DNC News

Coffee Lowers Risk of Liver Cancer:

 

Subject: repeated studies suggest that the more coffee consumed the lower the risk for liver cancer.   This holds true for people at high risk for liver cancer

 

We returned to the office Monday after a two week hiatus during which we volunteered to provide the food for the sixty plus participants of the 12th annual Building Bridges for Peace program that was held this year at Copper Mountain . This program gathers teenage girls, Israeli, Palestinian and American and brings them together for two weeks of training in communication skills and dialogue with the hope of planting seeds for future cooperation in finding solutions to some of the conflicts in the Middle East . An article about the program appeared in Tuesday's Denver Post. http://www.denverpost.com/search/ci_2944412

 

I confess that this ‘vacation' was more work and more exhausting than I possible. Working fourteen hour days rekindled my appreciation for coffee. For someone like me, unaccustomed to drinking coffee, those first few cups were close to a magical elixir. By the end of the week, the magic had worn off; it was a necessity not a pleasure. I needed those last few cups of coffee to stay awake driving the U-Haul back to Denver yet I sincerely hoped the other drivers on I-70 weren't feeling as irritable as me.

 

Mythology attributes the discovery of coffee's effect to an Ethiopian goatherd named Kaldi who noticed distinct behavioral changes in his flock after they grazed on coffee beans. Kaldi then took the "magic" berries to a nearby monastery where the abbot, believing them to be the work of the devil, threw them into the fire. This released the aroma of the coffee and the berries were hastily rescued from the flames and the monks learned how to make coffee.

 

The first ‘coffee shop' in which coffee brewed with hot water was served to patrons opened in Constantinople in 1475. Coffee beans reached Venice in 1615 but were traded as a medicinal herb and not used as a recreational beverage.

 

It wasn't until the siege of Vienna was broken in 1683 that coffee drinking reached European society. This to me is the highpoint in the story of coffee. And also one of the highpoints in the history of baking.

 

During the siege, the Turkish armies had surrounded Vienna and King Leopold's army but were unable to attack the actual fortifications because Leopold's artillery kept them at a distance. The Turks attempted to tunnel beneath the walls of Vienna in order to plant explosives and knock the walls down. One of the Turkish tunnels went beneath a bakery; the bakers heard the sounds of digging below them and alerted the garrison. Counter-mines were dug and the Turkish tunnels destroyed. The surprise attack turned into a surprise defeat and a hasty retreat. This historic battle left us with two remarkable things.

 

First, King Leopold, who is remembered as something of a cheap skate, did not reward the bakers who had saved his city with a bag of gold. Rather he granted them permission to make rolls in the shape of a crescent, the symbol of the Turkish Empire they helped defeat. From this monarchial decree came the crescent roll, to which we still apply the French name, croissant.

 

Second, in their haste to flee the Austrians, the defeated Turkish Army abandoned their camps and their supplies. Among their food rations were ample supplies of coffee beans which the Viennese appropriated, brewed and found to their liking.

 

Which brings me to last week's issues of the British Journal of Cancer and the International Journal of Cancer. Each contains an article confirming earlier studies that say coffee drinking lowers the risk of developing liver cancer. [i] [ii] Several similar studies have been published over the last few years. [iii] [iv] These two articles make what sounded like a Starbuck's PR fantasy at first to sound scientifically plausible.

 

The BJC study reported on data compiled from 110,688 people, aged 40-79 years, who were grouped by coffee intake into three categories: one or more cups per day, less than one cup per day and non-coffee drinkers. The hazard ratio of death due to liver cancer for drinkers of one and more cups of coffee per day, compared with non-coffee drinkers, was 0.50 (95% confidence interval 0.31-0.79), and the ratio for drinkers of less than one cup per day was 0.83 (95% confidence interval 0.54-1.25). The more coffee drunk, the less the risk.

 

In the IJC study, a self-administered questionnaire about the frequency of coffee consumption and other health habits was distributed to 22,404 subjects in Cohort 1 and 38,703 subjects in Cohort 2, aged 40 years or more, with no previous history of cancer. Over time the researchers identified 70 and 47 cases of liver cancer among the subjects in Cohort 1 and Cohort 2, respectively. The relative risk for developing liver cancer decreased with increasing coffee consumption. If those never drinking coffee had a risk of one, those drinking coffee occasionally had a relative risk of .71 and those who drdank one or more cups a day a risk of .58 . This protective effect was also seen in people with a history of liver disease, such as hepatitis or alcoholism, both of which drastically raise risk of liver cancer.

 

Similar results were reported last February in the Journal of the National Cancer Institute. [v]

 

Why would coffee do this? My first thought is that the ability to drink coffee simply selects out people who are less likely to get liver cancer. We all know that some people can drink a lot of coffee with seemingly little effect while other people need simply walk past a Starbucks to induce insomnia. People who aren't able to tolerate coffee have slow phase 1 liver detoxification pathways. Having a lower capacity to breakdown toxic chemicals may put these people at greater risk to develop cancer. On the other hand coffee induces phase I liver pathways and over time increase one's capacity to break down these toxic chemicals [vi] and provide protection. In other words coffee drinking will stimulate the liver to make more chemicals to protect itself from cancer causing chemicals. [vii] Research shows that getting rats to drink coffee protects them against the cancer causing effect of aflatoxins. [viii]

Coffee contains two specific chemicals, Cafestol and Kahweol, that have anticancer effect. [ix]

Thus the protection against liver cancer in these studies may be a combination of several factors. Non coffee drinkers may have an aversion to coffee due to genetic factors making them less able to tolerate it. Regular drinkers receive protection from coffee both by having liver function stimulated and from innate anti cancer effects of chemicals in the coffee.

 

The bottom line is that we need to rethink who should drink coffee. Obviously people at high risk of liver cancer should be encouraged to drink coffee. This would include people with a history of alcohol abuse and or alcoholic cirrhosis. It would also include people with a history of hepatitis B or ongoing chronic hepatitis C.

 

 

  A few other tidbits of information about coffee........

Over the years there have been conflicting studies whether coffee increases the risk of cardiovascular problems. Some studies have demonstrated significant increases in heart disease, [xi] others have shown none at all. [xii] [xiii] [xiv] This is confusing. Perhaps in selecting out coffee drinkers the researchers are also selecting out people who don't get enough sleep. I tend to seek out coffee when sleep deprived. Even a few hours of sleep debt a week can drastically increase the risk of heart disease.

