Alcohol and obesity mix to create deadly liver disease cocktail

Drinkers who are overweight are much more likely to develop deadly liver disease, according to scientists from the University of Glasgow. In a study conducted by Dr Carole Hart of the Section of Public Health and Health Policy, scientists examined whether a raised Body Mass Index (BMI) and alcohol consumption acted together to increase the risk of liver disease. They found that the combination of drinking and being overweight or obese led to a much greater risk of liver disease than either alcohol consumption or overweight/ obesity alone.

Meanwhile, another Glasgow University research team found that virtually the entire adult population of Scotland are dangerously at risk of illness or premature death as a result of unhealthy lifestyles.

Obesity and alcohol

Overweight (BMI of 25 to <30) men had higher death rates than normal weight men while obese men (BMI of 30 or more) had a five-fold increase in the risk of dying of liver disease.

Drinkers of 15 or more units a week of alcohol in any BMI category, and obese drinkers had higher risks of liver disease mortality than normal weight non-drinkers. Risks increased as BMI and alcohol levels increased. Obese men drinking 15 or more units a week had almost 19 times higher risk of dying of liver disease.

Dr Hart added: “We may need to consider recommending lower ‘safe’ limits of alcohol consumption for people who are overweight.”

The study was published in the British Medical Journal.
Hart, C et al - Effect of body mass index and alcohol consumption on liver disease: analysis of data from two prospective cohort studies. BMJ, 2010, doi - 10.1136/bmj. c1240

Scots living dangerously

In the second study, researchers examined the Scottish Health Survey and found that nearly the whole adult population (97.5%) reported to have at least one of five main behavioural risk factors for ill-health - tobacco use, alcohol consumption, poor diet, physical inactivity, overweight and obesity. 55% of the sample reported having three or more risk factors, and nearly 20% reported having four or all five risk factors. The most important determinants for having four or five multiple risk factors were low educational attainment which conferred over a 3-fold increased risk compared to high education, and residence in the most deprived communities (relative to least deprived) which had greater than 3-fold increased risk.

The study was led by Dr David Conway, who commented that the true picture could be even worse, due to respondents putting a positive spin on their behaviour.

The Scottish results are similar to those in a recent survey of English behaviour, and suggest both nations are more unhealthy than many European countries, and North America.

Scotland has earned a reputation as the ‘sick man’ of Europe in recent years. The country has higher death rates from cancer, heart disease and stroke than anywhere else in the UK, and among men, Scotland has more than twice as many alcohol-related deaths than England.

Scots Drink 24% more than English and Welsh

The reason alcohol features so large in the unusually high mortality rate in Scotland is that the Scots drink almost a quarter as much again as the English and Welsh. Figures based on alcohol sales data and analysed by NHS Scotland show that the drinking Scots population aged over 16 consume 13.5 litres of pure alcohol per annum, compared with 11.1 litres in England and Wales. Expressed in terms of alcohol units, Scots aged 16 and over purchased 1190 units in 2009, equivalent to 22.9 units per person per week. When the proportion of Scots who do not drink alcohol are taken into account, consumption per drinker increases to 25.9 units per week, almost five units per week more than the recommended weekly maximum for men. The equivalent English figures are 18.4 and 21.4 units.

Other highlights from the report are that:

• More than twice as much alcohol was purchased in Scotland from the off trade as from the on trade, with off sales continuing to increase and on sales to decline

• The price per unit of alcohol was between two and three times as high in the on-trade as in the off trade

• The average price per unit of alcohol in 2009 was 72 pence in Scotland, compared with 71 pence in England and Wales
  
  However, in Scotland 77% of all drink was sold from shops and supermarkets at less than 50p a unit, 51% at 40p or less and 16% at 30p or less

• A quarter of cider was sold for less than 20p per unit, 48% at less than 30p per unit and three-quarters at less than 40p per unit

• More than half (5%) of beer was sold at 40p per unit and 59% of vodka was sold for less than 35p per unit.

The study was published in the online journal BMC Public Health
Conway, D et al – Is the Scottish population living dangerously? Prevalence of multiple risk factors: the Scottish Health Survey 2003; BMC Public Health 2010, doi: 10.1186/1471- 2458-10-330