A study published in Hepatology states that people at risk for coronary heart disease are often at risk for nonalcoholic fatty liver disease (NAFLD). The association of modest wine consumption with NAFLD has not been studied and the recommendation of wine for patients at risk for both diseases is controversial. The aim was to test whether modest wine consumption is associated with lower rates of NAFLD. The investigators included Third National Health and Nutrition Examination Survey participants who either reported no alcohol consumption or drank up to 10g of wine a day. Multivariate analysis was adjusted for age, gender, race, neighbourhood, income, education, caffeine intake, and physical activity. A total of 7,211 nondrinkers and 945 modest wine drinkers comprised the study sample.
Results showed that NAFLD was observed in 3.2% of nondrinkers and 0.4% of modest wine drinkers. The adjusted odds ratio was 0.15 (95% confidence interval, 0.05-0.49). Suspected NAFLD was observed in 14.3% of nondrinkers and 8.6% of wine drinkers. The adjusted odds ratio was 0.51 (95% confidence interval, 0.33-0.79).
The authors conclude that modest wine consumption is associated with reduced prevalence of suspected NAFLD. The current study supports the safety of one glass of wine per day for cardioprotection in patients at risk for both coronary heart disease and NAFLD.
R Curtis Ellison comments: Since heavy drinking is a major risk factor for cirrhosis of the liver, most physicians are reluctant to encourage any consumption of alcohol among patients with any type of liver disease, including NAFLD.
NAFLD is a very common type of liver disease that may be present in up to one-third of Americans (associated with obesity). This paper is based on a very well done cross-sectional analysis from the NHANES study, which is a representative sample of the US population; hence, the results should be widely applicable to Americans. Instead of showing an increase in evidence of NAFLD among modest drinkers, the study showed no significant effect for beer and liquor drinkers and a marked lowering of prevalence of the disease among modest wine drinkers.
The authors adjusted for many factors, including income, education, and neighbourhood, that have been shown to relate to beverage preference in the US and many other countries. Even after taking all of these factors into consideration, the authors found that subjects reporting up to 10g of alcohol per day from wine showed an 85% lower prevalence of NAFLD; wine drinkers also showed a lower prevalence (49% lower) of having liver function test results above 95% of what is considered the “normal” range.
We agree with the authors’ conclusions: ‘The current study presents a paradigm shift that modest wine consumption may not only be safe from a liver perspective but may actually decrease the prevalence of NAFLD.’
Source: Dunn W, Xu R, Schwimmer JB. Modest wine drinking and decreased prevalence of suspected nonalcoholic fatty liver disease. Hepatology 2008;47:pre-publication release.