 

1. Coffee does not increase the risk for rectal cancer but decafe coffee appears to decrease risk. [xv]

2. Coffee consumption decreases risk of suicide in women. [xvi]

3. Coffee decreases risk of diabetes in women. [xvii] This may be due to the weight loss the coffee produces. [xviii]

4. Coffee as was once suggested to but in fact does not increase risk for ovarian cancer. [xix]

5. No connection with Rheumatoid Arthritis. [xx]

6. No connection with non Hodgkin's lymphoma. [xxi]

Coffee consumption does not appear to change risk of pancreatic cancer. [x]

 

 

Coffee enemas are a traditional cancer treatment and still in wide use in the alternative treatment clinics of Mexico [xxii] . Though the treatment has fallen from favor in recent years for lack of scientific support, these newer studies might suggest we reconsider this therapy.

 

Hard as I search the medical literature I have not found any data to support the consumption of a croissant or two with my cup of coffee. Be sure that I am looking and will let you know if and when a study is published supporting such activity.

 

 

 

[i] Br J Cancer. 2005 Aug 9; [Epub ahead of print]

Coffee and risk of death from hepatocellular carcinoma in a large cohort study in Japan .

Kurozawa Y, Ogimoto I, Shibata A, Nose T, Yoshimura T, Suzuki H, Sakata R, Fujita Y, Ichikawa S, Iwai N, Tamakoshi A.

 

1Department of Social Medicine, Division of Health Administration and Promotion, Faculty of Medicine, Tottori University , Nishimachi 86, Yonago 683-8503, Japan .

 

We examined the relation between coffee drinking and hepatocellular carcinoma (HCC) mortality in the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study). In total, 110 688 cohort members (46 399 male and 64 289 female subjects) aged 40-79 years were grouped by coffee intake into three categories: one or more cups per day, less than one cup per day and non-coffee drinkers. Cox proportional hazards model by SAS was used to obtain hazard ratio of HCC mortality for each coffee consumption categories. The hazard ratios were adjusted for age, gender, educational status, history of diabetes and liver diseases, smoking habits and alcohol. The hazard ratio of death due to HCC for drinkers of one and more cups of coffee per day, compared with non-coffee drinkers, was 0.50 (95% confidence interval 0.31-0.79), and the ratio for drinkers of less than one cup per day was 0.83 (95% confidence interval 0.54-1.25). Our data confirmed an inverse association between coffee consumption and HCC mortality.British Journal of Cancer advance online publication, 9 August 2005; doi:10.1038/sj.bjc.6602737 www.bjcancer.com.

 

PMID: 16091758 [PubMed - as supplied by publisher]

 

 

[ii] Int J Cancer. 2005 Aug 10;116(1):150-4

Coffee consumption and the risk of primary liver cancer: pooled analysis of two prospective studies in Japan .

Shimazu T, Tsubono Y, Kuriyama S, Ohmori K, Koizumi Y, Nishino Y, Shibuya D, Tsuji I.

 

Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai , Japan . tshimazu-thk@umin.ac.jp

 

Although case-control studies suggested that coffee consumption is associated with a decreased risk of liver cancer, no prospective cohort study has been carried out. To examine the association between coffee consumption and the risk of liver cancer, we conducted a pooled analysis of data available from 2 cohort studies in Japan . A self-administered questionnaire about the frequency of coffee consumption and other health habits was distributed to 22,404 subjects (10,588 men and 11,816 women) in Cohort 1 and 38,703 subjects (18,869 men and 19,834 women) in Cohort 2, aged 40 years or more, with no previous history of cancer. We identified 70 and 47 cases of liver cancer among the subjects in Cohort 1 (9 years of follow-up with 170,640 person-years) and Cohort 2 (7 years of follow-up with 284,948 person-years), respectively. We used Cox proportional hazards regression analysis to estimate the relative risk (RR) and 95% confidence interval (CI) of liver cancer incidence. After adjustment for potential confounders, the pooled RR (95% CI) of drinking coffee never, occasionally and 1 or more cups/day were 1.00 (Reference), 0.71 (0.46-1.09) and 0.58 (0.36-0.96), respectively (p for trend = 0.024). In the subgroup of subjects with a history of liver disease, we found a significant inverse association between coffee consumption and the risk of liver cancer. Our findings support the hypothesis that coffee consumption decreases the risk of liver cancer. Further studies to investigate the role of coffee in prevention of liver cancer among the high-risk population are needed. (c) 2005 Wiley-Liss, Inc.

 

Publication Types:

Multicenter Study

 

[iii] J Hepatol. 2005 Apr;42(4):528-34

Comment in:

J Hepatol. 2005 Apr;42(4):444-6.

Coffee consumption reduces the risk of hepatocellular carcinoma independently of its aetiology: a case-control study.

Gelatti U, Covolo L, Franceschini M, Pirali F, Tagger A, Ribero ML, Trevisi P, Martelli C, Nardi G, Donato F; Brescia HCC Study Group.

 

Department of Experimental and Applied Medicine, Chair of Hygiene, University of Brescia, Viale Europa 11, 25123 Brescia, Italy. gelatti@med.unibs.it

 

BACKGROUND/AIMS: The role of coffee in the development of hepatocellular carcinoma (HCC) is debated. The aim of this study was to investigate the role of coffee in HCC, taking the main risk factors into account. METHODS: A hospital-based case-control study was conducted in an area of northern Italy . We recruited 250 HCC cases and 500 controls hospitalized for any reasons other than neoplasms, and liver and alcohol-related diseases. Subjects were interviewed on their lifetime history of coffee consumption using a standardized questionnaire. RESULTS: Coffee consumption in the decade before the interview was associated with a decreasing risk of HCC with a clear dose-effect relation. With respect to non-drinking subjects, the odds ratios (ORs) were: 0.8, (95% CI 0.4-1.3) for 1-2 cups/day, 0.4 (95% CI 0.2-0.8) for 3-4 cups/day and 0.3 (95% CI 0.1-0.7) for 5 or more cups/day. The ORs for HCC decreased for drinking >2, compared to 0-2 cups/day of coffee, for an alcohol intake >80 g/day (OR from 5.7 to 3.3), for presence of hepatitis B virus infection (OR from 16.4 to 7.3) or hepatitis C virus infection (OR from 38.2 to 9.0). CONCLUSIONS: Coffee drinking was inversely associated with HCC regardless of its aetiology.

 

PMID: 15868652 [PubMed - indexed for MEDLINE]

 

 

[iv] Ann Epidemiol. 2002 Apr;12(3):202-5

Does coffee protect against liver cirrhosis?

Gallus S, Tavani A, Negri E, La Vecchia C.

