Effects of Moderate Alcohol Drinking in Patients with Nonalcoholic Fatty Liver Disease

Whether moderate alcohol intake is beneficial remains an unsolved issue. Recent studies have suggested that moderate alcohol consumption is associated with beneficial effects related to the prevention of cardiovascular diseases. Moderate alcohol consumption leads to a higher risk of hepatocellular carcinoma in patients with chronic viral liver diseases. However, the effects of moderate alcohol intake in patients with nonalcoholic fatty liver disease are unclear. In this review, we analyzed, from various perspectives, the effect of moderate alcohol consumption in patients with nonalcoholic fatty liver disease. We reviewed four cohort studies and seven cross-sectional studies. The results showed that moderate alcohol consumption was negatively related to the incidence of nonalcoholic steatohepatitis and liver fibrosis. However, moderate alcohol consumption was positively associated with the incidence of hepatocellular carcinoma in patients with nonalcoholic fatty liver disease. The results of the analysis of the relationship between moderate alcohol consumption and the levels of triglycerides, total cholesterol, high-density lipoprotein, and hypertension were diverse. More clinical data are needed to draw a conclusion about the effects of moderate alcohol consumption in patients with nonalcoholic fatty liver disease.

Moderate drinking and motivational enhancement therapy

Alcohol consumption rates of Korean men and women are 85.8% and 65.4%, respectively. In regard to the amount of drinking, the highest frequency in men, among 37.2%, was over 10 glasses and in women was 1-2 glasses (1 glass, 12-14 g of alcohol) per day. Moderate drinking was defined as 2 glasses per day for men and 1 glass per day for women. Drinking beyond the moderate level could be risky or problematic. Alcohol related problems such as liver disease, cancer, cerebrovascular disease, accidents, crimes, injuries, and social and family problems in Korea create a great socioeconomic burden and threaten public health. Evidence-based treatments for problematic drinking, such as brief intervention, behavior change counseling, and motivational enhancement interviewing or therapy, have been suggested. An especially effective method would be motivation enhancement treatment (MET) due to since it is a client-centered approach and enhances self-efficacy based decisional balance. The major techniques of MET are feedback, responsibility, advice about changing, menu of change options, empathic counseling, self efficacy. The success factors for MET are sit squarely, open posture, lean toward patient, eye contact, relax posture. However, scientific accumulation of research results on the benefit of counseling for problematic drinking in Korea is still insufficient to provide the evidence for above treatment techniques.

Patient Education for Moderate Drinking

A brief advice by a physician to problem drinkers are known to be very effective in reducing alcohol consumption, health care utilization, motor vehicle events, and its related costs. This article is to provide the definition of moderate drinking and screening methods for alcohol problems in the context of primary care. Various individualized strategies of education can be applied to the patients based on their drinking habits on each visit. Regular programs of group education for problem drinkers and their families are also considered to be useful methods in both ambulatory and hospital settings. From preventive perspectives, public health educations should be focused on the establishment of a culture of moderate drinking in the community.