Coffee consumption is associated with lower liver stiffness: a nationally representative study
Open accessAbstract
Background & aims Coffee is associated with a reduced risk of liver disease. This association is limited by important sources of confounding such as recall bias, healthy user bias, and indirect measures of liver outcomes or health. We aimed to examine the impact of coffee consumption with liver fibrosis and steatosis in a nationally representative sample.Methods We evaluated 4510 subjects 20 years and older from the 2017 to 2018 National Health and Nutrition Examination Survey study who underwent both transient elastography and two 24-hour dietary recall examinations. We tested the associations between liver stiffness measurements (LSM) of 9.5 kpa or greater or controlled attenuation parameter (CAP) and coffee consumption. We used decaffeinated coffee and tea consumption as controls. As a sensitivity analysis, we included all drinks in 1 model, examined the impact of caffeine consumption, and adjusted for the Healthy Eating Index-2015 and sugar-sweetened beverage consumption as separate models.Results The study sample described was aged 48 ± 0.6 years, 73% were overweight or obese, 10.6% had diabetes, 47.5% reported participation in vigorous physical activity, and 23% drank 2 or more alcoholic drinks per day. After multivariate adjustment, there was no association between coffee and controls with CAP. Subjects who drank more than 3 cups of coffee, but not other drinks, had a 0.9 lower kPa (95% CI, -1.6 to -0.1; P = .03). More than 3 cups of coffee were protective for LSM of 9.5 kpa or higher (odds ratio, 0.4; 95% CI, 0.2-1.0; P = .05). Accounting for all beverages in the same model, only consuming more than 3 cups of coffee remained independently associated with LSM (odds ratio, 0.5; 95% CI, 0.2-0.9; P = .03). Caffeine was not associated significantly with LSM at any dose. Finally, adjusting for sugar-sweetened beverage consumption and Healthy Eating Index-2015, coffee consumption remained associated with a lower LSM. The protective nature of coffee consumption therefore is not attributable to caffeine and persists in participants regardless of their diet quality.Conclusions Coffee is associated with lower liver stiffness, but not steatosis, as measured by CAP among US adults.
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In a nationally representative cross-sectional study, >-3 cups of coffee daily were independently associated with lower LSM but not with steatosis (measured by CAP).
“In a nationally representative cross-sectional study, > -3 cups of coffee daily were independently associated with lower LSM but not with steatosis (measured by CAP). 340”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [340]
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- Authors
- Niezen, S., Mehta, M., Jiang, Z. G., & Tapper, E. B.
- Affiliations
- Beth Israel Deaconess Medical Center (US)
- University of California, Los Angeles (US)
- University of Michigan (US)
- Corresponding author
- Tapper, Elliot B.
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2022-09
- Volume
- 20
- Issue
- 9
- Pages
- 2032-2040.e6
- ISSN
- 1542-3565 (ISSN-L)
- PMC
- PMC8983790
- OpenAlex
- W3204842674
- Cited by
- 47
- References
- 17
- Citations by year
- 2026: 4 · 2025: 17 · 2024: 14 · 2023: 8 · 2022: 2 · 2021: 2
- FWCI
- 3.79
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Valeant Pharmaceuticals International
- National Institute of Diabetes and Digestive and Kidney Diseases (1K23DK117055)
- Novo Nordisk
- Gilead Sciences
- National Institutes of Health
- Allergan
- Topics
- Health Sciences › Medicine › Pharmacology › Coffee research and impacts
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- coffee consumption, liver stiffness, liver fibrosis, hepatic steatosis, controlled attenuation parameter, caffeine, decaffeinated coffee, tea consumption, sugar-sweetened beverages, Healthy Eating Index-2015, transient elastography, liver disease risk, NHANES, United States adults, diet quality, alcohol consumption, obesity, diabetes mellitus, physical activity
- MeSH terms
- Adult, Beverages, Caffeine, Coffee, Fatty Liver, Humans, Nutrition Surveys, Tea
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