 

Istituto di Ricerche Farmacologiche Mario Negri, Milano , Italy . gallus@marionegri.it

 

PURPOSE: To evaluate the relation between consumption of coffee and other methylxanthine-containing beverages and liver cirrhosis. METHODS: A hospital-based case-control study of digestive tract and liver diseases was conducted in Greater Milan, Italy, including 101 cases with liver cirrhosis and 1538 controls. RESULTS: Compared with coffee non-drinkers, the multivariate odds ratio (OR) was 0.77 for one cup of coffee per day, 0.57 for two, and 0.29 for three or more. The OR for 40 years of coffee consumption or more was 0.45. Trends in risk were significant for both number of cups and duration of coffee drinking. No significant association was observed with decaffeinated coffee, tea and cola-containing beverages. The relation between coffee consumption and liver cirrhosis was not attributable to confounding and was observed across strata of tobacco, alcohol, and other major covariates of interest. In particular, an inverse relation was observed also in subjects reporting moderate alcohol drinking. CONCLUSIONS: The present study confirms, and further quantifies, the existence of an inverse association between coffee consumption and liver cirrhosis. However, the metabolism of caffeine is impaired in fasting subjects with liver cirrhosis, and the association could be due to a reduction of coffee drinking in subjects with liver cirrhosis.

 

PMID: 11897178 [PubMed - indexed for MEDLINE]

 

[v] J Natl Cancer Inst. 2005 Feb 16;97(4):293-300.

Influence of coffee drinking on subsequent risk of hepatocellular carcinoma: a prospective study in Japan .

Inoue M, Yoshimi I, Sobue T, Tsugane S; JPHC Study Group.

 

Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 Japan. mnminoue@gan2.res.ncc.go.jp

 

BACKGROUND: An association between coffee drinking and reduced risk of liver cancer has been suggested by animal studies, but epidemiologic evidence of such an association in a high-risk population is lacking. We conducted a large-scale population-based cohort study of the association between coffee drinking and hepatocellular carcinoma (HCC) in a Japanese population. METHODS: Newly diagnosed case patients (250 men and 84 women) with HCC were identified from a 10-year follow-up of the Japan Public Health Center-based Prospective Study, which consists of 90,452 middle-aged and elderly Japanese subjects (43,109 men and 47,343 women). Case patients were grouped according to coffee intake and were stratified by hepatitis virus infection, sex, age, diet, lifestyle factors, and previous history of liver disease. Multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CIs) for HCC were calculated with Cox proportional-hazards modeling. All statistical tests were two-sided. RESULTS: Subjects (men and women combined) who consumed coffee on a daily or almost daily basis had a lower HCC risk than those who almost never drank coffee (HR = 0.49 [95% CI = 0.36 to 0.66]); risk decreased with the amount of coffee consumed (compared with nondrinkers, the HR for 1-2 cups per day = 0.52 [95% CI = 0.38 to 0.73]; for 3-4 cups per day = 0.48 [95% CI = 0.28 to 0.83]; for > or =5 cups per day = 0.24 [95% CI = 0.08 to 0.77], P(trend) < .001). The risk of liver cancer in almost never drinkers in this population was 547.2 cases per 100,000 people over 10 years, but it was 214.6 cases per 100 000 people with drinking coffee on a daily basis. The inverse association persisted when the participants were stratified by lifestyle factors. Similar associations were observed when the analysis was restricted to hepatitis C virus-positive patients (all daily drinkers compared with nondrinkers: HR =0.57 [95% CI = 0.37 to 0.86]), to hepatitis B virus-positive patients (HR = 0.60 [95% CI = 0.31 to 1.18]) and to subjects with no past history of chronic liver disease (HR = 0.45 [95% CI = 0.30 to 0.67]). CONCLUSIONS: In the Japanese population, habitual coffee drinking may be associated with reduced risk of HCC.

 

 

[vi] Arch Toxicol. 2002 May;76(4):209-17. Epub 2002 Apr 4

Enhancement of the chemoprotective enzymes glucuronosyl transferase and glutathione transferase in specific organs of the rat by the coffee components kahweol and cafestol.

Huber WW, Prustomersky S, Delbanco E, Uhl M, Scharf G, Turesky RJ, Thier R, Schulte-Hermann R.

 

Institut fur Krebsforschung, University of Vienna , Borschkegasse, 8A, 1090 Vienna , Austria . wolfgang.huber@univie.ac.at

 

The coffee components kahweol and cafestol (K/C) have been reported to protect the colon and other organs of the rat against the formation of DNA adducts by 2-amino-1-methyl-6-phenylimidazo[4,5- b]pyridine (PhIP) and aflatoxin B1. PhIP is a cooked-food mutagen to which significant human exposure and a role in colon cancer etiology are attributed, and, interestingly, such cancers appear to develop at a lower rate in consumers of coffees with high amounts of K/C. Earlier studies in rodent liver have shown that a key role in the chemopreventive effect of K/C is likely to be due to the potential of these compounds to induce the detoxification of xenobiotics by glutathione transferase (GST) and to enhance the synthesis of the corresponding co-factor glutathione. However, mutagens like PhIP may also be detoxified by UDP-glucuronosyl transferase (UDPGT) for which data are lacking regarding a potential effect of K/C. Therefore, in the present study, we investigated the effect of K/C on UDPGT and, concomitantly, we studied overall GST and the pattern of individual GST classes, particularly GST-theta;, which was not included in earlier experiments. In addition, we analyzed the organ-dependence of these potentially chemopreventive effects. K/C was fed to male F344 rats at 0.122% in the chow for 10 days. Enzyme activities in liver, kidney, lung, colon, salivary gland, pancreas, testis, heart and spleen were quantified using five characteristic substrates and the hepatic protein pattern of GST classes alpha, mu, and pi was studied with affinity chromatography/HPLC. Our study showed that K/C is not only capable of increasing overall GST and GST classes alpha, mu, and pi but also of enhancing UDGPT and GST-theta. All investigated K/C effects were strongest in liver and kidney, and some response was seen in lung and colon but none in the other organs. In summary, our results show that K/C treatment leads to a wide spectrum of increases in phase II detoxification enzymes. Notably, these effects occurred preferentially in the well perfused organs liver and kidney, which may thus not only contribute to local protection but also to anti-carcinogenesis in distant, less stimulated organs such as the colon.

 

PMID: 12029384 [PubMed - indexed for MEDLINE]

 

 

[vii] Arch Toxicol. 2002 May;76(4):209-17. Epub 2002 Apr 4

Enhancement of the chemoprotective enzymes glucuronosyl transferase and glutathione transferase in specific organs of the rat by the coffee components kahweol and cafestol.

