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Rodrigues SG, van der Merwe S, Krag A, Wiest R. Gut-liver axis: Pathophysiological concepts and medical perspective in chronic liver diseases. Semin Immunol 2024; 71:101859. [PMID: 38219459 DOI: 10.1016/j.smim.2023.101859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/11/2023] [Accepted: 12/04/2023] [Indexed: 01/16/2024]
Affiliation(s)
- Susana G Rodrigues
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Schalk van der Merwe
- Department of Gastroenterology and Hepatology, University hospital Gasthuisberg, University of Leuven, Belgium
| | - Aleksander Krag
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark; Centre for Liver Research, Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark, University of Southern Denmark, Odense, Denmark
| | - Reiner Wiest
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland.
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Huang BH, Inan-Eroglu E, Shaban RZ, Hamer M, Britton A, Stamatakis E. Alcohol intake and mortality risk of COVID-19, pneumonia, and other infectious diseases: An analysis of 437191 UK biobank participants. Prev Med Rep 2022; 26:101751. [PMID: 35251915 PMCID: PMC8883723 DOI: 10.1016/j.pmedr.2022.101751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 02/23/2022] [Accepted: 02/26/2022] [Indexed: 11/17/2022] Open
Abstract
This study aims to investigate the association between alcohol consumption and COVID-19, infectious diseases, and pneumonia mortality. This is a prospective analysis of 437,191 UK Biobank participants (age 56.3 years, 54% female). The main exposure was self-reported alcohol consumption. In addition to never and previous drinkers, we applied quartiles-based and UK guidelines-based criteria to divide current drinkers by weekly consumption into four groups. Outcomes included COVID-19, infectious diseases, and pneumonia mortality, obtained from the national death registries until May 2020. After an 11-year follow-up, compared to never drinkers, previous drinkers had higher mortality risks of infectious diseases and pneumonia (adjusted HR: 1.29 [95% CI 1.06-1.57] and 1.35 [1.07-1.70], respectively), but not COVID-19. There was a curvilinear association of alcohol consumption with infectious diseases and pneumonia mortality. Drinking within-guidelines (<14 UK units/wk) and amounts up to double the recommendation (14 to < 28 UK units/wk) was associated with the lowest mortality risks of infectious diseases (0.70 [0.59-0.83] and 0.70 [0.59-0.83], respectively) and pneumonia (0.71 [0.58-0.87] and 0.72 [0.58-0.88], respectively). Alcohol consumption was associated with lower risks of COVID-19 mortality (e.g., drinking within-guidelines: 0.53 [0.33-0.86]). Drinkers reporting multiples of the recommended alcohol drinking amounts did not have higher mortality risks of COVID-19 and other infectious diseases than never drinkers. Despite the well-established unfavorable effects on general health, we found no deleterious associations between alcohol consumption and the risk of infectious diseases, including COVID-19. Future research with other study designs is needed to confirm the causality.
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Affiliation(s)
- Bo-Huei Huang
- Charles Perkins Centre, School of Health Sciences, the University of Sydney, New South Wales, Australia
| | - Elif Inan-Eroglu
- the Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, the University of Sydney, New South Wales, Australia
| | - Ramon Z. Shaban
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney and Western Sydney Local Health District, New South Wales Ministry of Health, New South Wales, Australia
| | - Mark Hamer
- Institute Sport Exercise & Health, Division of Surgery & Interventional Science, University College London, London, UK
| | - Annie Britton
- Institute of Epidemiology & Health Care, University College London, London, UK
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, the University of Sydney, New South Wales, Australia
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Zelber-Sagi S, Noureddin M, Shibolet O. Lifestyle and Hepatocellular Carcinoma What Is the Evidence and Prevention Recommendations. Cancers (Basel) 2021; 14:cancers14010103. [PMID: 35008267 PMCID: PMC8750465 DOI: 10.3390/cancers14010103] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 12/13/2022] Open
Abstract
Simple Summary The increasing public health burden of Hepatocellular carcinoma (HCC) emphasizes the importance of defining important modifiable risk factors. In the following review, we will discuss the evidence for the relation of major lifestyle risk factors, mostly from large population-based studies. Generally, it is has been shown that healthy lifestyle habits, including minimizing obesity, eating a healthy diet, avoidance of smoking and alcohol, and increasing physical activity, have the potential to prevent HCC. Dietary composition is important beyond obesity. Consumption of n-3 polyunsaturated fatty acids, as well as fish and poultry, vegetables and fiber, are inversely associated with HCC, while red meat, saturated fat, cholesterol and sugar are related to increased risk. Data from multiple studies clearly show a beneficial effect for physical activity in reducing the risk of HCC. Smoking and alcohol can lead to liver fibrosis and liver cancer and jointly lead to an even greater risk. Abstract The increasing burden of hepatocellular carcinoma (HCC) emphasizes the unmet need for primary prevention. Lifestyle measures appear to be important modifiable risk factors for HCC regardless of its etiology. Lifestyle patterns, as a whole and each component separately, are related to HCC risk. Dietary composition is important beyond obesity. Consumption of n-3 polyunsaturated fatty acids, as well as fish and poultry, are inversely associated with HCC, while red meat, saturated fat, and cholesterol are related to increased risk. Sugar consumption is associated with HCC risk, while fiber and vegetable intake is protective. Data from multiple studies clearly show a beneficial effect for physical activity in reducing the risk of HCC. However, the duration, mode and intensity of physical activity needed are yet to be determined. There is evidence that smoking can lead to liver fibrosis and liver cancer and has a synergistic effect with alcohol drinking. On the other hand, an excessive amount of alcohol by itself has been associated with increased risk of HCC directly (carcinogenic effect) or indirectly (liver fibrosis and cirrhosis progression. Large-scale intervention studies testing the effect of comprehensive lifestyle interventions on HCC prevention among diverse cohorts of liver disease patients are greatly warranted.
