Science
U.S. Surgeon General Calls for Cancer Warnings on Alcohol
Alcohol is a leading preventable cause of cancer, and alcoholic beverages should carry a warning label as packs of cigarettes do, the U.S. surgeon general said on Friday.
It is the latest salvo in a fierce debate about the risks and benefits of moderate drinking as the influential U.S. Dietary Guidelines for Americans are about to be updated. For decades, moderate drinking was said to help prevent heart attacks and strokes.
That perception has been embedded in the dietary advice given to Americans. But growing research has linked drinking, sometimes even within the recommended limits, to various types of cancer.
Labels currently affixed to bottles and cans of alcoholic beverages warn about drinking while pregnant or before driving and operating other machinery, and about general “health risks.”
But alcohol directly contributes to 100,000 cancer cases and 20,000 related deaths each year, the surgeon general, Dr. Vivek Murthy, said.
He called for updating the labels to include a heightened risk of breast cancer, colon cancer and at least five other malignancies now linked by scientific studies to alcohol consumption.
“Many people out there assume that as long as they’re drinking at the limits or below the limits of current guidelines of one a day for women and two for men, that there is no risk to their health or well-being,” Dr. Murthy said in an interview.
“The data does not bear that out for cancer risk.”
Only Congress can mandate new warning labels of the sort Dr. Murthy recommended, and it’s not clear that the incoming administration would support the change.
Still, President-elect Donald J. Trump does not drink, and his choice to head the Health and Human Services Department, Robert F. Kennedy Jr., swore off alcohol and drugs decades ago, and says he regularly attends AA meetings.
There is no question that heavy consumption is harmful. But supporters of moderate drinking — including makers of wine, beer and spirits, and some physicians and scientists — argue that a little alcohol each day may reduce cardiovascular disease, the No. 1 killer in the United States.
Newer scientific studies have criticized the methodology of earlier studies, however, and have challenged that view, which was once a consensus.
While most cancer deaths occur at drinking levels that exceed the current recommended dietary guidelines, the risk for cancers of the breast, the mouth and the throat may rise with consumption of as little as one drink a day, or even less, Dr. Murthy said on Friday.
Overall, one of every six breast cancer cases is attributable to alcohol consumption, Dr. Murthy said. More recent studies have also linked moderate alcohol consumption to certain forms of heart disease, including atrial fibrillation, a heart arrhythmia.
Two scientific reviews will be used to inform the updated recommendations about alcohol consumption in the federal dietary guidelines.
Five years ago, the scientific report that informed the writing of the 2020-2025 dietary guidelines acknowledged that alcohol is a carcinogen and generally unhealthy and suggested “tightening guidelines” by capping the recommendation for men at one standard drink, or 14 grams of alcohol a day.
When the final guidelines were drafted, however, there was no change in the advice that moderate drinking of up to two drinks a day for men was acceptable.
But the government acknowledged emerging evidence indicating that “even drinking within the recommended limits may increase the overall risk of death from various causes, such as from several types of cancer and some forms of cardiovascular disease.”
Since then, even more studies have linked alcoholic beverages to cancer. Yet any attempt to change the warning labels on alcoholic beverages is likely to face an uphill battle.
The current warning label has not been changed since it was adopted in 1988, even though the link between alcohol and breast cancer has been known for decades.
It was first mentioned in the 2000 U.S. Dietary Guidelines. In 2016, the surgeon general’s report on alcohol, drugs and health linked alcohol misuse to seven different types of cancer.
More recently, a scientific review of the research on moderate drinking, carried out under the auspices of the National Academies of Sciences, Engineering and Medicine, was commissioned by Congress.
That analysis found a link between alcohol consumption and a slight increase in breast cancer, but no clear link to any other cancers. The report also revived the theory that moderate drinking is linked to fewer heart attack and stroke deaths, and fewer deaths overall, compared with never drinking.
The World Health Organization says there is no safe limit for alcohol consumption, however, and 47 nations require warnings on alcoholic beverages. But cancer is rarely mentioned.
To date, only South Korea has a label warning about liver cancer, though manufacturers can choose alternative labels that don’t mention cancer. Ireland is currently slated to introduce labels that say there is a “direct link between alcohol and fatal cancers” in 2026.
The industry has a strong history of fighting warning labels that mention cancer, and alcohol-producing nations have also challenged warning labels under international trade law.