 

Huber WW, Prustomersky S, Delbanco E, Uhl M, Scharf G, Turesky RJ, Thier R, Schulte-Hermann R.

 

Institut fur Krebsforschung, University of Vienna , Borschkegasse, 8A, 1090 Vienna , Austria . wolfgang.huber@univie.ac.at

 

The coffee components kahweol and cafestol (K/C) have been reported to protect the colon and other organs of the rat against the formation of DNA adducts by 2-amino-1-methyl-6-phenylimidazo[4,5- b]pyridine (PhIP) and aflatoxin B1. PhIP is a cooked-food mutagen to which significant human exposure and a role in colon cancer etiology are attributed, and, interestingly, such cancers appear to develop at a lower rate in consumers of coffees with high amounts of K/C. Earlier studies in rodent liver have shown that a key role in the chemopreventive effect of K/C is likely to be due to the potential of these compounds to induce the detoxification of xenobiotics by glutathione transferase (GST) and to enhance the synthesis of the corresponding co-factor glutathione. However, mutagens like PhIP may also be detoxified by UDP-glucuronosyl transferase (UDPGT) for which data are lacking regarding a potential effect of K/C. Therefore, in the present study, we investigated the effect of K/C on UDPGT and, concomitantly, we studied overall GST and the pattern of individual GST classes, particularly GST-theta;, which was not included in earlier experiments. In addition, we analyzed the organ-dependence of these potentially chemopreventive effects. K/C was fed to male F344 rats at 0.122% in the chow for 10 days. Enzyme activities in liver, kidney, lung, colon, salivary gland, pancreas, testis, heart and spleen were quantified using five characteristic substrates and the hepatic protein pattern of GST classes alpha, mu, and pi was studied with affinity chromatography/HPLC. Our study showed that K/C is not only capable of increasing overall GST and GST classes alpha, mu, and pi but also of enhancing UDGPT and GST-theta. All investigated K/C effects were strongest in liver and kidney, and some response was seen in lung and colon but none in the other organs. In summary, our results show that K/C treatment leads to a wide spectrum of increases in phase II detoxification enzymes. Notably, these effects occurred preferentially in the well perfused organs liver and kidney, which may thus not only contribute to local protection but also to anti-carcinogenesis in distant, less stimulated organs such as the colon.

 

PMID: 12029384 [PubMed - indexed for MEDLINE]

 

[viii] Carcinogenesis. 1998 Aug;19(8):1369-75

The coffee-specific diterpenes cafestol and kahweol protect against aflatoxin B1-induced genotoxicity through a dual mechanism.

Cavin C, Holzhauser D, Constable A, Huggett AC, Schilter B.

 

Nestle Research Center , Lausanne , Switzerland .

 

The diterpenes cafestol and kahweol (C&K) have been identified in animal models as two potentially chemoprotective agents present in green and roasted coffee beans. It has been postulated that these compounds may act as blocking agents by producing a co-ordinated modulation of multiple enzymes involved in carcinogen detoxification. In this study, we investigated the effects of C&K against the covalent binding of aflatoxin B1 (AFB1) metabolites to DNA. Male Sprague-Dawley rats were treated with increasing amounts of a mixture of C&K in the diet (0-6200 p.p.m.) for 28 and 90 days. A dose-dependent inhibition of AFB1 DNA-binding was observed using S9 and microsomal subcellular fractions from C&K-treated rat liver in an in vitro binding assay. Significant inhibition was detected at 2300 p.p.m. and maximal reduction of DNA adduct formation to nearly 50% of the control value was achieved with 6200 p.p.m. of dietary C&K. Two complementary mechanisms may account for the chemopreventive action of cafestol and kahweol against aflatoxin B1 in rats. A decrease in the expression of the rat activating cytochrome P450s (CYP2C11 and CYP3A2) was observed, as well as a strong induction of the expression of the glutathione-S-transferase (GST) subunit GST Yc2, which is known to detoxify highly the most genotoxic metabolite of AFB1. These data and the previously demonstrated effects of C&K against the development of 7,12-dimethylbenz[a]anthracene (DMBA)-induced carcinogenesis at various tissue sites suggest the potential widespread effect of these coffee components against chemical carcinogenesis.

 

PMID: 9744531 [PubMed - indexed for MEDLINE]

 

 

[ix] Food Chem Toxicol. 2002 Aug;40(8):1155-63

Cafestol and kahweol, two coffee specific diterpenes with anticarcinogenic activity.

 

Cavin C, Holzhaeuser D, Scharf G, Constable A, Huber WW, Schilter B.

 

Food Safety Group, Nestle Research Center, PO Box 44, Vers-chez-les-Blanc, CH-1000 Lausanne 26, Switzerland. christophe.cavin@rdls.nestle.com

 

Epidemiological studies have found an inverse association between coffee consumption and the risk of certain types of cancers such as colorectal cancers. Animal data support such a chemopreventive effect of coffee. Substantial research has been devoted to the identification of coffee components that may be responsible for these beneficial effects. In animal models and cell culture systems, the coffee diterpenes cafestol and kahweol (C+K) were shown to produce a broad range of biochemical effects resulting in a reduction of the genotoxicity of several carcinogens including 7,12-dimethylbenz[a]anthracene (DMBA), aflatoxin B(1) (AFB(1)), benzo[a]pyrene (B[a]P) and 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP). Different mechanisms appear to be involved in these chemoprotective effects: an induction of conjugating enzymes (e.g. glutathione S-transferases, glucuronosyl S-transferases), an increased expression of proteins involved in cellular antioxidant defense (e.g. gamma-glutamyl cysteine synthetase and heme oxygenase-1) and an inhibition of the expression and/or activity of cytochromes P450 involved in carcinogen activation (e.g. CYP2C11, CYP3A2). In animal models, the C+K-mediated induction of conjugating and antioxidant enzymes has been observed in hepatic, intestinal and kidney tissues. In the small intestine, these inductions were shown to be mediated by Nrf2-dependent transcriptional activation. In vitro investigations obtained in cell cultures of human origin indicate that the effects and mechanisms observed in animal test systems with C+K are likely to be of relevance for humans. In human liver epithelial cell lines transfected to express AFB(1)-activating P450s, C+K treatment resulted in a reduction of AFB(1)-DNA binding. This protection was correlated with an induction of GST-mu, an enzyme known to be involved in AFB(1) detoxification. In addition, C+K was found to inhibit P450 2B6, one of the human enzymes responsible for AFB(1) activation. Altogether, the data on the biological effects of C+K provide a plausible hypothesis to explain some of the anticarcinogenic effects of coffee observed in human epidemiological studies and in animal experiments.

