Diet may modify the effect of alcohol consumption on chronic liver diseases and liver cirrhosis mortality – the Lifestyle and Mortality (LIMOR) study

Abstract

Introduction: Some laboratory evidence suggested that fruit, vegetable carbohydrate and animal protein may modify the effect of alcohol on liver cirrhosis but few epidemiological studies have investigated such interaction. Methods: This case-control study collected past lifestyle and demographic data from proxy informants (relatives) of the deceased (cases) and of living controls in all 4 death registries in Hong Kong in 1998. Causes of death were provided by Department of Health. This analysis included 339 deaths from chronic liver diseases or liver cirrhosis (ICD-9 571) and 13115 controls. The mortality odd ratios (ORs) due to alcohol consumption were calculated using logistic regression adjusting for demographic, lifestyle, and dietary intakes. Interaction between diet and alcohol was estimated by interaction terms and stratification analysis. Results: Compared with never and light drinkers (ethanol intake <168g/week in men or <112g/week in women), moderate and heavy drinkers (ethanol intake >=168g/week in men or >=112g/week in women) were associated with higher mortality OR (95% CI) of 3.89(2.74-5.50). Dietary intakes (fruit, vegetable, meat, fish and soy products) interacted with alcohol on the mortality (P<0.001). Among moderate and heavy drinkers, lower intake (<4 times/week) of fruit, vegetable, meat, fish and soy products produced higher mortality ORs (95% CI) of 6.03(3.15-11.56), 43.98(4.06-476.84), 7.30(2.30-23.11), 7.42(2.27-24.28) and 4.24(2.92-6.17), respectively. The corresponding mortality ORs for frequent intake (>=4 times/week) of these items were 3.49(2.28-5.34), 3.76(2.62-5.39), 3.78(2.61-5.47), 3.73(2.58-5.38) and 2.45(0.92-6.50). Conclusion: Frequent intake of fruit, vegetable, meat, fish and soy may lower the risk of alcohol drinking on chronic liver disease and cirrhosis mortality.