ATLANTA — Drinking alcohol if you have a large belly or diabetes more than doubles the risk of serious liver damage, while having high blood pressure and drinking nearly doubles the risk, a new study found.
Those are important health risks to consider, said Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver, Colorado, who was not involved in the study.
“People are going to do exactly what they shouldn’t do, and poison themselves,” Freeman said. “Particularly during big (sports events), people will eat things like hot dogs, sausage, bacon, pepperoni and ham — and these processed meats are in the same category as cigarettes for cancer risk.
“When you’re eating all these highly processed, high fat, high sugar foods, insulin goes into overdrive, which creates insulin resistance, then excess blood sugar and then fatty liver,” Freeman added. “Then if you’re drinking on top of it, it just amplifies the risk.”
A waist measurement of 35 inches or more for women and 40 inches or more for men, which is often associated with obesity, is one of several cardiometabolic risk factors that also include high blood sugar and elevated blood pressure.
Nearly half of all Americans have high blood pressure, more than 1 in 3 have pre-diabetes, while about 40% of the population is considered obese, according to the US Centers for Disease Control and Prevention.
These health conditions contribute to a buildup of fat in the liver, experts say, which can then lead to fibrosis or scarring of the liver.
“Most people don’t realize this, but before one develops diabetes, for example, they typically first develop fatty liver,” Freeman said. “It has to do with sugar dysregulation — when you have high blood sugars, your liver is storing fat to get rid of some of that sugar, and it’s that excess fat that impairs liver function.”
Separately, drinking damages liver cells trying to metabolize alcohol and can lead to additional fat buildup. The inflammation and scarring caused by excess fat may eventually lead to cirrhosis, which increases the risk of liver failure and liver cancer.
This double whammy of fatty deposits may be a reason behind the significant increase in liver scarring the study found among moderate to heavy drinkers with chronic conditions, said lead study author Dr. Brian Lee, an associate professor of clinical medicine at the University of Southern California’s Keck School of Medicine.
“The results identify a very high-risk segment of the population prone to liver disease and suggest that preexisting health issues may have a large impact on how alcohol affects the liver,” Lee said in a statement.
Just because a person may not have a big belly, high blood pressure, or diabetes does not mean that it’s safe for people to heavily consume alcohol, Lee said.
“We know that alcohol is toxic to the liver and all heavy drinkers are at risk for advanced liver disease,” Lee said.
What is a ‘heavy’ drinker?
The study, published recently in the Journal of Clinical Gastroenterology and Hepatology, analyzed data from the National Health and Nutrition Examination Survey, a national government survey of nearly 41,000 people. Of those, over 2,200 were categorized as “heavy” drinkers.
In the study, women who drank more than 0.7 ounces or more a day and men who drank 1.05 ounces or more a day were defined as heavy drinkers.
However, that amount of alcohol is typically considered to be “moderate” drinking, according to the CDC. A standard drink in the United States is defined as 0.6 ounces of pure liquor.
That’s equivalent to five ounces of wine with 12% alcohol, a 12-ounce can of beer that is 5% alcohol or 1.5 ounces of liquor (80 proof) or distilled spirts. Most people don’t realize they are pouring drinks that far exceed those standards, experts say.
“If you look at what people drink with dinner or as a cocktail, they’re filling up their glass with three or four ounces,” Freeman said. “If a restaurant came out and poured you five ounces of wine, you’d complain that they didn’t fill your glass. People are probably drinking much more than they realize.”
An alarming number of new studies are finding that any amount of alcohol is dangerous to health. In January, then-U.S. Surgeon General Dr. Vivek Murthy issued a strongly worded advisory about the link between alcohol and cancer.
“Alcohol is a well-established, preventable cause of cancer responsible for about 100,000 cases of cancer and 20,000 cancer deaths annually in the United States – greater than the 13,500 alcohol-associated traffic crash fatalities per year in the US – yet the majority of Americans are unaware of this risk,” Murthy said.
However, only 45% of Americans surveyed by the American Institute for Cancer Research in 2019 said they believed that drinking alcohol causes cancer, the new advisory notes.
The Key Takeaways for this article were generated with the assistance of large language models and reviewed by our editorial team. The article, itself, is solely human-written.
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