 

 

[x] Int J Cancer. 2002 Jun 10;99(5):742-6.

Risk of pancreatic cancer in relation to alcohol drinking, coffee consumption and medical history: findings from the Japan collaborative cohort study for evaluation of cancer risk.

 

Lin Y, Tamakoshi A, Kawamura T, Inaba Y, Kikuchi S, Motohashi Y, Kurosawa M, Ohno Y.

 

Department of Public Health, Aichi Medical University School of Medicine, Aichi , Japan .

 

We evaluated the associations of such lifestyle factors as alcohol drinking, coffee consumption and medical history with risk of death from pancreatic cancer in a large-scale prospective cohort study [the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC study)] in Japan. Subjects were 110,792 (46,465 men and 64,327 women) inhabitants who were enrolled from 45 areas throughout Japan . At baseline, a self-administered questionnaire was used to obtain information on lifestyle factors and medical history. Cox proportional hazard models were used to calculate relative risks. During the follow-up period (mean +/- SD 8.1 +/- 1.8 years), 225 deaths due to pancreatic cancer were identified. Overall, neither alcohol nor coffee intake was associated with risk of death from pancreatic cancer. Heavy coffee consumption (> or =4 cups/day), however, may increase the risk. Men who reported a history of diabetes mellitus and women who reported a history of gallstone/cholecystitis were at significantly (2-fold) increased risk of death from pancreatic cancer. Copyright 2002 Wiley-Liss, Inc.

 

PMID: 12115510 [PubMed - indexed for MEDLINE]

 

 

[xi] BMJ. 1990 Mar 3;300(6724):566-9

Coffee consumption and death from coronary heart disease in middle aged Norwegian men and women.

Tverdal A, Stensvold I, Solvoll K, Foss OP, Lund-Larsen P, Bjartveit K.

National Health Screening Service, Oslo , Norway .

 

OBJECTIVE--To study the association between number of cups of coffee consumed per day and coronary death when taking other major coronary risk factors into account. DESIGN--Men and women attending screening and followed up for a mean of 6.4 years. SETTING--Cardiovascular survey performed by ambulatory teams from the National Health Screening Service in Norway . PARTICIPANTS--All middle aged people in three counties: 19,398 men and 19,166 women aged 35-54 years who reported neither cardiovascular disease or diabetes nor symptoms of angina pectoris or intermittent claudication. MAIN OUTCOME MEASURE--Predictive value of number of cups of coffee consumed per day. RESULTS--At initial screening total serum cholesterol concentration, high density lipoprotein cholesterol concentration, blood pressure, height, and weight were measured and self reported information about smoking history, physical activity, and coffee drinking habits was recorded. Altogether 168 men and 16 women died of coronary heart disease during follow up. Mean cholesterol concentrations for men and women were almost identical and increased from the lowest to highest coffee consumption group (13.1% and 10.9% respectively). With the proportional hazards model and adjustment for age, total serum and high density lipoprotein cholesterol concentrations, systolic blood pressure, and number of cigarettes per day the coefficient for coffee corresponded to a relative risk between nine or more cups of coffee and less than one cup of 2.2 (95% confidence interval 1.1 to 4.5) for men and 5.1 (0.4 to 60.3) for women. For men the relative risk varied among the three counties. CONCLUSIONS--Coffee may affect mortality from coronary heart disease over and above its effect in raising cholesterol concentrations.

 

PMID: 2108750 [PubMed - indexed for MEDLINE]

 

 

[xii] J Health Popul Nutr. 2003 Dec;21(4):332-40.

Impact of coffee and other selected factors on general mortality and mortality due to cardiovascular disease in Croatia .

 

Jazbec A, Simic D, Corovic N, Durakovic Z, Pavlovic M.

 

Institute for Medical Research and Occupational Health, POB 291, HR-10001 Zagreb , Croatia .

 

In Croatia , the mortality rate is higher than that in the countries of the European Union (EU), and consumption of coffee is moderate compared to the EU countries. The study examined the effects of coffee consumption on all-cause (general) mortality, mortality due to cardiovascular disease, and survival. Analyses were based on data obtained from an epidemiological longitudinal study started in 1969 with follow-ups in 1972, including 1,571 men and 1,793 women aged 35-59 years, and in 1982, including 1,093 men and 1,330 women. The sample was age- and gender-stratified and included urban and rural populations from three coastal and three continental regions of Croatia . During the observation period from spring 1972 to the end of 1999, 568 men and 382 women died. In total, 254 men and 181 women died due to cardiovascular disease. The sample was classified in 4 groups: non-drinkers, consumption of coffee sometimes, regularly 1-2 cup(s), and regularly more than 2 cups per day. Apart from coffee, the effects of diastolic blood pressure, smoking habit, well-being, stomach ulcer, and resident status were analyzed. Data on general mortality and mortality due to cardiovascular disease were also analyzed. The influence of region and the effects of diastolic pressure and smoking habit on general mortality and cardiovascular disease-associated mortality were confirmed in both the sexes. No significant effects of coffee consumption on general mortality and mortality due to cardiovascular disease were found among men. Positive effects of coffee on general mortality (p = 0.0089) but not on cardiovascular disease-associated mortality were observed among women. Women who regularly drank coffee 1-2 cup(s) per day had a significantly lower risk of all-cause death adjusted for age, region, smoking, diastolic blood pressure, feeling of well-being, and history of stomach ulcer (relative risk = 0.631; p = 0.0033; confidence interval: 0.464-0.857). The role of coffee consumption on mortality was less relevant than other variables. However, it cannot be completely neglected in women.

 

 

 

[xiii] Arch Intern Med. 2000 Dec 11-25;160(22):3393-400

Coffee consumption and the risk of coronary heart disease and death.

Kleemola P, Jousilahti P, Pietinen P, Vartiainen E, Tuomilehto J.

 

Division of Nutrition, University of Helsinki , PO Box 27 , Latokartanonkaari 9, 00014 University of Helsinki , Finland .

