Factors associated with metabolic syndrome in a mediterranean population: role of caffeinated beverages

Metabolic syndrome risk in adult coffee drinkers with the rs301 variant of the LPL gene

BACKGROUND

Metabolic syndrome (MetS), a cluster of metabolic and cardiovascular risk factors is influenced by environmental, lifestyle, and genetic factors. We explored whether coffee consumption and the rs301 variant of the lipoprotein lipase (LPL) gene are related to MetS.

METHODS

We conducted multiple logistic regression analyses using data gathered from 9523 subjects in Taiwan Biobank (TWB).

RESULTS

Our findings indicated that individuals who consumed coffee had a reduced odds ratio (OR) for MetS (0.750 (95% confidence interval [CI] 0.653-0.861) compared to non-coffee drinkers. Additionally, the risk of MetS was lower for individuals with the 'TC' and 'CC' genotypes of rs301 compared to those with the 'TT' genotype. Specifically, the OR for MetS was 0.827 (95% CI 0.721-0.949) for the 'TC' genotype and 0.848 (95% CI 0.610-1.177) for the 'CC' genotype. We observed an interaction between coffee consumption and the rs301 variant, with a p-value for the interaction of 0.0437. Compared to the reference group ('no coffee drinking/TT'), the ORs for MetS were 0.836 (95% CI 0.706-0.992) for 'coffee drinking/TT', 0.557 (95% CI 0.438-0.707) for 'coffee drinking/TC', and 0.544 (95% CI 0.319-0.927) for 'coffee drinking/CC'. Notably, MetS was not observed in non-coffee drinkers regardless of their rs301 genotype.

CONCLUSION

Our findings suggest that rs301 genotypes may protect against MetS in Taiwanese adults who consume coffee compared to non-coffee drinkers.

Effect of Arabic Qahwa on Blood Pressure in Patients with Stage One Hypertension in the Eastern Region of Saudi Arabia

Hypertension (HT), which is a condition of increased blood pressure (BP), is a major health problem globally. In Saudi Arabia, morbidity and mortality rates are increasing due to HT. Arabic Qahwa (AQ) is a commonly consumed beverage in Saudi Arabia and has numerous health benefits. We conducted a randomized control trial to investigate the effect of AQ on BP among patients with HT (Stage 1). Based on the inclusion criteria, 140 patients were randomly selected, and 126 patients were followed up. After obtaining demographic information, we assessed the BP, heart rate, and lipid profile before and after the intervention of consuming four cups of AQ daily for four weeks. A paired 't' test was used with a significance level of 5%. In the AQ group, there were significant changes (p = 0.009) in systolic blood pressure (SBP), with means of 134.72 ± 3.23 and 133.14 ± 3.69 observed pre and post-test, respectively. Similarly, the diastolic blood pressure (DBP) pre- and post-test mean scores were 87.08 ± 1.8 and 85.98 ± 1.95, respectively, which also showed significance (p = 0.001). There were also significant changes (p = 0.001) observed in the lipid profile of the AQ group. In conclusion, AQ is effective in reducing SBP and DBP in patients with stage one HT.

Influence of Sex Differences on Serum Lipid Profiles among Habitual Coffee Drinkers: Evidence from 23,072 Taiwan Biobank Participants

The bioactive compounds of coffee are involved in lipid metabolism, and sex differences may play an important role. This study aimed to evaluate the influence of sex differences on serum lipid profiles among habitual coffee drinkers. We conducted a nationwide cross-sectional study of 23,628 adults using data obtained from the Taiwan Biobank database. Adults who drank more than one cup of coffee per day and those who drank less than one cup per day were compared with non-drinkers. After adjusting for baseline demographics and lifestyle, a generalized linear model was used to estimate the change in serum lipid profiles in men and women and in postmenopausal and premenopausal women among different coffee-drinking behaviors. We found that habitual coffee consumption changed the serum lipid profiles of men and women. Further, coffee drinkers had higher serum total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and lower serum triglyceride levels than non-drinkers. Compared with premenopausal women, both men and postmenopausal women had increased serum total cholesterol and low-density lipoprotein cholesterol levels. Menopausal status may play an important role in modulating the effect of habitual coffee intake on dyslipidemia. Moreover, premenopausal women potentially benefit more from habitual coffee drinking than men and postmenopausal women.

Effects of sumac supplementation on metabolic markers in adults with metabolic syndrome: a triple-blinded randomized placebo-controlled cross-over clinical trial

BACKGROUND

Despite the prior evidence of the impacts of sumac on glycemic indices, lipid profile and visceral fat, there is a lack of evidence regarding the efficacy of sumac in cases with metabolic syndrome (MetS). Therefore, we aimed to assess the effect of sumac supplementation on MetS markers among adults with this syndrome.

METHODS

In this triple-blinded randomized placebo-controlled cross-over clinical trial 47 adults with MetS were randomly assigned to receive 500 mg sumac or placebo (lactose) capsule, twice a day. Each phase took 6 weeks and there was a 2-week washout between phases. All clinical evaluations and laboratory tests were conducted before and after each phase.

RESULTS

At the baseline of the study, mean (± SD) age, weight, and waist circumference of participants were respectively 58.7 (± 5.8) yr, 79.9 (± 14.3) kg, and 107.6 (± 10.8) cm. Intention to treat analysis (ITT) analyses revealed that sumac supplementation decreased systolic blood pressure by 5 mmHg (128.8 ± 21.4 at the baseline vs. 123.2 ± 17.6 after 6 weeks intervention, P = 0.001). The comparison of changes in two trial arms showed that sumac supplementation significantly reduced systolic blood pressure (sumac group -5.59 ± 10.6 vs. control group 0.76 ± 10.5, P = 0.004), but did not change anthropometric indices or diastolic blood pressure. Similar results were also found in the per-protocol analyses.

