Study: Lower alcohol limit among older teen boys recommended
Study findings in Sweden prompt researchers to call for lower limit in guidelines on safe alcohol intake for older teenaged boys.
The large long-term study published in Journal of Hepatology showed that the risk of developing liver disease in adulthood was significant for daily alcohol consumption as low as 6 g per day in late adolescence before adjustment for body mass index, tobacco consumption, the use of narcotics, cardiovascular fitness and cognitive ability. Safe alcohol consumption for men is currently limited to 30 g per day—or about three drinks—to prevent alcoholic liver disease. [2018;68(3):505–510]
“Our study showed that how much you drink in your late teens can predict the risk of developing cirrhosis later in life,” said lead researcher Dr Hannes Hagström, of the Centre for Digestive Diseases, Division of Hepatology, Karolinska University Hospital, Stockholm, Sweden.
Researchers conducted a retrospective study to look at the link between alcohol consumption among teenagers and development of severe liver disease in adulthood. They used data from a nationwide population-based study conducted from 1969 to 1970 and involved 49,000 Swedish men aged 18 to 20 in the military service. Military service was compulsory in Sweden during those years so only 2 to 3 percent of men were exempted owing to severe disabilities or disease.
Researchers matched personal identity numbers from the military service data with records in the National Patient Register and the Causes of Death Register to determine if subjects had developed severe liver disease up to the end of 2009. Results were adjusted for body mass index, smoking, use of narcotics, cognitive ability and cardiovascular fitness.
After 39 years of follow-up, 383 men had developed severe liver disease including, liver cirrhosis, hepatocellular carcinoma, ascites, oesophageal varices, hepatorenal syndrome, hepatic encephalopathy, liver failure or death from liver disease (adjusted hazard ratio for every 1 g/day increase 1.20; 95% CI 1.01–1.02). The risk was greater among men who drank at least two drinks per day, which is about 20 g. Also, before adjustment for body mass index, tobacco consumption, the use of narcotics, cardiovascular fitness, and cognitive ability, even drinking as little as 6 g per day raised the risk significantly. [J Hepatol 2018;68(3):505–510]
Researchers noted that the results are only valid for men and need to be validated in women.
“If these results lead to lowering the cut-off levels for a ‘safe’ consumption of alcohol in men, and if men adhere to recommendations, we may see a reduced incidence of alcoholic liver disease in the future,” said Hagström.
In an accompanying editorial, Dr Alexandre Louvet, Department of Diseases of the Digestive System, Huriez Hospital, Lille, France, wrote that there are currently no approved treatments for alcoholic liver disease though the disease burden is huge. [J Hepatol 2018;68(3):389–390]
“The present study adds to our knowledge about the risks of chronic alcohol consumption at a younger age,” commented Louvet.
“Safe levels of alcohol consumption must be revised for the general population and public health policies must be adapted accordingly. General recommendations by physicians must be accompanied by alcohol-control policies, especially access to alcohol, prices, and advertising,” he added.
However, Louvet said that education and information are not sufficient on their own to reduce alcohol consumption in the general population. On the other hand, targeted interventions aimed at identifying and advising excessive drinkers are useful on an individual level, he said.