People who begin drinking early in life run the risk of developing liver problems in adulthood, according to a study. Alcohol is the leading cause of liver cirrhosis and liver-related deaths. Results of the large long-term study in Sweden suggest that guidelines for safe alcohol intake in men might have to be revised downwards.
Current recommended cut-off levels in some countries suggest that safe alcohol consumption for men to avoid alcoholic liver disease is 30 grams per day, roughly equivalent to three drinks. “Our study showed that how much you drink in your late teens can predict the risk of developing cirrhosis later in life,” explains lead investigator Hannes Hagstrom. “However, what can be considered a safe cut-off in men is less clear.”
Investigators conducted a retrospective study to assess the association between alcohol consumed early in life with later development of severe liver disease. They used data from a nationwide population-based study conducted during 1969-1970 of all Swedish men conscripted into military service.
The risk was dose-dependent, with no sign of a threshold effect and was more pronounced in men consuming two drinks per day, about 20 grams, or more. Before adjustment for body mass index, tobacco consumption, the use of narcotics, cardiovascular fitness, and cognitive ability, the risk was significant for daily alcohol consumption as low as six grams per day. These results are only valid for men and need to be validated in women.
“If these results lead to lowering the cut-off levels for a ‘safe’ consumption of alcohol in men, and if men adhere to recommendations, we may see a reduced incidence of alcoholic liver disease in the future,” says Dr. Hagstrom.
Alexandre Louvet, MD, PhD, Service des maladies de l’appareil digestif, Hopital Huriez, Lille, France, observes in an accompanying editorial that despite the huge disease burden, there are no approved treatments for alcoholic liver disease.
“The present study adds to our knowledge about the risks of chronic alcohol consumption at a younger age,” comments Dr Louvet. “Safe levels of alcohol consumption must be revised for the general population and public health policies must be adapted accordingly. General recommendations by physicians must be accompanied by alcohol-control policies, especially access to alcohol, prices, and advertising. Education and information are not sufficient on their own to reduce alcohol consumption in the general population. On the other hand, targeted interventions aimed at identifying and advising excessive drinkers are useful on an individual level.”
According to the World Health Organization’s 2014 global status report on alcohol and health, alcohol-related cirrhosis is responsible for 4,93,300 deaths each year. Although there is no approved treatment, alcohol-related disease is theoretically 100% preventable, which makes the role of preventive measures central in decreasing the impact of excessive alcohol consumption on society. The study has been pulished in the Journal of Hepatology.