CONCLUSIONS

This cross-over trial revealed that sumac supplementation could reduce systolic blood pressure in men and women with MetS. Daily intake of 1000 mg sumac, as an adjuvant therapy, may be beneficial in management of MetS in adults.

Ultra-Processed Food Consumption and Relation with Diet Quality and Mediterranean Diet in Southern Italy

Ultra-processed food (UPF) consumption has been the focus of major attention due to their potential effects on human health. The aim of this study was to investigate the intake of UPFs in a sample of southern Italian individuals and assess its relationship with nutrient profile and dietary quality parameters. A cross-sectional study was conducted on 1936 individuals older than 18 years randomly selected from the general population. A total of 110 food times have been categorized based on the level of processing using the NOVA classification. The average daily energy intake of the sample was 2091.1 kcal, 38.7% of which were from the NOVA group of unprocessed/minimally processed foods, 5.7% from processed culinary ingredients, 38.3% from processed foods, and 17.9% from the UPFs group. UPFs were more consumed among young, unmarried individuals, with high cultural level, smokers, and often eating out of home. The mean energy share of UPFs varied from 6.3% of total daily energy intake for individuals in the lowest quintile of UPF consumption to 34.2% for those in the upper quintile. Within the UPF group, the highest energy contribution was provided by fast foods and sweets. Compared to the lowest quintile of UPF consumption, individuals in the highest quintile consumed, on average, additional 300 kcals per day and less fiber. Some plant-derived vitamins, such as vitamin A and vitamin C showed an inverse trend toward increasing shares of UPF consumption, while sodium intake increased. A significant higher intake of UPFs in individuals meeting the European and Italian dietary recommendations for carbohydrates, vitamin B12, vitamin D, and vitamin E was found, while UPFs were less consumed among those meeting the recommendations for total fats, fiber, sodium, potassium, and vitamin C. Finally, individuals displaying a "healthier" dietary profile, such as higher adherence to either the Mediterranean diet, the Dietary Approaches to Stop Hypertension, the Alternate Diet Quality Index, and the Diet Quality Index-International, consumed less UPFs and more unprocessed/minimally processed foods, with minor variation in the other NOVA food categories. In conclusion, consumption of UPF in southern Italy is in line with those reported in some other Mediterranean countries, although it negatively impacted the nutrient profile. It is important to monitor the consumption of UPFs before their availability and popularity put the grounds on younger generations' dietary habits.

The Relationship between Habitual Coffee Drinking and the Prevalence of Metabolic Syndrome in Taiwanese Adults: Evidence from the Taiwan Biobank Database

Previous studies revealed inconsistent results between coffee drinking and metabolic syndrome (MetS). The aim of the study was to evaluate the relationship between habitual coffee drinking and the prevalence of MetS among men and women. We conducted a nationwide, cross-sectional study using 23,073 adults obtained from the Taiwan Biobank database (mean ± SD (range) age, 54.57 ± 0.07 (30–79) years; 8341 men and 14,731 (63.8%) women). Adults who drank more than one cup of coffee per day (n = 5118) and those who drank less than one cup per day (n = 4515) were compared with nondrinkers (n = 13,439). Multivariate logistic regression models were used to evaluate the risk of MetS between the two groups. Separate models were also estimated for sex-stratified and habitual coffee-type-stratified (black coffee (BC), coffee with creamer (CC), and coffee with milk (CM)) subgroup analyses. The MetS diagnosis was based on at least three of the five metabolic abnormalities. Coffee drinkers (≥1 cup/day) had a significantly lower prevalence of MetS than nondrinkers (AOR (95% CI): 0.80 (0.73–0.87)). Women who drank any amount of coffee and any type of coffee were more likely to have a significantly lower prevalence of MetS than nondrinkers. Only men who drank more than one cup of coffee per day or black coffee drinkers were more likely to have a lower prevalence of MetS. Our study results indicate that adults with habitual coffee drinking behaviors of more than one cup per day were associated with a lower prevalence of MetS. Moreover, women could benefit from habitual coffee drinking of all three coffee types, whereas men could only benefit from drinking BC.

Dietary Strategies for Management of Metabolic Syndrome: Role of Gut Microbiota Metabolites

Metabolic syndrome (MetS) is a complex pathophysiological state with incidence similar to that of a global epidemic and represents a risk factor for the onset of chronic non-communicable degenerative diseases (NCDDs), including cardiovascular disease (CVD), type 2 diabetes mellitus, chronic kidney disease, and some types of cancer. A plethora of literature data suggest the potential role of gut microbiota in interfering with the host metabolism, thus influencing several MetS risk factors. Perturbation of the gut microbiota’s composition and activity, a condition known as dysbiosis, is involved in the etiopathogenesis of multiple chronic diseases. Recent studies have shown that some micro-organism-derived metabolites (including trimethylamine N-oxide (TMAO), lipopolysaccharide (LPS) of Gram-negative bacteria, indoxyl sulfate and p-cresol sulfate) induce subclinical inflammatory processes involved in MetS. Gut microbiota’s taxonomic species or abundance are modified by many factors, including diet, lifestyle and medications. The main purpose of this review is to highlight the correlation between different dietary strategies and changes in gut microbiota metabolites. We mainly focus on the validity/inadequacy of specific dietary patterns to reduce inflammatory processes, including leaky gut and subsequent endotoxemia. We also describe the chance of probiotic supplementation to interact with the immune system and limit negative consequences associated with MetS.

