How do binge eating and drinking impact the liver?

• A new study simulated the food and alcohol consumption typical of so-called tailgate parties to assess how binge eating and drinking are likely to impact the body.
• The researchers found that, both during and the day after the simulated “party,” participants presented with increased levels of lipogenesis, or fat formation.
• Levels of liver fat differed greatly between participants after the experiment, leading the authors to hypothesize that the amount of carbohydrates consumed by each participant may have an important role to play.

A recent study that simulated a tailgate party found that eating foods high in carbohydrates while consuming relatively lower amounts of alcohol was associated with increased liver fat.

“Tailgating” refers to a social gathering where people serve and eat food from the back of a parked vehicle, often in the car park of a sports stadium.

Although this tradition has not been possible during the pandemic, some have continued the tradition virtually.

While tailgating can energize fans, it can also lead to excess eating and drinking, negatively affecting a person’s health. The Centers for Disease Control and Prevention (CDC) recommend not drinking, or sticking to two alcoholic drinks or fewer a day for males.

To study the effects of overconsumption on the body, researchers from the University of Missouri studied bodily changes after a tailgate party. Their results appear in the journal Alcohol.

Eligibility criteria

The researchers had several criteria for inclusion in the study. They focused on males aged 21–52 years with a sedentary lifestyle, which involved fewer than 3 hours of aerobic exercise per week.

The participants all had overweight or obesity, with body mass indexes (BMIs) of between 25.1 and 51 kilograms per square meter, and a waist circumference of fewer than 55 inches.

Participants were nonsmokers, did not have diabetes, and had no preexisting thyroid or kidney conditions.

For safety reasons, participants needed to report greater than moderate alcohol consumption, which the study defined as consuming alcohol regularly in the past year.

However, people who drank heavily, such as more than 16 alcoholic beverages a week, were excluded from the study.

A total of 18 males completed the research study.

Replicating a tailgate in the lab

To prepare for the tailgate experiment, the researchers instructed the participants to swallow deuterium oxide, also known as heavy water, twice daily for 3 days before starting the study.

This allowed the scientists to assess rates of lipogenesis, the metabolic process of forming fat.

The scientists also told the participants to follow their regular diet but avoid alcohol the night before the study.

On the morning of the simulated tailgate, scientists checked each participant’s vital signs. They then took blood samples before providing them with a light breakfast.

The researchers also used dual-energy X-ray absorptiometry to measure body composition.

Around 11:00 a.m., researchers took another blood sample and then encouraged participants to eat and drink for the next 5 hours. The foods ranged from hamburgers to cupcakes. The team collected blood samples every hour and measured participants’ breath alcohol content every 30 minutes to ensure they reached the desired level of intoxication.

In addition, 14 of the 18 participants underwent magnetic resonance spectroscopy (MRS) of the liver. This allowed the researchers to glimpse the level of fat in the liver.

After the 5-hour experiment, the participants stayed overnight in the research center. The scientists took a final blood sample in the morning, and each participant was given breakfast and discharged once their breath alcohol content was zero.

Individual responses

Before the experiment, 8 of the 18 participants kept a food diary for 3 days, which showed an average intake of 2,748 kilocalories (kcal) each day. On game day, people ate well beyond this, consuming an average of 5,087 kcal.

When broken down into food groups, 32% of the total calories consumed came from carbohydrates, 35% from fat, 10% from protein, and 23% from alcohol.

Alcohol consumption resulted in an average breath alcohol content level of 0.08 — meaning participants were legally intoxicated in the United States.

When looking at changes in the body, the group showed a higher level of plasma insulin after eating and drinking. Lipogenesis also increased, but overall, the group showed no changes to liver fat.

“Interestingly, in the present group as a whole, only the amount of alcohol consumed during [the 5 hours of eating and drinking] was found to be significantly related to the increase in percent [lipogenesis],” write the authors.

However, when looking at each participant who completed the MRS scan, they found different responses.

“Surprisingly, we found that in overweight males, after an extended duration of eating and drinking, metabolic responses were not uniform and revealed significant individual variation in the ability to protect the liver from nutrient toxicity,” the authors write.

Nine participants showed increased liver fat, five participants showed lower liver fat, and one participant experienced no changes.

The individual responses prompted the researchers to divide participants into two groups based on liver fat changes. Those with lower liver fat were less likely to have gained their calories from food and needed more alcohol to reach the specified breath alcohol range.

Lipogenesis was the only predictor of the differences in liver fat between the two groups.

“A potential explanation of these findings is that high carbohydrate consumption may have a greater impact on liver fat than alcohol in some people,” says corresponding author Dr. Elizabeth Parks.

“Given the high prevalence of overconsumption of food and alcohol in the U.S., further studies are needed in a larger population. Our goal is to understand differences between people in how they respond to excess food and alcohol. It may be that limiting meal carbohydrates may protect the liver.”

– Dr. Elizabeth Parks

Study limitations

A major limitation of the study was that it only included males. Not including females excludes a good portion of people that go tailgating.

Including females in the data analysis may have affected the results, as alcohol is processed differently in females than males. According to the National Institute on Alcohol Abuse and Alcoholism, females have proportionally less water in their bodies, leading to higher blood alcohol levels following drinking.

As a result, females may become more intoxicated than males who consumed the same amount of alcohol.

Also, due to safety concerns, the researchers regulated how much participants could drink during the tailgating simulation. The authors acknowledge this may not reflect drinking behavior at tailgate parties.

For instance, a survey by the American Addiction Centers found that people watching American football consumed between 6.2 and 8.4 alcoholic drinks on average, well above the level that would result in legal intoxication, with the highest number of drinks consumed in the stadium parking lot.

The researchers wanted to understand the effects of excessive food and drink consumption, using a protocol that mimicked real-life. However, there are no prior academic studies that show the average food and alcohol intake of spectators before and after sporting events.

Also, there is a possibility that the researchers’ interpretation of excess eating was no different from the average diet of an individual participant.

Link between carbohydrates and liver fat?

The researchers’ findings suggest that where participants received their calories from influenced liver fat production.

Eating many carbohydrates appeared to have a greater impact than other food groups and alcohol on increasing liver fat.

“Given the high prevalence of overconsumption of food and alcohol in the U.S., further studies are warranted to understand better the interactions between personal consumption habits and individual metabolic variation in handling excess nutrients,” conclude the authors.

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