Effects of supplementation with main coffee components including caffeine and/or chlorogenic acid on hepatic, metabolic, and inflammatory indices in patients with non-alcoholic fatty liver disease and type 2 diabetes: a randomized, double-blind, placebo-controlled, clinical trial

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Abstract

Background

Non-alcoholic fatty liver disease (NAFLD) is much more frequent and more severe, including cirrhosis, hepatocellular carcinoma in patients with type 2 diabetes. Coffee is a complex beverage with hundreds of compounds whereas caffeine and chlorogenic acid are the most abundant bioactive compounds. The published epidemiological data demonstrating beneficial associations between all categories of coffee exposure and ranges of liver outcomes are rapidly growing; however, the main contributors and cause-effect relationships have not yet been elucidated. To address existing knowledge gaps, we sought to determine the efficacy and safety of 6 months chlorogenic acid and/or caffeine supplementation in patients with type 2 diabetes affected by NAFLD.

Methods

This trial was carried out at two Diabetes Centers to assess the effects of supplementation with daily doses of 200 mg chlorogenic acid, 200 mg caffeine, 200 mg chlorogenic acid plus 200 mg caffeine or placebo (starch) in patients with type 2 diabetes and NAFLD. The primary endpoint was reduction of hepatic fat and stiffness measured by FibroScan, and changes in serum hepatic enzymes and cytokeratin − 18 (CK-18) levels. Secondary endpoints were improvements in metabolic (including fasting glucose, homeostasis model assessment-estimated insulin resistance (HOMA-IR), hemoglobin A1c (HBA1C), C-peptide, insulin and lipid profiles) and inflammatory (including nuclear factor k-B (NF-KB), tumor necrosis factor (TNF-α), high sensitive- C reactive protein(hs-CRP)) parameters from baseline to the end of treatment.

Results

Neither chlorogenic acid nor caffeine was superior to placebo in attenuation of the hepatic fat and stiffness and other hepatic outcomes in patients with diabetes and NAFLD. Except for the lower level of total cholesterol in caffeine group ( p = 0.04), and higher level of insulin in chlorogenic acid plus caffeine group ( p = 0.01) compared with placebo, there were no significant differences among the treatment groups.

Conclusion

These findings do not recommend caffeine and/or chlorogenic acid to treat NAFLD in type 2 diabetes patients.

Trial registration

IRCT201707024010N21. Registered 14 September 2017.

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Most cited references 47

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International physical activity questionnaire: 12-country reliability and validity.

CORA L. CRAIG, ALISON L. MARSHALL, MICHAEL SJ??STR??M … (2003)

Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity. Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the "last 7 d" or a "usual week" of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman's correlation coefficients are reported, based on the total reported physical activity. Overall, the IPAQ questionnaires produced repeatable data (Spearman's rho clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median rho of about 0.30, which was comparable to most other self-report validation studies. The "usual week" and "last 7 d" reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode. The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form "last 7 d recall" is recommended for national monitoring and the long form for research requiring more detailed assessment.

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Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes

Robin Poole, Oliver Kennedy, Paul Roderick … (2017)

Objectives To evaluate the existing evidence for associations between coffee consumption and multiple health outcomes. Design Umbrella review of the evidence across meta-analyses of observational and interventional studies of coffee consumption and any health outcome. Data sources PubMed, Embase, CINAHL, Cochrane Database of Systematic Reviews, and screening of references. Eligibility criteria for selecting studies Meta-analyses of both observational and interventional studies that examined the associations between coffee consumption and any health outcome in any adult population in all countries and all settings. Studies of genetic polymorphisms for coffee metabolism were excluded. Results The umbrella review identified 201 meta-analyses of observational research with 67 unique health outcomes and 17 meta-analyses of interventional research with nine unique outcomes. Coffee consumption was more often associated with benefit than harm for a range of health outcomes across exposures including high versus low, any versus none, and one extra cup a day. There was evidence of a non-linear association between consumption and some outcomes, with summary estimates indicating largest relative risk reduction at intakes of three to four cups a day versus none, including all cause mortality (relative risk 0.83, 95% confidence interval 0.83 to 0.88), cardiovascular mortality (0.81, 0.72 to 0.90), and cardiovascular disease (0.85, 0.80 to 0.90). High versus low consumption was associated with an 18% lower risk of incident cancer (0.82, 0.74 to 0.89). Consumption was also associated with a lower risk of several specific cancers and neurological, metabolic, and liver conditions. Harmful associations were largely nullified by adequate adjustment for smoking, except in pregnancy, where high versus low/no consumption was associated with low birth weight (odds ratio 1.31, 95% confidence interval 1.03 to 1.67), preterm birth in the first (1.22, 1.00 to 1.49) and second (1.12, 1.02 to 1.22) trimester, and pregnancy loss (1.46, 1.06 to 1.99). There was also an association between coffee drinking and risk of fracture in women but not in men. Conclusion Coffee consumption seems generally safe within usual levels of intake, with summary estimates indicating largest risk reduction for various health outcomes at three to four cups a day, and more likely to benefit health than harm. Robust randomised controlled trials are needed to understand whether the observed associations are causal. Importantly, outside of pregnancy, existing evidence suggests that coffee could be tested as an intervention without significant risk of causing harm. Women at increased risk of fracture should possibly be excluded.