Industry opposition led to the premature termination of a federally funded Canadian study of the impact of warning labels that mentioned cancer.
The surgeon general’s advisory provided a brief overview of research studies and reviews published in the past two decades, including a global study of 195 countries and territories involving 28 million people.
They all found that higher levels of alcohol consumption were associated with a greater risk of cancer.
Other studies looked at specific cancers, like breast cancer and mouth cancer, finding the risks increased by 10 percent and 40 percent, respectively, for those who had just one drink a day, when compared with those who did not drink.
The report described the biological mechanisms by which alcohol is known to induce cancerous changes at the cellular level.
The most widely accepted theory is that inside the body, alcohol breaks down into acetaldehyde, a metabolite that binds to DNA and damages it, allowing a cell to start growing uncontrollably and creating a malignant tumor.
Animal experiments have shown that rodents whose drinking water was spiked with either ethanol, the alcohol used in alcoholic beverages, or with acetaldehyde developed large numbers of tumors all over their bodies.
Research has shown that alcohol generates oxidative stress, which increases inflammation and can damage DNA.
It also alters levels of hormones like estrogen, which can play a role in breast cancer development, and makes it easier for carcinogens like tobacco smoke particles to be absorbed into the body, increasing susceptibility to cancers of the mouth and the throat.
The surgeon general’s report also goes into detail about the increase in risk associated with drinking, differentiating between the increases in absolute risk and in relative risk.
For example, the absolute risk of breast cancer over a woman’s life span is about 11.3 percent (11 out of 100) for those who have less than a drink a week.
The risk increases to 13.1 percent (13 of 100 individuals) at one drink a day, and up to 15.3 percent (15 of 100) at two drinks per day.
For men, the absolute risk of developing an alcohol-related cancer increases from about 10 percent (10 of every 100 individuals) for those who consume less than one drink a week to 11.4 percent (11 per 100) for those who have a drink every day on average. It rises to 13 percent (13 of 100 individuals) for those who have two drinks a day on average.
Many Americans don’t know there is a link between alcohol and cancer.
Fewer than half of Americans identified alcohol use as a risk factor for cancer, compared with 89 percent who recognized tobacco as a carcinogen, according to a 2019 survey of U.S. adults aged 18 and older carried out by the American Institute for Cancer Research.
Yet alcohol consumption is the third leading preventable cause of cancer, after tobacco and obesity, according to the surgeon general’s report.
Dr. Murthy said it was important to know that the risk rises as alcohol consumption increases. But each individual’s risk of cancer is different, depending on family history, genetic makeup and environmental exposures.
“I wish we had a magic cutoff we could tell people is safe,” he said. “What we do know is that less is better when it comes to reducing your cancer risk.”
“If an individual drinks occasionally for special events, or if you’re drinking a drink or two a week, your risk is likely to be significantly less than if you’re drinking every day,” he added.
Science
Jesse Marquez, tireless defender of L.A. port communities, dies at 74
When Jesse Marquez walked into the Los Angeles harbor commission hearing room in 2013, he didn’t bring a consultant or a slideshow. He brought death certificates.
Each sheet of paper, he told the commissioners, bore the name of a Wilmington resident killed by respiratory illness. Wedged between two of the country’s busiest ports, the neighborhood is dotted with oil refineries, chemical plants, railyards and freeways. It’s one of several portside communities known by some as a “diesel death zone,” where residents are more likely to die from cancer than just about anywhere else in the L.A. Basin. For decades, Marquez refused to let anyone forget it.
He knocked on doors, installed air monitors, counted oil wells, built coalitions, staged demonstrations, fought legal battles and affected policy. He dove deep into impenetrable environmental impact documents.
“Before Jesse, there was no playbook.” Earthjustice attorney Adrian Martinez said in an interview. “What was remarkable from the beginning is that Jesse wasn’t afraid to write stuff down, to demand things, to spend lots of time scouring for evidence.”
Marquez, founder of the Coalition for a Safe Environment, or CFASE, died surrounded by family in his Orange County home Nov. 3. His death was due to complications after he was struck by a vehicle while in a crosswalk in January. He was 74.
“He was one of a kind,” Martinez said. “He had a fierce independence and really believed in speaking up for himself and his community. He played an instrumental role in centering Wilmington in the fight for environmental justice.”
In 2001, when the port planned to ramp up operations and expand a major terminal operated by Trapac Inc. further north into Wilmington, Marquez and neighborhood organizers pushed back, winning a $200-million green-space buffer between residences and port operations.
