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Coffee May Offer Real Benefits to the Liver
http://www.clinicaloptions.com/Hepatitis/Treatment%20Updates/ClinicalThought/2013_Thought05.aspx
I'm off to get my frothy cappuccino~
I'm off to get my frothy cappuccino~
Coffee's Good, but Not Too Much
Published: Aug 15, 2013 | Updated: Aug 16, 201
Moderate amounts of coffee have been associated with some health benefits, but too much can be deadly, a prospective observational study suggested.
Women from ages 20 to 54 who drank more than 28 cups of coffee a week, or an average of more than four cups a day, were more than twice as likely to die from any cause as more moderate coffee drinkers, reported Junxiu Liu, MD, from the University of South Carolina in Columbia, and colleagues.
Men in the same age bracket were less at risk than women, but still had a 1.5 times higher risk of death than moderate drinkers, according to the study published online in Mayo Clinic Proceedings.
Although heavy coffee drinkers among the more than 40,000 participants were more likely to smoke and drink and have a lower cardiorespiratory fitness, the increased risk of death was independent of those lifestyle variables in the multivariable analysis, the researchers found.
Looking at the entire study population -- those younger than 55 and those 55 and older -- only men, but not women, who were heavy coffee drinkers had an increased risk of all-cause death (21%).
"People who drink more coffee may be prone to higher mortality; however, this may not be cause-and-effect, as there may be something else about the person who drinks 10 cups per day such as an addicting personality or is easily stressed out," co-author Carl J. Lavie, MD, medical director of cardiac rehabilitation and prevention at Ochsner Medical Center in New Orleans, told MedPage Today.
According to the latest National Coffee Drinking Study from the National Coffee Association, 83% of American adults drink coffee every day, "a five-point uptick compared with last year's study."
Hispanics outpace ethnic groups in coffee consumption -- 76% said they had drunk coffee the day before the survey, compared with 64% of Caucasians and 47% of African Americans. Hispanics also lead the rise in gourmet coffee consumption.
Unfortunately, in relation to the current study, Americans in the 40-to-59-year range have increased their intake of daily coffee, going from 65% to 69%, according to the coffee association.
A recent observational study of more than 400,000 men and women -- ages 51 to 71 when enrolled -- found a modest reduction in the risk of death with higher coffee consumption -- four or more cups daily. Like the current study, coffee intake was measured only once during enrollment.
A 2012 meta-analysis found that about two cups of coffee daily were associated with a decreased risk in heart failure compared with no coffee intake.
Although the results of the current study are consistent with prior studies, "results of recent studies have been highly variable," the investigators noted.
They therefore used data from 43,727 participants of the Aerobics Center Longitudinal Study cohort between Feb. 3, 1971, and Dec. 30, 2002, to examine the effect of coffee consumption on death from all causes and deaths from cardiovascular disease (33,900 men and 9,827 women). The average follow-up was 16 years.
The overall mean age for men and women was 43, which stayed fairly constant as coffee consumption increased (44 years for those drinking more than 28 cups per week).
The mean body mass index for men and women also was similar among the groups divided by rate of consumption (26 and 23 kg/m2 for men and women, respectively). There was a nonsignificant association with all-cause death and men who were overweight or obese.
Total cholesterol tended to increase with coffee consumption, as did fasting blood glucose, but blood pressure remained steady.
Also, coffee intake rose in parallel with family history of cardiovascular disease.
A total of 32% of the 2,512 deaths (men: 87.5%; women: 12.5%) were from cardiovascular disease.
There also was a nonsignificant association of all-cause death in those younger than 55 with coffee consumption, but this became significant at about 28 cups per week for men (HR 1.56, 95% CI 1.30-1.87) and women (HR 2.13, 95% CI 1.26-3.59).
The investigators found no adverse effects in heavy coffee drinkers over age 55.
