Public Release: 

Drinking just 1 or 2 alcoholic drinks a day linked to liver disease

New data highlights why reducing heavy drinking should be considered an important target for public health monitoring and policies

European Association for the Study of the Liver

April 25, 2015, Vienna, Austria: According to the World Health Organization, excessive alcohol drinking is the most common cause of cirrhosis worldwide. A new worldwide study presented at The International Liver CongressTM 2015 has shown the significant influence of daily drinking on this disease burden. New data shows that the cirrhosis burden caused by alcohol increased by 11.13% when moving from the moderate to heavy daily drinking (up to one drink/day for women; two drinks/day for men) classification (p<.001).

Most studies assessing the prevalence of alcohol abuse as a risk factor for alcoholic cirrhosis focus on total annual amount drunk per person. However, the researchers highlight that clinical studies suggest that it is a high daily consumption which is the strongest predictor of alcoholic cirrhosis. This new research concluded that heavy daily drinkers most significantly and independently influence a country's cirrhosis burden.

According to the World Health Organization's Global Status Report on Alcohol and Health, around 6% of global deaths are caused by drinking alcohol, the majority from alcoholic cirrhosis - scarring of the liver as a result of continuous, long-term liver damage. Half of all cases of cirrhosis are caused by alcohol.

The researchers analysed the WHO's Global Status Report on Alcohol and Health, which included parameters of alcohol consumption and drinking patterns from 193 countries.

Reducing heavy drinking should therefore be considered as an important target for public health monitoring and policies.

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About The International Liver Congress™

This annual congress is the biggest event in the EASL calendar, attracting scientific and medical experts from around the world to learn about the latest in liver research. Specialists share research studies and findings, and discuss the hottest topics related to liver disease. This year, the congress is expected to attract approximately 10,000 delegates from all corners of the globe. 2015 is a very special year for EASL and the hepatology community as they will celebrate the 50th annual meeting. The International Liver Congress™ takes place from April 22-26, 2015, Vienna, Austria.

About EASL

Since EASL's foundation in 1966, this not-for-profit organisation has grown to over 4,000 members from more than 100 countries around the world. EASL is the leading liver association in Europe, it attracts the foremost hepatology experts and has an impressive track record in promoting research in liver disease, supporting wider education and promoting changes in European liver policy.

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EU and Public Health: Hall C (Plenary)
Presentation time: 13:15 - 13:30
Presenter: Eva Stein (United States)
Abstract O127: A WORLDWIDE STUDY REVEALS THAT THE AMOUNT OF DAILY ALCOHOL INTAKE IS A BETTER PREDICTOR OF THE WEIGHT OF ALCOHOL IN THE CIRRHOSIS BURDEN THAN THE TOTAL PER CAPITA COMSUMPTION

A WORLDWIDE STUDY REVEALS THAT THE AMOUNT OF DAILY ALCOHOL INTAKE IS A BETTER PREDICTOR OF THE WEIGHT OF ALCOHOL IN THE CIRRHOSIS BURDEN THAN THE TOTAL PER CAPITA COMSUMPTION

Ramon Bataller1, Eva Stein* 2, Jose T. Altamirano3, Monica Cruz-Lemini4, Jueyon Cheong2

1Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chael Hill, 2Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, United States, 3Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), 4Institut dÍnvestigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

Background and Aims: Approximately 6% of global deaths are caused by alcohol consumption, with a major contribution from alcoholic cirrhosis (Global Status Report on Alcohol and Health, WHO, 2014). Moreover, of diseases not explicitly defined by alcohol consumption, cirrhosis has the highest alcohol-attributable fraction (50% of all cases worldwide). Most studies assessing the prevalence of alcohol abuse as a risk factor for alcoholic cirrhosis focus on total annual per capital consumption. However, clinical studies indicate that high daily consumption is the strongest predictor of alcoholic cirrhosis. We hypothesize that the counties with the highest daily alcohol consumption are at highest risk of having a greater burden of alcoholic cirrhosis.

Methods: We performed a comprehensive analysis of the WHO Global Status Report on Alcohol and Health, which included parameters of alcohol consumption and drinking patterns from 193 countries. We categorized countries by heavy or moderate drinking using the average daily consumption among drinkers, according to the US Dietary Guidelines threshold for heavy drinking (up to 1 drink/day for women, up to 2 drinks/day for men). Moreover, global rates of HCV and HBV were obtained from published seroprevalence estimates, and obesity data were obtained from the WHO Data Repository. Uni- and multivariate models were fitted to determine the correlation between alcohol parameters and the outcome measure of alcohol-attributable fraction (AAF) of cirrhosis, adjusting for the cofactors' effects.

Results: In an integrative model that adjusted for cirrhosis cofactors, the classification of countries by moderate or heavy daily drinking had the strongest influence on the weight of alcohol in the cirrhosis burden. Of note, the cirrhosis burden due to alcohol increased by 11.13% with a transition from the moderate to heavy classification (p<.001). In contrast, total yearly per capita consumption had a correlation coefficient of only 2.22 with the AAF of cirrhosis (p<.001). Importantly, drinking patterns such as heavy episodic drinking and the type of alcoholic beverages (wine, beer or spirits) did not independently correlate with AAF.

Conclusions: The presence of heavy daily drinkers in a population most significantly and independently influences the weight of alcohol in a country's cirrhosis burden. Reducing heavy drinking should therefore be considered as an important target for public health monitoring and policies.

Disclosure of Interest: R. Bataller: Consultant: ONCOZYME, SANDHILL, VITAL THERAPEUTICS, E. Stein: : None Declared, J. Altamirano: : None Declared, M. Cruz-Lemini: : None Declared, J. Cheong: : None Declared

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