ISIC Roundtable: Looking after the Liver

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Dr. Carlo La Vecchia, Professor of Medical Statistics and Epidemiology, Dept. of Clinical Sciences and Community Health, Università degli Studi di Milano, Italy

The liver is a key organ in the body and is involved in a number of vital metabolic processes including the regulation of blood sugar and fat, the digestions of food to nutrients, and the neutralisation and detoxifications of drugs and toxins. Consequently, any damage to the liver  can have a significant impact on overall health1.

ISIC hosted a roundtable of European experts from a variety of backgrounds, including academic research, medical practice and patient associations who convened at the Royal Society of Medicine in London to discuss the latest research on coffee and liver disease. Myself, alongside Professor Graeme Alexander of University College London and the British Liver Trust led the discussion on the known associations between coffee intake and a reduced risk of liver disease, and the potential mechanisms behind these associations.

Liver disease is a significant concern across Europe where chronic liver disease is the fifth most common cause of death2 and approximately 29 million people in the European Union suffer from a chronic liver condition3. There is an extensive and growing body of research considering associations between coffee consumption and liver disease, including hepatocellular cancer, cirrhosis, fibrosis and other liver diseases. During the roundtable, I summarized this research, concluding that regular moderate coffee consumption is associated with a reduced risk of liver disease4-6.

In addition to liver diseases, Professor Alexander and I presented on liver cancer, the fifth most common cancer globally and fourteenth most common in Europe2. Meta-analyses have suggested that coffee consumption versus no coffee consumption is associated with up to a 40% risk reduction of liver cancer, and there appears to be a dose-dependent relationship7-9. I highlighted data from Finland during the roundtable, which suggests that the risk of liver cancer is directly related to levels of the liver enzyme GGT and inversely related to coffee drinking10. This research also showed a dose response effect, whereby increasing coffee intake was associated with a lower risk of liver cancer.

Although the precise mechanisms remain unclear, the number of components found in coffee could explain the effect, including caffeine, coffee oils, kahweol and cafestol and antioxidants. Delegates from the roundtable commented that there is a vast range of coffee beverages available today and questioned whether different preparation methods have varying impacts on liver function. However, there is a limited amount of information available and further research is required.

It was also interesting to hear the delegates discuss the diagnosis of liver disease throughout the roundtable, and the fact that a majority of sufferers are unaware of their condition. I introduced the suggestion that ‘metabolic syndrome’ a combination of obesity, hypertension and type 2 diabetes, is associated with liver function and sufferers have a greater risk of liver cancer. This initiated a discussion about potential associations between metabolic syndrome, insulin resistance, liver health and coffee consumption. Roundtable members impressed the importance of communication to patients about healthy lifestyle, including information about coffee consumption.

The current body of research suggests that coffee consumption can play a role in reducing the risk of liver disease and this is important to acknowledge as physicians and patient associations strive to improve prevention, diagnosis and subsequent treatment of liver conditions.

To read ISIC’s export report, ‘Looking after the liver: lifestyle, coffee and caffeine’ click here.

References

  1. British Liver Trust ‘Liver Health’. Available at: https://www.britishlivertrust.org.uk/liver-information/
  2. European Association for the Study of the Liver (2013) ‘The burden of Liver Disease in Europe: A Review of Available Epidemiological Data’. Available at: http://www.easl.eu/medias/EASLimg/Discover/EU/54ae845caec619f_file.pdf
  3. Eurostat (2007) ‘Europe in Figures: Eurostat yearbook 2006-07’. Available at: http://www.nefmi.gov.hu/letolt/eu/ks_cd_06_001_en.pdf
  4. Saab S. et al. (2014) Impact of coffee on liver disease a systematic review. Liver Int, 34(4):495–504.
  5. Wadhawan M. and Anandt A.C. (2016) Coffee and Liver Disease. J Clin Exp Hepatol, 6(1):40–46.
  6. Heath R. et al. (2017) Coffee: The magical bean for liver diseases. World J Hepatol, 9(15):689–698.
  7. Bravi F. et al. (2007) Coffee drinking and hepatocellular carcinoma risk: a meta-analysis. Hepatol, 46:430–435.
  8. Larsson S.C. et al. (2007) Coffee consumption and liver cancer: a meta-analysis. Gastroenterol, 132:1740–1745.
  9. Bravi F. et al. (2013) Coffee reduces risk for hepatocellular carcinoma: An updated meta-analysis. Clin Gastro and Hepatol, 11:1413–1421.
  10. Hu G. et al. (2008) Joint effects of coffee consumption and serum gamma-glutamyltransferase on the risk of liver cancer. Hepatol, 48(1):129–36.

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