Association of Age and Sex with Metabolic Syndrome in Taiwanese Adults

Objective

This study aimed to investigate the association of age and sex with metabolic syndrome (MS) in Taiwanese adults.

Methods

We extracted information of 4307 men and 4783 women aged 30–70 from the Taiwan Biobank.

Results

The interaction between age and sex on MS was significant (p-value = 0.0001). After stratification by sex, men and women aged 50–70 years (reference: 30≤age<50 years) had a higher risk of MS. The odds ratio (OR), 95% confidence interval (CI) was 2.316, 1.936–2.772 in men and 3.101, 2.561–3.754 in women. After stratification by age, men aged 50–70 years had a lower risk of MS compared to women (OR, 95% CI = 0.713, 0.598–0.851).

Conclusion

The interaction between age and sex on MS was significant. Sex-wise, both men and women aged 50–70 years had a higher likelihood of MS. Age-wise, men aged 50–70 years had a lower risk of MS compared to women.

Polyphenol-Rich and Alcoholic Beverages and Metabolic Status in Adults Living in Sicily, Southern Italy

Polyphenol-rich beverage consumption is not univocally accepted as a risk modulator for cardio-metabolic risk factors, despite mechanistic and epidemiological evidence suggesting otherwise. The aim of this study was to assess whether an association between polyphenol-rich beverage consumption and metabolic status could be observed in a Mediterranean cohort with relatively low intake of tea, coffee, red and white wine, beer, and fresh citrus juice. Demographic and dietary characteristics of 2044 adults living in southern Italy were analyzed. Multivariate logistic regression analyses were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of the association between polyphenol-rich and alcoholic beverage consumption and metabolic status adjusted for potential confounding factors. Specific polyphenol-rich beverages were associated, to a various extent, with metabolic outcomes. Individuals with a higher total polyphenol-rich beverages had higher polyphenols intake and were less likely to have hypertension, type-2 diabetes, and dyslipidemia (OR = 0.57, 95% CI: 0.44–0.73; OR = 0.41, 95% CI: 0.26–0.66; and OR = 0.41, 95% CI: 0.29–0.57, respectively). However, when adjusted for potential confounding factors, only the association with hypertension remained significant (OR = 0.69, 95% CI: 0.50–0.94). Current scientific evidence suggests that such beverages may play a role on cardio-metabolic risk factors, especially when consumed within the context of a dietary pattern characterized by an intake of a plurality of them. However, these associations might be mediated by an overall healthier lifestyle.

Dose-response association between sugar- and artificially sweetened beverage consumption and the risk of metabolic syndrome: a meta-analysis of population-based epidemiological studies

OBJECTIVE

The associations between sugar-sweetened beverage (SSB) and artificially sweetened beverage (ASB) consumption and the risk of metabolic syndrome (MetS) remain controversial. A quantitative assessment of dose-response associations has not been reported. This study aims to assess the associations between the risk of MetS and SSB, ASB, and total sweetened beverage (TSB, the combination of SSB and ASB) consumption by reviewing population-based epidemiological studies.

DESIGN

Meta-analysis.

SETTING

We searched PubMed, Embase and Web of Science databases prior to 4 November 2019, for relevant studies investigating the SSB-MetS and ASB-MetS associations. A random effects model was used to estimate pooled relative risks (RR) and 95 % CI. Dose-response association was assessed using a restricted cubic splines model.

PARTICIPANTS

We identified seventeen articles (twenty-four studies, including 93 095 participants and 20 749 MetS patients).

RESULTS

The pooled RR for the risk of MetS were 1·51 (95 % CI 1·34, 1·69), 1·56 (1·32, 1·83) and 1·44 (1·19, 1·75) in high consumption group of TSB, SSB and ASB, respectively; and 1·20 (1·13, 1·28), 1·19 (1·11, 1·28) and 1·31 (1·05, 1·65) per 250 ml/d increase in TSB, SSB and ASB consumption, respectively. Additionally, we found evidence of non-linear, TSB-MetS and SSB-MetS dose-response associations and a linear ASB-MetS dose-response association.

CONCLUSIONS

TSB, SSB and ASB consumption was associated with the risk of MetS. The present findings provide evidence that supports reducing intake of these beverages to lower the TSB-, SSB- and ASB-related risk of MetS.

The Association Between Coffee Consumption and Metabolic Syndrome in Adults: A Systematic Review and Meta-Analysis

Previous meta-analyses that found an inverse association between coffee consumption and metabolic syndrome pooled data from cross-sectional and longitudinal studies, which could lead to potentially misleading conclusions. Hence, this work aimed to reassess this association by analyzing data from the 2 types of studies separately and including recent studies. Online databases including PubMed, Scopus, Embase, The Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus, and Science Direct were searched for relevant studies published up to July 2020. Both cross-sectional and longitudinal studies were included if published after 1999, reported both effect estimates and CIs, and presented results adjusted for confounding variables. Data of the highest coffee consumption level in each study, as well as those of medium consumption levels in studies with ≥3 consumption categories, were pooled using random-effect models, with sex-stratified and sex-adjusted results being analyzed separately. Results were obtained based on data from 13 cross-sectional studies involving 280,803 participants and 2 longitudinal studies involving 17,014 participants. The overall sex-adjusted association of the highest consumption level was not significant (n = 9 studies; OR: 0.88; 95% CI: 0.70, 1.10; I2: 91.5%) and the 2 longitudinal studies both yielded no association. Subgroup analysis revealed inverse associations in both males and females, as well as in Caucasians with medium coffee consumption (n = 4 studies, OR: 0.88; 95% CI: 0.84, 0.93; I2: 0%). Although residual confounding could affect the results of this meta-analysis, our findings suggested with a low certainty that coffee consumption may not be associated with metabolic syndrome, a finding that is different from those of previous meta-analyses and could be due to variation in characteristics of study participants. More longitudinal studies are also needed to further assess the temporal association between coffee consumption and metabolic syndrome. This meta-analysis was registered at https://www.crd.york.ac.uk/prospero as CRD42018110650.

