Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Epidemiology

Coffee consumption and liver-related hospitalizations and deaths in the ARIC study

European Journal of Clinical Nutrition volume 73, pages 1133–1140 (2019)Cite this article

Subjects

Abstract

Background/Objectives

Coffee consumption has been found to be associated with reduced risk of chronic conditions such as liver disease. However, less is known about the association between coffee and liver-related hospitalizations and deaths.

Subjects/Methods

We conducted a prospective analysis on 14,208 participants aged 45–64 years from the Atherosclerosis Risk in Communities (ARIC) study. Coffee consumption (cups/day) was assessed using food frequency questionnaires at visit 1 (1987–89) and visit 3 (1993–95). Liver-related hospitalizations were defined as a hospitalization with any International Classification of Diseases, Ninth Revision (ICD-9) code related to liver disease identified through cohort surveillance. Liver-related death was defined as any death with a liver disease ICD-9 code listed anywhere on the death certificate form.

Results

There were 833 incident cases of liver-related hospitalizations over a median follow-up of 24 years and 152 liver-related deaths over a median follow-up of 25 years. Participants who were in the highest category of coffee consumption (≥ 3 cups/day) were more likely to be men, whites, current smokers, and current alcohol drinkers. In our fully adjusted model, consuming ≥ 3 cups/day of coffee was significantly associated with a reduced risk of liver-related hospitalizations compared with never drinkers (hazard ratio: 0.79, 95% CI: 0.63–0.99). There were no significant associations between coffee consumption and liver-related deaths after adjusting for covariates.

Conclusions

Coffee drinkers may be at lower risk for liver-related hospitalizations. This supports current evidence that low and moderate levels of coffee may be protective to the liver.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. Accessed on 25 October 2017. Available from: http://health.gov/dietaryguidelines/2015/guidelines/.

  2. Floegel A, Pischon T, Bergmann MM, Teucher B, Kaaks R, Boeing H. Coffee consumption and risk of chronic disease in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Germany study. Am J Clin Nutr. 2012;95:901–8.

    Article  CAS  Google Scholar 

  3. Ding M, Bhupathiraju SN, Chen M, van Dam RM, Hu FB. Caffeinated and decaffeinated coffee consumption and risk of type 2 diabetes: a systematic review and a dose-response meta-analysis. Diabetes Care. 2014;37:569–86.

    Article  Google Scholar 

  4. Ding M, Bhupathiraju SN, Satija A, van Dam RM, Hu FB. Long-term coffee consumption and risk of cardiovascular disease: a systematic review and a dose-response meta-analysis of prospective cohort studies. Circulation. 2014;129:643–59.

    Article  CAS  Google Scholar 

  5. Bhoo-Pathy N, Peeters PH, Uiterwaal CS, Bueno-de-Mesquita HB, Bulgiba AM, Bech BH, et al. Coffee and tea consumption and risk of pre- and postmenopausal breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study. Breast Cancer Res. 2015;17:15.

    Article  Google Scholar 

  6. Zhou Q, Luo ML, Li H, Li M, Zhou JG. Coffee consumption and risk of endometrial cancer: a dose-response meta-analysis of prospective cohort studies. Sci Rep. 2015;5:13410.

    Article  CAS  Google Scholar 

  7. Ding M, Satija A, Bhupathiraju SN, Hu Y, Sun Q, Han J, et al. Association of coffee consumption with total and cause-specific mortality in 3 large prospective cohorts. Circulation. 2015;132:2305–15.

    Article  CAS  Google Scholar 

  8. Freedman ND, Park Y, Abnet CC, Hollenbeck AR, Sinha R. Association of coffee drinking with total and cause-specific mortality. N Engl J Med. 2012;366:1891–904.

    Article  CAS  Google Scholar 

  9. Gunter MJ, Murphy N, Cross AJ, Dossus L, Dartois L, Fagherazzi G, et al. Coffee drinking and mortality in 10 European countries: a multinational cohort study. Ann Intern Med. 2017;167:236–47.

    Article  Google Scholar 

  10. Park SY, Freedman ND, Haiman CA, Le Marchand L, Wilkens LR, Setiawan VW. Association of coffee consumption with total and cause-specific mortality among nonwhite populations. Ann Intern Med. 2017;167:228–35.

    Article  Google Scholar 

  11. Xiao Q, Sinha R, Graubard BI, Freedman ND. Inverse associations of total and decaffeinated coffee with liver enzyme levels in National Health and Nutrition Examination Survey 1999-2010. Hepatology. 2014;60:2091–8.

    Article  CAS  Google Scholar 

  12. Saab S, Mallam D, Cox GA 2nd, Tong MJ. Impact of coffee on liver diseases: a systematic review. Liver Int. 2014;34:495–504.

    Article  Google Scholar 

  13. Klatsky AL, Morton C, Udaltsova N, Friedman GD. Coffee, cirrhosis, and transaminase enzymes. Arch Intern Med. 2006;166:1190–5.

    Article  Google Scholar 

  14. Ruhl CE, Everhart JE. Coffee and tea consumption are associated with a lower incidence of chronic liver disease in the United States. Gastroenterology. 2005;129:1928–36.

    Article  Google Scholar 

  15. Bravi F, Tavani A, Bosetti C, Boffetta P, La Vecchia C. Coffee and the risk of hepatocellular carcinoma and chronic liver disease: a systematic review and meta-analysis of prospective studies. Eur J Cancer Prev. 2017;26:368–77.

