After a short run on a cold January night, the Fleet Feet Des Moines social running club ends with a treat: drinks at Single Speed Brewery.
Runners spread out over three tables chatting on an otherwise slow Thursday night at the local brewery. The team has a deal with the brewery. Every time they show up for the semi-weekly run, they get a token for a free drink.
For Lana Snyder, the club’s coach, the gatherings allow her to enjoy a Quirk, her favorite hard seltzer, and hang out with her team.
She’s not concerned about the impact the ritual could have on her health.
“We do enough running, and we do enough other activities and, like, one or two drinks...doesn't seem to be a big factor health wise,” she said.
Current health guidance says people who drink moderately –– defined as no more than two drinks per day for men, one for women by the current U.S. Dietary Guidelines –– can limit negative health impacts but a growing body of research and influential experts are shifting away from this, saying any amount of alcohol could elevate serious health risks, like cancer.
A new federal analysis published on Jan. 14 found that drinking even one alcoholic beverage a day raises a person's cancer risk. Separately, just days into the New Year, U.S. Surgeon General Vivek Murthy issued new guidance that grabbed headlines. He called for an update on the warning labels on alcohol addressing its link to seven different types of cancer: mouth, throat, esophagus, voice box, liver, colon and rectal, and breast.
This comes at a time when Midwestern states have seen an increase in alcohol consumption in recent years.
Research supporting alcohol as a carcinogen is something that’s not well known by the public.
It’s even taken experts like Michael Henry, the deputy director of the Holden Cancer Center at University of Iowa Health Care, by surprise.
“For me, personally, it was a revelation about the strength of the data. I had no idea how strong it was before I looked at it,” he said.
Research has found the risk is “dose dependent,” Henry said. This means the more someone drinks, the higher their risk of cancer is. That’s because alcohol is converted into aldehyde when it enters the body that can damage the DNA in your cells, he said.
“It's very well-established that cancer is a genetic disease that is driven by accumulation of mutations in disease and often that occurs over a lifetime,” he said.
For breast cancer, Henry said alcohol can alter levels of the estrogen hormone. Estrogen plays an important role in the development and progression of many breast cancers. Alcohol consumption leaves those who already have a genetic predisposition for the disease at an even higher risk of developing it, Henry said.
Whatever happened to a little wine is good for the heart?
Cancer is just part of a long list of health issues linked to alcohol.
The World Health Organization says it plays a role in more than 200 diseases, injuries and health conditions, including liver and heart diseases and even mental health issues like anxiety and depression.
The Centers for Disease Control and Prevention estimated around two-thirds of alcohol-related deaths in the U.S. from 2020 to 2021 –– around 117,000 –– were from chronic conditions that developed from drinking over time.
“There is this emerging consensus that there really aren't any health benefits of drinking alcohol,” Paul Gilbert, an associate professor of public health at the University of Iowa, said.
Researchers are looking back on studies from the 1980s and 1990s, such as the widely cited research that found drinking red wine in moderation might have some positive effects on heart health and finding they might be flawed, he said.
“They weren't done quite as well, quite as rigorously as we would do today, so it kind of casts some doubt on those findings,” Gilbert said.
A draft report released this month by the U.S. Department of Health and Human Services linked alcohol consumption with an increased risk for dying early, and found cancer risks are elevated even if people use alcohol at the level of the current recommended guidelines.
But not everyone agrees alcohol is universally harmful.
A controversial evidence review from the National Academies of Sciences, Engineering, and Medicine released last month seemed to go against this growing consensus. It found moderate drinking could be linked to some health benefits such as fewer heart attacks and strokes as compared to abstaining entirely.
Both the HHS report and the evidence review are expected to influence the updated U.S. Dietary Guidelines coming out this year.
“There is a hot debate right now among the scientific community about any benefits from alcohol use,” Gilbert said.
Social patterns are hard to break
Data from the CDC show many Midwesterners already exceed the current recommendation of no more than two drinks per day for men, one for women.
States like Iowa, Minnesota and Wisconsin have some of the highest rates of binge drinking in the country, according to the CDC, which defines it as five or more drinks for men, four or more for women on one occasion.
Recent trends suggest drinking among some groups like women is increasing, which could affect breast cancer rates years down the road, Gilbert said.
“This could be an effect that we don't fully see for, you know, 1, 2, 3, more decades from now, knowing that cancers don't just pop up spontaneously,” he said.
A 2022 report by the National Institute on Alcohol Abuse and Alcoholism found total alcohol use in the Midwest and the rest of the U.S. has been trending upwards since the 1990s.
But Gilbert said social patterns tend to shift slowly over time. He expects this to be the case for alcohol, as it was for smoking.
Recent polls show Americans are increasingly identifying drinking alcohol as being bad for their health, while fewer younger people are reporting using alcohol as compared to previous generations.
Gilbert said while it’s possible that drinking alcohol may have no health benefits, there are benefits to the social activity that often surrounds it.
“It is such a fundamental part of a lot of our cultural social practices. It's how we mark major life events, you know, births and marriages and deaths and retirements and graduations and all sorts of things like it,” he said.
For Snyder, the running coach, the semi-weekly post-run brewery hangouts are a chance for her to chat with her team.
“We unwind, we talk about our run, we talk about our next run, we talk about other stuff that we're going to go do,” she said.
At a neighboring table, fellow runner Eric Schmidt said he too enjoys hanging out after runs. He said he often grabs a beer, but this time, he’s drinking a non-alcoholic IPA.
Schmidt said over the past year, he’s cut back on alcohol and feels better without it.
“I enjoy sleeping a little bit better. I wear my watch to bed, and that monitors your sleep, and I actually do notice a difference,” he said.
Schmidt said he’s not very concerned about long-term health risks tied to alcohol use, like cancer, but said he’s just getting more motivated to be healthier as he grows older.
Side Effects Public Media is a health reporting collaboration based at WFYI in Indianapolis. We partner with NPR stations across the Midwest and surrounding areas — including KBIA and KCUR in Missouri, Iowa Public Radio, Ideastream in Ohio and WFPL in Kentucky.
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