​July 13 2016
Three health benefits of coffee

2015
Nov 15
Can Coffee Help Cut Risk of HCC Recurrence?
By Bryant Furlow 
Coffee consumption might reduce the risk of hepatocellular carcinoma (HCC) recurrence and improve survival following orthotopic liver transplantation (OLT), suggest study findings reported at the The Liver Meeting® 2015.

Nov 10
Coffee Consumption Decreases Risks for Hepatic Fibrosis and Cirrhosis: A Meta-Analysis
Previous studies have demonstrated that coffee consumption may be inversely correlated with hepatic fibrosis and cirrhosis. However, the reported results have been inconsistent. To summarize previous evidences quantitatively, a meta-analysis was performed.

Oct 5
Health Benefits of Tea? Here’s What the Evidence Says
After my Upshot column on the potential health benefits of coffee, the No. 1 request I got was to look into the potential benefits — or harms — of tea.

Oct 4
Oily fish, coffee and walnuts: Dietary treatment for nonalcoholic fatty liver disease
World J Gastroenterol 2015 October 7; 21(37): 10621-10635
Rates of non-alcoholic fatty liver disease (NAFLD) are increasing worldwide in tandem with the metabolic syndrome, with the progressive form of disease, non-alcoholic steatohepatitis (NASH) likely to become the most common cause of end stage liver disease in the not too distant future. Lifestyle modification and weight loss remain the main focus of management in NAFLD and NASH, however, there has been growing interest in the benefit of specific foods and dietary components on disease progression, with some foods showing protective properties. This article provides an overview of the foods that show the most promise and their potential benefits in NAFLD/NASH, specifically; oily fish/ fish oil, coffee, nuts, tea, red wine, avocado and olive oil.
Full Text Available @ World J Gastroenterol 

Sept 17
Caffeine Decreases Risk of Hepatic Fibrosis in Male HCV Patients
In a cross-sectional study, researchers found that coffee and caffeine were associated with a decreased risk of developing advanced hepatic fibrosis among a majority of male veterans with hepatitis C virus infection, according to study data.

Aug 22
Coffee consumption reduces the risk of gallstone disease
The latest issue of the Alimentary Pharmacology & Therapeutics investigates the association and dose–response of coffee consumption with gallstone disease.
Full Story

Aug 7 
Coffee reduces the risk of hepatic fibrosis in Hep C
Clinical Gastroenterology & Hepatology
August 2015 Volume 13, Issue 8, Pages 1521–1531.e3 
2015 Aug;13(8):1521-1531.e3. doi: 10.1016/j.cgh.2015.01.030
Coffee and caffeine are associated with decreased risk of advanced hepatic fibrosis among patients with Hepatitis C, reports the latest issue of the Clinical Gastroenterology & Hepatology.

Coffee or caffeine has been proposed to protect against hepatic fibrosis, but few data are available on their effects in patients with chronic hepatitis C virus (HCV) infection.

Dr Hashem El-Serag and colleagues from Texas, USA conducted a cross-sectional study of veterans with chronic HCV infection to evaluate the association between daily intake of caffeinated and decaffeinated coffee, tea, and soda, and level of hepatic fibrosis, based on the FibroSURE test.....

June 7 
Hepatitis C Resource Center Blog - Coffee Decreases HCV Advanced Fibrosis Risk
New study indicates that an average daily intake of an estimated 100 mg of caffeine from coffee, tea, or soda is associated with an approximately one-third reduction in odds of advanced fibrosis, although higher intake does not seem to confer any additional benefit. Interestingly, tea intake in those who do not consume coffee may also be associated with a decreased risk of advanced fibrosis. Study authors noted an average of 100 mg or more of caffeine daily from sodas and teas does not have the same protective effect as 100 mg or more of caffeine daily from combined sources (coffee, tea, soda) or from coffee alone, suggesting that caffeine alone may not entirely explain the effect of coffee on liver disease.
Continue reading...

May 24
ASSOCIATION OF CAFFEINE INTAKE AND LIVER FIBROSIS IN PATIENTS WITH CHRONIC HEPATITIS C 
Kalinca da Silva OLIVEIRA1 , Caroline BUSS² and Cristiane Valle TOVO1,3
DOI: 10.1590/S0004-28032015000100002

DISCUSSION Only
Full Text: PDF Download
The data in this study demonstrated an inverse relationship between caffeine intake and liver fibrosis, but no association with inflammatory activity was observed. Several studies in the literature have suggested the beneficial effect of coffee among individuals with chronic liver disease(5, 8, 13, 17, 29, 35), identifying an inverse association between inflammatory activity, fibrosis and caffeine consumption(22. 31). 

So far, no one knows for sure if coffee affects spontaneous HCV seroconversion or the response to HCV therapy among chronically-infected patients(28). Metabolic effects of caffeine responsible for liver protection are uncertain and it is suggested that an antioxidant effect could be beneficial(15). In the present study, no association between inflammatory activity and caffeine was observed. 

These findings are corroborated by the study of Modi et al.(22), which also found no association between inflammatory activity and caffeine. As for the progression of fibrosis it has been suggested that increasing intake of coffee is associated with a lower risk of advanced(23) fibrosis. Thus, it is suggested that coffee antifibrogenic may have some mechanism that could prevent progression of the disease. Any treatment modality that may potentially prevent the progression of fibrosis in chronic liver disease, especially if it confers few adverse effects, has the potential to improve morbidity and mortality(14). In this sense, a Norwegian population-based study demonstrated an inverse relationship between coffee consumption and mortality in cirrhotic patients(35). 

Freedman et al.(11) demonstrated in a prospective study with 766 patients that the higher caffeine consumption is associated with lower degrees of fibrosis in patients with chronic liver disease, especially those with chronic HCV infection. Other studies(8, 13) confirmed these results. In this study, patients who consumed a larger amount of caffeine per day had more mild fibrosis and the ones who consumed lower amounts presented more advanced fibrosis. Freedman et al.(11) has suggested that the beneficial effect requires caffeine consumption above a threshold equivalent to about two cups of coffee per day (≥222 mg of caffeine). We observed an inverse association between mean age and the degree of liver fibrosis, the youngest being those with less fibrosis, probably due to the shorter length of disease progression. Importantly, the progression of fibrosis depends on several factors, such as age over 40 years at the time of infection, consumption of alcohol above 80g/day, being male, among others(27). 

The analysis of these factors is relevant, since the degree of fibrosis could be related to some of these, and not the consumption of caffeine. In the present work, we observed that caffeine cannot yet be considered a statistically independent factor to explain the degree of fibrosis. 

Although patients did not report changes in patterns of caffeine intake over time, this result may not accurately reflect the consumption during the progression of liver disease, which may be considered as a limitation of the study. Nevertheless, the assessment of caffeine consumption was performed following previously published literature.

In conclusion, the higher caffeine intake was associated with a lower degree of liver fibrosis in HCV-infected patients. There was no association between caffeine consumption and inflammatory activity
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April 15
Caffeinated drinks associated with decreased risk of liver scarring
Modest daily consumption of caffeinated drinks is associated with less advanced liver scarring in people with hepatitis C, according to a recent study by Baylor College of Medicine researchers that appears online in the journal Clinical Gastroenterology and Hepatology. (abstract provided below)

Dr. Hashem El-Serag, chief of gastroenterology and hepatology at Baylor and at the Michael E. DeBakey Veterans Affairs Medical Center and lead author of the study, said the results showed that the risk of liver scarring in hepatitis C patients was decreased when individuals regularly consumed caffeinated coffee, and to a lesser extent tea and soda.

“We found that participants who drank caffeinated coffee daily had the best results,” he said. “This is most likely do to the fact that one coffee drink has more caffeine than tea or sodas.”

He said the researchers saw no benefit to patients who drank decaffeinated coffee, tea and soda.

This cross-sectional study consisted of 910 participants aged 18 to 70 years of age with confirmed hepatitis C who were not receiving antiviral therapy.

“We specifically chose to study hepatitis C patients because they are at an increased risk for hepatic fibrosis (liver scarring), and there is limited data on the effects of coffee or caffeine on the progression of scarring within this patient population,” said El-Serag, also a member of the Dan L. Duncan Cancer Center at Baylor.