The study is limited by having only one measurement of coffee intake, and the absence of data on coffee preparation methods, marital and education status, and physical activity, the authors said.
http://www.medpagetoday.com/TheGuptaGuide/PrimaryCare/41013
Published: Aug 15, 2013 | Updated: Aug 16, 201
Moderate amounts of coffee have been associated with some health benefits, but too much can be deadly, a prospective observational study suggested.
Women from ages 20 to 54 who drank more than 28 cups of coffee a week, or an average of more than four cups a day, were more than twice as likely to die from any cause as more moderate coffee drinkers, reported Junxiu Liu, MD, from the University of South Carolina in Columbia, and colleagues.
Men in the same age bracket were less at risk than women, but still had a 1.5 times higher risk of death than moderate drinkers, according to the study published online in Mayo Clinic Proceedings.
Although heavy coffee drinkers among the more than 40,000 participants were more likely to smoke and drink and have a lower cardiorespiratory fitness, the increased risk of death was independent of those lifestyle variables in the multivariable analysis, the researchers found.
Looking at the entire study population -- those younger than 55 and those 55 and older -- only men, but not women, who were heavy coffee drinkers had an increased risk of all-cause death (21%).
"People who drink more coffee may be prone to higher mortality; however, this may not be cause-and-effect, as there may be something else about the person who drinks 10 cups per day such as an addicting personality or is easily stressed out," co-author Carl J. Lavie, MD, medical director of cardiac rehabilitation and prevention at Ochsner Medical Center in New Orleans, told MedPage Today.
According to the latest National Coffee Drinking Study from the National Coffee Association, 83% of American adults drink coffee every day, "a five-point uptick compared with last year's study."
Hispanics outpace ethnic groups in coffee consumption -- 76% said they had drunk coffee the day before the survey, compared with 64% of Caucasians and 47% of African Americans. Hispanics also lead the rise in gourmet coffee consumption.
Unfortunately, in relation to the current study, Americans in the 40-to-59-year range have increased their intake of daily coffee, going from 65% to 69%, according to the coffee association.
A recent observational study of more than 400,000 men and women -- ages 51 to 71 when enrolled -- found a modest reduction in the risk of death with higher coffee consumption -- four or more cups daily. Like the current study, coffee intake was measured only once during enrollment.
A 2012 meta-analysis found that about two cups of coffee daily were associated with a decreased risk in heart failure compared with no coffee intake.
Although the results of the current study are consistent with prior studies, "results of recent studies have been highly variable," the investigators noted.
They therefore used data from 43,727 participants of the Aerobics Center Longitudinal Study cohort between Feb. 3, 1971, and Dec. 30, 2002, to examine the effect of coffee consumption on death from all causes and deaths from cardiovascular disease (33,900 men and 9,827 women). The average follow-up was 16 years.
The overall mean age for men and women was 43, which stayed fairly constant as coffee consumption increased (44 years for those drinking more than 28 cups per week).
The mean body mass index for men and women also was similar among the groups divided by rate of consumption (26 and 23 kg/m2 for men and women, respectively). There was a nonsignificant association with all-cause death and men who were overweight or obese.
Total cholesterol tended to increase with coffee consumption, as did fasting blood glucose, but blood pressure remained steady.
Also, coffee intake rose in parallel with family history of cardiovascular disease.
A total of 32% of the 2,512 deaths (men: 87.5%; women: 12.5%) were from cardiovascular disease.
There also was a nonsignificant association of all-cause death in those younger than 55 with coffee consumption, but this became significant at about 28 cups per week for men (HR 1.56, 95% CI 1.30-1.87) and women (HR 2.13, 95% CI 1.26-3.59).
The investigators found no adverse effects in heavy coffee drinkers over age 55.
The study is limited by having only one measurement of coffee intake, and the absence of data on coffee preparation methods, marital and education status, and physical activity, the authors said.
http://www.medpagetoday.com/TheGuptaGuide/PrimaryCare/41013
You have to be registered with Clinical Care Options for the actual article to come up. Otherwise it takes you to the log-in/registration page. It is free to register. The articles are excellent.
