Overview

• An NHANES-based study from Keck Medicine of USC found advanced liver fibrosis among heavy drinkers rose from 1.8% to 4.3% between 1999 and 2020 despite stable intake, with sharper increases in women, older adults, and people with metabolic syndrome.
• Non-heavy drinkers also saw a smaller rise in serious scarring (0.8% to 1.4%), while separate analyses report that even lower alcohol levels and binge episodes worsen MASLD and accelerate cirrhosis in hepatitis C.
• New mechanistic research explains why damaged livers may not recover after quitting alcohol, identifying disrupted RNA splicing and loss of the ESRP2 protein as blockers of regeneration, which points to potential anti-inflammatory or splicing-targeted therapies.
• Experts urge updated drinking thresholds, routine primary-care screening and brief interventions, and expanded treatment for alcohol use disorder, alongside population policies that raise prices, limit availability, and curb marketing.
• Clinicians advise practical steps to protect the liver: Mediterranean-style eating with olive oil, weight loss and regular exercise, several alcohol-free days each week, reduced sugar intake, and moderate coffee consumption linked to improved liver measures.