When oil refineries evaded pollution caps through what organizers called a “gaping loophole” in Environmental Protection Agency policy, Marquez and others sued, overturning the policy and successfully curtailing pollution spikes at California plants.
And when cargo ships idled at California ports burning diesel fuel, Marquez and his allies pressed the state to adopt the nation’s first rule requiring vessels to turn off their engines and plug into the electric grid while docked.
Born Oct. 22, 1951, Marquez was raised in Wilmington, and lived most of his life there. As a child, he had a view of Fletcher Oil Co.’s towering smokestacks from his frontyard.
Years later, black pearls of petroleum rained down on Wilmington the day the oil refinery exploded.
Then 17, Marquez hit the floor when he heard the blast. Frantic, he helped his parents hoist his six younger siblings over a backyard fence as fireballs of ignited crude descended around their home, just across the street. His grandmother was the last over, suffering third-degree burns along the entire left side of her body.
“From that moment on, he’s always had Wilmington in his mind,” his 44-year-old son, Alex Marquez, said in an interview.
The memory shaped the battles he fought decades later. In college at UCLA, he crossed paths with young members of the Brown Berets, Movimiento Estudiantil Chicanx de Aztlán, and the Black Panther Party, later volunteering in demonstrations led by Cesar Chavez and Dolores Huerta.
“He started off within that movement,” Alex Marquez said. “It was his reason to bring a lot of different communities into his work.”
After a career in aerospace, he began organizing in earnest in the 1990s, aligning with groups such as the Natural Resources Defense Council and Coalition for Clean Air to oppose port expansion projects.
When his sons were old enough, he brought them along to photograph and count oil wells, later folding them into his other projects.
He described his father as a man of contrasts.
“When it was time to work, he was the most serious, stern, no patience,” Alex Marquez said. “But the minute the job was done, he completely transformed. He was your best friend who brought a roast turkey and a six-pack of beers. He partied and relaxed better than anyone I’ve ever met.”
Marquez’s home was always filled with dogs — he jokingly called his lawyers his “legal beagles,” Martinez recalled. He loved reggae music, dancing and was an amateur archaeologist. He kept a collection of colonial maps tracing the migration of the Aztec people, part of what his son called “his love for Native American and Aztec culture.”
He founded CFASE with a group of Wilmington residents. After learning about the port’s expansion plans, he hosted an ad hoc meeting at his home. There, residents shared their experiences with industrial pollution in Wilmington.
They talked about the refinery explosions in 1969, 1984, 1986, 1991, 1992, 1995, 1996 and 2001.
“Then someone says, ‘Well, I have two kids and they have asthma,’” Jesse Marquez recalled in a media interview in January. “And then someone else says, ‘All three of my kids have asthma — My mom has asthma — I have asthma.’”
The group would play a central role in developing the Port of Los Angeles and Port of Long Beach’s landmark Clean Air Action Plan and Clean Truck Program, which replaced more than 16,000 diesel rigs with cleaner models.
It pushed for zero-emission truck demonstrations, solar power installations, and won millions of dollars for communities for public health and air-quality projects.
The coalition helped negotiate a $60-million settlement in the seminal China Shipping terminal case — securing local health grants, truck retrofit funds and the first Port Community Advisory Committee in the U.S. — and later helped establish the Harbor Community Benefit Foundation, which funds air filtration, land use, and job-training initiatives across Wilmington and San Pedro.
Marquez’s group also fought off proposals for liquefied natural gas terminals, oil tank farms and hydrogen power plants.
Since 2005, diesel emissions at the Port of Los Angeles have plummeted by 90%.
Now Alex Marquez finds himself suddenly in charge of the nonprofit his father built.
He’s been learning to manage the group’s finances, fix its monitoring equipment and reconnect with its network of allies.
“It’s literally been a crash course in how to run a nonprofit,” he said. “But we’re keeping it alive.”
In Wilmington, residents point to visible symbols of Marquez’s work: the waterfront park, the electrified port terminals and the health surveys that documented decades of illness.
“He left us too early, but a movement that was just budding when he started decades ago has now blossomed into national and even international networks,” Martinez wrote in a tribute to Marquez.
Marquez is survived by his sons Alex Marquez, Danilo Marquez, Radu Iliescu and, the many who knew him say, the environmental justice movement writ large.
