Moderate wine consumption may be protective against advanced liver damage

The current study aimed to determine whether the amount, the drinking pattern or the type of alcoholic beverage had an impact on liver fibrosis in patients with Non-alcoholic fatty liver disease (NAFLD). The results showed that moderate consumption of alcoholic beverages, in particular wine in a non-binge drinking pattern, is associated with a decreased risk of advanced liver damage in patients with NAFLD.

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in developed countries with a prevalence of more than 20% in the adult population. It occurs when too much fat is stored in the liver (steatosis) due to other causes than excessive consumption of alcoholic beverages. It is characterised by liver inflammation, which may progress to scarring and irreversible damage. This damage is similar to the damage caused by heavy alcohol use. At its most severe, nonalcoholic steatohepatitis can progress to cirrhosis and liver failure. It occurs in individuals who are at high risk of heart disease because of risk factors such as obesity and type 2 diabetes and it is closely linked to the metabolic syndrome.

It is generally accepted that an average daily consumption of alcoholic beverages < 30 g for men and < 20g for women does not cause alcohol-related steatosis of liver injury.

Since moderate consumption of alcoholic beverages has been reported to show benefits in cardiovascular disease, it has been suggested that it may be beneficial in NAFLD as well, however, the published data so far are inclusive.

In this study, the lifetime and current intake of alcoholic beverages of 187 NAFLD patients who underwent a liver biopsy was assessed. The results showed that moderate drinkers (1-70 g of alcohol per week), especially wine drinkers, had a lower degree of liver damage than abstainers and a lower risk of advanced liver damage. Excessive or a binge drinking pattern did not have a protective effect on the development of advanced liver damage in NAFLD patients. The authors concluded that prospective studies are needed before clinical recommendations can be made.

Mitchell T et al, Type and pattern of alcohol consumption is associated with liver fibrosis in patients with Non-Alcoholic Fatty Liver Disease, Am J Gastroenterology 2018, doi: 10.1038/s41395-018-0237-y.

Armstrong M et al, Alcohol consumption in patients with Non-Alcoholic Fatty Liver Disease: Convenient vs. inconvenient truths, Am J Gastroenterology 2018, http://doi.org!10.1038/s41395-018-0237-y.