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Affiliation(s)
- Shira Zelber-Sagi
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel
- Department of Gastroenterology & Hepatology, Tel Aviv Medical Center, Tel Aviv 6423906, Israel;
- Correspondence: ; Tel.: +972-54-4634440; Fax: +972-3-5446086
| | - Mazen Noureddin
- Karsh Division of Gastroenterology and Hepatology, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA;
| | - Oren Shibolet
- Department of Gastroenterology & Hepatology, Tel Aviv Medical Center, Tel Aviv 6423906, Israel;
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6697801, Israel
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Prevention of NAFLD-associated HCC: Role of lifestyle and chemoprevention. J Hepatol 2021; 75:1217-1227. [PMID: 34339764 DOI: 10.1016/j.jhep.2021.07.025] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 02/07/2023]
Abstract
In many countries worldwide, the burden of hepatocellular carcinoma (HCC) associated with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) is increasing. Preventive strategies are needed to counteract this trend. In this review, we provide an overview of the evidence on preventive strategies in NAFLD-associated HCC. We consider the impact of lifestyle factors such as weight loss, physical activity, smoking, dietary patterns and food items, including coffee and alcohol, on both HCC and NAFLD/NASH. Furthermore, evidence on chemopreventive treatments, including aspirin, antidiabetic treatments and statins is summarised. The role of adjuvant therapies for tertiary prevention of HCC is briefly reviewed.
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Inan-Eroglu E, Powell L, Hamer M, O’Donovan G, Duncan MJ, Stamatakis E. Is There a Link between Different Types of Alcoholic Drinks and Obesity? An Analysis of 280,183 UK Biobank Participants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145178. [PMID: 32709071 PMCID: PMC7400254 DOI: 10.3390/ijerph17145178] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/11/2020] [Accepted: 07/13/2020] [Indexed: 02/06/2023]
Abstract
Understanding the associations between types of alcoholic drinks and adiposity has public health relevance, considering that adult overweight and obesity prevalence are increasing worldwide. We aimed to evaluate the association between overall alcohol consumption and types of alcohol drinks with markers of adiposity from the UK Biobank baseline data (n = 280,183, 48.3% female). Generalized linear models were used to examine the associations between alcohol consumption with body mass index (BMI) and body fat percentage. Those drinking within the public health guidelines had a lower BMI by 1.34 kg/m2 (95% CI 1.42, 1.26 kg/m2) compared to never drinkers. Association between alcohol consumption and body fat percentage were not statistically significant. Compared to those who never drink wines (red wine, champagne and fortified wine), drinkers of these alcoholic beverages had lower BMI (difference of -0.75 kg/m2, 95% CI -0.78, -0.72 kg/m2; -0.48 kg/m2, 95% CI -0.52, -0.45 kg/m2; and -0.24 kg/m2, 95% CI -0.29, -0.18 kg/m2, respectively). Beer and spirits drinkers had higher BMI compared to never drinkers of beer and spirits (difference of 0.18 kg/m2, 95% CI 0.14, 0.22 kg/m2 and 0.64 kg/m2, 95% CI 0.61, 0.68 kg/m2, respectively). Our data did not find a link between alcohol drinking and higher risk of obesity.
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Affiliation(s)
- Elif Inan-Eroglu
- The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Faculty of Medicine and Health, The University of Sydney, Sydney NSW 2050, Australia;
- Prevention Research Collaboration, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney NSW 2050, Australia;
| | - Lauren Powell
- Prevention Research Collaboration, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney NSW 2050, Australia;
| | - Mark Hamer
- Faculty of Medical Sciences, University College London, London WC1E 6BT, UK;
| | - Gary O’Donovan
- Facultad de Medicina, Universidad de los Andes, Bogotá 57, Colombia;
| | - Mitch J. Duncan
- School of Medicine & Public Health; Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan NSW 2308, Australia;
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan NSW 2308, Australia
| | - Emmanuel Stamatakis
- Prevention Research Collaboration, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney NSW 2050, Australia;
- Charles Perkins Centre Epidemiology Unit, The University of Sydney, Sydney NSW 2050, Australia
- Correspondence: ; Tel.: +61-2-86271867
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