Ramon Estruch

Ramon Estruch

Spain - Barcelona


Professor Ramón Estruch is Senior Consultant of the Department of Internal Medicine at the Hospital Clínic (Barcelona, Spain), Professor of Medicine in the School of Medicine at the University of Barcelona, Member of the Steering Committee of the CIBER of Obesity and Nutrition at the Instituto de Salud Carlos III, Government of Spain and Scientific Director of the Mediterranean Diet Foundation, Barcelona, Spain.

He has published more than 650 manuscripts in high impact Journals, including 'The New England Journal of Medicine', 'JAMA', 'The Lancet', 'Annals of Internal Medicine', 'Archives of Internal Medicine', 'Circulation' and 'American Journal of Nutrition', among others. In this context, it should be underlined the results of the study “Effects of the Mediterranean Diet on the primary prevention of cardiovascular disease” (PREDIMED study), published in 'The New England Journal of Medicine', that was the second original article more read in the year 2013, and that has been the basis of the dietary guidelines recommended by several governments and scientific societies around the world. Finally, the years 2018, 2019, 2020 y 2021 has been recognized as a 'Highly Cited Researcher' by Claryvate Analytics, USA.


- Department of Internal Medicine at Hospital Clínic (Barcelona, Spain)
- School of Medicine, University of Barcelona
- Mediterranean Diet Foundation
- President of 'Lifestyle, Diet, Wine & Health' Scientific Committee

Areas of expertise

- Internal medicine
- Nutrition
- Mediterranean diet


2023 Serge Renaud Memorial lecture: Drinking Patterns, dietary habits, and cancer

Drinking patterns, dietary habits, and cancer

The consumption of fermented foods as wine is as old as mankind. If its consumption has been maintained for so long, it must be because these foods have healthy properties.

Over 100 observational studies have reported a lower risk of overall mortality, cardiovascular mortality, myocardial infarction, cardiovascular events, and type 2 diabetes in moderate alcohol drinkers compared to abstainers or heavy drinkers. Thus, there is a large consensus on the cardioprotective effects of moderate consumption of alcoholic beverages, especially wine. However, some recent publications have questioned the recommendations of several guidelines and concluded that there is no threshold in the relationship between alcohol consumption and incidence of cancer, underlying that the risk of all-cause mortality and incidence of cancer (especially breast cancer) rises with increasing alcohol consumption and that the level that minimizes health loss is zero. Thus, despite that long relationship with alcoholic beverages, epidemiology and nutrition experts still debate on the overall health effects of chronic alcohol consumption.

Alcohol misuse is considered as the third largest contributor to all cancer cases among women. Most part of the higher cancer incidence is attributable to high ethanol intake, but moderate alcohol consumption (5-14.9 g/d) was associated with an increased risk of overall breast cancer in a prospective large cohort study of female nurses. By contrast, in a deep analysis of the women included in the PREDIMED trial, those who were moderate or light alcohol drinkers had incidence rates of invasive breast cancer that were significantly lower than those of abstainers. When comparing the effects of different alcohol beverages, women who reported to usually drink red wine and follow-up a traditional Mediterranean diet had a nearly 80% reduced incidence of breast cancer.

In conclusion, despite the well-known carcinogenic effect of alcohol (ethanol), moderate alcohol consumption, mainly as red wine, in the setting of a healthy dietary pattern such as the Mediterranean diet is associated with a reduced incidence of breast cancer in postmenopausal women. This protective effect should be attributed to the polyphenol content of alcoholic beverages, especially red wine.

Acknowledgments: The author is grateful to the CIBEROBN from the Instituto de Salud Carlos III (ISCIII), Madrid, Spain, and the Generalitat de Catalunya (2021SGR 01194). INSA-UB is a Maria de Maeztu Unit of Excellence (grant CEX2021-001234-M funded by MICIN/AEI/FEDER, UE).