 

OBJECTIVES: To study prospectively the relation of coffee drinking with fatal and nonfatal coronary heart disease (CHD) and all-cause mortality and to perform a cross-sectional analysis at baseline on the association between coffee drinking and CHD risk factors, diagnosed diseases, self-reported symptoms, and use of medicines. METHODS: The study cohort consisted of 20 179 randomly selected eastern Finnish men and women aged 30 to 59 years who participated in a cross-sectional risk factor survey in 1972, 1977, or 1982. Habitual coffee drinking, health behavior, major known CHD risk factors, and medical history were assessed at the baseline examination. Each subject was followed up for 10 years after the survey using the national hospital discharge and death registers. Multivariate analyses were performed by using the Cox proportional hazards model. RESULTS: In men, the risk of nonfatal myocardial infarction was not associated with coffee drinking. The age-adjusted association of coffee drinking was J shaped with CHD mortality and U shaped with all-cause mortality. The highest CHD mortality was found among those who did not drink coffee at all (multivariate adjusted). Also, in women, all-cause mortality decreased by increasing coffee drinking. The prevalence of smoking and the mean level of serum cholesterol increased with increasing coffee drinking. Non-coffee drinkers more often reported a history of various diseases and symptoms, and they also more frequently used several drugs compared with coffee drinkers. CONCLUSIONS: Coffee drinking does not increase the risk of CHD or death. In men, slightly increased mortality from CHD and all causes in heavy coffee drinkers is largely explained by the effects of smoking and a high serum cholesterol level. Arch Intern Med. 2000;160:3393-3400.

 

PMID: 11112231 [PubMed - indexed for MEDLINE]

 

 

[xiv] Arch Intern Med. 1992 Sep;152(9):1767-72

Comment in:

Arch Intern Med. 1993 Apr 12;153(7):902.

Coffee and coronary heart disease.

Myers MG, Basinski A.

 

Department of Medicine, Sunnybrook Health Science Centre, Toronto , Ontario , Canada .

 

OBJECTIVE--We determined if coffee consumption is associated with an increased risk of developing coronary heart disease. DATA IDENTIFICATION--Articles published between 1966 and August 1991 examining a possible link between coffee and coronary heart disease were identified by a computer-aided literature search (Medline) and by standard bibliographic searches. STUDY SELECTION--All prospective cohort studies providing data on daily coffee consumption and coronary events (acute myocardial infarction and/or coronary death) were included. DATA EXTRACTION--Data from each published article were extracted. Additional unpublished data augmenting those published for one study were also included. Each cohort was categorized by reported daily coffee consumption. Incidence of coronary events at each level of coffee consumption was the primary outcome. RESULTS--Eleven prospective studies were included. The coronary events for subjects consuming little or no coffee (less than or equal to 1 cup per day) were compared with event rates for those consuming greater amounts of coffee. The studies exhibited heterogeneity of results. The typical odds ratios and 95% confidence intervals across studies were estimated by logistic regression analysis. Coffee intake from 1 to 4 cups per day was not associated with any increase in coronary heart disease occurrence compared with 1 cup or less per day (odds ratio, 1.01; confidence interval [0.93, 1.11]). The odds ratios for 4 to 6 and 6 cups or more per day compared with up to 1 cup per day were 1.01 (0.90, 1.12) and 1.09 (0.97, 1.22), respectively. CONCLUSIONS--There is no association between coffee consumption and the occurrence of coronary heart disease. This conclusion holds in the absence of adjustment for other coronary risk factors.

 

 

[xv] J Natl Cancer Inst. 2005 Feb 16;97(4):282-92.

Coffee, tea, and caffeine consumption and incidence of colon and rectal cancer.

Michels KB, Willett WC, Fuchs CS, Giovannucci E.

 

Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, and Harvard Medical School, 221 Longwood Ave., Boston, MA 02115, USA. kmichels@rics.bwh.harvard.edu

 

BACKGROUND: Frequent coffee consumption has been associated with a reduced risk of colorectal cancer in a number of case-control studies. Cohort studies have not revealed such an association but were limited in size. We explored the association between consumption of coffee and tea and the incidence of colorectal cancer in two large prospective cohorts of women and men. METHODS: We used data from the Nurses' Health Study (women) and the Health Professionals' Follow-up Study (men). Consumption of coffee and tea and total caffeine intake were assessed and updated in 1980, 1984, 1986, 1990, and 1994 among women and in 1986, 1990, and 1994 among men. The incidence of cancer of the colon or rectum was ascertained through 1998. Hazard ratios were calculated using Cox proportional hazards models that adjusted for potential confounders. All tests of statistical significance were two-sided. RESULTS: During almost 2 million person-years of follow-up, 1438 cases of colorectal cancer were observed. Consumption of caffeinated coffee or tea with caffeine or caffeine intake was not associated with the incidence of colon or rectal cancer in either cohort. For both cohorts combined, the covariate-adjusted hazard ratio for colorectal cancer associated with consumption of each additional cup of caffeinated coffee was 0.99 (95% confidence interval [CI] = 0.96 to 1.03). However, participants who regularly consumed two or more cups of decaffeinated coffee per day had a 52% (95% CI = 19% to 71%) lower incidence of rectal cancer than those who never consumed decaffeinated coffee. CONCLUSIONS: Consumption of caffeinated coffee, tea with caffeine, or caffeine was not associated with incidence of colon of rectal cancer, whereas regular consumption of decaffeinated coffee was associated with a reduced incidence of rectal cancer.

 

PMID: 15713963 [PubMed - indexed for MEDLINE]

 

 

[xvi] Arch Intern Med. 1996 Mar 11;156(5):521-5

Comment in:

ACP J Club. 1996 Sep-Oct;125(2):47.

Arch Intern Med. 1997 Jan 27;157(2):243-4.

 

A prospective study of coffee drinking and suicide in women.

 

Kawachi I, Willett WC, Colditz GA, Stampfer MJ, Speizer FE.

 

Channing Laboratory, Department of Medicine, Harvard Medical School , Boston , Mass. , USA .

 

BACKGROUND: Among the many reported central nervous system effects of long-term caffeine use is improvement in mood. OBJECTIVE: To examine prospectively the relationship of coffee and caffeine intake to risk of death from suicide. METHODS: We conducted a 10-year follow-up study (1980 to 1990) in an ongoing cohort of 86 626 US female registered nurses aged 34 to 59 years in 1980, who were free of diagnosed coronary heart disease, stroke, or cancer. Information on coffee and caffeine intake was collected by a semiquantitative food frequency questionnaire in 1980. Deaths from suicide were determined by physician review of death certificates. RESULTS: Fifty-six cases of suicide occurred during 832 704 person-years of observation. Compared with non-drinkers of coffee, the age-adjusted relative risk of suicide in women who consumed two to three cups per day was 0.34 (95% confidence interval [CI, 0.17 to 0.68) and 0.42 (95% CI, 0.21 to 0.86) in women who consumed four or more cups per day (P for linear trend=.002). These findings remained essentially unchanged after adjusting for a broad range of potential confounding factors, including smoking habit, alcohol intake, medication use (diazepam and phenothiazine), history of comorbid disease (hypertension, hypercholesterolemia, or diabetes), marital status, and self-reported stress. A strong inverse relationship was similarly found for caffeine intake from all sources and risk of suicide. CONCLUSIONS: The data suggest a strong inverse association between coffee intake and risk of suicide. Whether regular intake of coffee or caffeine has clinically significant effects on the maintenance of affect or the prevention of depression merits further investigation in clinical trials and population-based prospective studies.

