Nonalcoholic fatty liver disease (NAFLD), once considered a benign condition, has been associated with several cardiometabolic complications over the past two decades. The worldwide prevalence of NAFLD is as high as 30%. NAFLD requires the absence of a "significant alcohol intake." Conflicting reports have suggested that moderate alcohol consumption may be protective; therefore, the diagnosis of NAFLD previously relied on negative criteria. However, there has been a significant increase in alcohol consumption globally. Apart from the rise in alcohol-related liver disease (ARLD), alcohol, a major toxin, is associated with an increased risk of several cancers, including hepatocellular carcinoma. Alcohol misuse is a significant contributor to disability-adjusted life years. Recently, the term metabolic dysfunction-associated fatty liver disease (MAFLD) was proposed instead of NAFLD to include the metabolic dysfunction responsible for the major adverse outcomes in patients with fatty liver disease. MAFLD, dependent on the "positive diagnostic criteria" rather than previous exclusion criteria, may identify individuals with poor metabolic health and aid in managing patients at increased risk of all-cause and cardiovascular mortality. Although MAFLD is less stigmatizing than NAFLD, excluding alcohol intake may increase the risk of already existing underreported alcohol consumption in this subgroup of patients. Therefore, alcohol consumption may increase the prevalence of fatty liver disease and its associated complications in patients with MAFLD. This review discusses the effects of alcohol intake and MAFLD on fatty liver disease.
This paper provides an overview of the drinking survey experiences from majority of European countries. The main aim of this report is to summarise existing alcohol survey experiences identified in the course of study. The review of European surveys was based on data collected across Europe using questionnaire targeting European alcohol researches.The data were collected from 22 countries constituting 73% ofthe originally targeted sample and they cover 43 surveys.The review shows a low degree of uniformity across European surveys, as regardssampling, methods of administration as well as age ranges, and especially in relation to alcohol consumption measures both within and between countries. Various instruments to measure alcohol consumption, risky drinking, dependence/abuse, negative social consequences and harm to third parties are used across Europe. Even the terminology is not uniformed.This review identified most important areas of priority towards tandardization of alcohol measures across Europe including definitions of indicators and sampling standards.