12 January - 20 June 2016

Moderate coffee consumption is associated with a reduced risk of liver disease

A report published from a roundtable event held at the Royal Society of Medicine and chaired by Prof. Graeme Alexander, a senior advisor to the British Liver Trust, from University College London has suggested that moderate coffee consumption, defined by the EFSA as 3-5 cups per day, is associated with a reduced risk of liver disease.

A report published from a roundtable event held at the Royal Society of Medicine and chaired by Prof. Graeme Alexander, a senior advisor to the British Liver Trust, from University College London has suggested that moderate coffee consumption, defined by the EFSA as 3-5 cups per day, is associated with a reduced risk of liver disease. The event attended by media, medics, academics, and representatives from liver associations across seven European countries, notes that chronic liver disease is the 5th most common cause of death across Europe.  The report states that liver disease encompasses a number of conditions including hepatitis, cirrhosis, non-alcoholic fatty liver disease and hepatocellular cancer.  It suggests that “the links between liver disease and other conditions such as type 2 diabetes and metabolic syndrome are significant and those who suffer with one of these conditions should be monitored for others.”

Dr Carolo La Vecchia, Professor of Medical Statistics and Epidemiology at the University of Milan reviewed the research on coffee consumption and liver disease.  Although the International Agency for Research on Cancer report no “clear association” between coffee consumption and liver cancer, meta-analysis has indicated that compared to no coffee consumption, coffee consumption is associated with dose response effect of up to a 40% reduced risk of liver cancer.  Regarding cirrhosis, the report suggests “coffee consumption is consistently associated with a reduced risk of cirrhosis, with a potential risk reduction of 25-70%.” They note that the effect is greater in those with alcoholic liver cirrhosis although results are consistent across different group of people, including those who have pre-existing hepatisis B and C and alcohol drinkers.  They also suggest a dose response relationship between coffee consumption and liver cancer, noting that “a greater risk reduction observed in higher coffee consumers (50% risk reduction) compared to lower consumers (30% risk reduction).”  However, it is indicated that low and high consumption is not consistent and further research is needed to investigate the amount needed to reduce risk of chronic liver disease. 

The report discusses the mechanisms involved.  It suggests that studies from Japan, Europe and the USA, have found coffee consumption to be “inversely associated” with the activity of the liver enzyme gamma-glutamyl transferase (GGT).  Data from one study indicates that compared to non-drinkers, GGT levels are lower in those who consume 5 or more cups of coffee per day with those who regularly consume alcohol, having higher GGT levels.  Studies have also found coffee consumption to be associated with a 40% reduction in liver enzymes Alanine transaminase (ALT).  High amounts of ALT in the blood is associated with liver disease.  Whilst the mechanisms are unclear for the associations, Dr La Vecchia reports that coffee contains caffeine, coffee oils, kahoweol, cafestol and antioxidants and these components may explain the effect. 

Vecchia also investigates the association between metabolic syndrome, liver health and coffee, and reports that “research suggests that a moderate intake of coffee is associated with a reduced risk of type 2 diabetes, in addition to reduced risk of liver disease.”  It is thought that coffee consumption may be linked to a reduction in insulin resistance. 

The roundtable event also discussed way of improving communication in the consulting room, and discussed the importance of a healthy lifestyle, suggesting that patients associations have a specific role.  Delegates at the event indicated that “patients often have a negative opinion of coffee and are not given proactive advice on coffee consumption as part of a healthy lifestyle.” 

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