Friday, December 5, 2014

Liver Disease: Benefits of Coffee Consumption

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."

Coffee and Tea May Contribute to a Healthy Liver

An international team of researchers led by Duke-NUS Graduate Medical School (Duke-NUS) and the Duke University School of Medicine suggest that increased caffeine intake may reduce fatty liver in people with non-alcoholic fatty liver disease (NAFLD).

Worldwide, 70 percent of people diagnosed with diabetes and obesity have NAFLD, the major cause of fatty liver not due to excessive alcohol consumption. It is estimated that 30 percent of adults in the United States have this condition, and its prevalence is rising in Singapore. There are no effective treatments for NAFLD except diet and exercise.

Using cell culture and mouse models, the study authors - led by Paul Yen, M.D., associate professor and research fellow, and Rohit Sinha, Ph.D of the Duke-NUS Graduate Medical School’s Cardiovascular and Metabolic Disorders Program in Singapore - observed that caffeine stimulates the metabolization of lipids stored in liver cells and decreased the fatty liver of mice that were fed a high-fat diet. These findings suggest that consuming the equivalent caffeine intake of four cups of coffee or tea a day may be beneficial in preventing and protecting against the progression of NAFLD in humans.

The findings were published in the September, 2013 issue of the journal Hepatology.

The team said this research could lead to the development of caffeine-like drugs that do not have the usual side effects related to caffeine, but retain its therapeutic effects on the liver. It could serve as a starting point for studies on the full benefits of caffeine and related therapeutics in humans.

Consuming Coffee = Lower Risk of Liver Disease

Regular consumption of coffee is associated with a reduced risk of primary sclerosing cholangitis (PSC), an autoimmune liver disease, Mayo Clinic research shows. The findings were being presented at the Digestive Disease Week 2013 conference in Orlando, Fla.

PSC is an inflammatory disease of the bile ducts that results in inflammation and subsequent fibrosis that can lead to cirrhosis of the liver, liver failure and biliary cancer.

"While rare, PSC has extremely detrimental effects," says study author Craig Lammert, M.D., a Mayo Clinic gastroenterologist. "We're always looking for ways to mitigate risk, and our first-time finding points to a novel environmental factor that also might help us to determine the cause of this and other devastating autoimmune diseases."

The study examined a large group of U.S. patients with PSC and primary biliary cirrhosis (PBC) and a group of healthy patients. Data showed that coffee consumption was associated with reduced risk of PSC, but not PBC. PSC patients were much likelier not to consume coffee than healthy patients were. The PSC patients also spent nearly 20 percent less of their time regularly drinking coffee than the control.

Caffeine consumption = decreased risk of liver disease

Caffeine consumption has long been associated with decreased risk of liver disease and reduced fibrosis in patients with chronic liver disease. Now, newly published research confirms that coffee caffeine consumption reduces the risk of advanced fibrosis in those with nonalcoholic fatty liver disease (NAFLD). Findings published in the February, 2012 issue of Hepatology, a journal of the American Association for the Study of Liver Diseases, show that increased coffee intake, specifically among patients with nonalcoholic steatohepatitis (NASH), decreases risk of hepatic fibrosis.

The steady increase in rates of diabetes, obesity, and metabolic syndrome over the past 20 years has given rise to greater prevalence of NAFLD. In fact, experts now believe NAFLD is the leading cause of chronic liver disease in the U.S., surpassing both hepatitis B and C. The majority of patients will have isolated fatty liver which has a very low likelihood of developing progressive liver disease. However, a subset of patients will have NASH, which is characterized by inflammation of the liver, destruction of liver cells, and possibly scarring of the liver. Progression to cirrhosis (advanced scarring of the liver) may occur in about 10-11% of NASH patients over a 15 year period, although this is highly variable.

To enhance understanding of the correlation between coffee consumption and the prevalence and severity of NAFLD, a team led by Dr. Stephen Harrison, Lieutenant Colonel, U.S. Army at Brooke Army Medical Center in Fort Sam Houston, Texas surveyed participants from a previous NAFLD study as well as NASH patients treated at the center's hepatology clinic. The 306 participants were asked about caffeine coffee consumption and categorized into four groups: patients with no sign of fibrosis on ultrasound (control), steatosis, NASH stage 0-1, and NASH stage 2-4.

Researchers found that the average milligrams in total caffeine consumption per day in the control, steatosis, Nash 0-1, and Nash 2-4 groups was 307, 229, 351 and 252; average milligrams of coffee intake per day was 228, 160, 255, and 152, respectively. There was a significant difference in caffeine consumption between patients in the steatosis group compared to those with NASH stage 0-1. Coffee consumption was significantly greater for patients with NASH stage 0-1, with 58% of caffeine intake from regular coffee, than with NASH stage 2-4 patients at only 36% of caffeine consumption from regular coffee.

Multiple analyses showed a negative correlation between coffee consumption and risk of hepatic fibrosis. "Our study is the first to demonstrate a histopatholgic relationship between fatty liver disease and estimated coffee intake," concludes Dr. Harrison. "Patients with NASH may benefit from moderate coffee consumption that decreases risk of advanced fibrosis. Further prospective research should examine the amount of coffee intake on clinical outcomes."

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