Abstract
With the global increase in alcohol consumption, the incidence of alcohol-associated liver disease (ALD) is rising significantly. However, not all individuals who consume alcohol develop ALD, suggesting the influence of various mediating factors. While sex, age, and genetic predisposition have been widely studied, the impact of drinking patterns as direct behavioral factors remains underexplored. We introduce the concept of "drinking pattern", which refers to the behavioral characteristics and habits exhibited by an individual during alcohol consumption. An important research question arises: Are there healthier drinking patterns that could help prevent the onset of ALD or potentially slow its progression in individuals already affected by the condition? This narrative review synthesizes existing evidence on how distinct drinking patterns, including alcohol consumption amount, drinking speed, frequency, duration, type of alcoholic beverage, and whether alcohol is consumed with meals, influence the onset and progression of ALD. Current research suggests that lower alcohol consumption, slower drinking speed, reduced drinking frequency, shorter drinking duration, choosing fermented alcohol over distilled liquor, and consuming alcohol with meals can mitigate ALD. Nevertheless, alcohol abstinence remains the most effective strategy for preventing and managing ALD. The findings offer actionable clinical insights, providing evidence-based recommendations to guide clinical practice and public health initiatives for minimizing ALD. Future research should focus on elucidating the underlying mechanisms of these patterns and assessing their long-term implications to develop targeted interventions.