Liver scarring can lead to cirrhosis of the liver, liver failure and liver cancer, and may require liver transplantation.

Of the participant study population, 37.6 percent of them had advanced liver scarring while 62.4 percent had milder scarring. Participants with advanced fibrosis were significantly older, more likely to have type 2 diabetes and were more likely to be overweight or obese.

“Most participants reported drinking caffeinated coffee, and about half of those drank one or more cups of coffee per day,” El-Serag said. “Patients with milder liver scarring had a higher average daily intake of caffeinated coffee compared to those with more advanced cases.”

“An estimated 100 milligrams of caffeine from coffee, tea or soda was associated with approximately one-third reduction of advanced scarring, and higher consumption didn’t produce an additional benefit,” he said.

Others who took part in this study include Natalia Khalaf, Donna White, Fasiha Kanwal, David Ramsey, Sahil Mittal, Shahriar Tavakoli-Tabasi and Jill Kuzniarek, all of Baylor.

This research was funded in part by a VA Clinical Research and Development Merit Award (H-22934, PI: El-Serag) and the National Institute of Diabetes Digestive and Kidney Diseases (R03 DK095082, PI: White). The efforts of White and El-Serag effort were supported in part by the National Institute of Diabetes Digestive and Kidney Diseases (K24 DK04-107 and K01 DK081736, respectively) and the Houston VA Health Services Research and Development Center of Excellence (HFP90-020).


Abstract: - Coffee and Caffeine Are Associated With Decreased Risk of Advanced Hepatic Fibrosis Among Patients With Hepatitis C
Natalia Khalaf, Donna White, Fasiha Kanwal, David Ramsey, Sahil Mittal, Shahriar Tavakoli-Tabasi, 
Jill Kuzniarek,Hashem B. El-Serag
Published Online: March 14, 2015
DOI: http://dx.doi.org/10.1016/j.cgh.2015.01.030
Publication stage: In Press Uncorrected Proof

Abstract
Background & Aims
Coffee or caffeine has been proposed to protect against hepatic fibrosis, but few data are available on their effects in patients with chronic hepatitis C virus (HCV) infection.
Methods

We conducted a cross-sectional study of veterans with chronic HCV infection to evaluate the association between daily intake of caffeinated and decaffeinated coffee, tea, and soda, and level of hepatic fibrosis, based on the FibroSURE test (F0–F3, mild [controls] vs F3/F4–F4, advanced). Models were adjusted for multiple potential confounders including age, alcohol abuse, and obesity.

Results
Among 910 patients with chronic HCV infection, 98% were male and 38% had advanced hepatic fibrosis. Daily intake of caffeinated coffee was higher among controls than patients with advanced fibrosis (1.37 vs 1.05 cups/d; P = .038). In contrast, daily intake of caffeinated tea (0.61 vs 0.56 cups/d; P = .651) or soda (1.14 vs 0.95 cans/d; P = .106) did not differ between the groups. A higher percentage of controls (66.0%) than patients with advanced fibrosis (57.9%) consumed 100 mg or more of caffeine daily from all sources (P = .014); controls also received a larger proportion of their caffeine from coffee (50.2% vs 43.0%; P = .035). Hepatoprotective effects of an average daily intake of 100 mg or more of caffeine (adjusted odds ratio, 0.71; 95% confidence interval, 0.53–0.95; P = .020) and 1 cup or more of caffeinated tea by non–coffee drinkers (adjusted odds ratio, 0.56; 95% confidence interval, 0.34–0.94; P = .028) persisted after adjustment for confounders, including insulin resistance.

Conclusions
A modest daily caffeine intake (as little as 100 mg) may protect against advanced hepatic fibrosis in men with chronic HCV infection. Additional research is needed to confirm these findings in women and in people with other chronic liver diseases.

Mar 29, 2015
Regular Coffee Intake Could Prevent Liver Cancer in Alcohol Drinkers
By Judy Lawrence 
A new study suggests that regular coffee consumption could reduce the risk of liver cancer among people who, on a regular basis, drink more than safe amount of alcohol. London-based World Cancer Research Fund International (WCRF) has released the new study which discusses the probable causes and prevention of liver cancer. Previously coffee has been also proved to be associated with a number of health and cognitive benefits.

34 previous studies have been analyzed in detail, which included 8 million people, by the WCRF team, along with a team from the American Institute for Cancer Research for Continuous Update Project (CUP), for determining the risk factors for liver cancer. The study aimed at determining the impact of physical activity, diet and weight on liver cancer risk.

It was found that more than 45 ml of daily alcohol intake is associated with the higher risk of liver cancer among people having higher body mass index (BMI). The risk of liver cancer increases with alcohol consumption but more than three drinks per day can increase the risk dramatically. Consumption of foods contaminated by aflatoxins (toxins produced by fungi) also leads to higher risk of liver cancer. The foods which may get affected by aflatoxins include spices, Brazil nuts, figs, black pepper and cereals.

The panel of international experts from the WCRF, who carried out the research, reported that even a single cup of coffee per day is effective in reducing the risk of liver cancer in those who consume more than 45 ml of alcohol a day, which is roughly equivalent to three drinks. However, the researchers could not provide any reason behind the observation that coffee consumption lowers liver cancer risk. The new study also suggests that the daily intake of alcohol must be restricted to two drinks for men and one drink for women. Maintaining a healthy weight may also be helpful in reducing the risk.
Article Source Daily Science Journal 
Download Report From WCRF  LIVER CANCER REPORT 2015

Jan 16 2015
Coffee intake reduces liver cancer and death from chronic liver disease
The most recent issue of the American Journal of Gastroenterology evaluates the association of coffee intake with reduced incidence of liver cancer and death from chronic liver disease.


Coffee consumption may improve liver health
Xiao Q. Hepatology. 2014;60:2091-2098.

2014
December 23, 2014
People who consumed three or more cups of coffee per day lowered their chance of having high liver enzyme levels, indicating coffee could be associated with a healthy liver, according to study data.

Researchers, including Qian Xiao, PhD, from the National Cancer Institute, extracted data from the National Health and Nutrition Examination Survey to examine coffee intake and measure serum levels of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase (ALP) and gamma-glutamyl transaminase (GGT) to determine any relationship between coffee consumption and enzymatic levels. Of 62,539 participants in the survey, 27,793 were included in final analyses. Coffee intake was reported in 24-hour dietary recalls, according to the research.

Researchers found that the higher consumption of coffee, the lower abnormal liver enzymes. Participants who reported drinking three or more cups of coffee had an OR of 0.75 (95% CI, 0.63-0.89) for abnormal levels of ALT; 0.82 (95% CI, 0.68-0.98) for abnormal levels of ALP; 0.73 (95% CI, 0.55-0.95) for abnormal levels of AST; and 0.69 (95% CI, 0.57-0.83) for abnormal levels of GGT vs. participants who reported no coffee intake.

Abnormal AST and ALT levels ratio was inversely associated with coffee consumption (P=.006 for three or more cups vs. zero cups of coffee). 

Higher decaffeinated intake was associated with a lower chance of having abnormal ALT levels when having two or more cups of coffee compared with zero cups (OR=0.62; 95% CI, 0.41-0.94). Associations with decaffeinated coffee and enzyme levels were similar compared with caffeinated coffee, but was insignificant, according to the research. 

“We found that higher coffee consumption, regardless of caffeine content, was linked to lower levels of abnormal liver enzymes,” Xiao told Healio.com/Hepatology. “This suggests that chemical compounds in coffee other than caffeine may help protect the liver. Further studies are needed to identify these components.” – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.
Healio

Nov 18 2014
Chemical in coffee may help prevent obesity-related disease
Researchers at the University of Georgia have discovered that a chemical compound commonly found in coffee may help prevent some of the damaging effects of obesity.

In a paper published recently in Pharmaceutical Research, scientists found that chlorogenic acid, or CGA, significantly reduced insulin resistance and accumulation of fat in the livers of mice who were fed a high-fat diet.

"Previous studies have shown that coffee consumption may lower the risk for chronic diseases like Type 2 diabetes and cardiovascular disease," said Yongjie Ma, a postdoctoral research associate in UGA's College of Pharmacy and lead author of the paper. "Our study expands on this research by looking at the benefits associated with this specific compound, which is found in great abundance in coffee, but also in other fruits and vegetables like apples, pears, tomatoes and blueberries."

