It might not sound obvious, but drinking alcohol is not only linked to cancers in areas with which it comes into contact (throat, stomach, intestines, etc) but also to skin cancers. This may be associated with increased free radicals from alcohol affecting the body’s ability to protect itself. However, if you’re going to enjoy a G&T or cool beer in the sun this summer, you might find that there’s a fruity friend that can come to your rescue.
To give support to the proposal that eating fruits (especially berries) can help to protect our skin against both the effects of alcohol consumption and exposure of our skin to UV (ultra violet) sun rays (and, of course, to the combination of the two!) we need to establish that eating such foods can provide antioxidants and that those antioxidants have a tangible, and ideally statistically significant, effect on improving the skin’s ability to protect itself.
So, rather than just take this on face value – something I never advise anyone to do – we need to take a peek at the relevant research in this area…
Does alcohol increase the risk of sunburn?
Firstly, we need to see whether drinking alcohol before or during sunbathing is known to increase the risk of damage to the skin, and thus increase signs of ageing and risk of developing cancer. A 2013 study 1 identified that epidemiological data has already demonstrated that alcohol consumption is a risk factor for sunburn, melanoma and nonmelanoma skin cancer. They speculated that when concentrations of antioxidants in the skin would already be decreased by alcohol consumption, then the body would not have sufficient ability to neutralise the free radicals induced in the body by UV sunlight. They tested this hypothesis by determining the carotenoid concentration 2 in the skin and the minimal erythema dose (MED – that is, the amount of radiation which, applied to the skin, makes it turn temporarily red, known as erythematous) of a sample group of male human volunteers before and after consumption of alcohol. The researchers concluded that: “…results showed a significant decrease in the carotenoid concentration in the skin and the MED after alcohol consumption…” More on this study later, but for the time being, we have a clear indication that alcohol added to sunshine makes it harder for the body to resist oxidative stress, premature ageing and making you look like a certain seawater crustacean…
Antioxidant power of all plant foods
Eating plant foods in general has been shown to: “…represent an effective strategy to enhance an endogenous antioxidant network in humans. This is particularly evident in the presence of oxidative stress-related risk factors. 3 . And, of course, both alcohol 4 and UV sunlight 5 are known causes of oxidative stress on the body.
So, plant foods can increase antioxidant levels in our bloodstream, but can they be then deposited into our tissues to protect us against the sun? From the conclusions of a 2012 study 6 , the answer would appear to be that they can: “…an optimal supply of antioxidant micronutrients in the skin increases basal dermal defense against UV irradiation, supports longer-term protection, and contributes to maintenance of skin health and appearance.” They do add, of course, that one should still ensure that plenty of topical suncream is used when spending time in the sun.
Another study 7) randomised women into two groups: one group consumed 55 grams of tomato paste for a period of three months, the other group did not consume the extra tomato paste. They then exposed all women’s buttocks to a UV lamp to see if the antioxidant-richness of the tomatoes might reduce the sunburn of the tomato paste group. And, indeed, it did – by as much as a 40% reduction in redness. A natural sunscreen! The researchers concluded that: “Tomato paste containing lycopene provides protection against acute and potentially longer-term aspects of photodamage.”
A further study 8 offers support for the power of plant antioxidants to prevent sun damage. Again, having used tomato paste as the antioxidant source, the researchers concluded: “The data demonstrate that it is feasible to achieve protection against UV light-induced erythema by ingestion of a commonly consumed dietary source of lycopene.”
Which plant food is highest in antioxidants?
Ideally, you would want to consume the foods highest in antioxidants if you were going to spend time out in the sun with or without a glass of “a bit of what you fancy” in your hand. Oh, and by the way, don’t think that I am suggesting you should drink alcohol. Even though a recent study 9 suggested that there may be a positive association with consuming no more than 14 units of alcohol per week and a reduced risk of dementia, I’ve already pointed out elsewhere 10 why no amount of alcohol is safe for human health in general.
So which plants (and we are only talking about plants here, of course, since there’s little or no antioxidant content in animal foods) are highest in antioxidants 11 ?
Whilst small red beans are apparently at No.1 in the chart, you’ll see that the berries (blueberries, cranberries, blackberries etc) follow closely, and the fruity delights of apples and plums are not too far behind. A 2008 study 12 confirmed the above order of antioxidant richness, concluding that: “Increasing fruit consumption is a logical strategy to increase antioxidant intake and decrease oxidative stress and may lead to reduced risk of cancer….of the 25 fruits most commonly consumed in the United States…[p]omegranate and berries (wild blueberry, blackberry, raspberry, and blueberry) had the highest CAA [cellular antioxidant activity] values, whereas banana and melons had the lowest.” It was also no great surprise that of all the 25 fruits they looked at: “Apples were found to be the largest contributors of fruit phenolics to the American diet, and apple and strawberries were the biggest suppliers of cellular antioxidant activity.”
Sun & booze – better with or without added fruit?
