China study re Effect of Hot Tea Consumption & Its Interactions W/Alcohol & Tobacco Use on the Risk

LorettaMarshall
LorettaMarshall Member Posts: 662 Member
in Esophageal Cancer #1

Hello friends~

Here's an interesting article you can read with your morning "coffee or tea".  Hopefully, you're not starting out the day with alcohol as well!  Surprised

The referenced article #4 below my name is “interesting.”  This is a study based in China.  Among the many medical alerts I sign up for, this one came in this morning.  Once we start reading about possible causes of Esophageal Cancer, we can find ourselves deep into other articles as well.  All of which are interesting, but none of us have all day to spend at the computer.  This is just an article that I had not seen before.  Sometimes the articles will give me access to the entire published article, but at other times I only have access to the “abstract” since I’m not a “professional”.  Moreover, paid subscriptions are most often required.  So I’ll just settle for the basic facts as long as they come from a reputable source.

We’ve always known that alcohol consumption and smoking have always been associated with Esophageal Cancer.  But we also know that many who are diagnosed with Esophageal Cancer are young non-smokers and do not drink.  I’m not a doctor, quite obviously, but I think that many times when a person has heartburn and/or acid reflux, and because they are YOUNG, many doctors just “write off” Esophageal Cancer, because they have been trained to believe that EC only happens to “older” folks.  That is one reason I believe that so many doctors just write a prescription for “omeprazole.” 

Now we’ve heard so many pros and cons about aspirin being good for you—but oops—then here comes another study saying it’s bad for you.  The same goes for coffee consumption, salt, sugar, etc.  So we finally conclude “moderation” is the key.  But I’m not here to argue about any of those.  And so we really don’t know what to believe, do we?  However, I never believe anything I read on those side bars about how to “cure cancer” that constantly crop up on my computer screen.  So what’s the moral of this article? One might think the solution is to drink “ice tea” and “ice coffee” if you think you can’t curtail your cocktails.  So this referenced article #4 is “just for your consumption.” 

Loretta – “Alcohol, coffee & tobacco free” but guilty of drinking ICED TEA!

P.S.  All I do know for certain is that the lining of our Esophagus is not made of STEEL!  It’s different from the stomach lining which can withstand the strong acids.  Here’s an interesting article about how strong the acids in our stomach are!

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1.      https://www.livescience.com/52045-esophagus.html

“Esophagus: Facts, Functions & Diseases

By Alina Bradford, Live Science Contributor | May 3, 2016…

 

If the mouth is the gateway to the body, then the esophagus is a highway for food and drink to travel along to make it to the stomach. This body part has a very simple function, but can have many disorders. 

Function

The esophagus is a tube that connects the throat (pharynx) and the stomach. It is about 8 inches (20 centimeters) long. The esophagus isn’t just a hollow tube that food slips down like a water slide, though. The esophagus is made of muscles that contract to move food to the stomach. This process is called peristalsis, according to the Cleveland Clinic.

At the top of the esophagus is a band of muscle called the upper esophageal sphincter. Another band of muscle, the lower esophageal sphincter is at the bottom of the tube, slightly above the stomach. When a person swallows, these sphincters relax so food can pass into the stomach. When not in use, they contract so food and stomach acid do not flow back up the esophagus…”

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2.       https://medlineplus.gov/esophagusdisorders.html

 

Esophagus Disorders

Basics

§  Summary

§  Start Here

§  Diagnosis and Tests

§  Treatments and Therapies  -

§  Summary

The esophagus is the muscular tube that carries food and liquids from your mouth to the stomach. You may not be aware of your esophagus until you swallow something too large, too hot, or too cold. You may also notice it when something is wrong. You may feel pain or have trouble swallowing.

 

The most common problem with the esophagus is GERD (gastroesophageal reflux disease). With GERD, a muscle at the end of your esophagus does not close properly. This allows stomach contents to leak back, or reflux, into the esophagus and irritate it. Over time, GERD can cause damage to the esophagus.

 

Other problems include heartburn, cancer, and esophagitis. Doctors may use various tests to make a diagnosis. These include imaging tests, an upper endoscopy, and a biopsy.