During the past 20 years, there has been a dramatic increase in obesity in the United States. More than one-third of U.S. adults and approximately 17 percent of children are obese, according to the Centers for Disease Control and Prevention, and the annual medical cost of obesity is more than $147 billion.

Aside from weight gain, two common side effects of obesity are increased insulin resistance and the accumulation of fat in the liver. Left untreated, these disorders can lead to diabetes and poor liver function.

To test the therapeutic effects of CGA, researchers fed a group of mice a high-fat diet for 15 weeks while also injecting them with a CGA solution twice per week.

They found that CGA was not only effective in preventing weight gain, but it also helped maintain normal blood sugar levels and healthy liver composition.

"CGA is a powerful antioxidant that reduces inflammation," said Ma, who works in the laboratory of professor Dexi Liu in the department of pharmaceutical and biomedical sciences. "A lot of evidence suggests that obesity-related diseases are caused by chronic inflammation, so if we can control that, we can hopefully offset some of the negative effects of excessive weight gain."

But the authors are quick to point out that CGA is not a cure-all. Proper diet and regular exercise are still the best methods to reduce the risks associated with obesity.

The mice in this study received a high dose of CGA, much higher than what a human would absorb through regular coffee consumption or a diet rich in fruits and vegetables.

However, the researchers do believe that CGA may form the foundation of a treatment for those who need extra help. They plan to conduct more research to develop an improved CGA formulation specifically for human consumption.

"We're not suggesting that people start drinking a lot of coffee to protect themselves from an unhealthy lifestyle," said Ma, who is also a member of UGA's Obesity Initiative. "But we do think that we might be able to create a useful therapeutic using CGA that will help those at risk for obesity-related disease as they make positive lifestyle changes."
University of Georgia

Oct 9
Drinking decaf coffee may be good for the liver
Researchers from the National Cancer Institute report that decaffeinated coffee drinking may benefit liver health. Results of the study published in Hepatology, a journal of the American Association for the Study of Liver Diseases, show that higher coffee consumption, regardless of caffeine content, was linked to lower levels of abnormal liver enzymes. This suggests that chemical compounds in coffee other than caffeine may help protect the liver.

Coffee consumption is highly prevalent with more than half of all Americans over 18 drinking on average three cups each day according to a 2010 report from the National Coffee Association. Moreover, the International Coffee Association reports that coffee consumption has increased one percent each year since the 1980s, increasing to two percent in recent years. Previous studies found that coffee consumption may help lower the risk of developing diabetes, cardiovascular disease, non-alcoholic fatty liver disease, cirrhosis, and liver cancer.

"Prior research found that drinking coffee may have a possible protective effect on the liver. However, the evidence is not clear if that benefit may extend to decaffeinated coffee," explains lead researcher Dr. Qian Xiao from the National Cancer Institute in Bethesda, Maryland.

For the present study researchers used data from the U.S. National Health and Nutrition Examination Survey (NHANES, 1999-2010). The study population included 27,793 participants, 20 years of age or older, who provided coffee intake in a 24-hour period. The team measured blood levels of several markers of liver function, including aminotransferase (ALT), aminotransferase (AST), alkaline phosphatase (ALP) and gamma glutamyl transaminase (GGT) to determine liver health.

Participants who reported drinking three or more cups of coffee per day had lower levels of ALT, AST, ALP and GGT compared to those not consuming any coffee. Researchers also found low levels of these liver enzymes in participants drinking only decaffeinated coffee.

Dr. Xiao concludes, "Our findings link total and decaffeinated coffee intake to lower liver enzyme levels. These data suggest that ingredients in coffee, other than caffeine, may promote liver health. Further studies are needed to identify these components."
Source: Wiley

Sept 4
Does Coffee Affect Development of Cholestatic Liver Disorders?
Dr. Kristine Novak
Coffee is considered to be a medically beneficial beverage—consumption has been associated with reductions in metabolic syndromecardiovascular disease, and weight gain, as well as total and cause-specific mortality. Furthermore, many studies have reported that coffee consumption reduces the risk of liver diseases such as alcoholic liver diseasecirrhosis, and hepatocellular carcinoma.

Aug 16
Impact of Coffee on Liver Diseases A Systematic Review
This extensive new review examines the association of coffee consumption with liver diseases, such as cirrhosis, hepatitis, and fatty liver disease. What's the verdict?

July 5 2014
Drinking coffee cuts death risk
July 5, 2014
Findings indicate that those who drank at least 20 g of ethanol daily had a greater risk of cirrhosis mortality compared to non-drinker
Researchers have said that consuming two or more cups of coffee each day reduces the risk of death from liver cirrhosis by 66%, specifically cirrhosis caused by non-viral hepatitis.

Lead researcher, Dr. Woon-Puay Koh with Duke-NUS Graduate Medical School Singapore and the National University of Singapore, said prior evidence suggests that coffee may reduce liver damage in patients with chronic liver disease.

He said that their study examined the effects of consuming coffee, alcohol, black tea, green tea, and soft drinks on risk of mortality from cirrhosis.

This prospective population-based study, known as The Singapore Chinese Health Study, recruited 63,275 Chinese subjects between the ages of 45 and 74 living in Singapore.

Participants provided information on diet, lifestyle choices, and medical history during in-person interviews conducted between 1993 and 1998. Patients were followed for an average of nearly 15 years, during which time there were 14,928 deaths (24%); 114 of them died from liver cirrhosis. The mean age of death was 67 years.

Findings indicate that those who drank at least 20 g of ethanol daily had a greater risk of cirrhosis mortality compared to non-drinker. In contrast, coffee intake was associated with a lower risk of death from cirrhosis, specifically for non-viral hepatitis related cirrhosis.

Non-alcoholic fatty liver disease (NAFLD), a chronic liver disease related to the metabolic syndrome and more sedentary affluent lifestyle, likely predominates among the non-viral hepatitis related cirrhosis group. In fact, subjects who drank two or more cups per day had a 66 per cent reduction in mortality risk, compared to non-daily coffee drinkers.

The findings have been published in journal Hepatology.

May 2014
Intake of Coffee and Caffeine are Associated with Decreased Risk of Hepatitis C-related Hepatic Fibrosis
Coffee drinking has been associated with reduced risk of cirrhosis and hepatocellular carcinoma. The reasons for these observations are unclear, although caffeine has been proposed by experimental studies to have antifibrotic and antineoplastic effects. There are only a few studies that examined coffee intake as well as caffeine intake in different beverages among patients with a uniform risk factor for liver disease

April 2014
Coffee lovers: Drink up to reduce your risk of Type 2 diabetes
To reduce your risk of developing Type 2 diabetes, new research from Harvard University scientists offers an eye-opening suggestion: Drink more coffee.

Can Coffee Treat Liver Disease?
Rowen K. Zetterman, MD / Medscape Gastroenterology
Coffee and Mortality
More than 2.25 billion cups of coffee are consumed each day throughout the world. This requires harvesting and roasting 7 million tons of coffee beans every year.[1] Although coffee consumption varies from country to country, most Americans drink coffee daily. Despite early concerns about the deleterious effects of coffee on health, contemporary studies suggest that coffee is beneficial for many medical disorders, including Parkinson disease, diabetes mellitus, symptomatic gallbladder disease, stroke, and chronic liver diseases.[2]

Coffee contains caffeine, a methylxanthine that is also found in tea and other plants. The quantity of caffeine present in each cup of coffee varies depending on how the coffee is prepared, the type of coffee brewed, and whether it is ground or instant coffee. In general, from each cup of coffee, approximately 85 mg of caffeine[3] is absorbed in the stomach and small bowel and metabolized in the liver by cytochrome P450. The half-life of caffeine is 4-6 hours.

Current studies suggest that caffeine binds to adenosine receptors and reduces the development of hepatic fibrosis from liver injury by limiting stellate cell activation and the secretion of connective-tissue growth factors and collagen.[4] The diterpenes cafestol and kahweol present in coffee can increase cholesterol formation, but cafestol and kahweol are retained on paper filters during coffee brewing.

