It’s how you drink, not how much you drink, that determines the damage alcohol has on your body

By Steve Fink

Binge drinkers are three times more likely to suffer liver damage compared to individuals who consume a couple of glasses of wine a day, new research reveals. Scientists in London say the pattern of alcohol consumption is a more accurate predictor of liver and other disease risk than the total amount consumed.

Moreover, the results show individuals who binge drink and possess certain genetic traits are six times more likely to develop alcohol-related cirrhosis. The team notes this is a groundbreaking report for evaluating how drinking patterns, genetic profiles, and the presence of Type 2 diabetes influence the risk of developing alcohol-related cirrhosis (ARC).

Study authors have observed that the manner of drinking is more critical than the quantity consumed. This is especially true when genetic factors and Type 2 diabetes coexist in drinkers, offering a more precise method to identify those at heightened risk for liver disease.

Globally, liver disease ranks as a leading cause of premature death. Cirrhosis, or liver scarring, affects up to three percent of the world’s population. Since the onset of the COVID-19 pandemic, alcohol-related deaths have surged by 20 percent, according to the scientists.

For this study, researchers from University College London (UCL), the Royal Free Hospital, and the Universities of Oxford and Cambridge analyzed data from over 312,000 actively drinking U.K. adults. The team evaluated the impact of drinking patterns, genetic susceptibility, and Type 2 diabetes on the likelihood of developing ARC.

A baseline hazard ratio (HR) of one was established using data from participants who drank within daily limits, had a low genetic predisposition to ARC, and did not have diabetes. Individuals who engaged in heavy binge drinking, defined as consuming 12 drinks per day (equivalent to four pints of beer or six standard glasses of wine) at least once a week, were three times more likely to develop ARC.

The risk was four times higher for those with a significant genetic predisposition and twice as high for individuals with Type 2 diabetes.

“Many studies that look into the relationship between liver disease and alcohol focus on the volume of alcohol consumed. We took a different approach by focusing on the pattern of drinking and found that this was a better indicator of liver disease risk than volume alone. The other key finding was that the more risk factors involved, the higher the ‘excess risk’ due to the interaction of these factors,” says Dr. Linda Ng Fat, a first author of the study from UCL Epidemiology & Public Health, in a university release.

Dr. Ng Fat adds that when heavy binge drinking and a genetic predisposition for liver problems were at play, the risk of developing ARC was up to six times higher than the risk for a baseline drinker.

“Only one in three people who drink at high levels go on to develop serious liver disease. While genetics plays a part, this research highlights that pattern of drinking is also a key factor. Our results suggest, for example, that it would be more damaging to drink 21 units over a couple of sessions rather than spread evenly over a week. Adding genetic information, which may be widely used in healthcare over the coming years, allows an even more accurate prediction of risk,” explains Dr. Gautam Mehta, a senior author of the study from UCL Division of Medicine and the Royal Free Hospital.

“As liver disease, particularly alcohol-related fatalities, has seen a significant surge since the onset of the COVID-19 pandemic, it is imperative that we adopt innovative strategies to address this escalating crisis. This study equips us with novel tools that are essential in pinpointing individuals at highest risk, thereby enabling us to direct interventions more effectively towards those who stand to benefit the most,” adds Dr. Steven Bell, a senior author of the study from the University of Cambridge.

“This research is important because it reveals that it’s not just how much you drink overall but the way that you drink matters. Drinking a lot, quickly, or drinking to get drunk can have serious consequences for your liver health,” concludes Pamela Healy, the chief executive of the British Liver Trust.
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Credit: University College London