 

PMID: 8604958 [PubMed - indexed for MEDLINE]

 

 

[xvii] J Intern Med. 2004 Jan;255(1):89-95

Coffee and incidence of diabetes in Swedish women: a prospective 18-year follow-up study.

Rosengren A, Dotevall A, Wilhelmsen L, Thelle D, Johansson S.

 

Department of Medicine, Sahlgrenska University Hospital/Ostra, Goteborg , Sweden . annika.rosengren@hjl.gu.se

 

OBJECTIVES: To examine the long-term incidence of diabetes in relation to coffee consumption in Swedish women. DESIGN: Prospective longitudinal cohort study. SETTING: City of Goteborg , Sweden . SUBJECTS: A random population sample of 1361 women, aged 39-65 years, without prior diabetes or cardiovascular disease took part in a screening study in 1979-1981 with questionnaires, physical examination and blood sampling. MAIN OUTCOME MEASURES: The development of diabetes until 1999 was identified by questionnaires in a second screening and the Swedish hospital discharge register. RESULTS: Altogether, there were 74 new cases of diabetes. The risk of developing diabetes was 475 per 100 000 person-years in women who consumed two cups of coffee or less per day, 271 in women who consumed three to four cups per day, 202 with a consumption of five to six cups per day, and 267 in drinkers of seven cups or more per day. Associated hazard ratios, after adjustment for age, smoking, low physical activity, education and body mass index were 0.55 (0.32-0.95), 0.39 (0.20-0.77) and 0.48 (0.22-1.06) for daily consumption of three to four, five to six and seven cups or more, respectively, with a consumption of less than two per day as reference. Additional adjustment for serum cholesterol and triglycerides attenuated the relation between coffee and diabetes slightly, indicating a possible mediating effect on the effect of coffee by serum lipids. CONCLUSIONS: The findings of the present study support the hypothesis that coffee consumption protects from the development of diabetes in women.

 

PMID: 14687243 [PubMed - indexed for MEDLINE]

 

 

[xviii] Int J Obes Relat Metab Disord. 2005 Sep;29(9):1121-9

 

Coffee, tea and diabetes: the role of weight loss and caffeine.

Greenberg JA, Axen KV, Schnoll R, Boozer CN.

 

1Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York , Brooklyn , NY , USA .

 

OBJECTIVE:To assess the effect of weight change on the relationship between coffee and tea consumption and diabetes risk.DESIGN:Prospective cohort study, using data from the First National Health and Nutrition Examination Survey Epidemiologic Follow Up Study. Survival analyses were conducted using 301 selfreported cases of diabetes and eight documented diabetes deaths during an 8.4-y follow-up.SUBJECTS:A total of 7006 subjects aged 32-88 y with no reported history of diabetes were included in the study.RESULTS:For all subjects combined, increases in consumption of ground-caffeinated coffee and caffeine at baseline were followed by decreases in diabetes risk during follow-up. There were significant statistical interactions between age and consumption of caffeine (P=0.02) and ground-caffeinated coffee (P=0.03). Age-stratified analysis showed that the decrease in diabetes risk only applied to </=60-y-old subjects, for whom the decrease in diabetes risk also obtained for ground-decaffeinated coffee and regular tea. The multivariate hazard ratio (HR) and 95% confidence interval for a 2 cups/day increment in the intake of ground-caffeinated coffee, ground-decaffeinated coffee and regular tea was 0.86 (0.75-0.99), 0.58 (0.34-0.99) and 0.77 (0.59-1.00), respectively. The diabetes risk was negatively related to the consumption in a dose-response manner. There were strong statistical interactions between prior weight change and beverage consumption for </=60-y-old subjects. Further analysis revealed that the decrease in diabetes risk only applied to those who had lost weight, and that there was a positive dose-response relationship between diabetes risk and weight change. For example, the multivariate HR and 95% confidence interval for >0 vs 0 cups/day of ground-decaffeinated coffee was 0.17 (0.04-0.74), 0.52 (0.19-1.42), 0.77 (0.30-1.96) and 0.91 (0.39-2.14) for subgroups with weight change of </=0, 0-10, 10-20 and >20 lbs, respectively. There was no significant association between diabetes risk and consumption of instant-caffeinated coffee, instant-decaffeinated coffee or herbal tea. Caffeine intake appeared to explain some, but not all, of the diabetes-risk reduction and weight change.CONCLUSION:The negative relationship between diabetes risk and consumption of ground coffee and regular tea, observed for all NHEFS subjects, actually only applied to nonelderly adults who had previously lost weight.International Journal of Obesity (2005) 29, 1121-1129. doi:10.1038/sj.ijo.0802999; published online 31 May 2005 .

 

PMID: 15925959 [PubMed - in process]

 

 

[xix] Nutr Cancer. 2001;39(1):29-34.

Coffee and alcohol intake and risk of ovarian cancer: an Italian case-control study.

Tavani A, Gallus S, Dal Maso L, Franceschi S, Montella M, Conti E, La Vecchia C.

 

Istituto di Ricerche Farmacologiche Mario Negri, 20157 Milan , Italy . tavani@marionegri.it

 

The relation between coffee and alcohol intake and ovarian cancer risk was analyzed in a case-control study conducted in Italy between 1992 and 1999. Cases were 1,031 women, aged 18-79 years, with incident, histologically confirmed invasive epithelial ovarian cancer, and controls were 2,411 women, aged 17-79 years, admitted to the hospital for acute nonneoplastic non-hormone-related diseases. Coffee intake (mostly espresso and mocha) was not associated with ovarian cancer risk, with an odds ratio (OR) of 0.93 [95% confidence interval (CI) = 0.69-1.27] in drinkers of > or = 4 cups/day compared with drinkers of < 1 cup/day. No meaningful relation was observed with cappuccino (OR = 1.06, 95% CI = 0.85-1.32 for drinkers compared with nondrinkers), decaffeinated coffee (OR = 0.64, 95% CI 0.42-0.96), and tea intake (OR = 0.90, 95% CI = 0.75-1.08). Total alcohol intake was not associated with ovarian cancer risk (OR = 1.09, 95% CI = 0.76-1.57 in drinkers of > or = 36 g/day compared with never drinkers). No relationship was found with wine (OR = 1.03, 95% CI = 0.70-1.50 for > 39 g/day compared with never drinkers), beer, amari, grappa, and spirits. No significant heterogeneity was found for coffee or total alcohol intake across strata of age, education, parity, oral contraceptive use, family history of ovarian/breast cancer, body mass index, and calorie intake. This study, based on a large data set; provides no support for a causal association between invasive epithelial ovarian cancer risk and coffee and alcohol intake.

