It’s not always how much you drink, but how and when

It’s true: Men hold their liquor better than women, at least when it comes to how much they can drink before hurting their livers.

New research has found that males can safely consume three drinks a day before their livers begin to show signs of potential damage, but the threshold for women is about two drinks a day.

Lead author Dr. Saverio Stranges, a research instructor in social and preventive medicine at the State University of New York at Buffalo, reported that the damage varied not only by gender, but also depended on how and when people drink.

“The way in which you consume can be more important than the amount,” he said.

Liver damage is a major consequence of alcohol use or abuse, accounting for more than half of the 27,000 U.S. deaths from liver diseases in 2001.

In the first research to link liver disease to drinking habits, Stranges and his colleagues studied 2,943 white residents of two upstate New York counties who were 35 to 80 years old and had no known liver diseases. The men and women answered questions about their drinking habits and underwent blood tests for concentrations of three enzymes released in larger quantities by damaged liver cells.

In the study, published in the June issue of the journal Alcoholism: Clinical & Experimental Research, scientists focused on the enzyme gamma-glutamyltransferase (GGT). Among men, levels were highest in daily drinkers; among women, weekend drinkers. Stranges speculated that women who confined their drinking to weekends might be imbibing more heavily at each drinking occasion and potentially causing more damage.

Women who drank on an empty stomach -- which increases absorption of alcohol -- had more GGT in their blood than women who drank with meals or snacks, even when everyone consumed comparable amounts of alcohol. Among men, food made no difference in enzyme levels.

Although researchers don’t know what’s behind the gender gap in liver damage associated with alcohol, Stranges said it might stem from metabolic differences between genders, or it might reflect the influence of the female reproductive hormone estrogen on liver function.

Stranges, a native of Italy, suggested that Americans might want to pay attention to the Mediterranean style of drinking. “In Europe, we tend to drink with food, and don’t go out just to have a drink,” he said. Women, he suggested, might want to be particularly conscious about eating when they have a drink.

The study was funded by the National Institute on Alcohol Abuse and Alcoholism.