Association of Coffee Intake With Reduced Incidence of Liver Cancer and Death From Chronic Liver Disease in the US Multiethnic Cohort

doi:10.1053/j.gastro.2014.10.005

Gastroenterology

Volume 148, Issue 1, January 2015, Pages 118-125

https://doi.org/10.1053/j.gastro.2014.10.005 Get rights and content

Background & Aims

Coffee consumption has been proposed to reduce risk for hepatocellular carcinoma (HCC) and chronic liver disease (CLD), but few data are available from prospective, US multiethnic populations. We evaluated the association of coffee intake with HCC and CLD in 162,022 African Americans, Native Hawaiians, Japanese Americans, Latinos, and whites in the US Multiethnic Cohort (MEC).

Methods

We collected data from the MEC, a population-based prospective cohort study of >215,000 men and women from Hawaii and California, assembled in 1993–1996. Participants reported coffee consumption and other dietary and lifestyle factors when they joined the study. During an 18-year follow-up period, there were 451 incident cases of HCC and 654 deaths from CLD. Hazard rate ratios (RRs) and 95% confidence intervals (CIs) were calculated using Cox regression, adjusting for known HCC risk factors.

Results

High levels of coffee consumption were associated with reduced risk of incident HCC and CLD mortality (P_trend ≤ .0002). Compared with non-coffee drinkers, those who drank 2–3 cups per day had a 38% reduction in risk for HCC (RR = 0.62; 95% CI: 0.46–0.84); those who drank ≥4 cups per day had a 41% reduction in HCC risk (RR = 0.59; 95% CI: 0.35–0.99). Compared with non-coffee drinkers, participants who consumed 2–3 cups coffee per day had a 46% reduction in risk of death from CLD (RR = 0.54; 95% CI: 0.42–0.69) and those who drank ≥4 cups per day had a 71% reduction (RR = 0.29; 95% CI: 0.17–0.50). The inverse associations were similar regardless of the participants’ ethnicity, sex, body mass index, smoking status, alcohol intake, or diabetes status.

Conclusions

Increased coffee consumption reduces the risk of HCC and CLD in multiethnic US populations.

Section snippets

Study Population

The MEC is an ongoing population-based prospective cohort study with >215,000 men and women from Hawaii and California (mainly Los Angeles County), assembled between 1993 and 1996. The MEC was established to study dietary, environmental, and genetic risk factors for cancer and other chronic diseases. The details of the study design and baseline characteristics have been published previously.²² Briefly, the cohort is comprised predominantly of African Americans, Native Hawaiians, Japanese

Results

After a median of 18 years of follow-up, a total of 451 incident cases of HCC (55 whites, 69 African Americans, 32 Native Hawaiians, 152 Japanese Americans, and 143 Latinos) and 654 CLD deaths (166 whites, 83 African Americans, 34 Native Hawaiians, 102 Japanese Americans, and 269 Latinos) were identified during the follow-up period among the 162,022 at-risk cohort participants (Table 1). The mean age of diagnosis for HCC was 71.7 years, ranging from 68.7 years in whites to 73.8 years in

Discussion

In this prospective cohort of multiethnic US populations, we found that increasing coffee consumption was associated, in a dose-dependent manner, with lower risks of incident HCC and mortality from CLD. Compared with individuals who did not drink coffee, those who drank 2–3 cups per day had a 38% reduction in risk of HCC and a 46% reduction in risk of CLD death, and those who drank ≥4 cups per day had a 41% reduction in risk of HCC and a 71% reduction in risk of CLD death. Although the numbers

Acknowledgments

The authors thank the MEC participants for their participation and commitment. The authors thank Ms Jacqueline Porcel for her assistance in the analysis.