Treatment depends on the problem. Some problems get better with over-the-counter medicines or changes in diet. Others may need prescription medicines or surgery…” __________________________________________________________________ 

3.      https://wonderopolis.org/wonder/how-powerful-is-stomach-acid

  • How powerful is stomach acid?
  • What is the pH level of stomach acid?
  • What is stomach acid made of?

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4.      http://www.practiceupdate.com/content/effect-of-hot-tea-consumption-and-its-interactions-with-alcohol-and-tobacco-use-on-the-risk-for-esophageal-cancer/64110/15/9/1

“Primary Care

Journal Scan / Research · March 28, 2018

Effect of Hot Tea Consumption and Its Interactions With Alcohol and Tobacco Use on the Risk for Esophageal Cancer

Annals of Internal Medicine  1 Expert Comment ×

TAKE-HOME MESSAGE

  • This study sought to determine whether consumption of tea at very high temperatures is associated with risk of esophageal cancer and to what extent, if any, alcohol consumption and/or tobacco use add to the hot tea–associated risk. In all, data from over 450,000 individuals were evaluated, and, over a median follow-up of 9.2 years, 1731 cases of incident esophageal cancer were reported.
  • Participants who drank extremely hot tea daily and consumed ≥15 g of alcohol daily had a greater risk for esophageal cancer (HR, 5.00) compared with participants who drank tea less than weekly and consumed <15 g of alcohol daily. Similarly, the risk was higher for current smokers who drank extremely hot tea daily (HR, 2.03).
  • Consuming tea at very high temperatures may significantly elevate the risk of esophageal cancer when combined with excessive use of alcohol or tobacco products.

Primary Care - Written by Peter Lin MD, CCFP

 ESOPHAGEAL CANCER — IS HOT TEA AN ACCOMPLICE TO ALCOHOL OR SMOKING?

We know that alcohol and smoking are associated with increasing esophageal cancer risk. This study looked at whether hot tea could also increase that risk by damaging the esophageal lining.

This study looked 456,155 people in China and found 1731 esophageal cancers over 9.2 years. They noticed that there was an interaction of hot tea with smoking. Smokers who drank burning hot tea daily had double the risk of esophageal cancer (HR, 2.03; 95% CI, 1.55–2.67) compared with nonsmokers who only occasionally drank tea.

But the really striking finding was the effect of hot tea with alcohol. People who drank more than 15 g of alcohol per day and drank hot tea had an esophageal cancer risk that was five times (HR, 5.00; 95% CI, 3.64–6.88) that of those who did not drink alcohol and only occasionally drank tea.

Just for reference, one standard drink has 14 g of alcohol, which would be 12 oz beer, 5 oz of wine, or 1.5 oz of spirits. So, effectively, more than one drink per day was the cutoff used in this study.

The authors concluded that drinking hot tea along with alcohol or smoking increased the risk of esophageal cancer. But the problem with this study is that the comparator was people who did not drink alcohol or hot tea. Both variables were removed in the control arm. So, we really don’t know if it is the tea, the alcohol, or both causing that fivefold increase.

Now, this story gets even more interesting when you add in the fact that 36% of East Asians (Japanese, Chinese, and Koreans) have Asian flushing (their face gets red when they drink alcohol). 1

You see, alcohol is broken down in two steps. In the first step, alcohol dehydrogenase (ADH) converts alcohol into acetaldehyde. This is a very toxic substance and it can cause DNA damage, which is why a second enzyme very quickly converts it into acetate, which is not toxic and can be burned in the Krebs cycle for energy. This second enzyme is ALDH (aldehyde dehydrogenase).

Many Asians have a defective ALDH enzyme; they can’t break down acetaldehyde. Acetaldehyde accumulates, which causes the flushing. So, the flushing is a sign that they have more acetaldehyde, which means they are at an increased cancer risk.2

But why, specifically, an increase in esophageal cancer?

It turns out that bacteria in the mouth can break down alcohol into acetaldehyde.2 So, the first step has already happened in the mouth.

