Editor’s note: Diana drinks a glass of wine each evening to help protect her heart…Paula usually takes a pass, because drinking could boost her breast cancer risk. Who has the more healthful approach to alcohol? There’s no obvious answer (given that neither woman has a history of alcoholism, in which case abstinence would be the only safe option). So when Daily Health News, a sister publication from Bottom Line, interviewed two preeminent experts on the topic, I knew that HealthyWoman readers could benefit from their insights, too. Check out the DHN article below…then visit www.BottomLinePublications.com/free-e-letters for a free subscription to DHN. Here’s to your good health!

You’ve probably already heard that about one drink of alcohol a day may reduce a woman’s chances of developing heart disease. And you’ve probably also heard that drinking alcohol can raise the risk for breast cancer—in fact, a recent study shows that as few as three drinks a week can have that life-threatening effect! That sounds like a Catch-22 to me—what’s good for the heart may lead to cancer. I know that life is full of uncertainty—but really, must women live with such conflicting health advice?

In search of answers that would help any woman, I called researcher Wendy Chen, MD, an oncologist and epidemiologist at Brigham and Women’s Hospital and Dana-Farber Cancer Institute, both in Boston, who conducted the recent study, and cardiologist Robert Stark, MD, medical director of the cardiovascular prevention program at Greenwich Hospital/Yale New Haven Health in Greenwich, Connecticut.

HOW BOOZE AFFECTS BREAST HEALTH

First, Dr. Chen gave me the details about her study. She analyzed data from almost 106,000 women, ages 34 to 59, who participated in the US Nurses’ Health Study. Participants were followed from 1980 through 2008, and one thing that was tracked was their alcohol consumption. Dr. Chen found that those who reported having just three to six drinks per week were 15% more likely to develop breast cancer, compared with teetotalers—and the type of alcohol didn’t matter. Slightly heavier drinkers did worse—with those averaging about 11 or 12 drinks a week having a 51% higher risk for breast cancer. (That’s just under two drinks a day on average!) Alcohol is associated with higher estrogen levels and may make breast tissue more sensitive to the effects of estrogen, which can fuel cancer growth, said Dr. Chen. The findings were published in the Journal of the American Medical Association.

"We already knew that alcohol upped breast cancer risk, but this study gives us a better idea of the threshold," Dr. Chen told me. The study found that having two or fewer drinks a week was not "statistically significant" in terms of leading to an increased risk for breast cancer. It also provides a more long-term view of the effects of alcohol consumption, compared with prior research, since this study followed women for almost three decades. It’s important, she said, to focus on the common thread among those most at risk for breast cancer—drinking alcohol regularly over the course of many years. In other words, in terms of breast cancer risk, don’t worry about occasional drinking—because that type of consumption wasn’t linked to increased risk.

HOW ALCOHOL AFFECTS HEART HEALTH

How do we balance this news about breast cancer with the fact that one drink per day—especially red wine, which contains the antioxidant resveratrol—might keep the cardiologist away? Dr. Stark noted that a glass of alcohol a day has been shown in prior studies to help fend off cardiovascular problems by raising levels of HDL "good" cholesterol.

But make no mistake, he said—aerobic exercise, such as walking or running, does a better job at raising our levels of HDL cholesterol than drinking red wine. And there is no downside to a sensible program of regular exercise.

SO WHAT’S THE SOLUTION?

As you might have guessed, there’s no single answer to whether or not you should hesitate to fill your wine glass, and a lot has to do with the individual risk factors that you have for either condition. For example, Dr. Stark said, women with one or more cardiovascular risk factors should do several things to reduce their risk for heart disease—and having a nightly glass of red wine could be one of them.

But for women at high risk for breast cancer, drinking should probably be a rare indulgence, said Dr. Chen. Who else may want to cut back? Women under age 38, because their estrogen levels are at their peak, said Dr. Stark.

What if you carry risk factors for both cardiovascular disease and breast cancer? Now that’s a tougher question to answer. But keep this one uplifting thought in mind: There are so many risk factors that you can’t control, such as age and genetics—so focus on the fact that drinking alcohol is at least a modifiable risk factor, one that you can control. Talk to your doctor—maybe even bring along a copy of this article—and together, figure out your best sipping strategy.

Sources: Wendy Chen, MD, is an assistant professor of medicine at Harvard Medical School and associate physician at Brigham and Women’s Hospital and Dana-Farber Cancer Institute, all in Boston. Robert Stark, MD, is a cardiologist in Greenwich, Connecticut, and medical director of the cardiovascular prevention program at Greenwich Hospital/Yale New Haven Health.