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The beneficial effect of coffee consumption on the progression of liver fibrosis in NASH is controversial.
To compare coffee consumption in NASH patients with and without advanced fibrosis.
Cross-sectional observational study on 97 patients with NASH diagnosed by histology or the association of steatosis, metabolic syndrome, elastometry > 6 kPa, and exclusion of other liver diseases. Usual coffee and caffeine intake were assessed using a standardized questionnaire. Liver fibrosis was evaluated by elastometry (advanced fibrosis if ≥ 10 kPa).
Among the 97 patients, 49 patients (51%) had non-advanced fibrosis (group 1) and 48 (49%) advanced fibrosis (group 2). The mean consumption of caffeine from coffee was 251 mg ± 293 per day in group 1 and 257 mg ± 286 per day in group 2 (P = 0.92). In multivariable analysis, the odds ratio for the mean consumption of caffeine from coffee (100 mg/d) between groups was 1.00 (1.00–1.00, P = 0.92). There was no correlation between elastometry and the consumption of caffeine from coffee.
We found no relationship between caffeine or coffee consumption and the degree of liver fibrosis in NASH. Our result does not support a beneficial effect of coffee consumption on the progression of fibrosis in NASH.
L’effet du café sur la progression de la fibrose hépatique reste mal connu dans la stéatohépatite non alcoolique (NASH). Nous avons comparé la consommation habituelle de café chez des patients atteints de NASH selon qu’il aient ou non une fibrose avancée.
Étude observationnelle transversale sur 97 patients atteints de NASH diagnostiquée histologiquement ou par l’association de stéatose, d’un syndrome métabolique, d’une élastométrie > 6 kPa, et par l’exclusion d’autres causes de maladie hépatique. La consommation habituelle de café a été recueillie par questionnaire standardisé. La fibrose a été évaluée par élastométrie (la fibrose avancée a été définie par une élastométrie ≥ 10 kPa).
Parmi les 97 patients, 49 (51 %) n’avaient pas de fibrose avancée (groupe 1) et 48 (49 %) avaient une fibrose avancée (groupe 2). La consommation moyenne de café a été de 251 mg ± 293 de caféine par jour dans le groupe 1 et 257 mg ± 286 dans le groupe 2 (p = 0,92). En analyse multivariée, l’odds ratio pour la consommation moyenne de café entre les groupes a été de 1,00 (1,00–1,00 ; p = 0,92). Il n’y avait pas de corrélation entre l’élastométrie et la consommation de café.
Nous n’avons pas trouvé de corrélation entre la consommation de café ou de caféine et le degré de fibrose hépatique dans la NASH. Ces résultats ne sont pas en faveur d’un effet bénéfique de la consommation de café sur l’évolution de la fibrose dans la NASH.
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A comprehensive literature research was conducted in PubMed, Web of Science and Embase databases to identify case-control and cohort studies published up to March 15, 2022 in English. We included studies investigating associations of food and beverage items (excluding alcohol), food groups, dietary patterns, and dietary habits with incidence risk of four main chronic liver diseases involved in the NAFLD-to-HCC progression (i.e., NAFLD, liver fibrosis, liver cirrhosis, and HCC). Three researchers independently performed the literature search, selected eligible articles, performed data abstraction and evaluated study quality. After evaluating adequacy and credibility of the associations reported for each dietary factor and each liver disease outcome, we summarized and evaluated the consistency of associations based on a priori determined criteria considering study design and the proportion of significant associations.
There were 109 studies included in this review (47 on NAFLD, 1 on liver fibrosis, 6 on liver cirrhosis, and 55 on HCC). Consistent evidence suggested that higher dietary inflammatory potential was associated with increased risk of both NAFLD and HCC whereas Mediterranean diet was associated with lower risk of both diseases. Additionally, greater conformity to the Healthy Eating Index, Dietary Approaches to Stop Hypertension score, and Mediterranean Diet Score, and dietary patterns with high dietary antioxidant capacity reduced NAFLD risk. Some specific foods including soft drinks and red and/or processed meat were associated with increased NAFLD risk while total vegetables and spinach were associated with reduced NAFLD risk. Coffee and white meat consumption were inversely related to HCC risk.
Dietary patterns or individual foods representing a more anti-inflammatory potential were associated with reduced risk of both NAFLD and HCC, which implied diet-induced inflammation may impact NAFLD progression towards HCC.
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Coffee is associated with a reduced risk of liver disease. This association is limited by important sources of confounding such as recall bias, healthy user bias, and indirect measures of liver outcomes or health. We aimed to examine the impact of coffee consumption with liver fibrosis and steatosis in a nationally representative sample.
We evaluated 4510 subjects 20 years and older from the 2017 to 2018 National Health and Nutrition Examination Survey study who underwent both transient elastography and two 24-hour dietary recall examinations. We tested the associations between liver stiffness measurements (LSM) of 9.5 kpa or greater or controlled attenuation parameter (CAP) and coffee consumption. We used decaffeinated coffee and tea consumption as controls. As a sensitivity analysis, we included all drinks in 1 model, examined the impact of caffeine consumption, and adjusted for the Healthy Eating Index-2015 and sugar-sweetened beverage consumption as separate models.
The study sample described was aged 48 ± 0.6 years, 73% were overweight or obese, 10.6% had diabetes, 47.5% reported participation in vigorous physical activity, and 23% drank 2 or more alcoholic drinks per day. After multivariate adjustment, there was no association between coffee and controls with CAP. Subjects who drank more than 3 cups of coffee, but not other drinks, had a 0.9 lower kPa (95% CI, -1.6 to -0.1; P = .03). More than 3 cups of coffee were protective for LSM of 9.5 kpa or higher (odds ratio, 0.4; 95% CI, 0.2–1.0; P = .05). Accounting for all beverages in the same model, only consuming more than 3 cups of coffee remained independently associated with LSM (odds ratio, 0.5; 95% CI, 0.2–0.9; P = .03). Caffeine was not associated significantly with LSM at any dose. Finally, adjusting for sugar-sweetened beverage consumption and Healthy Eating Index-2015, coffee consumption remained associated with a lower LSM. The protective nature of coffee consumption therefore is not attributable to caffeine and persists in participants regardless of their diet quality.
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: This article has an accompanying continuing medical education activity on page e15. Learning Objective: Upon completion of this exercise, the learner will be able to discuss the potential hepatoprotective effects of coffee consumption on liver disease.

