A new study reveals that individuals with certain health conditions face a significantly higher risk of liver damage when consuming alcohol. Specifically, having a large waist circumference or diabetes more than doubles the likelihood of severe liver damage, while high blood pressure increases the risk nearly twofold.
Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver, Colorado, who was not involved in the study, emphasized the relevance of this research, especially with Super Bowl Sunday approaching. “People are going to indulge in ways that are harmful, especially during big football games,” Freeman said. “Many will consume highly processed, fatty, and sugary foods that can lead to insulin resistance, excess blood sugar, and fatty liver. Adding alcohol to the mix exacerbates the risk.”
Health conditions such as obesity, characterized by a waist measurement of 35 inches or more for women and 40 inches or more for men, along with high blood sugar and elevated blood pressure, contribute to fat buildup in the liver. According to the Centers for Disease Control and Prevention (CDC), nearly half of Americans have high blood pressure, over a third have pre-diabetes, and approximately 40% are obese.
These conditions lead to fatty liver, which can progress to liver fibrosis (scarring). Freeman highlighted that fatty liver often precedes diabetes, as the liver stores fat to regulate excess blood sugar, impairing its function in the process.
Excess alcohol consumption adds another layer of harm. The liver cells, responsible for metabolizing alcohol, become damaged, resulting in fat buildup and further inflammation. Over time, this can lead to cirrhosis, increasing the risk of liver failure and liver cancer.
The study, led by Dr. Brian Lee, an associate professor of clinical medicine at the University of Southern California’s Keck School of Medicine, points to the combined effect of pre-existing health conditions and alcohol consumption in accelerating liver damage. “This study highlights a high-risk group that could benefit from increased awareness about how their health conditions influence the impact of alcohol on the liver,” said Lee.
What is Considered Heavy Drinking?
The study, published in Clinical Gastroenterology and Hepatology, used data from the National Health and Nutrition Examination Survey, which included nearly 41,000 people. Among them, over 2,200 were classified as “heavy drinkers,” defined as women who consume 0.7 ounces (20 grams) or more of alcohol daily and men who drink 1.05 ounces (30 grams) or more.
Though this amount is categorized as heavy drinking, it aligns more with what the CDC considers moderate drinking. For reference, a standard drink in the U.S. contains 0.6 ounces (14 grams) of pure alcohol, which is equivalent to 5 ounces of wine, 12 ounces of beer, or 1.5 ounces of distilled spirits.
Many people may unknowingly consume much more than this standard amount. “At restaurants, for instance, a glass of wine might contain three or four ounces, and people may not realize they’re drinking much more than they think,” Freeman explained.
Alcohol and Cancer Risk
In addition to liver damage, alcohol consumption is a well-documented risk factor for cancer. In January, former U.S. Surgeon General Dr. Vivek Murthy issued an advisory linking alcohol to cancer. “Alcohol is a preventable cause of cancer, responsible for about 100,000 cases and 20,000 cancer deaths annually in the U.S.,” Murthy said. However, a 2019 survey by the American Institute for Cancer Research revealed that only 45% of Americans were aware of this risk.
Reducing Alcohol Consumption
Experts suggest substituting mocktails for alcohol, especially in social settings. Mocktails can be made with non-alcoholic spirits, botanicals, or simple combinations of fruit juices and soda.
For those seeking to reduce alcohol intake, the SMART method can help set realistic goals:
- Specific: Set clear, achievable goals like cutting back on drinking three days a week.
- Measurable: Track how many drinks you cut back and ensure the proper serving size.
- Achievable: Limit social gatherings where alcohol is prevalent.
Relevant: Reflect on how reducing alcohol will positively impact health and life. - Time-based: Establish a reasonable time frame for cutting back.
Dr. Sanam Hafeez, a neuropsychologist based in New York City, advised starting with a self-assessment: “Nothing starts without an honest conversation with yourself,” she said.
As this study shows, the combination of certain health conditions and alcohol consumption significantly raises the risk of liver damage, making it vital to consider both factors for better long-term health.
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