Coffee appears to have a significant effect on all-cause mortality. The National Institutes of Health-American Association of Retired Persons Diet and Health Study involving 229,119 men and 173,141 women demonstrated an inverse relationship between coffee consumption and mortality.[5] In other words, coffee drinkers had a reduction in mortality compared with non-coffee drinkers.

The men and women in the study were aged 50-71 years at baseline and were followed until death or the study end point. It was observed that coffee drinkers were also more likely to smoke cigarettes, a finding that has been documented in other studies. The inverse relationship of coffee consumption to overall mortality was dose-dependent and resulted in reduced deaths from heart disease, respiratory disease, stroke, injuries and accidents, diabetes mellitus, and infections. Cancer deaths were not reduced by coffee.

Coffee's Effect on Liver Tests
Alcohol (ethanol) consumption and cigarette smoking can increase gamma-glutamyl transferase (GGT) levels.[6] Coffee appears to reduce circulating levels of GGT.[7] When a Japanese study involving 12,687 general health examinees (7398 men and 5289 women) with no evidence of liver disease or elevated aminotransferase levels were surveyed for coffee consumption, a significant reduction in serum GGT activity was observed in men (P < .001), whereas a similar reduction of GGT in women was only weakly evident.[8] Men who were heavy consumers of alcohol-containing beverages had a reduction of GGT with coffee intake, whereas non-alcohol drinkers did not. Serum aminotransferase levels were also reduced in alcohol-consuming patients who drank coffee.[8,9] Green tea had no effect on GGT levels.

Another study of 1176 male office workers aged 40-59 years with no history of liver disease or abnormal aminotransferase levels[10] also had reduced circulating GGT levels from coffee intake. Elevated GGT levels were associated with increased body mass index, alcohol intake, cigarette smoking, and snacking between meals. Similar findings have been observed by others.[11]

Coffee in the Prevention of Cirrhosis Chronic Liver Disease
Using the 1971-1975 National Health and Nutrition Examination Survey (NHANES), 9849 persons were followed for a mean of 19 additional years until hospitalization or death from chronic liver disease.[12] Each patient was surveyed for coffee or tea consumption (< 1 cup, 1-2 cups, or > 2 cups daily). Chronic liver disease developed in 1.4% of the NHANES patients. A multivariate analysis showed that people drinking more than 2 cups of coffee or tea per day had less than one half the occurrence rate of chronic liver disease compared with those who consumed less than 1 cup per day (hazard ratio, 0.43; 95% confidence interval [CI], 0.24-0.78). This reduction in chronic liver disease was evident in persons with higher alcohol intake, those who were overweight, or those with diabetes mellitus or high iron saturation levels.

A similar cohort study of 125,580 multiethnic health plan members lacking known liver disease[13] were examined from 1978 to 1985 and then followed until a diagnosis of cirrhosis or the end of the calendar year 2002. Coffee consumption reduced the development of alcoholic cirrhosis but not nonalcoholic cirrhosis in this population. Tea consumption had no effect on either alcoholic or nonalcoholic cirrhosis.

Alcoholic Liver Disease
Alcoholic liver disease develops in patients with excessive alcohol intake; women are at greater risk for alcoholic hepatitis at lesser quantities of alcohol-containing beverages than are men. Fatty liver is common in patients with excessive alcohol intake. Alcoholic hepatitis or cirrhosis develops in 10%-20% of those with chronic alcoholism. The patient with alcoholic liver disease who is obese or has coexisting liver injury from chronic viral hepatitis may have an increased risk for advanced liver disease.

In a study of 749 alcohol-drinking patients who were referred for suspected liver disease,[14] alcohol consumption was described in units, with 1 unit equaling a beer, a glass of wine, or a measure of hard liquor. An intake of more than 3 units of alcohol daily was associated with an increase in cirrhosis in both men (odds ratio [OR], 4.3) and women (OR, 5.7). In this study, 63% of patients were mild to moderate alcohol drinkers (< 3 units daily) and 37% were heavy drinkers (> 3 units daily), with 25% of study participants consuming more than 5 units per day. The OR for liver disease from consumption of 3 or more units of alcohol daily was 2.4 (95% CI, 1.3-4.2).

Alcoholics who also drank coffee had a significant reduction in the risk for alcoholic cirrhosis. For those consuming more than 3 units of alcohol plus 0-2 cups of coffee daily, the OR for cirrhosis was 2.3 (95% CI, 1.2-4.4) compared with those drinking more than 3 units of alcohol and more than 2 cups of coffee per day, with an OR of 1.4 (95% CI, 0.6-3.6).

Of the 749 patients in the study, 8.1% were also hepatitis B surface antigen positive. The OR for development of advanced liver disease from hepatitis B virus alone was 0.2 (95% CI, 0.1-1.1); for those with hepatitis B virus who consumed more than 3 units of alcohol daily, it was 4.8 (95% CI, 1.9-12.4). Similarly, the 53% of patients who were hepatitis C virus (HCV)-RNA positive had an OR for advanced liver disease from HCV alone of 0.2 (95% CI, 0.2-0.8), whereas those with HCV who were drinking more than 3 units of alcohol daily had an OR for development of advanced liver disease of 3.2 (95% CI, 1.8-5.7).

Nonalcoholic Liver Disease
Obesity is an important contributing factor to the increasing prevalence of nonalcoholic fatty liver disease (NAFLD) in the United States,[15] although NAFLD can also develop in nonobese patients. NAFLD is associated with metabolic syndrome, obesity, increased waist circumference, diabetes mellitus, insulin resistance, and some medications[16] and is more prevalent in non-Hispanic white persons and Hispanic persons than in black persons.[12] Caffeine intake is associated with a reduced risk of developing NAFLD.[17]

In a study using ultrasonographic bright liver score as an indicator of NAFLD, 137 patients with NAFLD and 108 control patients were evaluated.[18] Study patients lacked evidence of hepatitis B, hepatitis C, significant alcohol consumption, diabetes mellitus, chronic renal disease, thyroid disease, or cancer. Insulin resistance was assessed using the homeostasis model-insulin resistance index. Less fatty liver disease was observed in coffee drinkers than in non-coffee drinkers. Coffee consumption had no relationship to insulin resistance.

In another study, 195 morbidly obese patients undergoing bariatric surgery were surveyed for consumption of regular and espresso coffee, decaffeinated coffee, tea, and chocolate, and these findings were compared with liver histology.[19] Liver tissue was obtained at operation, and NAFLD activity score, degree of fibrosis, and cirrhosis were determined.

Nonalcoholic steatohepatitis (NASH) was identified in 19.5% of operated patients. NAFLD activity score correlated with the presence of hepatic fibrosis (P < .0001). Coffee intake was unrelated to the findings of NASH or to the severity of inflammation as indicated by the NAFLD activity score.[20] However, fibrosis was reduced in coffee-drinking patients. Patients with the most severe hepatic fibrosis had significantly lower consumption of caffeine from coffee. Multivariate analysis found that the consumption of regular coffee was a significant factor in reducing hepatic fibrosis, whereas caffeine from espresso had no effect on fibrosis.

In another study, 400 patients aged 18-70 years who underwent ultrasonography and liver biopsy and completed a caffeine questionnaire (asking about all sources of caffeine)[21] were analyzed in 4 groups: ultrasonography-negative for steatosis, steatosis only, NASH with stage 0-1 fibrosis, or NASH with stage 2-4 fibrosis.[22] Significantly lower caffeine consumption was observed in NASH patients with stage 2-4 fibrosis vs those with stage 1 fibrosis (P < .016). Only caffeine from coffee correlated with a lower risk for fibrosis. Coffee drinkers who also had low insulin resistance were less likely to have advanced fibrosis in the presence of NASH, suggesting that the protective effect of coffee may be related to insulin resistance, which has been observed by others.[23] Coffee drinkers who had high insulin resistance were not protected from developing hepatic fibrosis.

