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Coffee consumption and risk chronic diseases: the epidemiological evidence. Rob M. van Dam, PhD. Channing Laboratory Brigham and Women’s Hospital, and Harvard Medical School. Department of Nutrition Harvard School of Public Health. Contribution of coffee to dietary intake.

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coffee consumption and risk chronic diseases the epidemiological evidence

Coffee consumption and risk chronic diseases:the epidemiological evidence

Rob M. van Dam, PhD

Channing Laboratory

Brigham and Women’s Hospital,

and Harvard Medical School

Department of Nutrition

Harvard School of Public Health

contribution of coffee to dietary intake

Contribution of coffee to dietary intake

  • Chlorogenic acid and quinides (primary source)
  • Other antioxidants
  • Caffeine (primary source)
  • Lignans
  • Magnesium
  • Potassium
  • Manganese
  • Trigonelline and niacin
  • Chromium
  • Fiber
  • Diterpenes Kahweol and Cafestol
kahweol and cafestol in different types of coffee urgert r et al j agric food chem 1995 43 2167 72
Kahweol and cafestol in different types of coffee(Urgert R et al. J Agric Food Chem 1995;43:2167-72)
slide4

Changes in serum total cholesterol, LDL-cholesterol, triglycerides, and HDL-cholesterol in 22 subjects drinking 0.9 L cafetiere coffee daily for 24 weeks (Urgert R, et al. BMJ 1996)

slide5
Effect of caffeine and caffeinated coffee intake on blood pressure: summary estimates for trials of at least 7 days

Noordzij M, et al. J Hypertension 2006

effects of coffee different than expected from it s caffeine content
Effects of coffee different than expected from it’s caffeine content
  • Exercise performance time and epinephrine response (Graham TE, J Appl Physiol 1998)
  • Postload glucose concentrations and lypolysis

(Battram DS, J Nutr 2006)

  • Blood pressure

(Noordzij M, J Hypertens 2005; Winkelmayer WC, JAMA 2005)

slide7

Effects of Caffeine on Endurance Times

100

Spriet et al, 1992

Costill et al, 1978

Trice & Haymes, 1995

Cohen et al, 1996

80

Van Soeren et al. 1998

Cadarette et al, 1982

Graham & Spriet, 1991

Graham & Spriet, 1995

Butts& Crowell, 1985

Pasman et al, 1995

60

Sasaki et al, 1987

Caffeine/Coffee (min)

Graham et al, 1998

Greer et al, 2000

40

Bell & McLellan,

2002

Plb vs Caf

Mohr et al, 1998

20

Flinn et al,

1990

Decaf vs Coffee

Plb vs Caf/Ele

Collomp et al, 1990

Jackman et al, 1996

Perkins & Williams, 1975

0

0

20

40

60

80

100

Placebo/Decaf (min)

slide8

Graham et al. JAP 85: 883-889, 1998

**

Coffee is not just caffeine

slide9

Caffeine and older individuals

Norager,et. al., J Appl Physiol. 99: 2302-2306, 2005

  • 15 women, 15 men; 74.7 years; ‘healthy’;
  • daily coffee 4.9 cups/day
  • 2 day withdraw; 6 mg/kg
  • cycling endurance at 65% HR max
  • endurance at 50% max strength
  • postural stability
physical performance and perceived effort endurance

Physical Performance and Perceived EffortEndurance

25% improvement

(min)

Norager,et. al., J Appl Physiol. 99: 2302-2306, 2005

physical performance and perceived effort isometric sub maximal strength
Physical Performance and Perceived EffortIsometric Sub-Maximal Strength

54% improvement

(s)

Norager,et. al., J Appl Physiol. 99: 2302-2306, 2005

postural sway velocity moment
Postural SwayVelocity Moment

Eyes open (25%), closed (40%) worse

(mm2/s)

