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Alcohol and Low Folate Intake Linked to Postmenopausal Breast Cancer

Postmenopausal women who drink more than 4 ounces (a half a glass of alcohol per day) and have low intakes of the B vitamin folate may be at increased risk of breast cancer.

In this Mayo Clinic study, which followed 34,387 postmenopausal women for 12 years, when only folate intake was evaluated, women who consumed the least dietary folate were found to have a 21% increased risk of breast cancer compared to those who consumed the most dietary folate.

When the women’s folate intake and and alcohol use was tabulated, however, the researchers found a striking inverse correlation between the women’s dietary folate intake and their alcohol consumption and risk for breast cancer.

Breast cancer risk was lowest in women whose folate intake was high and who did not consume alcohol. Women whose intake of folate was low, but who did not consume alcohol had an 8% increased risk of breast cancer, while women with low folate intake who consumed less than 4 ounces of alcohol daily had an increased risk of 33%. The worst case scenario was found among women whose dietary intake of folate was low, and who also drank more than 4 ounces of alcohol per day: these women had a 59% increased risk for developing breast cancer.

Evidence from numerous prospective studies has established that alcohol intake increases risk for breast cancer. Now research that takes into account the interaction between alcohol and folate is expanding our understanding of the epidemiological evidence linking alcohol use with increased breast cancer risk.

Alcohol is broken down in the body into a chemical called acetaldehyde, which has been shown to cause cancer. Acetaldehyde is detoxified in tiny organelles within cells called microsomes through a pathway called MEOS, which stands for microsomal ethanol oxidizing system. In this system, alcohol (or ethanol) is detoxified by oxidation that is carried out with the help of two B vitamin carriers NAD (which is made from niacin) and FAD (which is made from riboflavin.) The recycling of both FAD and NAD is dependent upon folate, so without enough folate, the body becomes unable to detoxify alcohol.

In addition to folate’s role in alcohol detoxification, low folate intake may also increase a woman’s risk of breast cancer by decreasing her DNA repair capacity, since folate plays an essential role in DNA methylation, synthesis and repair, all of which are crucial to the body's capacity to repair genetic damage that can lead to cancer.

Many of the World’s Healthiest Foods are rich in folate. Excellent sources of folate include spinach, parsley, broccoli, beets, turnip greens, asparagus, romaine lettuce, yeast, calf's liver, and lentils.

To learn more about any of these folate-rich foods, including quick and easy cooking and serving ideas for them, simply click on the highlighted name of the food in the above list.

To learn more about this essential B vitamin, click folate.

For even more suggestions for ways to enjoy foods rich in folate more frequently as part of your healthy way of eating, you can get a list of the World's Healthiest Foods' Recipes containing these foods. Simply, click on the Recipe Assistant, select the foods for which you’d like some recipes from the Healthy Foods List, and click on the Submit button. A list containing links to all our recipes containing the foods chosen will appear immediately below.

Reference: Sellers TA, Kushi LH, Cerhan JR, Vierkant RA, Gapstur SM, Vachon CM, Olson JE, Therneau TM, Folsom AR. Dietary folate intake, alcohol, and risk of breast cancer in a prospective study of postmenopausal women. Epidemiology 2001 Jul;12(4):420-8.


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