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What advice should be given to patients with NAFLD about the consumption of alcohol?

Nature Clinical Practice Gastroenterology & Hepatology volume 6, pages 18–19 (2009)Cite this article

Nonalcoholic fatty liver disease (NAFLD) is one of the most common liver diseases in the Western world. NAFLD is associated with chronic metabolic disorders such as obesity, type 2 diabetes, and dyslipidemia. Several studies have shown that individuals with NAFLD are more likely to have atherosclerosis and a heightened risk of cardiovascular disease than individuals without NAFLD. In fact, cardiovascular disease is the single most common cause of death in patients with NAFLD.1

Although heavy alcohol use has many detrimental effects, the cardiovascular benefits of moderate alcohol consumption are beyond doubt. In a prospective study of 490,000 people, Thun et al. demonstrated that individuals who consumed one alcoholic drink daily had a decrease in mortality from all causes of 20% and cardiovascular-associated mortality of 30–40% compared with nondrinkers.2 In the Copenhagen City Heart Study, individuals who consumed between three and five drinks of wine daily had a decreased relative risk of death from all causes, including cardiovascular and cerebrovascular events, of ∼50% compared with non-wine drinkers. No risk reduction was seen, however, with consumption of beer or liquor, suggesting that the nonalcohol constituents of wine were accountable for the protective effects observed in this study.3 A systematic review that evaluated the effects of alcohol on the incidence and progression of diabetes found that moderate alcohol consumption was associated with a decreased incidence of diabetes and with a decreased incidence of cardiovascular events in those already diagnosed with diabetes.4 These data raise the dilemma of whether patients with NAFLD who have a heightened risk of cardiovascular disease should, or should not, consume alcohol.

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Acknowledgements

Supported in part by F32AA017800 from the NIH/NIAAA (MSS), K08AA016570 from NIH/NIAAA (SL) and K24 DK069290 from the NIH/NIDDK (NC).

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Authors and Affiliations

  1. MS Sozio is a first year Gastroenterology Fellow and N Chalasani is Professor of Medicine and Director of the Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, IN.,

    Margaret S Sozio & Naga Chalasani

  2. S Liangpunsakul is Assistant Professor of Medicine at the Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, and at the Roudebush Veterans Administrations Medical Center, Indianapolis, IN, USA.,

    Suthat Liangpunsakul

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  1. Margaret S Sozio
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  2. Naga Chalasani
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  3. Suthat Liangpunsakul
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Correspondence to Naga Chalasani.

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Sozio, M., Chalasani, N. & Liangpunsakul, S. What advice should be given to patients with NAFLD about the consumption of alcohol?. Nat Rev Gastroenterol Hepatol 6, 18–19 (2009). https://doi.org/10.1038/ncpgasthep1314

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