Kaiser Permanente study is first & largest to examine connection between alcohol & Barrett's esophagus
March 2, 2009 (Oakland, Calif.) Drinking one glass of wine a day may lower the risk of Barrett's Esophagus by 56 percent, according to a new study by the Kaiser Permanente Division of Research in the March issue of Gastroenterology. Barrett's Esophagus is a precursor to esophageal cancer, the nation's fastest growing cancer with an incidence rate that's jumped 500 percent in the last 30 years.
Barrett's Esophagus affects 5 percent of the population and occurs when heartburn or acid reflux permanently damages the esophageal lining. People with Barrett's Esophagus have a 30- to 40-fold higher risk of developing esophageal adenocarcinoma (a type of esophageal cancer) because the Barrett's Esophagus cells can grow into cancer cells.
Because there are no symptoms or warning signs of Barrett's Esophagus, people discover they have Barrett's Esophagus when an endoscopy for anemia, heartburn or a bleeding ulcer reveals esophageal cells that were damaged, then changed form during the healing process. Currently nothing can be done to treat Barrett's Esophagus; it can only be monitored.
This is the first and largest population-based study to examine the connection between alcohol consumption and risk of Barrett's Esophagus. Funded in part by the National Institutes of Health, the Kaiser Permanente study 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 Barrett's Esophagus. There was no reduction of Barrett's Esophagus risk among people who drank beer or liquor.
"The rate of esophageal adenocarcinoma in this country is skyrocketing yet very little is known about its precursor, Barrett's Esophagus. We are trying to figure out how to prevent changes that may lead to esophageal cancer." said Douglas A. Corley, MD, a Kaiser Permanente gastroenterologist and the study's principal investigator.
The study findings are echoed by two other studies published in the same issue of the Gastroenterology journal: Australian researchers found that people who drank wine were at a lower risk of esophageal adenocarcinoma, and Irish researchers found that people who drank wine were at a lower risk for esophagitis, an irritation of the esophagus that follows chronic heartburn and often precedes Barrett's Esophagus and cancer.
Researchers are not certain why wine reduces the risk of Barrett's Esophagus and esophageal cancer. One theory is that the wine's antioxidants neutralize the oxidative damage caused by gastroesophageal reflux disease, a risk factor for Barrett's Esophagus. Another theory is that wine drinkers typically consume food with their wine as opposed to drinking straight liquor without food, thereby reducing the potentially damaging effect of alcohol on esophageal tissue, said Ai Kubo, MD, an epidemiologist at Kaiser Permanente and lead author on the study. "But we cannot preclude the possibility that wine drinking is a proxy for other 'health-seeking' behavior," Kubo added.
This study is part of larger, case-controlled Kaiser Permanente study led by Dr. Corley that looked at abdominal obesity and consumption of dietary antioxidants, fruits and vegetables in connection with Barrett's Esophagus. It found that people can reduce their risk of Barrett's Esophagus by eating eight servings of fruits and vegetables a day and maintaining a normal body weight.
"My advice to people trying to prevent Barrett's Esophagus is: keep a normal body weight and follow a diet high in antioxidants and high in fruits and vegetables," Corley 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."
Researchers noted, though, that the protective effect of wine in terms of preventing Barrett's Esophagus was greatest with just one or two glasses a day. The protective effect of wine did not increase with higher consumption.
"It's not actually clear that treating the acid reflux will necessarily prevent getting someone from getting Barrett's Esophagus," said Dr. Corley. "The best way to prevent reflux is to maintain a normal weight."
Authors of the study include: Ai Kubo, T. R. Levin, Gregory Rumore, Charles P. Quesenberry, Jr., of the Kaiser Permanente Division of Research in Oakland, Gladys Block and Patricia Buffler of the School of Public Health, University of California-Berkeley.
About the Kaiser Permanente Division of Research (http://www.dor.kaiser.org/)
The Kaiser Permanente Division of Research conducts, publishes, and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and the society at large. It seeks to understand the determinants of illness and well being and to improve the quality and cost-effectiveness of health care. Currently, the center's 400-plus staff is working on more than 250 epidemiological and health services research projects.
About Kaiser Permanente Research
Kaiser Permanente's eight research centers comprise one of the largest research programs in the United States and engage in work designed to improve the health of individuals everywhere. KP HealthConnect , Kaiser Permanente's electronic health record, and other resources provide population data for research, and in turn, research findings are fed into KP HealthConnect to arm physicians with research and clinical data. Kaiser Permanente's research program works with national and local health agencies and community organizations to share and widely disseminate its research data. Kaiser Permanente's research program is funded in part by Kaiser Permanente's Community Benefit division, which in 2007 directed an estimated $1 billion in health services, technology, and funding toward total community health.
About Kaiser Permanente
Kaiser Permanente is America's leading integrated health plan. Founded in 1945, the program is headquartered in Oakland, Calif. Kaiser Permanente serves 8.6 million members in nine states and the District of Columbia. Today it encompasses Kaiser Foundation Health Plan, Inc., Kaiser Foundation Hospitals and their subsidiaries, and the Permanente Medical Groups. Nationwide, Kaiser Permanente includes approximately 164,000 technical, administrative and clerical employees and caregivers, and 14,000 physicians representing all specialties. The organization's Labor Management Partnership is the largest such health care partnership in the United States. It governs how more than 130,000 workers, managers, physicians and dentists work together to make Kaiser Permanente the best place to receive care, and the best place to work. For more Kaiser Permanente news, visit the Kaiser Permanente News Center at: http://xnet.kp.org/newscenter
Farra Levin, 510.267.7364, Farra.R.Levin@kp.org
Maureen McInaney, 510-710-7322, Maureen.McInaney@kp.org
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