New study finds daily drinking rather than binge drinking is biggest risk factor in serious liver disease
Long-term daily drinking, rather than weekly binge drinking, is by far the biggest risk factor in serious liver disease, according to a new report from the University of Southampton.
The study, published in Addiction journal this week, concludes that increases in UK liver deaths are a result of daily or near daily heavy drinking, not episodic or binge drinking, and this regular drinking pattern is often discernable at an early age. It also recommends that several alcohol-free days a week is a healthier drinking pattern.
In the study of drinking patterns, dependency and lifetime drinking history in 234 subjects with liver disease, 106 had ALD (Alcohol-related Liver Disease) – 80 of whom had evidence of cirrhosis or progressive fibrosis – the team found that 71 per cent of ALD patients drank on a daily basis.
In contrast to the patients with alcohol-related cirrhosis or fibrosis, patients with other forms of liver disease tended to drink sparingly with only 10 subjects (8 per cent) drinking moderately on four or more days each week.
The study also explored lifetime drinking histories of 105 subjects and found that ALD patients started drinking at a significantly younger age (on average at 15 years old) than other subjects and had significantly more drinking days and units than non-ALD patients from the age of 20 onwards.
Lead author of the study Dr Nick Sheron, consultant hepatologist and senior lecturer at the University of Southampton, comments: “If we are to turn the tide of liver deaths, then along with an overall reduction in alcohol consumption – which means tackling cheap booze and unregulated marketing – we need to find a way to identify those people who are most likely to develop alcohol-related illnesses at a much earlier stage, and perhaps we need to pay as much attention to the frequency of drinking occasions as we do to binge drinking.
“The transition from a late teenage and early 20’s binge drinking pattern to a more frequent pattern of increased intake may prove to be a useful point of intervention in the future, and the importance of three alcohol-free days each week should receive more prominence.”
Notes for editors
1. The results were based on a prospective survey of 234 consecutive inpatients and outpatients from the liver unit of a teaching hospital in the South of England between October 2007 and March 2008. The survey, which was conducted by medical students from the University of Southampton, took the form of face-to-face interviews, AUDIT, seven-day drinking diary, severity of alcohol dependence, lifetime drinking history, and liver assessments. The full paper appears in Addiction journal (www.addictionjournal.org): Hatton J, Burton A, Nash H, Munn E, Burgoyne L, Sheron N. Drinking patterns, dependency and life-time drinking history in alcohol-related liver disease. Addiction 2009; 104: 587-592.
2. Total recorded alcohol consumption in the UK is estimated to have doubled between 1960 and 2002 and deaths from liver disease have increased eight-fold since the 1970s in England.
3. The latest ONS figures released January 26 2009 show that alcohol related deaths doubled over the last 15 years and most of these deaths were due to liver disease. Between 2006 and 2007 deaths in younger people increased by 6% for men (aged 15-34) and by a colossal 21% for women.
4. Dr Nick Sheron is a senior lecturer in the University of Southampton’s School of Medicine and is a member of the Alcohol Health Alliance UK Executive, the Royal College of Physicians Alcohol Committee and the EU Alcohol Forum. He is alcohol lead for the British Society for the Study of Liver Disease and an unpaid Trustee for Alcohol Concern and the Drinkaware Trust – the latter body is funded entirely by the drinks industry.
5. Established in 1971, the University of Southampton's School of Medicine is at the forefront of medical and basic science research. It is one of the top ten UK medical schools for research income and high quality outputs, and its innovative educational programme has been rated excellent (the highest possible rating) by the government-backed Quality Assurance Agency.
6. The School is committed to academic excellence in all aspects of research and medical education. It operates a highly focused research strategy with large interdisciplinary Research Divisions that bridge traditional subject boundaries. These divisions provide a critical mass of research resources and explore areas of common intellectual interests around important clinical problems. There are six Research Divisions and an Education Division reflecting the School's major strengths: Human Genetics; Community Clinical Sciences; Infection, Inflammation and Repair; Cancer Sciences; Developmental Origins of Health and Disease; and Clinical Neurosciences.
7. Addiction (www.addictionjournal.org) is a monthly scientific journal, read in over 60 countries and publishing more than 2,000 pages every year. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884. Addiction publishes peer-reviewed research reports on alcohol, illicit drugs and tobacco, bringing together research conducted within many different disciplines, as well as editorials and other debate pieces.