Drinking a Glass of Wine Daily Lowers the Risk for Barrett's Esophagus

Laurie Barclay, MD

March 09, 2009

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March 9, 2009 — Drinking 1 glass of wine a day may lower the risk for Barrett's esophagus by 56%, according to the results of a population-based, case-control study reported in the March issue of Gastroenterology.

"The rate of esophageal adenocarcinoma in this country is skyrocketing yet very little is known about its precursor, Barrett's esophagus," senior author Douglas A. Corley, MD, from Kaiser Permanente in Oakland, California, said in a news release. "We are trying to figure out how to prevent changes that may lead to esophageal cancer."

This analysis was part of a larger study evaluating the association of Barrett's esophagus with abdominal obesity and consumption of dietary antioxidants, fruits, and vegetables. That study showed a lower risk for Barrett's esophagus linked to eating 8 servings of fruits and vegetables daily 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," Dr. 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."

The study sample consisted of 953 men and women enrolled in Kaiser Permanente in Northern California between 2002 and 2005. Cases (n = 320) were patients enrolled for at least 2 years, with International Classification of Diseases, Ninth Revision (ICD-9), code for new diagnosis of Barrett's esophagus, and with endoscopy results reviewed by a gastroenterologist.

One control group (n = 316) had a diagnosis of gastroesophageal reflux disease (GERD) by ICD-9 code, and the other control group (n = 317) consisted of enrolled members without either condition.

Although total alcohol consumption was not consistently associated with the risk for Barrett's esophagus, there was a trend toward lower risk with moderate consumption and higher risk with heavy alcohol consumption. After adjustment for demographics, body mass index (BMI), smoking, and location, moderate drinking was inversely associated with the risk for Barrett's esophagus (odds ratio [OR], 0.52).

Compared with people who did not drink wine, those who reported consumption of 1 or more glasses of red or white wine daily had a 56% reduced risk for Barrett's esophagus.

However, people who drank beer or liquor had no lowering of risk for Barrett's esophagus. The protective effect of wine for lowering the risk for Barrett's esophagus was greatest with just 1 to 2 glasses daily, and it did not increase with greater consumption.

Limitations of this study include retrospective design.

Although the mechanism of the protective effect of wine is unclear, the investigators suggest that the antioxidants in wine may counteract the oxidative damage caused by GERD; or that wine drinkers typically consume food with their wine vs drinking alcohol without food, thereby reducing alcohol-related damage to esophageal tissue.

"But we cannot preclude the possibility that wine drinking is a proxy for other 'health-seeking' behavior," said lead author Ai Kubo, MD, an epidemiologist from Kaiser Permanente.

Two other studies reported in the same issue of Gastroenterology showed that wine drinking was associated with a lower risk for esophageal adenocarcinoma and esophagitis.

"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."

The National Institutes of Health and Kaiser Permamente funded this study in part.

Gastroenterology. 2009;136:806-815.

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