Norager,et. al., J Appl Physiol. 99: 2302-2306, 2005

prospective cohort studies of coffee and risk of coronary heart disease chd
Prospective cohort studies of coffee and risk of coronary heart disease (CHD)
  • Nurses’ Health Study:
    • N=84,488 women
    • 20 years of follow-up
    • 2254 incident cases of CHD
  • Health Professionals Follow-up Study:
    • N=44,005 men
    • 14 years of follow-up
    • 2173 incident cases of CHD

Lopez-Garcia E, et al. Circulation 2006

caffeinated coffee and chd risk
Caffeinated coffee and CHD risk

Adjusted for age, smoking, body mass index, physical activity, alcohol intake, parental history of myocardial infarction, use of aspirin, use of vitamin supplements, hypertension, hypercholesterolemia, diabetes mellitus at baseline, menopausal status, hormone therapy

high coffee consumption during pregnancy
High coffee consumption during pregnancy
  • Associations with lower birth weight reported, but not in a randomized trial of moderate amounts of caffeinated vs. decaffeinated coffee

(Fernandes O et al 1998, Clausson B et al 2002)

  • Few studies reported association with risk of childhood leukemia, but not consistent

(Menegaux F et al 2005, Petridou E 1997)

  • Higher sensitivity of the fetus to caffeine
slide20

Caffeine

Effect of Caffeine on Insulin Sensitivity in Obesity and Type 2 Diabetes

Caffeine significantly lower than placebo in all trials (P <0.05)

20

* Greater than pre-treatment (P <0.05)

*

*

15

Glucose Uptake (mg/kgSM.min-1)

10

Placebo

5

0

Pre

Pre

Post

Post

Pre

Post

Lean

Obese

T2D

Glucose uptake was measured 4 days post exercise

slide21

Thong & Graham(Lean)

Graham et al (Lean)

Battram et al (Lean - CAF)

Petrie

(Obese - with wt loss)

Battram et al (Lean - Coffee)

Chown et al (Obese)

Robinson et al (Type 2 diabetics)

Petrie

(Obese - before wt loss)

Insulin Sensitivity Index* for Various Studies During Placebo and Caffeine Trials

8

6

CAFFEINE

4

2

0

0

2

4

6

8

10

12

PLACEBO

* Index calculation reference: Matsuda & De Fronzo. Diabetes Care 22:1462, 1999.

slide22

Is caffeine the same as coffee ?

Venous Blood Samples:

fasting blood

sample

Glucose

Lactate

Insulin

C-peptide

FFA

Glycerol

Incretins (GLP-1; GIP)

t(min) =

-15 0 15 30 45 60 90 120 150 180 185 200 215 230 245 275 305

tchallenge2 = 0 15 30 45 60 90 120

Catecholamines Methylxanthines

CHO Challenge #1

CHO Challenge #2

(given AFTER blood sample @ 180min)

Coffee (5mg/kg caffeine), Decaf, Water

75g CHO (Crispix ® + skim milk)

15 min to eat

*Blood sample #2 taken immediately

after meal completion

75g OGTT

(Trutol)

5 min to ingest

L. Moisey (in progress)

results first meal

Insulin

35000

550

CC

30000

500

DC

W

25000

450

20000

400

Insulin (pM/3h)

350

15000

Insulin (pM)

300

10000

250

5000

200

0

CC

DC

W

150

Treatment

100

50

0

-30

0

30

60

90

120

150

180

Time (min)

Results: First Meal
first meal glucose

7.5

140

a

CC

7.0

120

DC

W

6.5

a

100

6.0

80

5.5

Glucose (mM)

Glucose (mM/3h)

5.0

60

4.5

b

40

4.0

20

3.5

3.0

0

-30

0

30

60

90

120

150

180

CC

DC

W

Time (min)

Treatment

First Meal: Glucose
second meal insulin

550

550

a

a

500

CC

500

DC

W

450

40000

450

400

400

b

b

b

350

b

350

30000

Insulin (pM/2h)

