Moderate drinking also prevents the irreversible liver damage associated with NALFD, according to a national study led by UCSD’s Jeffrey Schwimmer, M.D., Winston Dunn, M.D. and Michael Donohue, Ph.D.

NAFLD currently affects 40 million Americans, or approximately one-third of the U.S. population. It is caused by the accumulation of fat in liver cells that eventually inflames or scars the liver. Obesity and diabetes increase the risks of being diagnosed with NAFLD. 

The cross-sectional study, which included 251 lifetime non-drinkers (zero drinks a day) and 331 moderate drinkers (one to two drinks a day), showed that NALFD patients who are non-drinkers are twice as likely as moderate drinkers to develop hepatitis or non-alcoholic steatohepatitis, also known as NASH. Moderate drinkers also tended to have less severe liver scarring and were less likely to die from cardiovascular disease than non-drinkers. 

“The reasons aren’t entirely clear,” Schwimmer said in UCSD News. 

According to Schwimmer, alcohol can increase “good” cholesterol and improve a patient’s sensitivity to insulin. Since NALFD patients have low levels of “good” cholesterol and are insulin-resistant, Schwimmer thought that alcohol could help treat patients. Additionally, alcohol may have anti-inflammatory effects depending on the type of alcohol, Schwimmer said. 

Schwimmer said that the moderate alcohol treatment may not be beneficial for everyone, and that each patient should be looked at individually. For specific stages of NAFLD, such as cirrhosis (advanced scarring of liver tissue) or NASH (inflammation of the liver), it may not be effective. 

In UCSD News, Schwimmer said that even small amounts of alcohol can be bad for patients with cirrhosis or NASH. However, he said it “may not be applicable to all forms of liver disease.” 

“I suspect modest alcohol consumption will be an appropriate recommendation for many [liver] patients, but clearly not all,” Schwimmer said.

Since NALFD patients are two times more likely to die from coronary heart disease than from liver disease — due to the increased cardiovascular risks that come with the disease — the research team is now interested in seeing if the effects of moderate alcohol consumption outweigh the negative effects of alcohol use in other areas. They hope to reach a consensus on how alcohol consumption can be coordinated for NALFD treatment.