Coffee and tea protect against chronic liver disease
A study that is the first of its kind to examine the relationship between coffee and tea consumption and chronic liver disease among Americans revealed that consuming the two or more cups of either beverage on a daily basis may be protective to high risk individuals. Chronic liver diseases include fibrosis, cirrhosis, and hepatitis, and can have a number of causes. The effect was seen in those at high risk of liver disease from being overweight, drinking heavily, being a diabetic, or having iron overload. The study was published online in Gastroenterology, the journal of the American Gastroenterological Association, and will appear in the December 2005 issue.
Constance E Ruhl, MD, PhD, of Social and Scientific Systems, Inc., in Silver Spring, Maryland and James E. Everhart, MD, MPH, of the National Institutes of Health in Bethesda analyzed data obtained from 9,849 data from the first National Health and Nutrition Examination Survey (NHANES I). Participants were asked about the number of cups of coffee and tea consumed daily in interviews conducted during 1971 to 1975, and were followed for an average of 19 years. A second analysis of 9,650 NHANES I Epidemiologic Follow-Up Study participants who were interviewed during 1982 to 1984 was also conducted.
During the follow-up period, 1.4 percent of the subjects developed chronic liver disease. Drs Ruhl and Everhart found that consuming more than two cups of coffee or tea per day was associated with less than half the risk of developing chronic liver disease than that experienced by those who drank less than one cup per day. When subjects who were at low risk and those who were at high risk of liver disease were analyzed separately, the protective benefit of drinking two or more cups of coffee and tea per day emerged only among those in the high risk group. Analysis of participants in the NHANES I Epidemiologic Follow-Up study revealed a similar association, however, the risk reduction was only statistically significant for coffee consumption.
Dr Ruhl stated, "While it is too soon to encourage patients to increase their coffee and tea intake, the findings of our study potentially offer people at high-risk for developing chronic liver disease a practical way to decrease that risk. In addition, we hope the findings will offer guidance to researchers who are studying liver disease progression."
"In the analysis, we determined that caffeine was partly responsible for the protective effect found,” Dr Ruhl added. “We believe that investigations into the mechanism of action of caffeine for protecting the liver and its clinical application are needed."
Cirrhosis of the liver is a chronic, diffuse (widely spread throughout the organ), degenerative disease in which the parenchyma (the functional organ tissue) deteriorates; the lobules are infiltrated with fat and structurally altered; dense perilobular connective tissue forms; and often areas of regeneration develop. The surviving cells multiply in an attempt to regenerate and form "islands" of living cells that are separated by scar tissue. These islands of living cells have a reduced blood supply, resulting in impaired liver function. As the cirrhotic process continues, blood flow through the liver becomes blocked; portal hypertension may occur (high blood pressure in the veins connecting the liver with the intestines and spleen); glucose and vitamin absorption decrease; the manufacturing of hormones and stomach and bowel function are affected; and noticeable facial veins may appear. Most patients die from cirrhosis in the fifth or sixth decade of life (Wolf 2001).
Green tea has been in widespread, common use in China for thousands of years. In the last several decades, green tea has also been widely used in the treatment of hepatic disease in Europe. Green tea has active ingredients called catechin polyphenols. Catechins in green tea have potential therapeutic significance because of their potent antioxidants, which have an ability to neutralize free radicals and act as free-radical scavengers. Green tea has been shown to have antiviral activity and immune-stimulating properties (Kaul et al. 1985); protective benefits from hepatotoxicity caused by carbon tetrachloride, ethanol, and 2-nitropropane (a common industrial solvent also found in tobacco smoke) (Lewis et al. 1979); promise for treatment of many types of hepatic disease, particularly acute and chronic viral hepatitis; and fibrosis (overgrowth of collagen) (Pontz et al.1982).
Phosphatidylcholine is one of the most important substances for liver protection and health and is a primary constituent of the cell membrane. As such, PC is necessary for integrity of liver cells. In studies in rats, PC has prolonged the survival of rat liver cells in culture by stabilizing the cell membrane (Miyazak et al. 1991). Liver cells that have been damaged by alcohol or cirrhosis are unable to meet the ongoing demands of the liver for phospholipid synthesis. Adding phospholipids such as PC via oral intake played an important role in regeneration of damaged liver cells (Horejsova et al. 1994).
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