Coffee beneficial for patients with liver disease

Coffee is beneficial for health in general and particularly for patients with liver disease, said Dr. Manav Wadhawan, Senior Consultant, Fortis Escorts Liver and Digestive Diseases Institute.

Describing coffee as the most commonly consumed and most popular beverage in the world, Dr. Wadhawan said that consuming more than two cups a day protects against progression of almost all forms of liver disease.

Elaborating further, Dr. Wadhawan said that the incidence of advanced fibrosis and cirrhosis is lower among coffee drinkers.

The risk of hepatocellular carcinoma also is lower in coffee drinkers as compared to the non-coffee consuming population.

Dr. Wadhawan said, "The protective effects are irrespective of etiology of liver disease, and more pronounced in alcohol related liver disease. However, in view of retrospective nature of data, more interventional trials are required before coffee finds its way in the regular prescription in liver disease patients."

He said that coffee is a very rich source of antioxidants and the protective effects of coffee have been proposed in a variety of conditions ranging from heart disease to stroke to type 2 diabetes as well as Parkinson disease.

"There is increasing evidence in favor of protective effects of coffee consumption in development and progression of liver disease."

From a pharmacology point of view, coffee fruits (cherries) are harvested and undergo pulp extraction to obtain green coffee seeds, which can then be either roasted or processed for decaffeination. It is only through roasting that the seeds gain the characteristic aroma and flavor of coffee.

According to Dr.Wadhawan, one cup of coffee is equivalent to 10 grams of whole bean coffee and 5 grams of instant coffee.

"Incremental beneficial effects have been reported up to four to six coffee cups a day. However, coffee drinking in pediatric age group should be discouraged in view of side effects of caffeine in form of anxiety, restlessness, etc. Up to 400 mg of caffeine a day is considered safe," he said.

He also said that young people should be warned about the side effects of consuming large amounts of coffee, such as headaches and insomnia and potential risk of dependence.

In an observational study of 217 people (median age 17) who used caffeinated energy drinks recreationally, 87 percent had adverse effects (palpitations, tremor, agitation, and gastrointestinal upset); 21 individuals demonstrated serious neurologic or cardiac signs (arrhythmias, ischemia, seizures, hallucinations); more than 125 were hospitalized for adverse effects, and of these, 57 consumed caffeinated energy drinks alone.

The data provided in favor of coffee consumption in liver disease patients may seem to be overwhelming. However, it should be understood that most of the trials listed above have either been retrospective, observational and/or cross sectional point prevalence studies.

In the absence of significant prospective data, conclusive comments can only be made about the association between coffee drinking and better liver health. In other words, we need more interventional, prospective trials before we can say that coffee drinking causes less liver disease.