Coffee and Viral Hepatitis
Chronic HCV InfectionFor patients with chronic HCV infection, coffee drinkers and those consuming caffeine-containing beverages are more likely to maintain normal aminotransferase levels (P < .037) or to reduce aminotransferase levels than are those with lower caffeine intake.[24] No chronic HCV-infected patient drinking decaffeinated coffee had improvement of aminotransferase levels. An assessment of daily caffeine intake compared with hepatic inflammation and fibrosis in liver histology in patients with chronic HCV found a reduction of inflammation with caffeine intake, but no change in fibrosis.[25] The finding of less hepatic fibrosis in patients with chronic HCV disease and high caffeine intake has been observed by others.[26]

The HALT-C trial assessed baseline coffee and tea intake in 766 chronic HCV-infected patients with bridging fibrosis or cirrhosis who were followed for 3.8 years.[27] Coffee intake varied from 0 to 5 or more cups of coffee daily (median intake, 1 cup/day). Outcomes included clinical worsening or a 2-point increase in the Ishak fibrosis score[28] at follow-up liver biopsy. High coffee intake was associated with male sex, white race, higher lifetime alcohol and cigarette use, increased tea consumption, lower baseline insulin-resistance score, lower fasting insulin levels, higher HCV RNA levels, and less severe liver disease (as measured by alpha-fetoprotein level, serum aspartate aminotransferase/alanine aminotransferase ratio, hepatic steatosis grade, and higher albumin levels). No association was found between coffee consumption and age, body mass index, cirrhosis status, diabetes mellitus, HCV genotype, inflammation score, platelet count, or prothrombin time.

In the HALT-C trial, an inverse relationship between 1 cup or more of daily coffee intake and progressive liver disease during follow-up was observed (relative risk, 0.88; 95% CI, 0.79-0.98). For those who consumed 3 or more cups of daily coffee compared with non-coffee drinkers, the relative risk for cirrhosis was further reduced (0.56; 95% CI, 0.33-0.97). No relationship was seen between progression and intake of green or black tea.

Chronic HBV Infection
Patients with chronic hepatitis B virus (HBV) disease were evaluated for liver stiffness by use of transient elastography, a noninvasive modality used to estimate liver fibrosis,[29] and interviewed about daily alcohol and caffeine intake from coffee, tea, soda, and chocolate. Excessive alcohol intake was defined as more than 30 g daily in men and 20 g daily in women. Of 1045 patients, 216 (21%) had advanced fibrosis according to elastography. There was no relationship of coffee consumption or alcohol intake with advanced fibrosis as determined by elastography.

Coffee in the Prevention of HCC
Primary liver cancer is the third leading cause of death in the world[30]; more than 600,000 new cases develop annually, with a survival rate of 3%-5%. Associations with the occurrence of liver cancer include cirrhosis, HBV and HCV, alcohol, alpha-1-antitrypsin deficiency, hemochromatosis, NAFLD, aflatoxin, and cigarette smoking. Coffee consumption appears to reduce the risk for hepatocellular carcinoma (HCC) in those at elevated risk.

There are numerous cohort and case/control studies of the relationship between coffee (caffeine) intake and protection from development of HCC.

Two cohorts of Japanese patients (one with 22,404 patients and the other with 38,703 patients) developed 117 primary liver cancers.[31] All patients completed a questionnaire about coffee, black and green tea use, alcohol consumption, and use of tobacco products. Occasional or daily coffee intake of 1 or more cups was associated with a reduced risk for primary liver cancer (P trend < .024). This reduction of cancer risk from coffee was also observed in those who had a history of liver disease (P = .47). Tea use was not associated with reduced liver cancer risk.

In a case/control study, patients with HCC were stratified by underlying HBV and HCV infection, age, sex, diet, history of liver disease, and lifestyle factors.[32] Occasional or daily coffee drinkers had a reduction of HCC compared with non-coffee drinkers (hazard ratio, 0.48; 95% CI, 0.36-0.66), and as daily coffee intake increased, the risk for HCC declined further (P trend < .001). Whereas patients with HCV disease had reduced HCC risk with coffee intake, patients with HBV disease in this group were not protected by coffee.

The protective effect of coffee on HCC risk was observed in another Japanese case/control study,[33] as well as in 2 cohort studies from Finland[34,35] and 1 from Singapore[35] that similarly observed a protective effect of coffee intake on the development of HCC. One study also observed that an elevated GGT level was associated with the development of HCC.[34] Patients who had both an elevated GGT and a low coffee intake had a 9-fold increase in liver cancer risk. The protective effect of coffee was seen regardless of whether coffee was boiled or filtered.[36]

A meta-analysis of 16 case/control and cohort studies of liver cancer risk in coffee drinkers found that the reduction in liver cancer risk occurred regardless of sex, alcohol use, or an underlying history of hepatitis or cirrhosis.[37] Another meta-analysis of 9 case/control and 7 cohort studies also demonstrated a reduction of HCC risk with coffee intake.[38]

Two case/control studies specifically looked at the protective effect of coffee on cancer risk in patients with HBV disease.[39,40] Whereas one demonstrated a 46% risk reduction for HCC with increasing intake of coffee (OR, 0.56; 95% CI, 0.30-0.97),[39] the other failed to show a reduction in HCC risk with coffee intake,[40] similar to that seen by others.[32] It is evident that further studies are needed to assess the risk for liver disease progression and development of HCC in patients with or without cirrhosis.

Summary: 2 Cups Daily?
Daily consumption of coffee appears to have an effect on developing fibrosis in some liver diseases, especially alcoholic liver disease and NAFLD. In addition to improving liver tests, such as GGT and ALT, coffee appears to inhibit the development of fibrosis in chronic hepatic inflammatory disorders. Whereas reduction of fibrosis and a potential effect on the outcome of patients with chronic HCV infection has been demonstrated, a similar benefit for the HBV-infected patient is not as clear. Additional studies of the effect of coffee on cirrhosis of HBV infection are needed.

Furthermore, coffee appears to reduce the risk for HCC in patients who are at risk for the disease. Once again, the evidence for any effect of coffee on HBV-related liver cancer needs additional study.

Whether the effect of coffee on liver disease is related to caffeine or some other agent in coffee is not clear. However, many studies have failed to show a significant effect of other caffeine-containing drinks, such as green or black tea, on reducing fibrosis or inhibiting the development of HCC.

Although we have treatments for many forms of chronic liver disease, alcoholics who continue to consume ethanol-containing beverages and patients with NAFLD who are unable to control their associated causal factors might benefit from drinking 2 or more cups of regular coffee daily. Whether this should be a boiled or filtered coffee preparation is probably up to the wishes of the patient. However, this recommendation for coffee is obviously an unapproved indication, and reaching a stronger conclusion will require many more studies. A careful conversation with patients at risk is needed before giving this advice.
Medscape Gastroenterology

Coffee Consumption Reduces Mortality Risk from Liver Cirrhosis
New research reveals that consuming two or more cups of coffee each day reduces the risk of death from liver cirrhosis by 66%, specifically cirrhosis caused by non-viral hepatitis. Findings in Hepatology, a journal published by Wiley on behalf of the American Association for the Study of Liver Diseases, show that tea, fruit juice, and soft drink consumption are not linked to cirrhosis mortality risk. As with previous studies heavy alcohol use was found to increase risk of death from cirrhosis.

A 2004 report from The World Health Organization (WHO) estimates that each year 1.3% of total death worldwide is caused by liver cirrhosis. Previous research shows that 29 million Europeans have chronic liver disease, with 17,000 deaths annually attributed to cirrhosis. Further WHO reports state that liver cirrhosis is the 11th leading cause of death in the U.S.

“Prior evidence suggests that coffee may reduce liver damage in patients with chronic liver disease,” said lead researcher, Dr. Woon-Puay Koh with Duke-NUS Graduate Medical School Singapore and the National University of Singapore. “Our study examined the effects of consuming coffee, alcohol, black tea, green tea, and soft drinks on risk of mortality from cirrhosis.”

This prospective population-based study, known as The Singapore Chinese Health Study, recruited 63,275 Chinese subjects between the ages of 45 and 74 living in Singapore. Participants provided information on diet, lifestyle choices, and medical history during in-person interviews conducted between 1993 and 1998. Patients were followed for an average of nearly 15 years, during which time there were 14,928 deaths (24%); 114 of them died from liver cirrhosis. The mean age of death was 67 years.