Targeting obesity with plant-derived pancreatic lipase inhibitors: A comprehensive review

The prevalence of obesity is alarmingly increasing in the last few decades and leading to many serious public health concerns worldwide. The dysregulated lipid homeostasis due to various genetic, environmental and lifestyle factors is considered one of the critical putative pathways mediating obesity. Nonetheless, the scientific advancements unleashing the molecular dynamics of lipid metabolism have provided deeper insights on the emerging roles of lipid hydrolysing enzymes, including pancreatic lipase. It is hypothesized that inhibiting pancreatic lipase would prevent the breakdown of triglyceride and delays the absorption of fatty acids into the systemic circulation and adipocytes. Whilst, orlistat is the only conventional pancreatic lipase enzyme inhibitor available in clinics, identifying the safe clinical alternatives from plants to inhibit pancreatic lipase has been considered a significant advancement. Consequently, plants which have shown significant potential to combat obesity are now revisited for its abilities to inhibit pancreatic lipase. In this regard, our review surveyed the potential of medicinal plants and its phytoconstituents to inhibit pancreatic lipase and to elicit anti-obesity effects. Thus, the review collate and critically appraise the potential of medicinal plants and phyto-molecules inhibiting pancreatic lipase enzyme and consequently modulating triglyceride absorption in gut, and discuss its implications in the development of novel therapeutic strategies to combat obesity.

Comparison of Periodontal Status According to the Additives of Coffee: Evidence from Korean National Health and Nutrition Examination Survey (2013-2015)

It is well known that periodontal disease is highly related to dietary habits. As coffee is a typical beverage consumed worldwide, the relationship between coffee and periodontal disease was analyzed in this study using the data from the Korean National Health and Nutrition Survey (KNHANES) 2013–2015. Complex-samples chi square tests were performed for the comparison of the demographic characteristics of the 6528 study subjects and coffee components. Poisson linear regression analysis was performed for the analysis of the periodontal condition and coffee component effects, while complex-samples logistic regression analysis was performed to determine the demographic characteristics and coffee component effects. Over the years, the proportion of people drinking coffee with syrup or drinking a coffee mix containing both syrup and cream has decreased significantly. The results of the analysis, conducted by integrating the study subjects’ demographic characteristics and the coffee components, showed that the prevalence of periodontal disease was 0.83-times lower when drinking coffee with cream than when drinking black coffee. Coffee is the world’s second largest trade commodity following oil, and about 70%–80% of the world’s population drinks coffee. Drinking coffee with milk or cream can have a beneficial impact on periodontal disease.

Association between the prevalence of metabolic syndrome and coffee consumption among Korean adults: results from the Health Examinees study

The aim of this study was to evaluate the association between the frequency and quantity of coffee consumption and metabolic syndrome (MetS) in the Health Examinees study. A total of 130 420 participants (43 682 men and 86 738 women) were included in our study. Coffee consumption was categorized into 5 categories (0, <1, 1, 2-3, and ≥4 cups/day). We calculated odds ratios (ORs) and 95% confidence intervalS (CIs) using multivariate logistic regression. In this study population, the prevalence of MetS was 12 701 (29.1%) in men and 21 338 (24.6%) in women. High coffee consumption (≥4 cups/day) was associated with a lower prevalence of MetS compared with non-coffee consumers (OR = 0.79, 95% CI = 0.70-0.90, p for trend <0.0001 in men; OR = 0.70, 95% CI = 0.62-0.78, p for trend <0.0001 in women). The multivariable-adjusted ORs for high fasting glucose decreased with increasing levels of coffee consumption in men (OR = 0.60, 95% CI = 0.54-0.67, p for trend <0.0001) and women (OR = 0.70, 95% CI = 0.63-0.79, p for trend <0.0001). For women, the multivariable-adjusted ORs for hypertriglyceridemia (OR = 0.84, 95% CI = 0.75-0.93, p for trend = 0.0007) decreased with increasing levels of coffee consumption. We found that coffee consumption was inversely associated with the prevalence of metabolic syndrome among Korean men and women. Our study warrants further prospective cohort studies.

Coffee Intake and Obesity: A Meta-Analysis

Many studies have explored the relationship between coffee—one of the most commonly consumed beverages today—and obesity. Despite inconsistent results, the relationship has not been systematically summarized. Thus, we conducted a meta-analysis by compiling data from 12 epidemiologic studies identified from PubMed and Embase through February 2019. The included studies assessed obesity by body mass index (BMI, a measure of overall adiposity) or waist circumference (WC, a measure of central adiposity); analyzed the measure as a continuous outcome or binary outcome. Using random effects model, weighted mean difference (WMD) and 95% confidence interval (CI) were obtained for continuous outcomes; summary relative risk (RR) and 95% CI for the highest vs. lowest categories of coffee intake were estimated for binary outcome. For BMI, WMD was −0.08 (95% CI −0.14, −0.02); RR was 1.49 (95% CI 0.97, 2.29). For WC, WMD was −0.27 (95% CI −0.51, −0.02) and RR was 1.07 (95% CI 0.84, 1.36). In subgroup analysis by sex, evidence for an inverse association was more evident in men, specifically for continuous outcome, with WMD −0.05 (95% CI −0.09, −0.02) for BMI and −0.21 (95% CI −0.35, −0.08) for WC. Our meta-analysis suggests that higher coffee intake might be modestly associated with reduced adiposity, particularly in men.

