Fact checked byHeather Biele

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December 14, 2023
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Researchers advise limit of 7.4 grams of alcohol per day in early steatotic liver disease

Fact checked byHeather Biele
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Key takeaways:

  • Mortality rates for those at intermediate/high risk vs. low risk for advanced cirrhosis were 4,342 vs. 1,099 per 100,000.
  • Recommended intake for low-risk patients is half a 12 oz. beer or half a glass of wine.
Perspective from William Carey, MD

Researchers recommended that patients with steatotic liver disease who are at a lower risk for advanced cirrhosis should consume no more than 7.4 grams of alcohol per day, the equivalent of a half a 12 oz. beer or half a glass of wine.

“A recent update in nomenclature, steatotic liver disease (SLD), encompasses all fatty liver diseases confirmed by histological or radiological evidence, irrespective of etiology,” Yee Hui Yeo, MD, of Cedars-Sinai Medical Center in Los Angeles, and colleagues wrote in JAMA Network Open. “While individuals with severe SLD should abstain from alcohol, little evidence exists for acceptable alcohol intake for patients with early stages of SLD who are disinclined toward complete abstinence.”

Patients with steatotic liver disease at a lower risk for advanced cirrhosis should consume no more than 7.4 grams of alcohol per day.
Data derived from: Yeo YH, et al. JAMA Netw Open. 2023;doi:10.1001/jamanetworkopen.2023.47548.

To determine the dose-dependent association between alcohol use and disease progression, Yeo and colleagues analyzed 2,834 patients with SLD (median age, 42 years; 51.8% men) using the U.S. National Health and Nutrition Examination Survey III database. Researchers reported an intermediate or high risk for advanced fibrosis, defined as a Fibrosis-4 index score of 1.3 or higher, among 20.8% of patients.

During 66,299 person-years of follow-up, the mortality rate for those at intermediate or high risk was 4,342 per 100,000 vs. 1,099 per 100,000 for those at low-risk.

After adjusting for demographic and metabolic variables, researchers identified a nonlinear association between alcohol consumption and mortality in the low-risk group, noting that mortality risk “exceeded an adjusted hazard ratio of 1” with intake of 7.4 grams per day (HR = 0.99).

Researchers further observed a linear association between daily alcohol consumption and the increased risk for mortality in the intermediate- or high-risk group.

“In this cohort study, the recommended level of alcohol consumption was less than 7.4 g per day for individuals with SLD at lower risk for advanced fibrosis, which equals half a 12-oz (336 g) beer or half a glass of wine,” Yeo and colleagues wrote. “Notably, 7.4 g per day corresponds to half a standard U.S. drinking unit and three-fourths of a traditional European drink, emphasizing modest ranges of acceptable alcohol consumption per individual.”

They added, “Individuals with SLD should be advised to maintain regular health monitoring and lifestyle management.”