Findings indicate that those who drank at least 20 g of ethanol daily had a greater risk of cirrhosis mortality compared to non-drinker. In contrast, coffee intake was associated with a lower risk of death from cirrhosis, specifically for non-viral hepatitis related cirrhosis. Non-alcoholic fatty liver disease (NAFLD), a chronic liver disease related to the metabolic syndrome and more sedentary affluent lifestyle, likely predominates among the non-viral hepatitis related cirrhosis group. In fact, subjects who drank two or more cups per day had a 66% reduction in mortality risk, compared to non-daily coffee drinkers. However, coffee intake was not associated with viral hepatitis B related cirrhosis mortality.

“Our study is the first to demonstrate a difference between the effects of coffee on non-viral and viral hepatitis related cirrhosis mortality,” concludes Dr. Koh. “This finding resolves the seemingly conflicting results on the effect of coffee in Western and Asian-based studies of death from liver cirrhosis. Our finding suggests that while the benefit of coffee may be less apparent in the Asian population where chronic viral hepatitis B predominates currently, this is expected to change as the incidence of non-viral hepatitis related cirrhosis is expected to increase in these regions, accompanying the increasing affluence and westernizing lifestyles amongst their younger populations.” 

This study was funded by grants from the U.S. National Institutes of Health (NCI R01 CA55069, R35 CA53890, R01 CA80205 and R01 CA144034).
Abstract
Source - Hepatology-2014

Coffee, alcohol and other beverages in relation to cirrhosis mortality: the Singapore Chinese Health Study
  1. George Boon-Bee Goh (MBBS, MRCP )1,Wan-Cheng Chow (MBBS, FRCP)1,4, Renwei Wang (MD)2,Jian-Min Yuan (MD, PhD)2,3 and Woon-Puay Koh (PhD)4,5,
  2. DOI: 10.1002/hep.27054

Limited experimental and epidemiologic data suggest that coffee may reduce hepatic damage in chronic liver disease. The association between consumption of coffee and other beverages, and risk of cirrhosis mortality was evaluated in The Singapore Chinese Health Study. This is a prospective population-based cohort of 63,275 middle-aged and older Chinese subjects who provided data on diet, lifestyle and medical histories through in-person interviews using structured questionnaire at enrollment between 1993 and 1998. Mortality from cirrhosis in the cohort was ascertained through linkage analysis with nationwide death registry. After a mean follow-up of 14.7 years, 114 subjects died from cirrhosis; 33 of them from viral hepatitis B (29%), two from hepatitis C (2%), and 14 from alcohol-related cirrhosis (12%). Compared to non-drinkers, daily alcohol drinkers had a strong dose-dependent positive association between amount of alcohol and risk of cirrhosis mortality. Conversely, there was a strong dose-dependent inverse association between coffee intake and risk of non-viral hepatitis related cirrhosis mortality (p for trend=0.013). Compared to non-daily coffee drinkers, those who drank two or more cups per day had 66% reduction in mortality risk (HR=0.34, 95% CI=0.14-0.80). However, coffee intake was not associated with hepatitis B related cirrhosis mortality. The inverse relationship between caffeine intake and hepatitis B related cirrhosis mortality became null after adjustment for coffee drinking. The consumption of black tea, green tea, fruit juices or soft drinks was not associated with risk of cirrhosis death.

Conclusion: This study demonstrates the protective effect of coffee on non-viral hepatitis related cirrhosis mortality, and provides further impetus to evaluate coffee as a potential therapeutic agent in patients with cirrhosis. (Hepatology 2014;)

Coffee did not increase mortality risk in cirrhotic patients
  • April 4, 2014
Drinking coffee daily did not increase mortality risk in Chinese liver disease patients, according to data from a new study.
Researchers recruited 63,275 middle-aged Singapore residents for The Singapore Chinese Health Study between 1993 and 1998 and patients provided information on diet, lifestyle and medical histories through questionnaires.
Full Story »

March 2014
2014
Coffee Is Probably Good For Your Liver
By Nat Rudarakanchana
Mounting scientific evidence has shown that coffee prevents and mitigates liver disease, even among the thousands of Americans who may not realize they have liver disease, according to the Canadian Liver Foundation.

Several studies from the late 1990s to date have shown that coffee helps prevent liver inflammation, which is often related to hepatitis C, cirrhosis, and liver cancer. One April 2013 overview study showed that 16 studies, surveying over 500,000 subjects over several years, all demonstrated coffee’s benefits on the liver.

But awareness among the general public about coffee’s benefits for your liver remains “very poor”, said Canadian Liver Foundation chairman Dr. Morris Sherman to IBTimes on Thursday, at a New Orleans coffee conference.

That holds true of the coffee industry itself, who may not know much about the scientific connection, added Sherman.

Several studies from the late 1990s to date have shown that coffee helps prevent liver inflammation, which is often related to hepatitis C, cirrhosis, and liver cancer. One April 2013 overview study showed that 16 studies, surveying over 500,000 subjects over several years, all demonstrated coffee’s benefits on the liver.

But awareness among the general public about coffee’s benefits for your liver remains “very poor”, said Canadian Liver Foundation chairman Dr. Morris Sherman to IBTimes on Thursday, at a New Orleans coffee conference.

That holds true of the coffee industry itself, who may not know much about the scientific connection, added Sherman.

March 6
Caffeine dependence tied to physical, emotional problems
In the San Francisco Chronicle an article discusses - caffeine use disorder - a term used to describe dependence on caffeine. 
Caffeine is ubiquitous in coffee and the idea that the substance can be addictive is hardly new. But for some people, that dependence can be so strong, physically and emotionally, that it becomes problematic.
Continue reading........

February 9 2014
HOW DOES COFFEE PREVENT LIVER FIBROSIS?
identification of simple measures that can slow fibrosis and prevent cirrhosis in at-risk patients is critical. Since coffee consumption appears to have salutary effects on human health overall, coffee is an attractive lifestyle measure that patients can take.
 
Are we ready to "write a prescription for coffee", as asked by Torres and Harrison in a recent commentary article? (1) Most likely, the answer is yes. Our rationale is as follows. First, there is sufficient evidence to provide biological plausibility for coffee as an anti-fibrotic. Second, coffee (for most individuals) is a pleasant addition to the diet, without profound adverse effects and possibly some other health benefits (again for most individuals). Lastly, other anti-fibrotic treatments are simply lacking; they are in the pipeline, but not yet available clinically...........

Of Interest
Tea Benefits: A Research Wrap-Up - Skip green tea supplements
In December a dozen review papers from the Fifth International Scientific Symposium on Tea and Human Health were published in the American Journal of Clinical Nutrition. These drew largely on the more than 2,000 studies done on tea in the past few years. Here’s a wrap-up of this and other tea research.

Caffeine has positive effect on memory, Johns Hopkins researchers say
Latarsha Gatlin
Research, published by the journal Nature Neuroscience, shows that caffeine enhances certain memories at least up to 24 hours after it is consumed.

"We've always known that caffeine has cognitive-enhancing effects, but its particular effects on strengthening memories and making them resistant to forgetting has never been examined in detail in humans," said Yassa, senior author of the paper. "We report for the first time a specific effect of caffeine on reducing forgetting over 24 hours."
January 28 2014
Caffeinated and Decaffeinated Coffee Consumption and Risk of Type 2 Diabetes: A Systematic Review and a Dose-Response Meta-analysis, Diabetes Care
Volume 37 (2) 27th Jan 2014
M Ding et al, 2014

OBJECTIVE: Previous meta-analyses identified an inverse association of coffee consumption with the risk of type 2 diabetes. However, an updated meta-analysis is needed because new studies comparing the trends of association for caffeinated and decaffeinated coffee have since been published.

RESEARCH DESIGN AND METHODS:  PubMed and Embase were searched for cohort or nested case-control studies that assessed the relationship of coffee consumption and risk of type 2 diabetes from 1966 to February 2013. A restricted cubic spline random-effects model was used.

RESULTS: Twenty-eight prospective studies were included in the analysis, with 1,109,272 study participants and 45,335 cases of type 2 diabetes. The follow-up duration ranged from 10 months to 20 years. Compared with no or rare coffee consumption, the relative risk (RR; 95% CI) for diabetes was 0.92 (0.90-0.94), 0.85 (0.82-0.88), 0.79 (0.75-0.83), 0.75 (0.71-0.80), 0.71 (0.65-0.76), and 0.67 (0.61-0.74) for 1-6 cups/day, respectively. The RR of diabetes for a 1 cup/day increase was 0.91 (0.89-0.94) for caffeinated coffee consumption and 0.94 (0.91-0.98) for decaffeinated coffee consumption (P for difference = 0.17).