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Caffeinated and Decaffeinated Coffee Consumption and Risk of Type 2 Diabetes: A Systematic Review and a Dose-Response Meta-analysis

Xiang-Ming Ding, Shilpa Bhupathiraju, Mu-Ya Chen … (2014)

OBJECTIVE Previous meta-analyses identified an inverse association of coffee consumption with the risk of type 2 diabetes. However, an updated meta-analysis is needed because new studies comparing the trends of association for caffeinated and decaffeinated coffee have since been published. RESEARCH DESIGN AND METHODS PubMed and Embase were searched for cohort or nested case-control studies that assessed the relationship of coffee consumption and risk of type 2 diabetes from 1966 to February 2013. A restricted cubic spline random-effects model was used. RESULTS Twenty-eight prospective studies were included in the analysis, with 1,109,272 study participants and 45,335 cases of type 2 diabetes. The follow-up duration ranged from 10 months to 20 years. Compared with no or rare coffee consumption, the relative risk (RR; 95% CI) for diabetes was 0.92 (0.90–0.94), 0.85 (0.82–0.88), 0.79 (0.75–0.83), 0.75 (0.71–0.80), 0.71 (0.65–0.76), and 0.67 (0.61–0.74) for 1–6 cups/day, respectively. The RR of diabetes for a 1 cup/day increase was 0.91 (0.89–0.94) for caffeinated coffee consumption and 0.94 (0.91–0.98) for decaffeinated coffee consumption (P for difference = 0.17). CONCLUSIONS Coffee consumption was inversely associated with the risk of type 2 diabetes in a dose-response manner. Both caffeinated and decaffeinated coffee was associated with reduced diabetes risk.

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Author and article information

Contributors

Azita Hekmatdoost:

ORCID: http://orcid.org/0000-0002-1944-0052

a_hekmat2000@yahoo.com

Journal

Journal ID (nlm-ta): Nutr J

Journal ID (iso-abbrev): Nutr J

Title: Nutrition Journal

Publisher: BioMed Central (London )

ISSN (Electronic): 1475-2891

Publication date (Electronic): 10 April 2021

Publication date PMC-release: 10 April 2021

Publication date Collection: 2021

Volume: 20

Electronic Location Identifier: 35

Affiliations

[1 ]GRID grid.411600.2, Department of Clinical Nutrition & Dietetics, Faculty of Nutrition Sciences and Food Technology, , National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, ; Tehran, Iran

[2 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Endocrinology and Metabolism Research Center, , Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, ; Tehran, Iran

[3 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Radiology Department, Shariati Hospital, , Tehran University of Medical Sciences, ; Tehran, Iran

[4 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Non-communicable Diseases Research Center, , Alborz University of Medical Sciences, ; Karaj, Iran

[5 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Chronic Diseases Research Center, , Endocrinology and Metabolism Population Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, ; Tehran, Iran

[6 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Liver and Pancreatobiliary Diseases Research Center, , Digestive Diseases Research Institute, Tehran University of Medical Sciences, ; Tehran, Iran

[7 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Diabetes Research Center, , Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, ; Tehran, Iran

Author information

Azita Hekmatdoost http://orcid.org/0000-0002-1944-0052

Article

Publisher ID: 694

DOI: 10.1186/s12937-021-00694-5

PMC ID: 8037901

PubMed ID: 33838673

SO-VID: 99abb971-0d1f-443e-8fdc-0f0fdc642bd0

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 22 July 2020

Date accepted : 3 April 2021

Funding

Funded by: National Institute for Medical Research Developments

Funded by: FundRef http://dx.doi.org/10.13039/501100008036, National Nutrition and Food Technology Research Institute;

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ScienceOpen disciplines: Nutrition & Dietetics

Keywords: coffee,caffeine, chlorogenic acid,type 2 diabetes,non-alcoholic fatty liver disease,clinical trial

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ScienceOpen disciplines: Nutrition & Dietetics

Keywords: coffee, caffeine, chlorogenic acid, type 2 diabetes, non-alcoholic fatty liver disease, clinical trial

Effects of supplementation with main coffee components including caffeine and/or chlorogenic acid on hepatic, metabolic, and inflammatory indices in patients with non-alcoholic fatty liver disease and type 2 diabetes: a randomized, double-blind, placebo-controlled, clinical trial

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Abstract

Background

Methods

Results

Conclusion

Trial registration

Related collections

Better latte than never: Is coffee good for your health?

Most cited references 47

International physical activity questionnaire: 12-country reliability and validity.

Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes

Caffeinated and Decaffeinated Coffee Consumption and Risk of Type 2 Diabetes: A Systematic Review and a Dose-Response Meta-analysis

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