 

PMID: 11588899 [PubMed - indexed for MEDLINE]

 

[xx] Arthritis Rheum. 2003 Nov;48(11):3055-60

Coffee consumption and risk of rheumatoid arthritis.

Karlson EW, Mandl LA, Aweh GN, Grodstein F.

 

Harvard Medical School , and Brigham and Women's Hospital, Boston , Massachusetts 02115 , USA . ekarlson@partners.org

 

OBJECTIVE: Recent reports have suggested an association between consumption of coffee or decaffeinated coffee and the risk of rheumatoid arthritis (RA), although data are sparse and somewhat inconsistent. Furthermore, existing studies measured dietary exposures and potential confounders only at baseline and did not consider possible changes in diet or lifestyle over the followup period. We studied whether coffee, decaffeinated coffee, total coffee, tea, or overall caffeine consumption was associated with the risk of RA, using the Nurses' Health Study, a longitudinal cohort study of 121,701 women. METHODS: Information on beverage consumption was assessed with a food frequency questionnaire (FFQ) that was completed every 4 years, from baseline in 1980 through 1998. Among the 83,124 women who completed the FFQ at baseline, the diagnosis of incident RA (between 1980 and 2000) was confirmed in 480 women by a connective tissue disease screening questionnaire and medical record review for American College of Rheumatology criteria. Relationships between intake of various beverages and the risk of RA were assessed in age-adjusted models and in multivariate Cox proportional hazards models including the cumulative average intake of each beverage during the followup period, adjusted for numerous potential confounders. In addition, for direct comparisons with prior reports, multivariate analyses were repeated using only baseline beverage information. RESULTS: We did not find a significant association between decaffeinated coffee consumption of >/=4 cups/day (compared with no decaffeinated coffee consumption) and subsequent risk of incident RA, in either an adjusted multivariate model (relative risk [RR] 1.1, 95% confidence interval [95% CI] 0.5-2.2) or a multivariate model using only baseline reports of decaffeinated coffee consumption (RR 1.0, 95% CI 0.6-1.7). Similarly, there was no relationship between cumulative caffeinated coffee consumption and RA risk (RR 1.1, 95% CI 0.8-1.6 for >/=4 cups per day versus none) or between tea consumption and RA risk (RR 1.1, 95% CI 0.7-1.8 for >3 cups/day versus none). Total coffee and total caffeine consumption were also not associated with the risk of RA. CONCLUSION: In this large, prospective study, we find little evidence of an association between coffee, decaffeinated coffee, or tea consumption and the risk of RA among women.

 

PMID: 14613266

 

 

[xxi] Eur J Cancer Prev. 1994 Jul;3(4):351-6

Coffee consumption and risk of non-Hodgkin's lymphoma.

Tavani A, Negri E, Franceschi S, Talamini R, La Vecchia C.

 

Istituto di Ricerche Farmacologiche Mario Negri, Milano , Italy .

 

There is no adequate information on the carcinogenicity of coffee and, specifically, on a potential association of coffee drinking with non-Hodgkin's lymphoma. Consumption of coffee and other methylxanthine-containing beverages has been researched in a case-control study conducted in northern Italy . A total of 429 cases of incident histologically confirmed non-Hodgkin's lymphoma and 1,157 controls in hospital for acute, non-neoplastic, non-immunological, non-digestive tract diseases were interviewed during their hospital stay. Relative risk (RR) estimates and their 95% confidence intervals (CI), according to consumption of coffee and other methylxanthine-containing beverages, were derived from multiple logistic regression equations including terms for age, sex, study centre, body mass index, alcohol and smoking status. Compared with non-drinkers, the RR was 1.2 (95% CI, 0.8-1.7) for coffee drinkers. No trend in risk emerged with number of cups of coffee consumed/day (RR = 1.1 for one and three cups; RR = 1.2 for two; or RR = 0.9 for four cups/day), or duration of coffee intake (RR = 1.2 for less than 20 years; RR = 1.3 for 21-30 years; and RR = 1.1 for more than 30 years). Similarly, no significant association was observed with consumption of decaffeinated coffee (RR = 0.9) or tea (RR = 1.2). Consumption of cola was associated with a borderline risk (RR = 1.7; 95% CI 1.0-2.7). We found no association between non-Hodgkin's lymphoma and consumption of regular or decaffeinated coffee and tea.

 

PMID: 7950889

 

 

[xxii] CA Cancer J Clin. 1991 Sep-Oct;41(5):310-9

Questionable cancer practices in Tijuana and other Mexican border clinics.

 

[No authors listed]

 

Tijuana , Mexico , has become a refuge for cancer patients who have been convinced that they may be cured of their terminal illness by unconventional, unproved, and disproved methods offered in the border clinics. About a dozen United States promoters have joined with Mexican colleagues to offer a variety of treatments. Some patients are diagnosed using standard methods prior to arrival at the clinics, but many healthy individuals are misdiagnosed as having cancer or "precancer" and are then treated there. Others are told they have been cured or are improving even though they still have active disease. The modalities and regimens used are often referred to as "metabolic therapy" and, for the most part, are either not based on sound scientific principles or have been shown in controlled clinical trials to be useless or even dangerous. A basic metabolic regimen consists of three phases: detoxification with fasting and bowel cleansing, strengthening the immune system with numerous "supplements," and attacking cancer with "natural and non-toxic" chemicals. Popular treatments include injections of hydrogen peroxide, large quantities of pressed liver and carrot juice, coffee enemas, infusions of Laetrile mixed with massive doses of vitamins and dimethylsulfoxide (DMSO), special diets, and a host of other pseudoscientific regimens. Unfortunately, no evidence exists that any of these modalities is more effective than no treatment at all. Patients traveling to the Mexican border clinics for metabolic therapy are subjecting themselves to costly and hazardous regimens, especially if they forgo responsible medical care in the process. The American Cancer Society, therefore, strongly urges individuals with cancer not to seek treatment with metabolic therapies in the Mexican border clinics.

 


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