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Moderate coffee intake reduces risk for liver cancer, cirrhosis, fibrosis
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In a roundtable format, experts gathered to discuss the latest research on coffee and liver disease, which indicate that drinking approximately three to five cups per day is associated with a reduced risk for hepatocellular carcinoma, cirrhosis and fibrosis.
“I’ve been in the field for 30-odd years and it’s not a topic that’s come up until very recently. I would imagine patients will always ask, ‘What can I do, to help myself?’ And the advice is always lose weight, don’t drink too much alcohol and don’t smoke at all — a lot of advice that is somewhat negative,” Graeme Alexander, MD, senior advisor to the British Liver Trust, told Healio.com/Hepatology. “But to be told something positive, rather than negative, is a good message. If people ask, ‘Should I drink coffee?’ the answer would be yes.”
During the roundtable discussion, hosted by the Institute for Scientific Information on Coffee in association with the British Liver Trust, attendees highlighted data on coffee consumption and liver cancer.
Data from the International Agency for Research on Cancer showed no correlation between coffee intake and any forms of cancer, whereas the agency suggested that coffee consumption may reduce the risk for certain cancers.
Additionally, the attendees discussed study results from Finland, Japan, Europe and the U.S. that showed inverse associations between coffee consumption and activity of the gamma-glutamyl transferase liver enzyme. Members of the roundtable noted that these findings were valuable because the effect appears in genetically different populations.
Data from Italy and the U.S. showed correlation between coffee consumption and a 25% to 75% reduced risk for cirrhosis. In the Italian study, this association remained regardless of a patient’s history of hepatitis B and hepatitis C.
While the precise mechanisms remain unclear, Alexander suggested that any of the components found in coffee, including coffee oils, kahweol and cafestol and antioxidants, may explain the effect of coffee consumption on liver health.
“It doesn’t appear to be the caffeine, it does appear to be other contents, which are found in other drinks such as [certain kinds of] tea,” Alexander said.
Of interest to the roundtable members, a study from Finland showed that coffee intake was inversely associated with liver cancer, regardless of whether it was boiled or filtered.
The roundtable members suggested that patient-to-patient advice is often rated highly and potentially more likely to affect individuals’ opinions compared with advice from a health professional. They also advise that understanding liver disease risk factors can influence a patient’s interest in diet and lifestyle changes.
“When I started looking up how coffee might be working on fibrosis and liver cancer, I found a lot of data ... that showed coffee appeared to halt or partly reverse the effects of aging, so I began to become more interested,” Alexander said. “If coffee has an effect on cellular senescence, that would be fascinating, because we’re desperate to try and find drugs that inhibit the process or reverse the process of liver injury.” – by Talitha Bennett
Disclosure: Healio.com/Hepatology was unable to determine relevant financial disclosures of the other researchers at the time of publication.
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Perspective
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Naga P. Chalasani, MD
There is growing agreement among the experts that coffee drinking offers protection against chronic liver disease, cirrhosis and liver cancer. However, it is not clear cut how much coffee one would have to drink each day to derive such benefits and, furthermore, it is not clear if benefit is limited to certain type of caffeinated beverages or certain subpopulations (eg, obese, diabetic, men).
Logical next steps would be to undertake basic experiments to elucidate which ingredients contained within caffeinated beverages are responsible for such benefits, such that those ingredients can be developed as therapeutic targets. Also, in one preliminary study there was an interesting interaction between PNPLA3 genetic variation and coffee drinking for causing acute alcoholic hepatitis among heavy consumers of alcohol and this preliminary observation needs to expand to other types of chronic liver disease.
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