Eating well and exercising can slash the risk of dying from alcohol–related liver disease – even for heavy drinkers, according to a major new study.
Scientists analysing records from 60,000 adults found that a healthy diet and regular activity dramatically cut alcohol-related liver deaths, with the greatest benefits seen in those at high risk.
The research, published in the Journal of Hepatology, shows that heavy drinks who made these simple tweaks were 86 per cent less likely to die of liver disease, compared with those who had unhealthy lifestyles.
Heavy drinkers – defined as men having more than 14 drinks a week (around 24 UK units) or women more than seven (12 units) – cut their risk by 36 per cent if they exercised regularly.
For binge drinkers – defined as five drinks in one sitting for men or four for women – healthy eating slashed liver death risk by 84 per cent, while exercise cut it by 69 per cent.
UK health chiefs advise no more than 14 units a week for both men and women, spread over several days.
Lead investigator Professor Naga Chalasani, a liver specialist at Indiana University School of Medicine, said: ‘We found that adherence to high levels of physical activity and/or diet quality was associated with a lower risk of liver–related death across all drinking patterns.’
The team linked long–term US survey data – the National Health and Nutrition Examination Survey – with national death records.
Eating well and exercising can slash the risk of dying from alcohol–related liver disease – even for heavy drinkers, according to a major new study
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Participants were categorised as light, moderate or heavy drinkers, and their diets were scored using the Healthy Eating Index.
Exercise was assessed from self–reported activity levels.
They found that while any amount of alcohol, including low–level daily drinking, raised the risk of dying from liver disease, lifestyle changes could significantly offset the danger.
Women were found to be especially vulnerable: they face a greater risk of alcohol–related liver damage than men, but also gained the strongest protective effect from diet and exercise.
The protective diet identified in the study is similar to the Mediterranean diet, rich in vegetables, fruit, wholegrains, seafood, plant proteins and healthy fats such as olive oil, while cutting back on processed foods, sugar and saturated fats.
Exercise did not need to be extreme – the benefits were seen in people who achieved recommended weekly activity levels, equivalent to around 150 minutes of moderate exercise.
The researchers stressed that the safest option for liver health remains cutting down alcohol itself. But for those who continue to drink, eating better and being active can still make a critical difference.
The findings come against a backdrop of rising liver disease deaths. In the US, excessive alcohol kills around 178,000 people every year.
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In Britain, deaths linked to alcohol hit record highs during and after the Covid pandemic, with rates more than doubling since 2001.
The UK’s Office for National Statistics recorded nearly 10,000 alcohol–specific deaths in 2022 – the majority from liver disease.
Charities have repeatedly warned that middle–aged drinkers are at greatest risk, particularly those in deprived areas where poor diet and low activity are also more common.
The new study confirmed that people from economically disadvantaged backgrounds are most at risk of dying from alcohol–related liver disease, due to the combined impact of heavy drinking, unhealthy eating and lack of exercise.
Professor Chalasani said the findings should change how doctors talk to patients about alcohol.
‘Our study offers a more nuanced and complete view of the risks of drinking,’ he said.
Health experts say the research does not give drinkers a free pass but shows there are meaningful steps people can take if they are worried about their alcohol intake.
Public health officials are increasingly concerned about the burden of liver disease on the NHS.
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Hospital admissions for alcohol–related liver damage have been rising steadily, with treatment costs running into hundreds of millions of pounds a year.
Specialists say more emphasis must now be put on lifestyle advice alongside warnings about alcohol.
Better diet and activity levels are seen as achievable changes that can be promoted even among people who struggle to cut down their drinking.
The researchers said their work highlights the need for joined–up policies addressing alcohol, diet and physical activity together, rather than treating them in isolation.