Apr 05, 2026
3 min read
Many people believe that occasional drinking is bad if they drink less, but new research suggests that this notion may be wrong.A large study in the United States found that people with metabolic dysfunction-associated steatotic liver disease (MASLD), a condition that affects one in three adults, face a higher risk of severe liver disease if they drink more than once a month.
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- April 4, 2026
- University of Southern California - Health Sciences
- Many people think that sometimes drinking is simple if they drink in moderation, but new research shows that this assumption could be dangerously wrong.A large US study has found that people with metabolic dysfunction-related steatotic liver disease (MASLD), a condition that affects one in three adults, are at greater risk of developing severe liver damage if they drink too much alcohol once a month.
LOS ANGELES - People may assume that if they drink light during the week or month, having a heavy drink on Friday or Saturday may not harm their liver.
New research suggests otherwise, according to a USC Keck Medicine study published today in Clinical Gastroenterology and Hepatology.
People with metabolic dysfunction-related fatty liver disease (MASLD), the most common liver disease affecting one in three adults, are at increased risk of developing liver fibrosis, or harmful liver scarring, if they drink too much, scientists have found.Frequency of alcohol consumption is four or more drinks per day for women and five or more drinks per day for men at least once a month.
According to the results, people who drank heavy alcohol at least once a month were three times more likely to develop liver fibrosis than those who drank the same amount of alcohol over time.
Young adults and men were more likely to report drinking excessively, and those who drank more at one time were more likely to suffer from liver fibrosis.
"This study is a big wake-up call because traditionally, doctors have tended to look at the total amount of alcohol consumed rather than actual alcohol consumption when determining liver risk," said Brian P.Lee, MD, MAS, a hepatologist and liver transplant specialist at Keck Medicine and lead investigator of the study.
How the research is done
Lee and his colleagues used data from the nationally representative National Health and Nutrition Examination Survey, a longitudinal health survey of the US population.They included data on more than 8,000 adults collected between 2017 and 2023.In particular, they looked at the link between episodic heavy drinking and advanced liver fibrosis, and how drinking patterns — not just total drinks — can be harmful even for moderate drinkers, which is as much as seven drinks per week for women and women aged 14 or younger.
The research team looked at MASLD because of its prevalence among Americans.MASLD affects people who are overweight, obese or have other metabolic diseases, such as type 2 diabetes, high blood pressure or high cholesterol, and is on the rise.In addition, although MASLD has not been defined to affect alcohol measurements, Li and his colleagues wanted to determine whether alcohol actually acts on behavior.
More than half of the adults in the study reported drinking large amounts of alcohol on occasion, and almost 16% of MASLD patients drank occasionally.
Researchers compared people with MASLD of the same age, gender and average weekly alcohol consumption, classifying some as heavy drinkers and others as light drinkers, to conclude that drinkers with MASLD were almost three times more likely to experience liver fibrosis.
Lee hypothesizes that heavy episodic drinking can directly and indirectly harm the liver.Consuming large amounts of alcohol at once can depress the liver, increase inflammation, and lead to scarring and damage.People with MASLD are especially at risk, as Lee's previous research has shown that obesity, high blood pressure and other conditions associated with MASLD more than double the risk of liver disease.
According to Lee, alcohol-related liver disease has doubled in the past two decades.He believes the trend is driven by an increase in alcohol consumption during the pandemic era and an increase in people with risk factors for MASLD, such as obesity and diabetes.
"Although this study focused on patients with MASLD, these findings may apply to the general population," Lee said."Since more than half of adults report heavy drinking, this problem deserves attention from doctors and researchers to help understand, prevent and treat liver disease."
For more information about USC's Keck Medicine, please visit news.Keck Medicine.org.
The research was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism, grant number K23AA029752.
Materials provided by University of Southern California - Health Sciences.Note: Content may be edited for style and length.
- Yinan Su, Jennifer L. Dodge, Brian P. Lee.Episode drinking and implications for the nomenclature of steatotic liver disease: a national cross-sectional study.Clinical gastroenterology and hepatology, 2026;DOI: 10.1016/j.cgh.2026.03.004
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