Alcohol-related liver disease has more than doubled in the U.S. over the last 20 years.
The increase is tied to four groups that make up a greater share of heavy drinkers than they did two decades ago: Women, adults ages 45 and older, people living in poverty, and those with metabolic syndrome. Metabolic syndrome refers to a number of conditions, including high blood pressure, blood sugar, and cholesterol, that increase the risk of heart disease, stroke and type 2 diabetes.
Exactly why these groups are drinking more remains unclear. Vanderbilt University School of Medicine’s Dr. Peter Martin previously told NBC News that “it’s become more and more socially acceptable for women to drink as much as men” and George Koob, director of the National Institute on Alcohol Abuse and Alcoholism, told The New York Times that he believed older Americans are even less “likely” to understand the hazards of alcohol.
“Alcohol-related liver disease is the main cause of liver-related death and these results are a major wakeup call to the dangers of drinking,” researcher Dr. Brian Lee, a hepatologist and liver transplant specialist at Keck Medicine of the University of Southern California, said in a statement after the new study published Wednesday.
The findings, Lee said, provide the first comprehensive look at the demographics of heavy drinking and their relation to liver disease since the 1990s.
Because the average drinking rate in the U.S. was unchanged over the last 20 years - outside of the pandemic - it suggested factors such as changing health and demographics may be playing a role.
The researchers analyzed data from the National Health and Nutrition Examination Survey of adults and children in the U.S. from 1999 through 2020.
They tracked the total increase in significant liver disease, a point when scar tissue impairs the organ’s function, often caused by heavy drinking. More than 51,600 adults died from liver disease in 2020 in the U.S.
The researchers looked at the demographic and health profiles of adults, age 20 or older, who drank heavily - eight drinks per week for women and 15 for men, according to the Centers for Disease Control and Prevention. Previous research had tied the four groups looked at in this study to a higher risk of liver disease when exposed to alcohol.
A separate 2024 study, authored by Lee, found that heavy drinking rose at the pandemic’s peak and continued for two years after that. Lee hypothesized that increase may have been due to stress.
Liver disease deaths have also roughly doubled over the last 20 years, and the number of annual alcohol deaths due to cancer has doubled in the same time period.
Lee believes the results will help to provide doctors with necessary updates to better treat patients and potentially result in more screenings and interventions for Americans in high-risk populations.
“Our results show that the makeup of the American public with heavy alcohol consumption has changed compared to 20 years ago,” he said.
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