Science
State agriculture dept. is hiding bird flu information, legal aid group alleges in lawsuit
A rural legal aid group is suing the California Department of Food and Agriculture for refusing to disclose the locations of dairies infected with H5N1 bird flu.
More than half of the 70 confirmed human cases of H5N1 bird flu infection in the United States in the last year and a half have been in California dairy workers.
California Rural Legal Assistance, a nonprofit that provides free civil legal services to low-income rural residents, together with the First Amendment Coalition, says the California agriculture department is withholding information that could protect the public and allow front-line responders, such as health clinics and labor groups, to assist farmworkers and others at risk of infection.
“As a matter of first principle, the California Constitution and the California Public Records Act enshrine the strong right of the public to inspect the conduct of its public officials and to ensure that they are basically executing the duties that are given to them,” said David Cremins, an attorney with the rural legal group. The suit was filed Monday in Sacramento County Superior Court.
A spokesman for the state’s agriculture agency said he could not provide comment “because the matter is in litigation.”
Anja Raudabaugh, chief executive of Western United Dairies — California’s largest dairy trade group — also declined to comment.
It was a surprise when H5N1 bird flu was found to have infected Texas dairy cattle in March 2024. It soon spread to workers. Most cases in the U.S. have been mild, but one person in Louisiana died, and several others were hospitalized.
Globally, H5N1 has killed hundreds of people. Until recently, its mortality rate was considered roughly 50%. It has also killed millions of wild birds, mammals, domestic cats and commercial poultry. The virus was first discovered in China’s Guangdong province in 1996.
Public health officials, epidemiologists and infectious disease researchers worry it would only take a minor mutation in the virus now circulating in dairy cows and commercial poultry to enable it to spread easily between people, or cause serious illness, or both. The more opportunities the virus has to move between individual animals or jump into new species, the greater the likelihood such changes could occur.
In December 2024, Gov. Gavin Newsom declared a state of emergency in response to H5N1 and said he wanted to make sure that “Californians have access to accurate, up-to-date information” about the disease.
The state did release information on outbreaks at poultry facilities and in wild animals at the county level. But it did not do so for dairy outbreaks.
Agriculture officials described the infected cattle only as being in “the Central Valley” — an area encompassing roughly 20,000 square miles — or Southern California — a roughly 56,000 square mile area.
More than 770 dairies in California have been infected since the outbreak began in 2024.
Such vague information is “completely useless in terms of trying to figure out how the flu is spreading around,” said Angela Rasmussen, a virologist at the University of Saskatchewan’s Vaccine and Infectious Disease Organization in Canada.
“It’s a bit mystifying why that information isn’t clear and transparent,” she said. “I mean, when you’re dealing with an outbreak that has major implications in terms of both people’s livelihoods and in terms of the nation’s food supply, to not be more transparent about that, I think is actually really harmful in the long run, because it’s like, what are you guys doing? Like, why are you keeping this a secret?”
Cremins, the attorney, said it’s possible infections among dairy workers could have been avoided had location information been shared, because groups like his and “other members of the public” could have targeted “outreach and education to at-risk workers and communities.”
The plaintiffs also allege in their filing that the agriculture department’s “refusal to disclose the locations of H5N1 outbreaks … perpetuated a stark and unjustifiable information asymmetry: CDFA (the ag agency) and dairy producers know where and when bird flu outbreaks are occurring; CRLA (the legal organization), dairy workers, and the broader public do not.”
Other states, including Michigan, Arizona and Nevada, reported outbreaks at the county level.
The plaintiffs are seeking disclosure of quarantine records, a declaration from a judge that the agriculture agency violated the state’s open record laws, and — should they succeed — payment of attorney’s fees.
Science
The federal SNAP-funding mess has made L.A.’s food-insecurity crisis clearer than ever
A strange scene unfolded at the Adams/Vermont farmers market near USC last week.
The pomegranates, squash and apples were in season, pink guavas were so ripe you could smell their heady scent from a distance, and nutrient-packed yams were ready for the holidays.
But with federal funding in limbo for the 1.5 million people in Los Angeles County who depend on food aid from the Supplemental Nutrition Assistance Program — or SNAP — the church parking lot hosting the market was largely devoid of customers.
Even though the market accepts payments through CalFresh, the state’s SNAP program, hardly anyone was lined up when gates opened. Vendors mostly idled alone at their produce stands.
A line of cars stretches more than a mile as people wait to receive a box of free food provided by the L.A. Food Bank in the City of Industry on Wednesday.