    Article  CAS  Google Scholar 

  16. Bravi F, Bosetti C, Tavani A, Gallus S, La Vecchia C. Coffee reduces risk for hepatocellular carcinoma: an updated meta-analysis. Clin Gastroenterol Hepatol. 2013;11:1413–21 e1.

    Article  CAS  Google Scholar 

  17. The Atherosclerosis Risk in Communities (ARIC) Study: design and objectives. The ARIC investigators. Am J Epidemiol. 1989;129:687–702.

    Article  Google Scholar 

  18. Willet W. Nutritional Epidemiology. 3rd edn, Oxford University Press; New York, NY 2013.

  19. Kim WR, Brown RS Jr., Terrault NA, El-Serag H. Burden of liver disease in the United States: summary of a workshop. Hepatology. 2002;36:227–42.

    Article  Google Scholar 

  20. Rebholz CM, Crews DC, Grams ME, Steffen LM, Levey AS, Miller ER 3rd, et al. DASH (Dietary Approaches to Stop Hypertension) diet and risk of subsequent kidney disease. Am J Kidney Dis. 2016;68:853–61.

    Article  Google Scholar 

  21. Gallus S, Bertuzzi M, Tavani A, Bosetti C, Negri E, La Vecchia C, et al. Does coffee protect against hepatocellular carcinoma? Br J Cancer. 2002;87:956–9.

    Article  CAS  Google Scholar 

  22. Liu F, Wang X, Wu G, Chen L, Hu P, Ren H, et al. Coffee consumption decreases risks for hepatic fibrosis and cirrhosis: a meta-analysis. PLoS ONE. 2015;10:e0142457.

    Article  Google Scholar 

  23. Gutierrez-Grobe Y, Chavez-Tapia N, Sanchez-Valle V, Gavilanes-Espinar JG, Ponciano-Rodriguez G, Uribe M, et al. High coffee intake is associated with lower grade nonalcoholic fatty liver disease: the role of peripheral antioxidant activity. Ann Hepatol. 2012;11:350–5.

    Article  CAS  Google Scholar 

  24. Esposito F, Morisco F, Verde V, Ritieni A, Alezio A, Caporaso N, et al. Moderate coffee consumption increases plasma glutathione but not homocysteine in healthy subjects. Aliment Pharmacol Ther. 2003;17:595–601.

    Article  CAS  Google Scholar 

  25. Vitaglione P, Morisco F, Mazzone G, Amoruso DC, Ribecco MT, Romano A, et al. Coffee reduces liver damage in a rat model of steatohepatitis: the underlying mechanisms and the role of polyphenols and melanoidins. Hepatology. 2010;52:1652–61.

    Article  CAS  Google Scholar 

  26. Dranoff JA, Feld JJ, Lavoie EG, Fausther M. How does coffee prevent liver fibrosis? Biological plausibility for recent epidemiological observations. Hepatology. 2014;60:464–7.

    Article  Google Scholar 

  27. Arauz J, Moreno MG, Cortes-Reynosa P, Salazar EP, Muriel P. Coffee attenuates fibrosis by decreasing the expression of TGF-beta and CTGF in a murine model of liver damage. J Appl Toxicol. 2013;33:970–9.

    Article  CAS  Google Scholar 

  28. Svilaas A, Sakhi AK, Andersen LF, Svilaas T, Strom EC, Jacobs DR Jr., et al. Intakes of antioxidants in coffee, wine, and vegetables are correlated with plasma carotenoids in humans. J Nutr. 2004;134:562–7.

    Article  CAS  Google Scholar 

  29. Arion WJ, Canfield WK, Ramos FC, Schindler PW, Burger HJ, Hemmerle H, et al. Chlorogenic acid and hydroxynitrobenzaldehyde: new inhibitors of hepatic glucose 6-phosphatase. Arch Biochem Biophys. 1997;339:315–22.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank the staff and participants of the ARIC study for their important contributions. The Atherosclerosis Risk in Communities study has been funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contract nos. (HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700004I, HHSN268201700005I). Ms. Hu was supported by a grant from the National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute (training grant T32 HL007024). Dr. Rebholz was supported by a mentored research scientist development award from the National Institute of Diabetes and Digestive and Kidney Diseases (K01 DK107782). Dr. Selvin was supported by NIH/NIDDK grants K24DK106414 and R01DK089174.

Author information

Authors and Affiliations

  1. Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA

    Emily A. Hu, Mariana Lazo, Elizabeth Selvin, Morgan E. Grams, Josef Coresh & Casey M. Rebholz

  2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Emily A. Hu, Mariana Lazo, Elizabeth Selvin, Josef Coresh & Casey M. Rebholz

  3. Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    James P. Hamilton

  4. Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Morgan E. Grams

  5. Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA

    Lyn M. Steffen

Authors
  1. Emily A. Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mariana Lazo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elizabeth Selvin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. James P. Hamilton
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Morgan E. Grams
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lyn M. Steffen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Josef Coresh
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Casey M. Rebholz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Casey M. Rebholz.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hu, E.A., Lazo, M., Selvin, E. et al. Coffee consumption and liver-related hospitalizations and deaths in the ARIC study. Eur J Clin Nutr 73, 1133–1140 (2019). https://doi.org/10.1038/s41430-018-0346-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41430-018-0346-0

Search

Advanced search

Quick links