but lowerrates of thyroid cancer, non-Hodgkin lymphoma, and renal cell carcinoma. Recognizing that a gold-standard randomized control study would be well-nigh impossible to conduct, the most reasonable approach is to equip people with information that allows them to understand why less alcohol is better, and zero risk is only possible at zero consumption.
Our recommendations:
If you don’t drink, don’t start, as benefits are unproven, and the downsides are clear. Avoid alcohol completely if you are pregnant or trying, have a personal or family history of alcohol use disorder (AUD), have a medical condition that alcohol can aggravate (e.g., liver disease, precancerous conditions of the digestive tract), use medication that can cause interactions, or operate potentially dangerous machinery. However, if you are debating whether you can enjoy an occasional glass of chardonnay, please talk to us. We’ll help you make an informed decision based on multiple factors, including age, gender, medical history, diet, fitness, and lifestyle.
Symptoms of Alcohol Use Disorder (AUD)
What defines a heavy drinker, or a person with AUD? If you’ve experienced two or more of these symptoms in the past year, you may benefit from professional guidance to help you decrease or stop alcohol consumption:
Had times when you ended up drinking more, or longer, than you intended?
More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
Spent a lot of time being sick from drinking, or getting over other aftereffects?
Wanted a drink so badly you couldn’t think of anything else?
Found that drinking—or being sick from drinking—often interfered with taking care of your home or family, or caused job troubles?
Continued to drink even though it was causing trouble with your family or friends?
Given up or cut back on activities important to you to drink?
Gotten into unsafe situations while or after drinking e.g., driving, walking in a dangerous area?
Continued to drink even though it was making you feel depressed/anxious or after an alcohol-related memory blackout?
Found that your usual number of drinks had much less effect than before?
Experienced withdrawal symptoms when the effects of alcohol were wearing off e.g., trouble sleeping, shakiness, restlessness, nausea, sweating?
“A lie can travel halfway around the world while the truth is still putting its boots on.” *
It’s not easy to cut through the clutter in our world of often viral misinformation and find irrefutable facts. Healthcare is especially prone to misinterpretation because the scientific method—developing, testing, experimenting and refining hypotheses—can seem imperfect but is fundamental to reaching a solid conclusion. As the evidence evolves, previous findings may be corroborated, but may also be contradicted. Importantly, even some widely publicized studies may be unreliable or not based on a solid foundation. All of which proves frustrating to people seeking unequivocal advice on issues ranging from nutrition (is a low fat diet healthier than a high protein one?) to exercise (are 10,000 daily steps necessary or will 5,000 do?) to longevity (can a healthy lifestyle overcome challenging genetics?). No definitive answers just yet, but as new research reports continue to flow in, we offer this short guide to help you identify the characteristics of a good, credible scientific study.
Randomized design, where participants are divided into control and test groups in a random manner to minimize the chance of bias. This is the gold standard of research, ensuring findings are causal and not confounded by other factors.
Double-blinded, where neither participants or researchers are aware of whether the participant is in the control or test group.
Observational, where the effects of a risk factor or treatment are studied over time without changing who is or isn’t exposed to them; used to develop the Surgeon General’s advisory on alcohol and cancer risk.
A large enough sample size to have statistically significant findings, and allow for a range of individual differences.
Has been replicated by other researchers.
Results published in a peer-reviewed, respected professional journal, with no conflicts of interest reported by the researchers.
*Has been erroneously attributed to Mark Twain; but actually appeared in the 1859 book Spurgeon’s Gems by Rev. CH Spurgeon.
Set Your Sites
Start with any of these 18 websites for trustworthy health information:
Mayoclinic.org – Mayo Clinic guide to diseases and conditions