(Genaro Molina/Los Angeles Times)
As thousands across Southern California lined up at food banks to collect free food, and the fight over delivering the federal allotments sowing uncertainty, fewer people receiving aid seemed to be spending money at outdoor markets like this one.
“So far we’re doing 50% of what we’d normally do — or less,” said Michael Bach, who works with Hunger Action, a food-relief nonprofit that partners with farmers markets across the greater L.A. area, offering “Market Match” deals to customers paying with CalFresh debit cards.
The deal allows shoppers to buy up to $30 worth of fruit produce for only $15. Skimming a ledger on her table, Bach’s colleague Estrellita Echor noted that only a handful of shoppers had taken advantage of the offer.
All week at farmers markets where workers were stationed, the absence was just as glaring, she said. “I was at Pomona on Saturday — we only had six transactions the whole day,” she said. “Zero at La Mirada.”
CalFresh customers looking to double their money on purchases were largely missing at the downtown L.A. market the next day, Echor said.
A volunteer loads up a box of free food for a family at a drive-through food distribution site in the City of Industry.
(Genaro Molina/Los Angeles Times)
“This program usually pulls in lots of people, but they are either holding on to what little they have left or they just don’t have anything on their cards,” she said.
The disruption in aid comes as a result of the Trump administration’s decision to deliver only partial SNAP payments to states during the ongoing federal government shutdown, skirting court order to restart funds for November. On Friday night, Supreme Court Associate Justice Ketanji Brown Jackson temporarily blocked the order pending a ruling on the matter by the U.S. Circuit Court of Appeals.
But by then, CalFresh had already started loading 100% of November’s allotments onto users’ debit cards. Even with that reprieve for food-aid recipients in California, lack of access to food is a persistent problem in L.A., said Kayla de la Haye, director of the Institute for Food System Equity at USC.
A study published by her team last year found that 25% of residents in L.A. County — or about 832,000 people — experienced food insecurity, and that among low-income residents, the rate was even higher, 41%. The researchers also found that 29% of county residents experienced nutrition insecurity, meaning they lacked options for getting healthy, nutritious food.
Those figures marked a slight improvement compared to data from 2023, when the end of pandemic-era boosts to state, county and nonprofit aid programs — combined with rising inflation — caused hunger rates to spike just as they did at the start of the pandemic in 2020, de la Haye said.
“That was a big wake-up call — we had 1 in 3 folks in 2020 be food insecure,” de la Haye said. “We had huge lines at food pantries.”
But while the USC study shows the immediate delivery of food assistance through government programs and nonprofits quickly can cut food insecurity rates in an emergency, the researchers discovered many vulnerable Angelenos are not participating in food assistance programs.
Despite the county making strides to enroll more eligible families over the last decade, de la Haye said, only 29% of food insecure households in L.A. County were enrolled in CalFresh, and just 9% in WIC, the federal nutrition program for women, infants and children.
De la Haye said participants in her focus groups shared a mix of reasons why they didn’t enroll: Many didn’t know they qualified, while others said they felt too ashamed to apply for aid, were intimidated by the paperwork involved or feared disclosing their immigration status. Some said they didn’t apply because they earned slightly more than the cutoff amounts for eligibility.
Even many of those those receiving aid struggled: 39% of CalFresh recipients were found to lack an affordable source for food and 45% faced nutrition insecurity.
De la Haye said hunger and problems accessing healthy food have serious short- and long-term health effects — contributing to higher rates of heart disease, diabetes and obesity, as well greater levels of stress, anxiety and depression in adults and children. What’s more, she said, when people feel unsure about their finances, highly perishable items such as fresh, healthy food are often the first things sacrificed because they can be more expensive.
The USC study also revealed stark racial disparities: 31% of Black residents and 32% of Latinos experienced food insecurity, compared to 11% of white residents and 14% of Asians.
De la Haye said her team is analyzing data from this year they will publish in December. That analysis will look at investments L.A. County has made in food system over the last two years, including the allocation of $20 million of federal funding to 80 community organizations working on everything from urban farming to food pantries, and the recent creation of the county’s Office of Food Systems to address challenges to food availability and increase the consumption of healthy foods.
“These things that disrupt people’s ability to get food, including and especially cuts to this key program that is so essential to 1.5 million people in the county — we don’t weather those storms very well,” de la Haye said. “People are just living on the precipice.”
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