This post is a PSA of sorts to any wine drinkers out there who turn red when they drink - experiencing what has been colloquially termed “Asian Flush” or “Asian Glow” (because about 30-50% of people of East Asian descent seem to experience this problem) but can affect drinkers of many different genetic backgrounds. I came across a study published by the medical journal PLoS Medicine that finds that alcohol drinkers who are subject to this condition are at a greatly increased risk of developing esophogeal cancer; the study was published in 2009, so it’s not news, but it was news to me, so I thought I’d share it with any wine lovers who may be reading this who experience the flush response to drinking alcohol.
For those who are averse to tracking through the details of the article about the study, here’s my super-simplified, in-a-nutshell-but-I’m-not-a-doctor version. If you are a person who turns red when they drink, but can actually drink at some level of comfort, you may well have an inherited deficiency in an enzyme necessary to properly metabolize alcohol (called aldehyde dehydrogenase 2, or ALDH-2). Apparently, alchohol in alcoholic drinks is metabolized in 2 steps: step 1) from ethanol to acetaldehyde and then step 2) from acetaldehyde to acetate. People who experience the flush reaction but can drink more than a nominal amount of alcohol turn red and experience other symptoms when their ALDH-2 deficiency causes them not to be able to metabolize acetaldehyde quickly enough.
The problem is, acetaldehyde is a known carcinogen. According to the study, people who experience the flush reaction have an increased risk of esophogeal cancer even if they drink only moderate amounts of alcohol; the New York Times article about the study notes: “An ALDH2-deficient person who has two beers a day has six to 10 times the risk of developing esophageal cancer as a person not deficient in the enzyme.” Heavy drinkers have it even worse - the NIH article about the study explains: “Notably, these studies showed that individuals with the inactive variant who drink the equivalent of 33 or more U.S. standard drinks per week have a 89-fold increased risk of esophageal cancer compared to non-drinkers.” Moreover, although the incidence rate of esophogeal cancer seems low (from less than 2% up to about 4% in most countries from what I’ve read), the survival rates are low - the PLoS study cites five-year survival rates of 15.6% in the United States, 12.3% in Europe, and 31.6% in Japan.
So what’s a wine lover to do if they do experience the flush reaction when they drink wine? To eliminate the increase in risk completely, you’d have to cut out alcohol from your consumption entirely. If that’s not an option, I would encourage drinking less often, and drinking lower-alcohol wines. Perhaps you can drink less wine per week, take more days off from drinking any wine, or replace that 16% alchohol fruit bomb with a refreshing moscato d’asti or a wonderfully mineral and complex riesling that clocks in at only 8% alcohol. Whatever you decide, please keep your health in mind whenever you indulge in the enjoyment of a wine hobby.
Links:
The Alcohol Flushing Response: An Unrecognized Risk Factor for Esophageal Cancer from Alcohol Consumption" onclick="window.open(this.href);return false;
http://www.nytimes.com/2009/03/21/health/research/21alcohol.html?_r=1" onclick="window.open(this.href);return false;
Alcohol Flush Signals Increased Cancer Risk among East Asians | National Institutes of Health (NIH)" onclick="window.open(this.href);return false;