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Semin Liver Dis 2024; 44(01): 069-078
DOI: 10.1055/s-0044-1785228
Review Articles

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

Manuel Romero-Gómez
1   UCM Digestive Diseases and CIBERehd, Institute of Biomedicine of Seville (HUVR/CSIC/US), Virgen del Rocío University Hospital, University of Seville, Seville, Spain
,
Juan Pablo Arab
2   Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
3   Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University and London Health Sciences Centre, London, Ontario, Canada
4   Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, Ontario, Canada
,
Claudia P. Oliveira
5   Division of Clinical Gastroenterology and Hepatology, Department of Gastroenterology, Faculdade de Medicina, Universidade de São Paulo, Hospital das Clínicas HCFMUSP, Sao Paulo, Brazil
,
María Hernández
6   Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
,
Marco Arrese
2   Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
8   Centro de Envejecimiento y Regeneración, Santiago, Chile
,
Helena Cortez-Pinto
9   Clínica Universitaria de Gastrenterologia, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
,
Ramón Bataller
7   Liver Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain
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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.

Keywords

ethanol - liver cirrhosis - steatotic liver disease - alcohol threshold


Publication History

Article published online:
04 April 2024

© 2024. Thieme. All rights reserved.

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