Mediterranean Diet and Cardiodiabesity: A Systematic Review through Evidence-Based Answers to Key Clinical Questions

The Mediterranean Diet (MedDiet) has been promoted as a means of preventing and treating cardiodiabesity. The aim of this study was to answer a number of key clinical questions (CQs) about the role of the MedDiet in cardiodiabesity in order to provide a framework for the development of clinical practice guidelines. A systematic review was conducted to answer five CQs formulated using the Patient, Intervention, Comparison, and Outcome (PICO) criteria. Twenty articles published between September 2013 and July 2016 were included, adding to the 37 articles from the previous review. There is a high level of evidence showing that MedDiet adherence plays a role in the primary and secondary prevention of cardiovascular disease (CVD) and improves health in overweight and obese patients. There is moderate-to-high evidence that the MedDiet prevents increases in weight and waist circumference in non-obese individuals, and improves metabolic syndrome (MetS) and reduces its incidence. Finally, there is moderate evidence that the MedDiet plays primary and secondary roles in the prevention of type 2 diabetes mellitus (T2DM). The MedDiet is effective in preventing obesity and MetS in healthy and at-risk individuals, in reducing mortality risk in overweight or obese individuals, in decreasing the incidence of T2DM and CVD in healthy individuals, and in reducing symptom severity in individuals with T2DM or CVD.

Metabolic syndrome, Mediterranean diet, and polyphenols: Evidence and perspectives

Metabolic syndrome (MetS) is defined as the co-occurrence of metabolic risk factors that includes insulin resistance, hyperinsulinemia, impaired glucose tolerance, type 2 diabetes mellitus, dyslipidemia, and visceral obesity. The clinical significance of MetS consists of identifying a subgroup of patients sharing a common physiopathological state predisposing to chronic diseases. Clinical and scientific studies pinpoint lifestyle modification as an effective strategy aiming to reduce several features accountable for the risk of MetS onset. Among the healthy dietary patterns, the Mediterranean diet (MedDiet) emerges in terms of beneficial properties associated with longevity. Current evidence highlights the protective effect exerted by MedDiet on the different components of MetS. Interestingly, the effect exerted by polyphenols contained within the representative MedDiet components (i.e., olive oil, red wine, and nuts) seems to be accountable for the beneficial properties associated to this dietary pattern. In this review, we aim to summarize the principal evidence regarding the effectiveness of MedDiet-polyphenols in preventing or delaying the physiopathological components accountable for MetS onset. These findings may provide useful insights concerning the health properties of MedDiet-polyphenols as well as the novel targets destined to a tailored approach to MetS.

Moderate coffee consumption is inversely associated with the metabolic syndrome in the Korean adult population

Results from studies investigating the association between coffee consumption and the metabolic syndrome in Koreans have been inconsistent and remain controversial. We examined coffee intake in relation to the metabolic syndrome using data from the Korea National Health and Nutrition Examination Survey 2012-2015, with 8387 adults aged 19-64 years. Furthermore, we conducted a stratified analysis by obesity status (BMI <25 v. ≥25 kg/m2) to examine whether the association varied by obesity status. A 112-item FFQ was used to assess diet. Multivariable logistic regression models were used to determine the association of coffee consumption (<1, 1-2, 3-4 and ≥5 times/d) and the metabolic syndrome. Compared to people who consumed <1 time/d of coffee, the OR for the metabolic syndrome in those who consumed 3-4 times/d of coffee was 0·75 (95 % CI 0·58, 0·97). However, ≥5 times/d of coffee consumption was not significantly associated with the metabolic syndrome. By obesity status, in non-obese people, those consuming more coffee had lower odds of the metabolic syndrome, showing a significant linear trend (P-trend=0·0248). In obese people, the OR for the metabolic syndrome in people with 3-4 times/d of coffee consumption v. <1 time/d was 0·68 (95 % CI 0·50, 0·93), but ≥5 times/d of coffee consumption showed a non-significant positive association. Our findings suggest that moderate coffee consumption of 3-4 times/d is inversely associated with the metabolic syndrome in Korean adults. The association between heavy coffee consumption of ≥5 times/d and the metabolic syndrome varied by obesity status.

Coffee Drinking and Associated Factors in an Elderly Population in Spain

Coffee consumption is highly prevalent worldwide, and many studies have reported positive and inverse associations of coffee with many diseases. However, factors associated with coffee consumption remain poorly characterized in some populations, such as the elderly. This study aimed to assess the factors associated with total, caffeinated and decaffeinated coffee consumption in an elderly population in Spain. Data were analyzed from 903 participants, aged 65 years and above, from two population-based studies carried out in the Valencia region in Spain (Valencia Nutritional Survey (VNS) and European Eye Study (EUREYE-Study). Total, caffeinated and decaffeinated coffee consumption was assessed through two specific questions using a validated food frequency questionnaire. Information on personal characteristics, anthropometry and lifestyles was collected in personal interviews. Multinomial logistic regression analysis was used to estimate the adjusted relative risk ratios (RRR) and confidence intervals (95% CI). The prevalence of total, caffeinated and decaffeinated coffee consumption was 70%, 38% and 32%, respectively. The consumption of caffeinated coffee was positively associated with: Educational level, RRR = 1.63 (1.09–2.44); body mass index (≥30), RRR = 2.03 (1.05–3.95); tobacco smoking, RRR = 1.96 (1.13–3.39); alcohol intake [≥12 g/day category intake vs. no-alcohol intake, RRR = 6.25 (3.56–10.95)]; and energy intake (p < 0.05). Consumption of caffeinated coffee was negatively associated with: Age (≥75 years), RRR = 0.64 (0.43–0.94); and pre-existing hypertension, RRR = 0.67 (0.45–0.98). The consumption of decaffeinated coffee was positively associated with: Alcohol intake, RRR = 2.63 (1.19–4.64); pre-existing diabetes, RRR = 1.67 (1.06–2.62); and energy intake (p < 0.01). The consumption of coffee is high among elderly people in Spain. It is a novelty in this study with elderly population that tobacco smoking and alcohol drinking were the two main factors associated with higher coffee consumption. Self-reported hypertension was associated with a lower consumption of caffeinated coffee, and pre-existing diabetes was associated with a higher consumption of decaffeinated coffee. These associations should be taken into account when the health effects of coffee consumption are investigated.

