The World Health Organization cites hepatocellular carcinoma (HCC) as the cause of 600,000 deaths worldwide each year, making it the third deadliest form of cancer.1 According to a recently published review article, most patients with HCC present to their health care providers after they have developed chronic liver disease, resulting from heavy alcohol consumption, cirrhosis, hepatitis B and C, nonalcoholic fatty liver disease (NAFLD), nonalcoholic steatohepatitis (NASH), or exposure to aflatoxins.2 The leading risk factor for HCC in the United States is hepatitis C (HCV), whereas hepatitis B (HBV) poses the greatest risk worldwide.2

DIETARY COMPONENT

As the scientific community focuses on HCV and HBV, NAFLD, NASH, and their progression towards HCC, diet and nutrition are apparent important factors in the development of these diseases. Consequently, diet may also be important in their prevention, with coffee being one of the most significant foods. If the incidence of a disease such as HCV could be lowered, then there might be fewer cases of HCC as well. 

COFFEE’S EFFECT ON HCV

In a prospective study involving patients with chronic HCV, coffee apparently had a beneficial effect on ALT levels.3 Among the 376 study participants, 229 had baseline ALT levels within a normal range and 147 had higher levels. The investigators asked the patients about the quantity and frequency of their coffee consumption, including brewing method and type (ie, filtered or unfiltered, and regular or decaffeinated). The research team followed the participants for 12 months, obtaining data on ALT levels at 6 and 12 months. They found that filtered coffee exhibited a consistently beneficial effect among the participants who consumed it. If ALT levels were normal, they remained normal throughout the 12 months of follow-up. However, if the participants had elevated ALT levels at baseline, those levels actually decreased by 20 to 30 IU/L. The investigators concluded that, “Among patients with chronic HCV infection, daily consumption of filtered coffee may have a beneficial effect on the stabilization of ALT levels.”3 New studies will determine whether the filtered coffee contains a beneficial substance that is not in unfiltered or decaffeinated coffee.  


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ANTIOXIDANTS

A number of studies point to the antioxidants in coffee as the reason for its beneficial effects. Of all the foods commonly consumed in the United States, coffee is ranked sixth in total antioxidants. It is also the major source of antioxidants in the diet in many other countries.4 Coffee contains more polyphenols, such as chlorogenic acid, diterpines, quinic acid, caffeic acid, ferulic acid and coumaric acid than any other food.5 Chlorogenic acids alone comprise up to 12% of the dry weight of unroasted coffee beans.6