Here is the article from Clinical Care Options that Bocepgal linked to:
Coffee May Offer Real Benefits to the Liver
Mark S. Sulkowski, MD - 8/13/2013
Mixed Realities of Alternative Therapies for Hepatitis
Approximately 50% of patients who have failed initial therapy for hepatitis C take some form of alternative or complementary therapy. In my practice, I’m frequently asked by these and other patients: “What can I do to help my liver?” Most have heard of, have taken, or are taking milk thistle, licorice root, ginseng, schisandra, and/or thymus extract—with milk thistle being the most common. Not all alternative therapies are created equal and there are few randomized controlled trials to guide clinicians seeking answers. For instance, the active ingredient in milk thistle, silymarin, has been evaluated and generally found to provide little or no clinical benefit to the liver. In fact, a recent study found that even at higher-than-usual doses, silymarin failed to reduce HCV RNA or ALT levels more than placebo.
There is, however, a growing body of research supporting a beverage I’d wager a majority of you have enjoyed today: coffee.
The Coffee Alternative
Curiously, patients who will spend up to $30 a day or more for milk thistle and its extracts or ingest unproven therapies of varying quality are skeptical about the idea that drinking coffee can actually be good for you. Real and perceived cardiovascular and other effects of coffee have led many patients to view coffee as “unhealthy.” But the reality is that coffee consumption has been linked to a number of potential benefits – lower risk of diabetes, dementia and, yes, liver disease. Coffee contains more than 1000 compounds; one or more of which is responsible for the benefit that has been linked to coffee intake on liver disease in patients with alcoholic and viral hepatitis. Benefits include decreases in markers of liver disease progression and reductions in the risk for fibrosis and hepatocellular carcinoma.
Epidemiologic studies have suggested that there is a cause and effect associated with coffee intake and its benefits on the liver. These findings are supported by the few randomized controlled trials available. In one study comparing patients infected with hepatitis C, those who drank 3 cups of coffee per day or more received the greatest benefit. In order to maximize the effects of the coffee some (but not all) studies suggest that caffeinated coffee may be better for the liver than decaffeinated coffee. However, it seems that caffeine itself does not appear to have a beneficial effect.
There is also an interesting conundrum. Not just any caffeinated beverage will do. For instance, studies evaluating the effect of green tea – popularly considered a “healthier” source of caffeine – have not shown the benefits associated with filtered, caffeinated coffee. This lack of benefit appears to be true for sources of caffeine other than green tea as well.
Lastly, coffee should ideally be prepared by filtration because filtering removes cafestol and kahweol, two substances found in coffee that may increase serum cholesterol.
So, What Do We Tell Our Patients?
Simply put: moderation and common sense are my watchwords. Investigate what you are taking. What’s in it, by whom and how is it manufactured? Is there any literature supporting its use, or recommending against it? Natural, alternative, and complementary substances may provide benefits, but there are far too many tragic stories in the scientific popular press to proceed without caution. For example, in the late 1990s, several cases were reported of previously healthy patients who presented with a toxic serum digoxin level after the ingestion of botanical dietary supplements due to contamination of the natural product.
I support my hepatitis patients’ interests in adding natural products to a “liver healthy” lifestyle which include no alcohol, daily exercise and maintaining a normal body mass index. So, I discuss the data supporting moderate coffee intake of 2-3 cups per day in addition to abstaining from alcohol use, achieving or maintaining a normal BMI by eating a low fat, low cholesterol diet, and taking a curative hepatitis therapy. Of course, when patients are taking antiviral therapy, I recommend that patients limit their intake of all complementary and alternative therapies to avoid the potential for drug-drug interaction that can undermine the efficacy of treatment or increase the risk of toxicity. Despite this pragmatism, many of my patients are surprised by my willingness to accept a nontraditional adjunct to care, but my acceptance is based on data from respected sources. What could be more traditional than that? "
Here is the article from Clinical Care Options that Bocepgal linked to:
Coffee May Offer Real Benefits to the Liver
Mark S. Sulkowski, MD - 8/13/2013
Mixed Realities of Alternative Therapies for Hepatitis
Approximately 50% of patients who have failed initial therapy for hepatitis C take some form of alternative or complementary therapy. In my practice, I’m frequently asked by these and other patients: “What can I do to help my liver?” Most have heard of, have taken, or are taking milk thistle, licorice root, ginseng, schisandra, and/or thymus extract—with milk thistle being the most common. Not all alternative therapies are created equal and there are few randomized controlled trials to guide clinicians seeking answers. For instance, the active ingredient in milk thistle, silymarin, has been evaluated and generally found to provide little or no clinical benefit to the liver. In fact, a recent study found that even at higher-than-usual doses, silymarin failed to reduce HCV RNA or ALT levels more than placebo.
