Many people ask about liver wellness and what they can do to keep their liver healthy. The best recommendations that I can give are to avoid potential risk factors for chronic liver disease such as drug and alcohol use, make sure vaccination against hepatitis A and B are performed and proven effective and to follow a healthy diet with adequate exercise. The healthiest diet is one low in carbohydrates, high in fruits and vegetables, low in red meat and high in proteins such as chicken, turkey or fish. Exercise should consist of at least 30 minutes a day of a vigorous regimen.
Coffee has repeatedly been studied and coffee drinking has been associated with liver wellness in patients with chronic liver disease. From the health pages to the business sections of the media and social media, coffee is a hot item. A recent study pointed out that coffee drinkers live longer. Coffee is the second most commonly traded commodity in the world behind petroleum and is the world’s most consumed beverage. Coffee had been popular in the Middle East long before it made its way to Europe. Interestingly, the first coffee house in Europe was reported to have been opened in England by a Turkish immigrant in the mid-17th-century, some 30 years before the opening of the famed coffee houses in Vienna.
Over the centuries, coffee has become a mainstay of our culture with coffee shops, both independent and chain stores, located on almost all main streets in America. It is the first beverage most adult Americans drink in the morning. For this author, it functions as an eye-opener on many early mornings. Coffee is consumed not only because of taste and pleasant aroma, but because of the effect it has on those who drink it. Caffeine, found in most coffees, is a known stimulant. For this reason, it is popular among Americans who use its effects to get more energy for work, to stay awake at night, or sometimes to help reverse the fatigue effects of alcohol. In addition to caffeine, coffee has also been shown to stimulate the production of cortisone and adrenaline, two stimulatory hormones.
Coffee has been shown to have numerous medical benefits. It increases the effectiveness of some painkillers and may be helpful in improving symptoms of migraine headaches. Coffee increases gastrointestinal motility and thus may help improve symptoms of constipation but it can also cause significant diarrhea. It also acts as a diuretic, which leads to frequent urination, and can lead to dehydration. Therefore, dehydrated people should avoid coffee until they adequately rehydrate themselves. Some people claim that coffee increases short-term memory, improves asthma symptoms and lessens the likelihood of gallstone formation although these claims have never been proven.
Researchers report that drinking coffee decreases the risk of the development of alcoholic cirrhosis by 22 percent. Four cups of coffee per day reduced the risk of alcoholic cirrhosis by 80 percent. Research has also shown that coffee drinking can prevent the development of liver cancer in people with chronic liver disease. There is an inverse association between coffee consumption and liver cancer in people with and without a history of liver disease.
Overall, an increase in consumption of two cups of coffee per day is associated with a 43 percent reduced risk of liver cancer amongst populations who typically consume anything from one to more than five cups per day. These studies did not state or speculate as to how coffee was playing a role but they did note that this protective effect was not seen in tea drinkers. However, more than 10 separate studies have come to the same conclusion. It should be noted that these findings pertain to black coffee, not all the fancy flavored or high caloric sugar and milk laden products which are so common in our country. While coffee seems protective in this population, the primary approach to reduction of alcoholic cirrhosis is the avoidance or cessation of heavy alcohol drinking.
Drinking coffee, however, does not come without some potential health risks. Too much caffeine can lead to nervousness, anxiety, discoloration of the teeth and increased blood pressure. While some people drink coffee to stay awake, others find that coffee leads to significant insomnia thus creating a cycle of drinking coffee to stay awake and alert during the day but being unable to sleep at night requiring at times the use of sleeping medications.
So what are we to take away from all this information? Certainly, many of us love our coffee and will continue to imbibe regardless of any new information. Perhaps coffee is good for us, perhaps not. Perhaps drinking it in moderation is the safest strategy until we are told otherwise.
David Bernstein, MD, FAASLD,FACG, AGAF, FACP, is the chief of hepatology at Sandra Atlas Bass Center for Liver Diseases and a professor of medicine at Hofstra-Northwell School of Medicine.