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Coffee, chronic diseases and cancer

The paper by von Ruesten et al.,1 recently published in the Eur J Clin Nutr, reports data demonstrating that coffee consumption is associated with a significant reduction of chronic diseases overall and, specifically, of type II diabetes but not of cardiovascular diseases or cancer. The authors comment their interesting findings as ‘paradoxical’ but, if this can well be true for sweets and snacks, also inversely correlated in the EPIC-Potsdam study with a reduced risk, it is not certainly so for coffee. Even though not fully confirmed in the preliminary analysis of EPIC-Postdam study data, the protective effects of regular coffee consumption for several neoplastic diseases, including for instance colon cancer, is supported by reviews and meta-analyses.2 Also the evidence in favor of coffee consumption as a protective factor for the development of advanced liver damage and hepatocellular carcinoma is sound and sustained by several case–control studies and by meta-analysis.3 We recently published a prospective randomized controlled study with a crossover design showing that, in patients with chronic hepatitis C virus (HCV)-related liver damage, the daily consumption of four cups of coffee induces a reduction in collagen synthesis and in free radical-mediated oxidative DNA damage, and increases the levels of circulating markers of apoptosis.4 In our interpretation, these findings explain, at least in part, the reduction in the progression rate of chronic liver damage toward cirrhosis and cancer.

We think it might be worth to contribute to the discussion by reporting the data we have now available on a new series of 106 patients consecutively referring to our out-patient clinic for disease staging and treatment. All patients were affected by chronic HCV-related liver disease in different stages, and underwent the determination of free radical-mediated oxidative DNA damage in circulating leukocytes. Together with a reduction in the levels of liver damage parameters, such as alkaline phosphatase (ALP), the daily consumption of three or more cups of coffee was linked to almost two times lower levels of 8-hydroxydeoxyguanosine (8-OHdG), a DNA adduct marker of oxidative DNA damage that accumulates, causes mispairing and DNA mutation, and is therefore involved in liver carcinogenetic process5—this with similar disease stage, similar levels of circulating HCV–RNA and a body mass index not significantly different in the two groups (Table 1). The protective effect of coffee with respect to hepatocellular carcinoma, a cancer in which free radical-mediated damage is of major relevance, may be due to the many antioxidant compounds contained in this beverage, among which are polyphenols and many others, or to the induction of antioxidant enzymes, an effect exerted even at very small doses6 or, in any case, when coffee is consumed for a relatively short period of time, as in our previously quoted study.4

Table 1 Mean levels (±s.d.) of oxidative DNA damage (8-OHdG), viral load (HCV–RNA), BMI, ALP and fibrosis stage in two patients’ groups with different coffee consumption

In conclusion, many are the favorable effects of coffee and among them cancer prevention is neither the last nor obviously the least one, even though the point is still open to discussion, in particular with respect to causality and mechanisms involved.


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Correspondence to F Farinati.

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Farinati, F., Cardin, R. & Piciocchi, M. Coffee, chronic diseases and cancer. Eur J Clin Nutr 67, 898 (2013).

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