There is, however, a growing body of research supporting a beverage I’d wager a majority of you have enjoyed today: coffee.
The Coffee Alternative
Curiously, patients who will spend up to $30 a day or more for milk thistle and its extracts or ingest unproven therapies of varying quality are skeptical about the idea that drinking coffee can actually be good for you. Real and perceived cardiovascular and other effects of coffee have led many patients to view coffee as “unhealthy.” But the reality is that coffee consumption has been linked to a number of potential benefits – lower risk of diabetes, dementia and, yes, liver disease. Coffee contains more than 1000 compounds; one or more of which is responsible for the benefit that has been linked to coffee intake on liver disease in patients with alcoholic and viral hepatitis. Benefits include decreases in markers of liver disease progression and reductions in the risk for fibrosis and hepatocellular carcinoma.
Epidemiologic studies have suggested that there is a cause and effect associated with coffee intake and its benefits on the liver. These findings are supported by the few randomized controlled trials available. In one study comparing patients infected with hepatitis C, those who drank 3 cups of coffee per day or more received the greatest benefit. In order to maximize the effects of the coffee some (but not all) studies suggest that caffeinated coffee may be better for the liver than decaffeinated coffee. However, it seems that caffeine itself does not appear to have a beneficial effect.
There is also an interesting conundrum. Not just any caffeinated beverage will do. For instance, studies evaluating the effect of green tea – popularly considered a “healthier” source of caffeine – have not shown the benefits associated with filtered, caffeinated coffee. This lack of benefit appears to be true for sources of caffeine other than green tea as well.
Lastly, coffee should ideally be prepared by filtration because filtering removes cafestol and kahweol, two substances found in coffee that may increase serum cholesterol.
So, What Do We Tell Our Patients?
Simply put: moderation and common sense are my watchwords. Investigate what you are taking. What’s in it, by whom and how is it manufactured? Is there any literature supporting its use, or recommending against it? Natural, alternative, and complementary substances may provide benefits, but there are far too many tragic stories in the scientific popular press to proceed without caution. For example, in the late 1990s, several cases were reported of previously healthy patients who presented with a toxic serum digoxin level after the ingestion of botanical dietary supplements due to contamination of the natural product.
I support my hepatitis patients’ interests in adding natural products to a “liver healthy” lifestyle which include no alcohol, daily exercise and maintaining a normal body mass index. So, I discuss the data supporting moderate coffee intake of 2-3 cups per day in addition to abstaining from alcohol use, achieving or maintaining a normal BMI by eating a low fat, low cholesterol diet, and taking a curative hepatitis therapy. Of course, when patients are taking antiviral therapy, I recommend that patients limit their intake of all complementary and alternative therapies to avoid the potential for drug-drug interaction that can undermine the efficacy of treatment or increase the risk of toxicity. Despite this pragmatism, many of my patients are surprised by my willingness to accept a nontraditional adjunct to care, but my acceptance is based on data from respected sources. What could be more traditional than that? "
I couldn't get the link to come up.
However, yes, coffee is good for the liver and good for people with hep C and those doing treatment. 3+ cups per day.
Google coffee and hep C and you'll find various articles supporting these claims.
However, yes, coffee is good for the liver and good for people with hep C and those doing treatment. 3+ cups per day.
Google coffee and hep C and you'll find various articles supporting these claims.
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