How Safe Is Moderate Alcohol Consumption in Overweight and Obese Individuals?

Abstract

The prevalence of nonalcoholic fatty liver disease (NAFLD) has reached global epidemic proportions,1 paralleling that of the increasing trends in the prevalence of obesity and type 2 diabetes (T2D). In fact, obesity is one of the most frequently associated comorbidities of NAFLD,2 and, furthermore, NAFLD and obesity integrate the myriad risk factors for cardiovascular disease (CVD) clustered in the metabolic syndrome (MetS). By definition, NAFLD is characterized by abnormal liver fat accumulation in the absence of significant alcohol consumption and other causes of secondary hepatic steatosis. Once diagnosed, the treatment of NAFLD is complex and often requires pharmacologic intervention to control associated risk factors and/or lifestyle modifications. Conflicting results on whether social or moderate alcohol consumption (MAC) is detrimental or beneficial leave physicians uncertain as to whether or not to apply tight restrictions or allow low levels of social alcohol use for potential health benefit.