People with the bad enzyme have up to three times more acetaldehyde in their saliva than normal people. They swallow this acetaldehyde, which now coats the esophagus.

Hot tea could damage the protective layer on the esophagus, which provides a way for the acetaldehyde to get into the cells of the esophagus. Hence, more esophageal cancer with hot tea and alcohol.

Perhaps this puzzle has several key pieces. One piece is the bacteria that make that toxic metabolite in the mouth.

The second piece is the missing the enzyme so that people can’t get rid of that toxic metabolite.

Then the final piece is something like hot tea, which damages the protective layer of the esophagus.

And presto! We have the recipe for esophageal cancer.

The good news is that now we know the perfect conditions, we can disrupt them. So, let’s let tea cool before we guzzle it and let’s use less alcohol, especially if you have the Asian flush.

References

Eng MY, Luczak SE, Wall TL. ALDH2, ADH1B, and ADH1C genotypes in Asians: a literature review. Alcohol Res Health. 2007;30(1):22–27. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860439/

Brooks PJ, Enoch MA, Goldman D, Li TK, Yokoyama A. The alcohol flushing response: an unrecognized risk factor for esophageal cancer from alcohol consumption. PLoS Med. 2009;6(3):e50.

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5.      http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000050

“The Alcohol Flushing Response: An Unrecognized Risk Factor for Esophageal Cancer from Alcohol Consumption…”

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6.      http://annals.org/aim/article-abstract/2671921/hot-tea-consumption-its-interactions-alcohol-tobacco-use-risk-esophageal?doi=10.7326%2fM17-2000

“Original Research |3 April 2018

Hot Tea Consumption and Its Interactions With Alcohol and Tobacco Use on the Risk for Esophageal Cancer: A Population-Based Cohort Study

Canqing Yu, PhD (*); Haijing Tang, PhD (*); Yu Guo, MSc; Zheng Bian, MSc; Ling Yang, PhD; Yiping Chen, DPhil; Aiyu Tang, MD; Xue Zhou, PhD; Xu Yang, PhD; Junshi Chen, MD; Zhengming Chen, DPhil; Jun Lv, PhD; Liming Li, MD, MPH; on behalf of the China Kadoorie Biobank Collaborative Group (†)

Article, Author, and Disclosure Information

ABSTRACT

This abstract is available on the publisher's site.

Background

Although consumption of tea at high-temperatures has been suggested as a risk factor for esophageal cancer, an association has not been observed consistently, and whether any relationship is independent of alcohol and tobacco exposure has not been evaluated.

Objective

To examine whether high-temperature tea drinking, along with the established risk factors of alcohol consumption and smoking, is associated with esophageal cancer risk.

Design

China Kadoorie Biobank, a prospective cohort study established during 2004 to 2008.

Setting

10 areas across China.

Participants

456 155 persons aged 30 to 79 years. Those who had cancer at baseline or who reduced consumption of tea, alcohol, or tobacco before baseline were excluded.

Measurements

The usual temperature at which tea was consumed, other tea consumption metrics, and lifestyle behaviors were self-reported once, at baseline. Outcome was esophageal cancer incidence up to 2015.

Results

During a median follow-up of 9.2 years, 1731 incident esophageal cancer cases were documented.

High-temperature tea drinking combined with either alcohol consumption or smoking was associated with a greater risk for esophageal cancer than hot tea drinking alone.

Compared with participants who drank tea less than weekly and consumed fewer than 15 g of alcohol daily, those who drank burning-hot tea and 15 g or more of alcohol daily had the greatest risk for esophageal cancer (hazard ratio [HR], 5.00 [95% CI, 3.64 to 6.88]).

Likewise, the HR for current smokers who drank burning-hot tea daily was 2.03 (CI, 1.55 to 2.67).

Limitation

Tea consumption was self-reported once, at baseline, leading to potential nondifferential misclassification and attenuation of the association.

CONCLUSION

Drinking tea at high temperatures is associated with an increased risk for esophageal cancer when combined with excessive alcohol or tobacco use.”

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