: Conflicts of interest The authors disclose no conflicts.

: Funding This work supported by National Cancer Institute grants CA164973 and CA186203.

: Author names in bold designate shared co-first authorship.

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Original ResearchFull Report: Clinical—LiverAssociation of Coffee Intake With Reduced Incidence of Liver Cancer and Death From Chronic Liver Disease in the US Multiethnic Cohort

Background & Aims

Methods

Results

Conclusions

Section snippets

Study Population

Results

Discussion

Acknowledgments

Clin Gastroenterol Hepatol

Gastroenterology

Gastroenterology

Gastroenterology

Clin Gastroenterol Hepatol

Ann Epidemiol

Gastroenterology

Hepatocellular carcinoma incidence, mortality, and survival trends in the United States from 1975 to 2005

J Clin Oncol

Epidemiology of hepatocellular carcinoma: consider the population

J Clin Gastroenterol

Ethnic variations in chronic liver diseases

Dig Dis Sci

Deaths: leading causes for 2010

Natl Vital Stat Rep

Epidemiology of hepatocellular carcinoma in the United States: Where are we? Where do we go?

Hepatology

Epidemiology of hepatocellular carcinoma in Hispanics in the United States

Arch Intern Med

Coffee, cirrhosis, and transaminase enzymes

Arch Intern Med

Original Research
Full Report: Clinical—Liver
Association of Coffee Intake With Reduced Incidence of Liver Cancer and Death From Chronic Liver Disease in the US Multiethnic Cohort