CONCLUSIONS: Coffee consumption was inversely associated with the risk of type 2 diabetes in a dose-response manner. Both caffeinated and decaffeinated coffee was associated with reduced diabetes risk.

Jan 10 2014
Liver cancer: A rising risk
Liver cancer is the sixth most common type, and the third leading cause of cancer death, worldwide.
A type called hepatocellular carcinoma or HCC accounts for more than 90 percent of cases, and is linked to hepatitis B and C infections, alcohol, tobacco, obesity, and diabetes.

Rates of HCC continue to rise in the United States, especially among white men aged 45 to 54 years of age … which may be explained by hepatitis C infections acquired during the 1960s and 1970s (El-Serag HB et al. 2004).
Now, research from Italy suggests that coffee may reduce the risk of HCC, very substantially.

Coffee may curb the most common liver cancer
According to an evidence review from Italy, drinking coffee daily may reduce the risk of hepatocellular carcinoma (HCC), by about 40 percent (Bravi F et al. 2013).

Further, some evidence indicates that drinking three cups of coffee per day reduces liver cancer risk by more than 50 percent.

“Our research confirms past claims that coffee is good for your health, and particularly the liver,” said co-author Carlo La Vecchia, MD, from Italy’s University of Milan.

As he noted, “The favorable effect of coffee on liver cancer might be mediated by coffee’s proven prevention of diabetes, a known risk factor for the disease, or for its beneficial effects on cirrhosis and liver enzymes.” (AGA 2013)  
The Italian team performed a meta-analysis (review) of articles published from 1996 through September 2012. They found 16 high-quality epidemiological studies, covering 3,153 cases of HCC.
The results possess considerable credibility, thanks to consistent results across studies, time periods and populations. 
However, epidemiological studies cannot prove whether an association between a food or nutrient and reduced disease risk is causal.

The researchers said that the apparent link could in part be due to the fact that patients with liver diseases often reduce their coffee intake.

“It remains unclear whether coffee drinking has an additional role in liver cancer prevention,” added Dr. La Vecchia. “But, in any case, such a role would be limited as compared to what is achievable through the current measures.” (AGA 2013)
Primary liver cancers are largely avoidable through hepatitis B vaccinations, control of hepatitis C transmission, and cutting back on booze.

These three measures could, in principle, prevent more than 90 percent of liver cancers worldwide.
Article Source

References
  • Ahmed F, Perz JF, Kwong S, Jamison PM, Friedman C, Bell BP. National trends and disparities in the incidence of hepatocellular carcinoma, 1998-2003. Prev Chronic Dis. 2008 Jul;5(3):A74. Epub 2008 Jun 15. American Gastroenterological Association (AGA).
  • Coffee consumption reduces risk of liver cancer. Accessed at http://www.eurekalert.org/pub_releases/2013-10/aga-ccr102213.php 
  • Ascherio A, Zhang SM, Hernán MA, Kawachi I, Colditz GA, Speizer FE, Willett WC. Prospective study of caffeine consumption and risk of Parkinson's disease in men and women. Ann Neurol. 2001 Jul;50(1):56-63.
  • Bravi F, Bosetti C, Tavani A, Bagnardi V, Gallus S, Negri E, Franceschi S, La Vecchia C. Coffee drinking and hepatocellular carcinoma risk: a meta-analysis. Hepatology. 2007 Aug;46(2):430-5.
  • Bravi F, Bosetti C, Tavani A, Gallus S, La Vecchia C. Coffee reduces risk for hepatocellular carcinoma: an updated meta-analysis. Clin Gastroenterol Hepatol. 2013 Nov;11(11):1413-1421.e1. doi: 10.1016/j.cgh.2013.04.039. Epub 2013 May 6.
  • Campos H, Baylin A. Coffee consumption and risk of type 2 diabetes and heart disease. Nutr Rev. 2007 Apr;65(4):173-9. Review.
  • El-Serag HB, Davila JA, Petersen NJ, McGlynn KA. The continuing increase in the incidence of hepatocellular carcinoma in the United States: an update. Ann Intern Med. 2003 Nov 18;139(10):817-23. Erratum in: Ann Intern Med. 2004 Jan 20;140(2):151.
  • Inoue M, Yoshimi I, Sobue T, Tsugane S; JPHC Study Group. Influence of coffee drinking on subsequent risk of hepatocellular carcinoma: a prospective study in Japan. J Natl Cancer Inst. 2005 Feb 16;97(4):293-300.
  • Larsson SC, Wolk A. Coffee consumption and risk of liver cancer: a meta-analysis. Gastroenterology. 2007 May;132(5):1740-5. Epub 2007 Mar 24.
  • León-Carmona JR, Galano A. Is caffeine a good scavenger of oxygenated free radicals? J Phys Chem B. 2011 Apr 21;115(15):4538-46. doi: 10.1021/jp201383y. Epub 2011 Mar 25.Palacios N, Gao X, McCullough ML, Schwarzschild MA, Shah R, Gapstur S, Ascherio A. Caffeine and risk of Parkinson's disease in a large cohort of men and women. Mov Disord. 2012 Sep 1;27(10):1276-82. doi: 10.1002/mds.25076. Epub 2012 Aug 27.
  • Nehlig A Is caffeine a cognitive enhancer? J Alzheimers Dis. 2010;20 Suppl 1:S85-94. doi: 10.3233/JAD-2010-091315. Review.
  • Qi H, Li S. Dose-response meta-analysis on coffee, tea and caffeine consumption with risk of Parkinson's disease. Geriatr Gerontol Int. 2013 Jul 23. doi: 10.1111/ggi.12123. [Epub ahead of print]
  • van Dam RM. Coffee consumption and risk of type 2 diabetes, cardiovascular diseases, and cancer. Appl Physiol Nutr Metab. 2008 Dec;33(6):1269-83. doi: 10.1139/H08-120. Review.
  • Wedick NM, Brennan AM, Sun Q, Hu FB, Mantzoros CS, van Dam RM. Effects of caffeinated and decaffeinated coffee on biological risk factors for type 2 diabetes: a randomized controlled trial. Nutr J. 2011 Sep 13;10:93. doi: 10.1186/1475-2891-10-93.

Of Interest - Coffee consumption affects cancer risk differently for liver vs. pancreatic cancers
According to two recent studies, consuming coffee of any kind may reduce the risk of the most common liver cancer by as much as 50 percent


Heartwire

Caffeine: No Downside, Hint of Benefit in Atrial Fibrillation
Fran Lowry

January 10, 2014A meta-analysis from Chinese researchers has concluded that there is an inverse relationship between regular caffeine consumption and atrial fibrillation risk[1].

"It is unlikely that habitual caffeine intake increases AF risk," write Dr Min Cheng (State Key Laboratory of Cardiovascular Disease, Beijing, China) and colleagues in their study, published online January 6, 2014 in the Canadian Journal of Cardiology.

In fact, they conclude, habitual caffeine consumption may actually reduce AF risk.

"The finding of this study is meaningful. First, there is no need for concern that habitual caffeine intake may increase AF risk. Second, as atrial fibrosis is an important substrate for AF and caffeine has an antifibrosis property, the finding may pave the way for seeking effective antifibrosis agents for AF management or prompt development of caffeine as an agent for preventing AF," Cheng et al write.

Commenting on this study, Dr Stanley Nattel (University of Montreal, QC) called the findings "reassuring" for patients, many of whom have felt they need to steer clear of coffee and other caffeinated drinks.

Caffeine and AF: Link Unclear

Caffeine is a major component of some of the most widely consumed beverages, and the link between regular caffeine intake with incident AF was unknown. The aim of this meta-analysis was to investigate the association between chronic exposure to caffeine and AF risk and also to evaluate the potential dose-response relationship.

Cheng et al's analysis consisted of six prospective cohort studies that included 228 465 participants. Three of these studies were done in the US, two in Sweden, and one in Denmark.

During a mean follow-up of from four to 25.2 years, 4261 participants suffered from AF.

