Take a coffee or tea break to protect your liver

By Journal of Hepatology - EASL June 07,2017

New study indicates that drinking even a few cups a day may prevent hardening of the liver, reports the Journal of Hepatology

Amsterdam, The Netherlands, June 6, 2017 – Chronic liver diseases rank as the 12th cause of death worldwide and many of these disorders are associated with unhealthy lifestyles. Conversely, a healthier lifestyle can help prevent or reverse liver disease. Liver-related mortality is closely related to the development of cirrhosis, the final consequence of progressive fibrosis, i.e. scarring of the liver resulting from chronic inflammation. According to a new study published in the Journal of Hepatology, researchers found that drinking coffee and herbal tea may protect against liver fibrosis, estimated as the degree of liver stiffness, which is high in extensive scarring of the liver. Because these beverages are popular, widely available, and inexpensive, they could have the potential to become important in the prevention of advanced liver disease.

 “Over the past decades, we gradually deviated towards more unhealthy habits, including a sedentary lifestyle, decreased physical activity, and consumption of a ‘Happy Diet’,” explains lead author Louise J. M. Alferink, MD, of the Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands, “This Happy Diet, also known as the Western diet, is typically rich in unhealthy foods including processed foods lacking nutrients and artificial sugars. This has led not only to an obesity epidemic, but also to a rapid increase in the prevalence of non-alcoholic fatty liver disease (NAFLD), which is due to extensive accumulation of fat in the liver and resembles alcoholic liver disease in people who do not exceed two drinks a day of alcohol. In this context, examining accessible and inexpensive lifestyle strategies that have potential health benefits, such as coffee and tea consumption, is a viable approach to finding ways to halt the rapid increase of liver disease in developed countries.”

Sarwa Darwish Murad, MD, PhD, principal investigator of the study and hepatologist at the Erasmus MC University Medical Center, continues “There is quite some epidemiological, but also experimental data suggesting that coffee has health benefits on liver enzyme elevations, viral hepatitis, NAFLD, cirrhosis, and liver cancer. Beyond the liver, coffee has been demonstrated to be inversely associated with overall mortality in the general population. The exact mechanism is unknown but it is thought that coffee exerts anti-oxidant effects. We were curious to find out whether coffee consumption would have a similar effect on liver stiffness measurements in individuals without chronic liver disease.”

Data was gathered from 2,424 participants of the Rotterdam study, a large population-based cohort study including participants 45 years or older living in a suburb of Rotterdam, The Netherlands. All participants underwent an extensive physical work-up, including data collection for anthropometrics, blood sampling, hepatological imaging using abdominal ultrasound and Fibroscan®, which quantitatively measures liver stiffness. In addition, they completed an externally validated 389-item Food Frequency Questionnaire, which included detailed information on coffee and tea consumption.

Coffee and overall tea consumption was divided into three categories: none, moderate (>0-3 cups per day), and frequent (≥3). Tea consumption was categorized by herbal, green, or black tea and further into none (0) or any (>0) consumption.

 

Caption: Using data from the Rotterdam Study researchers determined that frequent coffee and herbal tea consumption were inversely related to liver stiffness but not steatosis in the general population.  Credit: L. Alferink and S. Darwish Murad.

Investigators found that frequent coffee consumption was significantly associated with lower odds of high liver stiffness values (≥8 kPa as proxy for liver fibrosis), i.e. less scarring of the liver, independent of lifestyle, metabolic, and environmental traits. When they looked at the whole range of liver stiffness values, they found that both frequent coffee and any herbal tea consumption, even in small amounts, were significantly associated with lower liver stiffness values. Finally, while no direct association was found between either coffee or tea and the presence of fat accumulation in the liver (NAFLD) per se, the effect of coffee on lowering the liver stiffness was significant in both the group with and without liver fat. The authors, therefore, concluded that frequent coffee and herbal tea seem to have beneficial effects on preventing liver scarring even before overt liver disease has developed.

However, some caution in the interpretation of the results is necessary, as underlined in an accompanying editorial by Salvatore Petta, MD, PhD, of the Section of Gastroenterology and Hepatology, Di.Bi.M.I.S., University of Palermo, Italy, and Giulio Marchesini, MD, of the Department of Medical and Surgical Sciences (DIMEC), ‘‘Alma Mater” University, Bologna, Italy., In fact, the study included only an elderly Caucasian population and there were few participants in the no-coffee or no-tea control groups, which limit a straightforward conclusion about the effect of coffee and tea on the liver.. The amount of tea consumed was generally low, making estimation of any protective effect difficult. Further, they note that more than 100 components are present in coffee and tea, including polyphenols and caffeine, which are contained in both beverages in very different and variable amounts.

Hence, when asked “Should we add regular coffee and tea breaks to our daily life? Dr. Petta’s and Dr. Marchesini’s conclusion is, “Before this policy can be recommended, prospective studies are needed to identify the optimum amounts and the type(s) of coffee and tea leading to more favorable liver outcomes.”

 

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Notes for Editors

The article is “Coffee and Herbal Tea Consumption Is Associated with Lower Liver Stiffness in the General Population: The Rotterdam Study,” by Louise Johanna Maria Alferink, MD; Juliana Fittipaldi; Jessica C. Kiefte-de Jong, RD, PhD ; Pavel Taimr, MD; Bettina E. Hansen, PhD; Herold J. Metselaar, Prof. MD; Josje D. Schoufour, PhD; Arfan M. Ikram, MD, PhD; Harry L. Janssen, Prof. MD; Oscar H. Franco, Prof. MD; and Sarwa Darwish Murad, MD, PhD (http://dx.doi.org/10.1016/j.jhep.2017.03.013). The editorial is “Coffee and Tea Breaks for Liver Health,” by Salvatore Petta, MD, PhD, and Giulio Marchesini, MD (http://dx.doi.org/10.1016/j.jhep.2017.04.014). Both contributions are published in the Journal of Hepatology, volume 67, issue 2 (August 2017) by Elsevier.

 Full text of these articles is available to credentialed journalists upon request; contact Sybrand Boer Iwema at +31 20 485 2781 or hmsmedia@elsevier.com. Journalists wishing to interview the authors of the article should contact Sarwa Darwish Murad at +31 628021137 or +31 107035942 (secr.) or s.darwishmurad@erasmusmc.nl. Contact Salvatore Petta at +39 091 655 2170 or salvatore.petta@unipa.it related to the editorial. For questions concerning the Journal of Hepatology, please contact Editor-in-Chief Rajiv Jalan at hmsmedia@elsevier.com.

About the Journal of Hepatology

The Journal of Hepatology is the official journal of the European Association for the Study of the Liver (EASL). It publishes original papers, reviews, case reports, and letters to the Editor concerned with clinical and basic research in the field of hepatology. www.journal-of-hepatology.eu

About EASL

In the fifty plus years since EASL was founded, it has grown from a small organization that played host to 70 participants at its first meeting, to becoming the leading liver association in Europe. EASL attracts the foremost hepatology experts as members and has an impressive track record in promoting research in liver disease, supporting wider education and promoting changes in European liver policy. www.easl.eu

About Elsevier

Elsevier is a global information analytics company that helps institutions and professionals progress science, advance healthcare and improve performance for the benefit of humanity. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, more than 35,000 e-book titles and many iconic reference works, including Gray’s Anatomy. Elsevier is part of RELX Group, a global provider of information and analytics for professionals and business customers across industries. www.elsevier.com