All coffee types protect against chronic liver disease

June 23, 2021

A UK Biobank study investigating associations of coffee consumption, including decaffeinated, instant and ground coffee, with chronic liver disease (CLD) outcomes, found that all types of coffee are protective against CLD, according to an article posted by BMC Public Health.

CLD is a growing cause of morbidity and mortality worldwide, particularly in low to middle-income countries with high disease burden and limited treatment availability. Coffee consumption has been linked with lower rates of CLD, but little is known about the effects of different coffee types, which vary in chemical composition. These findings significant given the increasing incidence of CLD worldwide and the potential of coffee as an intervention to prevent CLD onset or progression.

A total of 494,585 UK Biobank participants with known coffee consumption and electronic linkage to hospital, death and cancer records were included in this study. Cox regression was used to estimate hazard ratios (HR) of incident CLD, incident CLD or steatosis, incident hepatocellular carcinoma (HCC) and death from CLD according to coffee consumption of any type as well as for decaffeinated, instant and ground coffee individually.

Among 384,818 coffee drinkers and 109,767 non-coffee drinkers, there were 3600 cases of CLD, 5439 cases of CLD or steatosis, 184 cases of HCC and 301 deaths from CLD during a median follow-up of 10.7 years. Compared to non-coffee drinkers, coffee drinkers had lower adjusted HRs of CLD, CLD or steatosis, death from CLD and HCC. The associations for decaffeinated, instant and ground coffee individually were similar to all types combined.

Between 1990 and 2017, global deaths due to CLD increased from 899,000 (1.9% of total) to 1.32 million (2.4% of total). During the same period, disability-adjusted life-years lost to CLD increased from 30.5 million to 41.4 million. The burden of CLD is highest in low to middle-income countries where treatment options are also limited. Sub-Saharan Africa is the region that is most affected followed by Central and South America, Eastern Europe and Southeast Asia. The commonest aetiologies of CLD are alcohol-related liver disease (ALD), chronic hepatitis B and C infection, and non-alcoholic fatty liver disease (NAFLD). These conditions involve destruction and regeneration of liver parenchyma leading to liver fibrosis and then cirrhosis. Cirrhosis can be fatal due to complications related to portal hypertension, liver failure or the development of hepatocellular carcinoma (HCC).

Coffee is a popular beverage in most societies. It comprises hundreds of chemical compounds, some of which are thought to have in vivo properties, including caffeine, chlorogenic acid, kahweol and cafestol. Observational and laboratory studies suggest that consumption of coffee confers a protective effect against CLD, including cirrhosis and HCC. This effect has been observed among drinkers of caffeinated and, to a lesser extent, decaffeinated coffee. Based on these observations, coffee has been proposed as a potential intervention to prevent CLD onset and progression or HCC in at-risk patients. However, the attributes of an effective coffee-based intervention remain uncertain in terms of quantity and preparation, which substantially affects composition (e.g. decaffeinated coffee lacks caffeine, while filtered and instant coffee have only minimal amounts of kahweol and cafestol). The aim of this study was to investigate associations of coffee consumption, including the effects of different coffee types (and, thus, composition), with CLD outcomes in a large prospective cohort.

BMC Public Health has the article.