Participants' mean age at baseline ranged from 53 to 63 years. The prevalence of smoking ranged from 5.8% among participants with the lowest caffeine intake to 76.8% among participants with the highest caffeine intake.

All of the studies documented the incidence of AF by electrocardiography; three studies estimated daily caffeine intake by the frequency of caffeine or coffee consumption during the previous year, and three studies estimated caffeine consumption according to reported daily coffee consumption. In addition, three studies summed the daily intake of coffee, tea, cola, cocoa, or chocolate for each subject.

The pooled relative risk (RR) for the incidence of AF from habitual caffeine exposure was 0.90 (95% CI 0.81–1.01; p=0.07) in the primary analysis. There was also significant heterogeneity among the six studies (I2=73%; p=0.002).

The researchers also found an inverse relationship between the amount of caffeine consumed and the risk of AF.

Pooled results from studies that adjusted for potential confounders showed an 11% reduction for low doses of caffeine (RR 0.89, 95% CI 0.80–0.99; p=0.032), and a 16% reduction for high doses (RR 0.84, 95% CI 0.75–0.94; p=0.002).

Similarly, an inverse relation was found between habitual caffeine intake and AF risk (p=0.015 for overall trend), and the incidence of AF decreased by 6% (RR 0.94, 95% CI 0.90–0.99) for every 300-mg/day increment in habitual caffeine intake.

A Second Cup?

In their discussion, the authors suggest that habitual caffeine consumption may offer a moderate protective effect against AF for a variety of reasons.

The studies in this meta-analysis showed that 400 mg of caffeine did not induce change in P-wave indices compared with the baseline electrocardiography, and one showed that 400 mg of caffeine did not change PR interval, QRS duration, corrected QT interval, RR interval, or corrected QT-interval dispersion.

Nor, in another study, did 300 mg of caffeine increase the occurrence or severity of ventricular arrhythmias during the healing phase of acute MI. Even in patients with clinical ventricular arrhythmias, caffeine did not significantly alter inducibility or severity of arrhythmias, the authors noted.

Further, in people who habitually consumed caffeine, the adrenergic effects of caffeine were greatly attenuated and its possible acute proarrhythmia effect reduced.

Habitual caffeine intake may also reduce AF risk because of its antifibrosis effect, Cheng et al write.

Harm vs Benefit

"AF is a very common condition, affecting about one in four people over their lifespan. Patients with AF are often told to avoid stimulants like caffeine, but the evidence for deleterious effects of caffeine is quite weak," Nattel, who was not part of the current study, pointed out. He also applauded the rigorous criteria investigators used in their meta-analysis.

But, unlike the authors, Nattel stopped short of saying that patients should actually consider "using" caffeine to treat AF.

"Even though the study suggested a dose-related protective effect of caffeine against AF, I would not recommend using caffeine to treat AF on this basis. But the results do reassure us that AF patient can enjoy their cup of coffee with a clear conscience," he said.

The study was supported by the National Natural Science Foundation of China and the National Basic Research Program of China. Cheng reports no relevant financial relationships. Nattel is editor in chief of the Canadian Journal of Cardiology.
Source - Medscape

Jan 6

Coffee Reduces Risk for Hepatocellular Carcinoma: An Updated Meta-analysis
Bravi F, Bosetti C, Tavani A, Gallus S, La Vecchia C
Clin Gastroenterol Hepatol. 2013;11:1413-1421

Study Summary
The meta-analysis by Bravi and colleagues is a logical extension of the data demonstrating the beneficial effects of coffee on NAFLD, now showing a reduction in associated risk for hepatocellular carcinoma (HCC). Sixteen studies were identified. Overall, compared with no coffee consumption, the risk for HCC was reduced by 28% with low-level consumption, and by 36% with high-level consumption (3 or more cups/day). It is likely that this favorable effect is the result of reduced cirrhosis evident in coffee drinkers, as well as improvement in the metabolic syndrome, because diabetes is another known risk factor for HCC. The researchers adjusted for other major risk factors for HCC, including hepatitis B virus, hepatitis C virus, cirrhosis, alcohol use, and tobacco use.

Viewpoint
The data on beneficial effects of coffee consumption are impressive. These effects extend across all geographic areas as well as evidence from animals and retrospective and prospective clinical studies.

There are differences in coffee bean composition as well as extractions used in preparation, but these findings seem to be specifically related to brewed, roasted, regular (not decaffeinated) coffee. Of interest, the beneficial effects have not been evident in nonfiltered, boiled (Turkish), or French press preparations.

Reportedly, there are more than 1500 chemical components of coffee, which are subject to agricultural and preparation-related influences. Although caffeine is the major active ingredient, many other components have significant antioxidant activity. Caffeine was thought previously to have antioxidant effects, but this has not been demonstrated subsequently in animal or human models.

The specific mechanisms by which coffee exerts these beneficial effects have not been clearly defined. What is apparent is that these effects extend across the spectrum of liver disease, ranging from hepatic steatosis to fibrosis, cirrhosis, and HCC. Of interest, these beneficial effects do not seem to extend to risk reduction for pancreatic cancer.[1] On the basis of the evidence, however, moderate consumption of brewed regular coffee seems to have clinical benefit for patients at risk for NAFLD or viral-related hepatic fibrosis. As clinicians who often recommend avoidance or reduction of delectables that contribute to disease states, it is nice to be able to give one back to patients.
Abstract
Source - Medscape

Jan 3
Full Text Available @ PloS One
Effect of caffeine-containing beverage consumption on serum alanine aminotransferase levels in patients with chronic hepatitios C virus infection: a hospital based cohort study.

Abstract
INTRODUCTION: 
To date, there have been no prospective studies examining the effect of coffee consumption on serum alanine aminotransferase (ALT) level among individuals infected with the hepatitis C virus (HCV). We conducted a hospital-based cohort study among patients with chronic HCV infection to assess an association between baseline coffee consumption and subsequent ALT levels for 12 months.

MATERIALS AND METHODS:
From 1 August 2005 to 31 July 2006, total 376 HCV-RNA positive patients were recruited. A baseline questionnaire elicited information on the frequency of coffee consumption and other caffeine-containing beverages. ALT level as a study outcome was followed through the patients’ medical records during 12 months. The association between baseline beverage consumption and subsequent ALT levels was evaluated separately among patients with baseline ALT levels within normal range (≤45 IU/L) and among those with higher ALT levels (>45 IU/L).

RESULTS: 

Among 229 patients with baseline ALT levels within normal range, 186 (81%) retained normal ALT levels at 12 months after recruitment. Daily drinkers of filtered coffee were three times more likely to preserve a normal ALT level than non-drinkers (OR=2.74; P=0.037). However, decaffeinated coffee drinkers had a somewhat inverse effect for sustained normal ALT levels, with marginal significance (OR=0.26; P=0.076). In addition, among 147 patients with higher baseline ALT levels, 39 patients (27%) had ALT reductions of ≥20 IU/L at 12 months after recruitment. Daily drinkers of filtered coffee had a significantly increased OR for ALT reduction (OR=3.79; P=0.034). However, in decaffeinated coffee drinkers, OR could not be calculated because no patients had ALT reduction.

CONCLUSION: 
Among patients with chronic HCV infection, daily consumption of filtered coffee may have a beneficial effect on the stabilization of ALT levels.

Full Text Available @ PloS One

Association between elevated coffee consumption and daily chocolate intake with normal liver enzymes in HIV-HCV infected individuals
View Both Studies:
From Jules @ NATAP - The first reporting coffee and chocolate appear to reduce liver enzymes in HCV/HIV coinfected, both coffee & chocolate contain similar class of polyphenols which research finds may have anti-inflammatory activity, and the 2nd study from Mayo Clinic

Proceedings concluding: "In this large cohort, a positive association between coffee consumption and all-cause mortality was observed in men and in men and women younger than 55 years. On the basis of these findings, it seems appropriate to suggest that younger people avoid heavy coffee consumption (ie, averaging >4 cups per day). However, this finding should be assessed in future studies of other populations."

Full Text @ NATAP
Association between elevated coffee consumption and daily chocolate intake with normal liver enzymes in HIV-HCV infected individuals: Results from the ANRS CO13 HEPAVIH cohort study. Association of Coffee Consumption With All-Cause and Cardiovascular Disease Mortality - 2 new studies