Coffee Lowers risk of Gallstone Disease for Men in Major Study
Results of a large American population study suggest that regular
consumption of coffee (Coffea arabica L. and C.
canephora Pierre ex Froehner, Rubiaceae) may provide protection
against the development of symptomatic gallbladder disease (Leitzmann
et al., 1999). According to the study, men who drank two
to three cups of regular (caffeinated) coffee a day had a 40 percent
lower risk of developing gallstone disease, and risk was reduced
by 45 percent for those who drank four or more cups a day. All
brewing methods (including filtered, instant, and espresso) were
associated with decreased risk. Risk also declined with increasing
caffeine intake. Men in the highest category of caffeine intake
(more than 800 mg a day) had a risk reduction of 45 percent, compared
with those who consumed less than 25 mg of caffeine a day. Decaffeinated
coffee was not associated with any risk reduction.
The coffee analysis was part of the Health Professionals Follow-up
Study, a prospective cohort study that tracked the dietary habits
and health histories of 51,529 male physicians, veterinarians,
and dentists aged 40 to 75 between 1986 and 1996. The study assessed
the consumption of coffee and other caffeinated beverages as part
of a 131-item food frequency questionnaire. A total of 46,008
men were eligible for inclusion in the coffee analysis, after
exclusion of those with histories of gallbladder disease, cancer,
or calorie intake outside a normal range. Dietary and health histories
were established with a baseline questionnaire and updated biennially
through follow-up questionnaires. The main outcome measurement
was new symptomatic gallstone disease (diagnosed by ultrasound
or x-ray) or cholecystectomy (gallbladder removal).
The investigators speculate that a number of coffee constituents
may contribute to the protective effect, citing earlier research
on the metabolic effects of caffeine, cafestol, and whole-bean
coffee. According to the authors, caffeine has demonstrated an
ability to increase bile flow, decrease gallbladder fluid absorption,
and inhibit biliary cholesterol crystallization, and cafestol
(a lipid compound in coffee beans) may affect the concentration
of bile cholesterol. Coffee itself has been shown to stimulate
the release of cholecystokinin (a polypeptide that stimulates
contraction of the gallbladder and release of pancreatic juice)
and to increase gallbladder and large bowel motility. Most population
studies investigating the relationship between coffee consumption
and gallbladder disease have demonstrated lowered risks for people
with high coffee intake, but at least three studies have suggested
an increased risk. Gallstone disease is estimated to affect more
than 20 million Americans and result in at least 800,000 hospitalizations
a year, with direct costs of more than $2 billion. - Evelyn
Leigh, HRF
[Leitzmann MF, Willett WC,
Rimm EB, Stampfer MJ, Spiegelman D, Colditz GA, Giovannucci E. A
prospective study of coffee consumption and the risk of symptomatic
gallstone disease in men. JAMA 1999; 281(22): 2106-2112.] |
