Is There a Safe Alcohol Consumption Limit for the General Population and in Patients with Liver Disease?

Abstract

Excessive alcohol consumption represents an important burden for health systems worldwide and is a major cause of liver- and cancer-related deaths. Alcohol consumption is mostly assessed by self-report that often underestimates the amount of drinking. While alcohol use disorders identification test - version C is the most widely used test for alcohol use screening, in patients with liver disease the use of alcohol biomarker could help an objective assessment. The amount of alcohol that leads to significant liver disease depends on gender, genetic background, and coexistence of comorbidities (i.e., metabolic syndrome factors). All patients with alcohol-associated liver disease are recommended to follow complete abstinence and they should be treated within multidisciplinary teams. Abstinence slows down and even reverses the progression of liver fibrosis and can help recompensate patients with complicated cirrhosis. Whether there is a safe amount of alcohol in the general population is a matter of intense debate. Large epidemiological studies showed that the safe amount of alcohol to avoid overall health-related risks is lower than expected even in the general population. Even one drink per day can increase cancer-related death. In patients with any kind of chronic liver disease, especially in those with metabolic-associated steatotic liver disease, no alcohol intake is recommended. This review article discusses the current evidence supporting the deleterious effects of small-to-moderate amounts of alcohol in the general population and in patients with underlying chronic liver disease.

Treatment Options and Continuity of Care in Metabolic-associated Fatty Liver Disease: A Multidisciplinary Approach

“…Thus, in patients with low to mild fibrosis (F1–F2), a modest consumption of alcohol (≤1 drink per day for women and ≤2 drinks per day for men; one drink equals one bottle of regular beer (12 ounces), one glass of wine (5 ounces), or one shot of liquor or spirits (1.5 ounces)) seems to be liver-safe as in the general population, while alcohol consumption must be completely discouraged in patients with significant and advanced fibrosis or cirrhosis (F3–F4). [ 70 ]…”