A modified Mediterranean diet score is inversely associated with metabolic syndrome in Korean adults

BACKGROUND/OBJECTIVES

Findings from studies in Western countries showed that Mediterranean diet is inversely associated with metabolic syndrome, but little is known about this association in Asian countries. To evaluate the association between Mediterranean diet and metabolic syndrome in Korean population, this study was conducted.

SUBJECTS/METHODS

A total of 8387 adults 19-64 years of age from the Korea National Health and Nutrition Examination Survey 2012-2015 were assessed. A 112-item dish-based semiquantitative food frequency questionnaire was used to assess dietary intakes. Mediterranean diet was assessed by a modified Mediterranean diet score, which was based on the alternate Mediterranean diet score of Fung et al. Multivariable logistic regression models were used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) adjusted for other dietary and lifestyle variables.

RESULTS

Participants with 5-6 and 7 or higher modified Mediterranean diet scores had a lower prevalence of metabolic syndrome by 27% (OR = 0.73, 95% CI: 0.56-0.96) and 36% (OR = 0.64, 95% CI: 0.46-0.89; P-trend = 0.0031), compared with those with 2 or lower modified Mediterranean diet scores, respectively. Higher modified Mediterranean diet scores were associated with a lower prevalence of abdominal obesity and hypertriglyceridemia, which are components of metabolic syndrome CONCLUSIONS: Our findings suggest that diet rich in fruit, vegetables, whole grains, legumes, peanuts and fish is associated with a lower prevalence of metabolic syndrome in Korean adults.

Do Coffee Polyphenols Have a Preventive Action on Metabolic Syndrome Associated Endothelial Dysfunctions? An Assessment of the Current Evidence

Epidemiologic studies from several countries have found that mortality rates associated with the metabolic syndrome are inversely associated with coffee consumption. Metabolic syndrome can lead to arteriosclerosis by endothelial dysfunction, and increases the risk for myocardial and cerebral infarction. Accordingly, it is important to understand the possible protective effects of coffee against components of the metabolic syndrome, including vascular endothelial function impairment, obesity and diabetes. Coffee contains many components, including caffeine, chlorogenic acid, diterpenes and trigonelline. Studies have found that coffee polyphenols, such as chlorogenic acids, have many health-promoting properties, such as antioxidant, anti-inflammatory, anti-cancer, anti-diabetes, and antihypertensive properties. Chlorogenic acids may exert protective effects against metabolic syndrome risk through their antioxidant properties, in particular toward vascular endothelial cells, in which nitric oxide production may be enhanced, by promoting endothelial nitric oxide synthase expression. These effects indicate that coffee components may support the maintenance of normal endothelial function and play an important role in the prevention of metabolic syndrome. However, results related to coffee consumption and the metabolic syndrome are heterogeneous among studies, and the mechanisms of its functions and corresponding molecular targets remain largely elusive. This review describes the results of studies exploring the putative effects of coffee components, especially in protecting vascular endothelial function and preventing metabolic syndrome.

Role of anthropometric factors, self-perception, and diet on weight misperception among young adolescents: a cross-sectional study

PURPOSE

Adolescence overweight and obesity have increased considerably, and the misperception of their weight status could reduce the efficiency of intervention programs. The aim of this study was to evaluate the prevalence rate of misperception and to assess the relationship between weight perception and anthropometric parameters, self-perception, physical activity, and adherence to the Mediterranean diet.

METHODS

A total of 1643 young adolescents (11-16 years old) were surveyed in a cross-sectional investigation during two scholastic years (period October-May of 2012-2013 and 2013-2014) in 15 secondary schools of Sicily, southern Italy. Data on demographic information, anthropometric characteristics (bioelectrical impedance), physical activity level, The Children and Youth Physical Self-Perception Profile, weight perception, and dietary habits (KIDMED) were collected.

RESULTS

Misperception was found in the 27.6 % of the young adolescents, and boys were more likely to underestimate their weight status, while girls had a high percentage of overestimation. The strong association with weight misperception was with socioeconomic status, waist circumference, physical activities, and physical self-worth. Moreover, a good adherence to the Mediterranean diet was inversely associated with both overestimation and underestimation in both boys and girls.

CONCLUSION

These findings highlight that almost one-third of the participants had a weight misperception that was associated with several anthropometric, social, and lifestyle factors. Future intervention to prevent overweight and obesity should consider not only gender-specific differences, but also parental SES, perception, and satisfaction of body weight status.

