MANILA -- "Drink responsibly" or "Drink moderately" no more?

A health expert is promoting "abstinence" from alcohol to combat liver diseases.

For Dr. Angelo Lozada, vice president of the Hepatology Society of the Philippines, "there is really no safe limit of alcohol consumption," based on recent studies.

"Alcohol consumption has been shown to accelerate or cause liver disease, so talagang wala nang safe limits," Lozada said Wednesday during a forum of the Department of Health (DOH).

"Kami, from the Hepatology Society of the Philippines, we really advocate abstinence from alcohol. Dati kasi may mga safe limits pa tayong tinatawag. Thirty grams for men, and 20 grams for women a day. To put it into perspective, parang ang 10 grams of alcohol is equivalent to one bottle of beer. So parang sinasabi natin, three bottles of beer for men and two bottles of beer for women are safe drinking limit," he added.

But why did Lozada's group veer away from the so-called safe drinking limit?

"Kasi, from recent studies, even those who consume lesser amounts of alcohol still have potential risk for developing alcohol-related diseases. So talagang sa alcohol, avoid as much as possible," he explained.

Lozada said data show an estimated 40 percent prevalence of alcoholic liver disease in the Philippines, with "around 21.1 deaths per 100,000 men, mostly common siya sa males."

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'HEPATITIS A' IN STREET FOOD?

Lozada also warned the public against eating street food, which "can be full of fat and be really unhealthy."

"Consumption of food that is high fat, high fructose, high sugar can lead to accelerated development of fatty liver. Not just fatty liver, [but] other metabolic diseases -- hypertension, diabetes, dyslipidemia, bad cholesterol," Lozada explained.

"Avoidance of these certain food products would help curb development of not just fatty liver, but also the development of these particular metabolic diseases," he added.

Lozada explained that eating poorly prepared food may also put people at risk for hepatitis A--a communicable hygiene-related disease.

"Iyong food na hindi well-prepared, hindi malinis, so a person who has hepatitis A, pwede niyang ma-transfer iyong hepatitis A doon sa pagkain. Kasi ang transmission ng hepatitis A is fecal-oral route. So a person with hepatitis A iyong shedding ng virus is through the feces. So iyong feces may go to anywhere, for example water source, iyong hygiene practices hindi maayos," he shared.

"Commonly sa mga street food siya associated, kasi street food are also associated with being not very hygienically prepared. But of course, you can get hepatitis A from anywhere. Basta hindi hygienic iyong pagka-prepare ng food or may source of hepatitis A," he added.

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LIVER DISEASES

There are 325 million people living with chronic hepatitis infection, which pertains to either hepatitis B or C, based on data from the World Health Organization (WHO) cited by Lozada.

Deaths reach close to 100 million, most of them caused by hepatitis B.

"These are mostly related to deaths from either liver cirrhosis, which is a complication of viral hepatitis, or iyong dreaded complication din ng liver cirrhosis, which is hepatocellular carcinoma or liver cancer," Lozada explained.

The health expert said that in the Philippines, 11,569 die daily because of hepatitis B.

The country is also among those with a "high prevalence" and an "endemic" of hepatitis B because more than 8 percent of the total population is estimated to have the disease.

"Merong one out of six Filipinos who are estimated to be living with hepatitis B... Based on the study of Dr. Ong, which is a local study that was done in 2013, merong estimated na around 17 percent ng adult Filipinos are estimated to have hepatitis B... In 2017, the prevalence estimate of the general population [is] 9.7 [percent], representing 10 million chronic infections," Lozada explained.

"There's an estimated projection of increase in terms of decompensated liver cirrhosis, which is iyong complication ng hepatitis B, at saka iyong incidence of liver cancer. Iyong 10-year projection is estimated to increase by 20 to 30 percent kung hindi tayo mag-aaksyon... at the present time... Between males and females, there's really no difference by age as well as by sex," he added.

Lozada said some pregnant women also have hepatitis B, which they may transmit to their children.

He estimates screening, initial evaluation, and treatment costs with medication at the range of over P8,000 to as much as over P73,000, depending on whether patients go to public or private hospitals.

Liver transplants are at P2 million to P5 million, depending on the hospital. Subsequent medications range from P300,000 to P600,000 per year.

In 2016, Lozada said there were an estimated six liver transplants conducted.

Meanwhile, the health expert's data show hepatitis C has a lower prevalence in the country at 0.94 percent, while fatty liver's prevalence is at 10 to 19.9 percent.

Hepatocellular carcinoma or liver cancer is the sixth most common diagnosed cancer and the third most common cause of death from cancer worldwide, based on the 2020 Global Cancer Observatory (GLOBOCAN).

"In the Philippines, we're not very different kasi [liver cancer is the] fourth most common cancer and it's the second most common cause of cancer deaths... Mas mataas talaga ang mortality ng liver cancer compared to other cancers because of the complexity as well as iyong cost of treating it," Lozada said.

"Liver diseases are a major public health concern kasi it really causes significant morbidity, so iyong decrease ng quality of life, as well as iyong pagkamatay or mortality, kasi iyong disease burden niya sobrang taas," he added.

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