300

Insulin (pM)

300

250

250

20000

200

200

150

150

10000

100

100

50

50

0

CC

W

DC

0

0

0

30

60

90

120

150

180

210

240

270

300

330

-30

Treatment

Time (min)

Second Meal: Insulin
second meal glucose

7.5

7.5

CC

DC

7.0

7.0

W

300

6.5

6.5

250

a

6.0

6.0

200

5.5

5.5

Glucose (mM)

Glucose (mM/2h)

150

5.0

5.0

b

100

4.5

4.5

b

4.0

4.0

50

3.5

3.5

0

3.0

3.0

CC

DC

W

Treatment

-30

0

30

60

90

120

150

180

210

240

270

300

330

Time (min)

Second Meal: Glucose
coffee consumption and incidence of type 2 diabetes in the netherlands
Coffee consumption and incidence of type 2 diabetesin the Netherlands

Van Dam RM, Feskens EJ. Lancet 2002.

coffee consumption and risk of type 2 diabetes in dutch adults
Coffee consumption and risk of type 2 diabetes in Dutch adults

van Dam RM, Feskens EJM. Lancet 2002

slide30

Coffee and risk of type 2 diabetes (van Dam & Hu JAMA 2006)

Highest ( 6-7 cups/d) vs. lowest ( 0-2 cups/d) coffee consumption

relative risk

Study

95% CI

van Dam

Reunanen

Rosengren

Salazar-Martinez, M

Salazar-Martinez, F

Tuomilehto

Carlsson

Hoorn

0.65 (0.54-0.78)

Total (95% CI)

0.1

0.2

0.5

1

2

5

10

Favours high coffee

Favours low coffee

slide31

Coffee and risk of type 2 diabetes

2nd highest (4-6 cup/d) vs. lowest ( 0-2 cups/d) coffee consumption

relative risk

Study

95% CI

van Dam

Reunanen

Rosengren

Salazar-Martinez, M

Salazar-Martinez

Tuomilehto

Carlsson

Hoorn

Total (95% CI)

0.72 (0.62-0.83)

0.1

0.2

0.5

1

2

5

10

Favours coffee

Favours no coffee

cohort studies of coffee and risk of type 2 diabetes published after the 2006 meta analysis
Cohort studies of coffee and risk of type 2 diabetes published after the 2006 meta-analysis
coffee and adjusted 2 hr glucose the hoorn study van dam et al diabetologia 2004
Coffee and adjusted 2-hr glucose: the Hoorn Study(van Dam et al. Diabetologia 2004)

P trend=0.001

P trend <0.0001

change in caffeinated coffee consumption and change in weight over 12 years
Change in caffeinated coffee consumption and change in weight over 12 years

Lopez-Garcia E, et al. Am J Clin Nutr 2006;83:674-80

change in caffeinated coffee consumption and change in weight over 12 years37
Change in caffeinated coffee consumption and change in weight over 12 years

Very small difference in weight for a 12 year period

Lopez-Garcia E, et al. Am J Clin Nutr 2006;83:674-80

conclusions
Conclusions
  • Although coffee was associated with CVD and cancer risk in earlier studies, this has not been confirmed in larger prospective studies
  • Coffee consumption is associated with a lower risk of liver cancer and type 2 diabetes. Coffee components other than caffeine appear to contribute to the inverse association with type 2 diabetes.
  • There is some concern about health effects of high intakes of caffeine during pregnancy on the fetus
  • For most adults, coffee does not appear to increase risk of major chronic diseases and quitting smoking, engaging in physical activity, and a healthy diet should be prioritized for the prevention of chronic diseases
acknowledgments
Acknowledgments

Harvard

Frank Hu, JoAnn Manson, Walter Willett,

Esther Lopez-Garcia

Netherlands

Edith Feskens, Rob Heine, Coen Stehouwer,

Lex Bouter, Giel Nijpels, Jacqueline Dekker

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