Obesity and alcohol, increasing numbers and serious consequences for the liver. Childhood obesity and alcoholism among the elderly are of concern in Italy
The liver of the Italians under observation. While for the epatiti virali there are more and more solutions to heal or to control pathologies, what today most worries about the health of the liver is the cirrhosis due to obesity and ad alcohol abuse, phenomena that worsened during the pandemic. Complications in terms of cardiovascular and hepatology are bound to cause consequences in the years to come. This is the alarm raised by hepatologist specialists during the 54th National Congress of theAISF – Italian Association for the Study of the Liver underway in Rome on 24 and 25 March.
Obesity: in Italy 25% are overweight and 12 are obese
The topic of nutrition is particularly relevant to the liver, which constitutes the metabolic control unit, the organ that allows you to receive all the substances acquired in meals and to sort them out in the body. Its crucial role goes into crisis if the organ is sick, a consequence that can occur if you do not follow a “healthy lifestyle” characterized by a Proper nutrition, moderate alcohol consumption and adequate physical activity. An excess diet accumulates fat in the liver, and in 5-10% of cases it can lead to liver cirrhosis: since in this historical period the subjects who accumulate fat are millions, the effects are also reflected on the epidemiology of diseases of the liver.
“In some Pacific States over 50% of the population is within the obesity range – underlines Prof. Giulio Marchesiniformerly Full Professor of Clinical Dietetics at theUniversity of Bologna – Italy is better off than other European countries, with about 12% of the population in the obesity range and 20-25% in the overweight range. However, ours is the second European country for childhood obesity and the projections for the future indicate that a child with obesity has an 80% chance of becoming an obese adult, with related complications and pathologies of a cardiological, hepatological and nephrological type. In fact, fat is localized in the abdomen, damaging the pancreas and liver: on the one hand it causes diabetes, on the other hand it causes liver damage that can lead to cirrhosis and in epatocarcinoma“.
“Moreover – adds Prof.ssa Manuela MerliFull Professor of Gastroenterology La Sapienza of Rome – when cirrhosis intervenes, a progressive malnutrition can develop which is also reflected on the body muscles, causing an early sarcopenia, which can lead a 40-year-old patient with severe cirrhosis to have a frailty similar to that of a 70-year-old. Malnutrition, frailty and sarcopenia must be tackled because they have negative effects on survival “.
Alcohol: increased consumption during the pandemic and the risks for young and old
In the pandemic period, according to the data PASSI d’Argento dell’Higher Institute of Health, 57% of adults aged 18-64 reported having consumed alcohol in the 30 days prior to the interview. Overall, 17% of the interviewees consumed alcohol at greater risk to health, in terms of quantity and method of consumption: 3% consumed it regularly, exceeding the average daily consumption thresholds indicated by international guidelines, 8% is a binge drinker and another 9% mainly consumed alcohol between meals.
The consumption of alcohol at risk remains a prerogative of the most socially advantaged classes, in terms of income or education, residing in the Northern Italy and it is greater among men. Furthermore, in 2020, the Monitoring System EARTHQUAKE of the ONA-ISSthe ISS elaborations of ISTAT Multipurpose data and the detection systems of the Ministry of Health found 8.6 million consumers at risk (22.9% male and 9.4% female) with an annual increase of 6.6% and 5.3%, respectively for the two genders.
The most vulnerable population targets are affected: minors (760 thousand) and the elderly (2 million 600 thousand) the most critical age groups. The increase in consumption among minors is very worrying: between 16 and 17 the frequency of at-risk consumers (40.5%) reaches that of male peers (43.8%); 10 out of 100 minors between 11 and 15 are at risk. The binge drinking with over 4 million consumers abused in 2020, 930 thousand between 11 and 25 years of age, with 120 thousand intoxicated minors.
“During the pandemic there was an increase in alcohol consumption as measured by sales, which led to an increase in hospitalizations for alcoholic hepatitis in the US and an increase in liver transplant cases for alcohol-related diseases in Northern Europe. Prof. Alessio AghemoSecretary AISF – In Italy we do not yet have updated data, but it is reasonable to assume that there will be a prolonged impact over time. The increase in complications will likely occur over the next 5-10 years, as these are not always acute, and sometimes take a long time to emerge. “
“Currently the quantities of alcohol that are not considered harmful in those with a healthy liver are respectively 3 units of alcohol in men and 2 in women during the day. One unit of alcohol corresponds to a glass of wine or a can of beer – he explains. Prof.ssa Manuela Merli Also, under the age of 18 you should not drink because the enzymes are not yet mature to metabolize alcohol. Even after the age of 65, these same enzymes undergo a reduction in activity, which suggests that even the elderly population should considerably moderate alcohol consumption. However, alcohol is more and more widespread among young people, sometimes through the phenomenon of binge drinking, for which it is not usually consumed, but on special occasions more than 5 alcoholic units are consumed in a few hours, causing an important toxic effect on the liver. , with the risk especially on the youngest of causing an ethyl coma “.