So, we finally get to the issue of whether or not damage from the combination of sun and alcohol can be reduced by consuming fruit before and/or during exposure. Also, note that the above studies with tomatoes were looking at long-term consumption. What we would like to know is whether having some fruit (as a drink or as a whole food) just before or during exposure can have a protective effect. And to get at least one answer to this question, we’ll look again at the above-mentioned 2013 study1 .
During this study, the researchers had actually divided the subjects into two groups: one group was given three shots of neat vodka, and the other group was given the same amount of vodka but this time with orange juice added. They then tested within eight minutes whether or not there was a difference in the level of carotenoid antioxidants in the skin of the individuals within the two different groups. And there was – a dramatic decrease in skin antioxidants in the neat vodka group, while in the vodka and orange group there was only a small drop in skin antioxidant level.
But would this difference continue when the two groups were then exposed to sunlight?
The subjects’ skin was then exposed to a UV lamp and monitored to see how long it would take for them to burn. The researchers concluded: “The results showed a significant decrease in the carotenoid concentration in the skin and the MED after alcohol consumption, but no significant decrease after a combined intake of alcohol and orange juice.” The difference in length of time that the two groups started to burn was around half an hour of UV exposure.
Now bear in mind that this was only testing with relatively low-antioxidant containing oranges (and, by the way, bananas have even less antioxidant power), and oranges don’t even appear on the list above of the top antioxidants. So, it might be better to eat those berries (or have berry juice) before or during your boozy sun exposure. Dr Greger, in his usual whimsical way, suggests 13 a strawberry daiquiri might be an ideal tipple at these times.
Researchers in the latter study did stress that we should be aware of the fact that “…consumption of alcohol in combination with UV light increases their risk of sunburn and therefore their risk of developing premature skin aging and even skin cancer.” So, as in most cases, research findings are only as good as the scope of their study. For instance, they could have compared four groups: group 1 consuming neat alcohol, group 2 consuming alcohol with added fruit, group 3 consuming fruit but no alcohol, and group 4 consuming no alcohol and no fruit.
Until further research is undertaken, it’s hard to expect that any option would be healthier than to eat lots of fruit, forget the alcohol and don’t spend too much time in the sun – if you do, then use a good quality (and in date) suncream to reduce ageing and oxidative damage.
- Skin Pharmacol Physiol. 2013;26(1):45-51. Alcohol consumption decreases the protection efficiency of the antioxidant network and increases the risk of sunburn in human skin. Darvin ME, Sterry W, Lademann J, Patzelt A.
- Details on how carotenoids are antioxidants: Antioxidants (Basel). 2018 Feb; 7(2): 28. Carotenoids—Antioxidant Properties. Andrew J. Young, and Gordon L. Lowe.
- Br J Nutr. 2013 May;109(9):1544-56. doi: 10.1017/S0007114513000263. Epub 2013 Mar 14. Effect of plant foods and beverages on plasma non-enzymatic antioxidant capacity in human subjects: a meta-analysis. Lettieri-Barbato D, Tomei F, Sancini A, Morabito G, Serafini M.
- NIH Institute on Alcohol Abuse and Alcoholism: Alcohol, Oxidative Stress, and Free Radical Damage. Oct 2004. Defeng Wu, Ph.D., and Arthur I. Cederbaum, Ph.D.
- Indian J Clin Biochem. 2013 Apr; 28(2): 110–115. Oxidative Stress and Skin Cancer: An Overview. R. T. Narendhirakannancorresponding author and M. Angeline Christie Hannah.
- Am J Clin Nutr. 2012 Nov;96(5):1179S-84S. doi: 10.3945/ajcn.112.034819. Epub 2012 Oct 10. β-Carotene and other carotenoids in protection from sunlight. Stahl W, Sies H.
- Br J Dermatol. 2011 Jan;164(1):154-62. Tomato paste rich in lycopene protects against cutaneous photodamage in humans in vivo: a randomized controlled trial. Rizwan M, Rodriguez-Blanco I, Harbottle A, Birch-Machin MA, Watson RE, Rhodes LE.
- J Nutr. 2001 May;131(5):1449-51. Dietary tomato paste protects against ultraviolet light-induced erythema in humans. Stahl W, Heinrich U, Wiseman S, Eichler O, Sies H, Tronnier H.
- Alcohol consumption and risk of dementia: 23 year follow-up of Whitehall II cohort study. BMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k2927 (Published 01 August 2018) BMJ 2018;362:k2927.
- No Amount of Alcohol Consumption is Safe
- Wikipedia: List of antioxidants in food.
- J Agric Food Chem. 2008 Sep 24;56(18):8418-26. doi: 10.1021/jf801381y. Epub 2008 Aug 30. Cellular antioxidant activity of common fruits. Wolfe KL, Kang X, He X, Dong M, Zhang Q, Liu RH.
- How to Counteract the Effects of Alcohol. Written By Michael Greger M.D. FACLM on July 31st, 2018.