Coffee Intake Decreases Risk of Postmenopausal Breast Cancer: A Dose-Response Meta-Analysis on Prospective Cohort Studies

Aim: A dose-response meta-analysis was conducted in order to summarize the evidence from prospective cohort studies regarding the association between coffee intake and breast cancer risk. Methods: A systematic search was performed in electronic databases up to March 2017 to identify relevant studies; risk estimates were retrieved from the studies and linear and non-linear dose-response analysis modelled by restricted cubic splines was conducted. A stratified and subgroup analysis by menopausal and estrogen/progesterone receptor (ER/PR) status, smoking status and body mass index (BMI) were performed in order to detect potential confounders. Results: A total of 21 prospective studies were selected either for dose-response, the highest versus lowest category of consumption or subgroup analysis. The dose-response analysis of 13 prospective studies showed no significant association between coffee consumption and breast cancer risk in the non-linear model. However, an inverse relationship has been found when the analysis was restricted to post-menopausal women. Consumption of four cups of coffee per day was associated with a 10% reduction in postmenopausal cancer risk (relative risk, RR 0.90; 95% confidence interval, CI 0.82 to 0.99). Subgroup analyses showed consistent results for all potential confounding factors examined. Conclusions: Findings from this meta-analysis may support the hypothesis that coffee consumption is associated with decreased risk of postmenopausal breast cancer.

Coffee Intake Decreases Risk of Postmenopausal Breast Cancer: A Dose-Response Meta-Analysis on Prospective Cohort Studies

Aim: A dose-response meta-analysis was conducted in order to summarize the evidence from prospective cohort studies regarding the association between coffee intake and breast cancer risk. Methods: A systematic search was performed in electronic databases up to March 2017 to identify relevant studies; risk estimates were retrieved from the studies and linear and non-linear dose-response analysis modelled by restricted cubic splines was conducted. A stratified and subgroup analysis by menopausal and estrogen/progesterone receptor (ER/PR) status, smoking status and body mass index (BMI) were performed in order to detect potential confounders. Results: A total of 21 prospective studies were selected either for dose-response, the highest versus lowest category of consumption or subgroup analysis. The dose-response analysis of 13 prospective studies showed no significant association between coffee consumption and breast cancer risk in the non-linear model. However, an inverse relationship has been found when the analysis was restricted to post-menopausal women. Consumption of four cups of coffee per day was associated with a 10% reduction in postmenopausal cancer risk (relative risk, RR 0.90; 95% confidence interval, CI 0.82 to 0.99). Subgroup analyses showed consistent results for all potential confounding factors examined. Conclusions: Findings from this meta-analysis may support the hypothesis that coffee consumption is associated with decreased risk of postmenopausal breast cancer.

A comprehensive meta-analysis on evidence of Mediterranean diet and cardiovascular disease: Are individual components equal?

Many studies have reported that higher adherence to Mediterranean diet may decrease cardiovascular disease (CVD) incidence and mortality. We performed a meta-analysis to explore the association in prospective studies and randomized control trials (RCTs) between Mediterranean diet adherence and CVD incidence and mortality. The PubMed database was searched up to June 2014. A total of 17 studies were extracted and 11 qualified for the quantitative analysis. Individuals in the highest quantile of adherence to the diet had lower incidence [relative risk (RR): 0.76, 95% confidence intervals (CI): 0.68, 0.83] and mortality (RR: 0.76, 95% CI: 0.68, 0.83) from CVD compared to those least adherent. A significant reduction of risk was found also for coronary heart disease (CHD) (RR: 0.72, 95% CI: 0.60, 0.86), myocardial infarction (MI) (RR: 0.67; 95% CI: 0.54, 0.83), and stroke (RR: 0.76; 95% CI: 0.60, 0.96) incidence. Pooled analyses of individual components of the diet revealed that the protective effects of the diet appear to be most attributable to olive oil, fruits, vegetables, and legumes. An average reduced risk of 40% for the aforementioned outcomes has been retrieved when pooling results of RCTs. A Mediterranean dietary pattern is associated with lower risks of CVD incidence and mortality, including CHD and MI. The relative effects of specific food groups should be further investigated.

Coffee Consumption and the Risk of Obesity in Korean Women

Instant coffee mixes that contain sugar and non-dairy creamer account for 80-90% of the total coffee market in Korea. The objective of this study was to investigate the relationship between coffee consumption and obesity in Korean women. We included 5995 women who participated in a health screening examination at the Korean National Cancer Center between 2007 and 2016. Daily coffee consumption and the use of sugar and creamer in coffee was evaluated using a 106-item food frequency questionnaire. Obesity was assessed by body mass index (BMI), and abdominal obesity was assessed by waist circumference (WC). A multiple logistic regression model was used to calculate the odds ratio (OR) of obesity according to coffee consumption. After multivariate adjustment, high coffee consumption was positively associated with obesity as measured by BMI (≥3 cups vs. no drinks, OR = 2.52; 95% confidence interval (CI) = 1.91-3.34; p for the trend < 0.001) and abdominal obesity as measured by WC (≥3 cups vs. no drinks, OR = 2.11; 95% CI = 1.59-2.79; p for the trend < 0.001). The positive association between daily coffee consumption and obesity prevalence was not altered by menopause. The amount of coffee with additives consumed per day by Korean women was positively correlated with the prevalence of obesity, but causation cannot be determined due to the cross-sectional nature of the study design. The mechanism underlying the observed relationship is yet to be elucidated.

Coffee Decreases the Risk of Endometrial Cancer: A Dose-Response Meta-Analysis of Prospective Cohort Studies

AIM

The aim of this study was to perform a comprehensive meta-analysis of the association between coffee consumption and risk of endometrial cancer.

METHODS

Eligible studies were identified by searching the PubMed and EMBASE databases. The dose-response relationship as well as the risk of endometrial cancer for the highest versus the lowest categories of coffee consumption were assessed. Subgroup analyses considering the menopausal and receptor statuses, the smoking status, and the BMI (Body Mass Index) were performed in order to identify potential confounders.

