Food, drinks and dilemma

▶ Liu B, Balkwill A, Reeves G, et al. Million Women Study Collaborators. Body mass index and risk of liver cirrhosis in middle aged UK women: prospective study. BMJ 2010;340:c912.

▶ Hart CL, Morrison DS, Batty GD, et al. Effect of body mass index and alcohol consumption on liver disease: analysis of data from two prospective cohort studies. BMJ 2010;340:c1240.

▶ Wang L, Lee IM, Manson JE, et al. Alcohol consumption, weight gain, and risk of becoming overweight in middle-aged and older women. Arch Intern Med 2010;170:453–61.

Obesity has become a considerable threat to public health worldwide. Hospitalisation and death from alcoholic liver disease have been increasing relentlessly in the UK. Recently, a few prospective cohort studies have investigated the interaction between these two factors.

Liu et al, analysed the data from the Million Women Study (1 230 662 women; mean age 56 years) followed for an average of 6.2 years. The authors found that the adjusted relative risk of cirrhosis increased by 28% for every 5 unit increase in body mass index (BMI). Among women who reported drinking less than 70 g alcohol per week, the absolute risk of liver cirrhosis over 5 years was 0.8 (0.7–0.9) per 1000 women for those with a BMI of 22.5–25 and 1.0 (0.9–1.2) for those with a BMI of 30 or more. Among women who reported drinking 150 g alcohol or more per week, the corresponding figures were 2.7 (2.1–3.4) and 5.0 (3.8–6.6). The authors estimated that 17% of incident or fatal liver cirrhosis is attributable to excess …