IS LIGHT DRINKING A LIFE CHANGER?

 Generally speaking, alcohol consumption and liver disease do not go together but a recent study would say otherwise. A national team of scientists led by researchers at the University of California, San Diego School of Medicine report that people with nonalcoholic fatty liver disease (NALFD) who consume alcohol in modest amounts are half as likely to develop hepatitis as non-drinkers with the same condition. NALFD is the most common liver disease in the US. It’s characterized by abnormal fat accumulation in the liver. Usually, patients with NAFLD have few or no symptoms, but in its most progressive form, known as nonalcoholic steatohepatitis (NASH), there is a significantly heightened risk of cirrhosis, liver cancer and liver-related death. NALFD is also a known risk factor for cardiovascular disease (CVD). Patients with the condition are approximately two times more likely to die from coronary heart disease than from liver disease. The study’s authors wanted to know if the well-documented heart-healthy benefits of modest alcohol consumption outweighed alcohol’s negative effects.

Jeffrey Schwimmer, MD, associate professor of clinical pediatrics at UC San Diego, director of the Fatty Liver Clinic at Rady Children’s Hospital-San Diego and senior author, and colleagues discovered that the benefits of modest alcohol consumption were compelling, at least in terms of reducing the odds of patients with NAFLD from developing more severe forms of the disease. Patients with NASH are 1O times more likely to progress to cirrhosis, the final phase of chronic liver disease. “Our study showed that those people with modest alcohol intake – two drinks or less daily – had half the odds of developing NASH than people who drank no alcohol,” said Schwimmer. “The reasons aren’t entirely clear. It’s known that alcohol can have beneficial effects on lipid levels, that it increases ‘good’ cholesterol, which tends to be low in NAFLD patients. Alcohol may improve insulin sensitivity, which has a role in NAFLD. And depending upon the type of alcohol, it may have anti-inflammatory effects.” The study also found that in patients with NAFLD, modest drinkers experienced less severe liver scarring than did lifelong non-drinkers. Schwimmer said the findings indicate patients with liver disease should be treated individually, with nuance. “For a patient with cirrhosis or viral hepatitis, the data says even small amounts of alcohol can be bad. But that may not be applicable to all forms of liver disease. Forty million Americans have NAFLD. Physicians need to look at their patient’s overall health, their CVD risk, their liver status, whether t hey’re already drinking modestly or not. They need to put all of these things into a framework to determine risk. I suspect modest alcohol consumption will be an appropriate recommendation for many patients, but clearly not all.” The findings are published in the April 19 online issue of the journal of hepatology.