Advanced liver fibrosis (MASLD) occurs in the late stage of chronic liver disease. It involves the accumulation of scar tissue due to long-term inflammation, according to the American Liver Foundation. Lead researcher Brian P. Lee, a hepatologist and liver transplant specialist at Keck Medicine of USC, said patients often ask how much they can drink and that in hepatology, average alcohol consumption is typically considered, reports the New York Post.
Patients are categorized based on how much alcohol they drink weekly. Researchers therefore wanted to determine whether drinking patterns affect the risk of liver disease compared to the total amount of alcohol consumed. The study analyzed six years of data from the U.S. National Health and Nutrition Examination Survey (NHANES), which included over 8,000 adults.
Scientists focused on individuals with MASLD. Estimates from large epidemiological studies indicate that MASLD affects about 25 to 30 percent of adults in the U.S. The condition is linked to excess body weight and obesity, as well as disorders like type 2 diabetes, high blood pressure, and elevated cholesterol. More than half of the adults in the study reported occasional heavy drinking, including nearly 16 percent of those with MASLD.
Binge drinking, defined as four or more drinks in one day for women and five or more for men, at least once a month, was associated with at least a threefold higher likelihood of advanced liver fibrosis compared to consuming the same amount of alcohol spread over a longer period.
The study also found that younger adults and men are more prone to binge drinking. The results were published in the journal Clinical Gastroenterology and Hepatology. Lee further emphasized the importance of consumption patterns:
"Many patients ask if they don’t drink on weekdays, can they drink more on weekends, like a weekly 'quota,' and our research shows the answer is no. This pattern of episodic heavy drinking is particularly bad compared to spreading alcohol intake over a longer period."
The authors note, however, that the study has certain limitations. It was observational and cannot prove that binge drinking directly causes advanced liver fibrosis. It also relied on self-reported alcohol consumption, which may be inaccurate, and the results primarily relate to individuals with MASLD.
Julian Braithwaite, executive director of the International Alliance for Responsible Drinking, assessed that the study highlights how important the way one drinks is:
"How you drink matters. Binge drinking is high risk, even occasionally, but it is not the same as moderate consumption, which is widely considered lower risk. Not all drinking patterns are equal, and individual risk is important. The focus should be on helping people avoid harmful patterns and make informed decisions."