LIVER HEALTH IS OVERLOOKED BY ALCOHOL DRINKERS IN BRAZIL

•A cross-sectional survey was conducted to evaluate the frequency of consumption of alcoholic beverages and behaviors concerning liver diseases in Brazil.

•There is a high frequency of alcohol consumption, especially among young people and individuals from lower social classes, with frequent consumption among women.

•Despite the knowledge of its adverse impact on liver health, less than half of the Brazilians have been evaluated at least once for liver diseases.

ABSTRACT

Background:

Chronic excessive use of alcohol is an important risk factor for several health and social conditions.

Methods:

A cross-sectional survey, in a sample representative of the Brazilian population,was conducted to evaluate the frequency of consumption of alcoholic beverages and behaviors concerning liver diseases. Participants were prospectively interviewed using a questionnaire regarding alcohol consumption and actions toward liver health. The study accepted at most one sampling error of ±2 percentage points and considered a 95% confidence interval.

Results:

One thousand nine hundred ninety-five subjects (1.048 women, mean age 44 years) from all Brazilian regions were interviewed. Most of the Brazilian subjects believe that alcohol abuse (63-87%) is the leading cause of cirrhosis and liver cancer, however, most responders (56%) had never been screened to assess liver damage related to alcohol consumption. A total of 55% of Brazilians drink alcoholic beverages. Among Brazilians who drink alcoholic beverages, 44% consume three or more drinks at a time, 11% consume more than 10 doses a day. Among those who consume 1 to 2 drinks a day, women (42%) consume more than men (32%) and more than the national average (37%).

Conclusion:

There is a high frequency of alcohol consumption, especially among young people, and individuals from lower social classes, with frequent consumption among women. Despite the knowledge of its adverse impact on liver health, less than half of the Brazilians have been evaluated at least once for liver disease. Education and prevention strategies need to be implemented to reduce theharmful use of alcohol.

Keywords:
Harmful use of alcohol; prevention; cirrhosis

	All participants
	Unweighted	Weighted (%)
Gender
Male	947	945	(47)
Female	1.048	1.050	(53)
Age (years)
18 to 24	297	275	(14)
25 to 34	412	396	(20)
35 to 44	391	399	(20)
45 to 59	505	499	(25)
60 or more	390	427	(21)
Geographical region
South	299	302	(15)
Southeast	848	873	(44)
Middle West	163	155	(8)
Northeast	524	510	(26)
North	161	155	(8)
Education level
Elementary school	625	666	(33)
High school	964	889	(45)
Higher education	406	441	(22)
Socioeconomic class
A/ B	493	487	(24)
C	965	935	(47)
D/ E	537	574	(29)
Place of living
Metropolitan area of state capitals	877	832	(42)
Countryside small cities	1.118	1.163	(58)
EAP
Yes	1.447	1.426	(71)
No	548	570	(29)
Alcohol consumption
Yes	1.096	1.093	(55)
No	899	903	(45)
Alcohol consumption (drinks per day)
Up to two	398	403	(20)
More than two	685	677	(34)

	n	None	Once per month	2-4 times per month	Once per week	2 to 3 times per week	≥4 times per week
Total	1995	45	17	6	15	12	5
Gender
Male	947	37	14	7	18*	17	8*
Female	1048	53*	19*	6	13	8	2
Age (years)
18 to 24	297	33	18	10	19*	16	4
25 to 34	412	34	21	9	17*	15	5
35 to 44	391	41	19	5	16*	15	4
45 to 59	505	48	13	6	16*	10	6
60 or more	390	63*	13	3	9	7	4
Education level
Elementary school	625	55*	11	5	13	10	6
High school	964	41	17*	7	18*	13	4
Higher education	406	38	23*	8	13	14	4
Place of living
Metropolitan region of state capitals	877	44	19	6	15	12	4
Countryside	1118	46	15	6	15	13	5
Geographical region
Southeast	848	43	18	6	13	14	5
South	299	39	16	5	21	14	5
Northeast	524	51	15	6	15	9	4
Middle West	163	48	15	8	14	9	5
North	161	46	16	8	17	10	3
EAP
Yes	1447	40	17	7	17*	14*	5
No	548	59*	15	5	11	7	4
Socioeconomic class
A/B	493	34	19	7	16	16*	7*
C	965	45	17	6	16	12	4
D/E	537	55*	14	6	13	8	4
Alcohol consumption
Yes	1096	-	30	11	28	22	9
No	899	100	-	-	-	-	-
Alcohol consumption (drinks per day)
1 to 2	398	-	41*	11	28	15	5
>2	685	-	24	12	28	27*	10*

n	n	<2	3-4	5-6	7-9	> 10	Undefined	Do not know
Total	1083	37	18	10	5	11	18	1
Gender
Male	591	32	18	11	6	14	17	1
Female	492	42*	18	9	4	7	18	2
Age (years)
18 to 24	195	34	19	10	6	11	20	1
25 to 34	266	33	19	11	5	12	19	1
35 to 44	225	29	19	12	6	13	20	1
45 to 59	253	41	15	11	5	11	15	2
60 or more	144	52*	18	5	2	5	17	1
Education level
Elementary school	274	38	16	9	4	16*	17	1
High School	558	33*	20	10*	6	10	20	1
Higher education	251	43	17	12	5	6	16	1
Place of living
Metropolitan region of state capitals	493	38	19	12*	4	11	15	1
Countryside	590	36	18	9	6*	10	20*	1
Geographical region
Southeast	479	39	20	11	5	8	15	1
South	173	48*	20	9	2	8	10	3
Northeast	259	27	14	10	5	14	29	1
Middle West	87	31	21	15	5	16	11	1
North	85	31	12	9	10	16	22	-
EAP
Yes	1447	34	18	11*	6*	11	18	1
No	548	46*	17	7	2	9	17	1
Socioeconomic class
A/B	318	37*	24*	13	5	6	12	2
C	529	40*	17	9	4	10*	20*	1
D/E	236	31	13	10	6	18*	21*	1

Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. Rua Dr. Seng, 320, 01331-020 São Paulo - SP Brasil, Tel./Fax: +55 11 3147-6227 - São Paulo - SP - Brazil
E-mail: secretariaarqgastr@hospitaligesp.com.br

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[1] Corresponding author: Liana Codes. E-mail: lianacodes@uol.com.br