RESULTS

We identified a total of 12 studies eligible for meta-analysis. A dose-response meta-analysis showed a decreased risk of endometrial cancer. Moreover, a subgroup analysis indicated that coffee consumption is significantly associated with a decreased risk of postmenopausal cancer. Increasing coffee consumption by four cups per day was associated with a 20% reduction in endometrial cancer risk (relative risk (RR) 0.80; 95% confidence interval (CI) 0.72 to 0.89) and with a 24% reduction in postmenopausal cancer risk (RR 0.76; 95% CI 0.69 to 0.83).

CONCLUSIONS

Our findings suggest that increased coffee consumption is associated with decreased risk of endometrial cancer, and this association is observed also for postmenopausal cancer.

Association between Dietary Phenolic Acids and Hypertension in a Mediterranean Cohort

Background: Certain foods rich in phenolic acids have been shown to reduce the risk of hypertension, but evidence from epidemiological studies focused on dietary phenolic acid intake is scarce. The aim of this study was to determine the association between dietary phenolic acid intake, as well as their major food sources, and hypertension in a Mediterranean cohort. Methods: Demographic and dietary data of 2044 adults living in Southern Italy were collected. Food frequency questionnaires and Phenol-Explorer were used to calculate dietary intake of polyphenols. Multivariate logistic regression analyses were used to test associations. Results: The mean intake of total phenolic acids in the cohort was 362.6 mg/day. Individuals in the highest quartile of phenolic acid intake (median intake = 522.2 mg/day) were less likely to have hypertension (OR (odds ratio) = 0.68, 95% CI (confidence interval): 0.46, 1.00). When taking into account individual subclasses of phenolic acids, only hydroxyphenylacetic acid was inversely associated with hypertension (highest vs. lowest quartile, OR = 0.63, 95% CI: 0.40, 0.96). Among dietary sources of phenolic acids considered in the analysis, only beer was significantly inversely associated with hypertension (highest vs. lowest quartile, OR = 0.32, 95% CI: 0.15, 0.68). Conclusions: The findings of this study suggest that dietary phenolic acids may be inversely associated with hypertension, irrespectively of their dietary source.

Coffee Consumption and Risk of Biliary Tract Cancers and Liver Cancer: A Dose-Response Meta-Analysis of Prospective Cohort Studies

Background: A meta-analysis was conducted to summarize the evidence from prospective cohort and case-control studies regarding the association between coffee intake and biliary tract cancer (BTC) and liver cancer risk. Methods: Eligible studies were identified by searches of PubMed and EMBASE databases from the earliest available online indexing year to March 2017. The dose–response relationship was assessed by a restricted cubic spline model and multivariate random-effect meta-regression. A stratified and subgroup analysis by smoking status and hepatitis was performed to identify potential confounding factors. Results: We identified five studies on BTC risk and 13 on liver cancer risk eligible for meta-analysis. A linear dose–response meta-analysis did not show a significant association between coffee consumption and BTC risk. However, there was evidence of inverse correlation between coffee consumption and liver cancer risk. The association was consistent throughout the various potential confounding factors explored including smoking status, hepatitis, etc. Increasing coffee consumption by one cup per day was associated with a 15% reduction in liver cancer risk (RR 0.85; 95% CI 0.82 to 0.88). Conclusions: The findings suggest that increased coffee consumption is associated with decreased risk of liver cancer, but not BTC.

Coffee with High but Not Low Caffeine Content Augments Fluid and Electrolyte Excretion at Rest

BACKGROUND

Low levels of caffeine ingestion do not induce dehydration at rest, while it is not clear if larger doses do have an acute diuretic effect. The aim of the present investigation was to examine the acute effect of low and high levels of caffeine, via coffee, on fluid balance in habitual coffee drinkers (at least one per day) at rest.

METHODS

Ten healthy adults (eight males and two females; age: 27 ± 5 years, weight: 89.5 ± 14.8 kg, height: 1.75 ± 0.08 m, and body mass index: 29.1 ± 4.4 kg m^-2) ingested 200 mL of water (W), coffee with low caffeine (3 mg kg^-1, LCAF), or coffee with high caffeine (6 mg kg^-1, HCAF) on three respective separate occasions. All sessions were performed at 09:00 in the morning in a counterbalanced, crossover manner, at least 5 days apart. Subjects remained in the laboratory while urine samples were collected every 60 min for 3 h post ingestion.

RESULTS

Absolute caffeine consumption was 269 ± 45 and 537 ± 89 mg for the LCAF and HCAF, respectively. Coffee ingestion at the HCAF trial induced greater diuresis during the 3-h period (613 ± 101 mL, P < 0.05), when compared to W (356 ± 53 mL) and LCAF (316 ± 38 mL). In addition, cumulative urinary osmotic excretion was significantly greater in the HCAF (425 ± 92 mmol, P < 0.05), as compared to the W (249 ± 36 mmol) and LCAF (177 ± 16 mmol) trials.

CONCLUSION

The data indicate that caffeine intake of 6 mg kg^-1 in the form of coffee can induce an acute diuretic effect, while 3 mg kg^-1 do not disturb fluid balance in healthy casual coffee drinking adults at rest.

Association between tea and coffee consumption and prevalence of metabolic syndrome in Poland - results from the WOBASZ II study (2013-2014)

The study aimed to assess a relationship between tea and coffee consumption and metabolic syndrome (MetS). Cross-sectional study of a random sample of total Polish population was done (The WOBASZ II Study), and the present analysis included 5146 participants at age 20 years and above. Tea and coffee consumption was assessed by 24-h recall method. MetS was defined according to IDF/NHLBI/AHA criteria. After adjustment for covariates, coffee consumption was related to blood pressure and HDL cholesterol, and moderate drinkers had 17% lower odds of MetS compared with non-drinkers (OR = 0.83, 95%CI = 0.72-0.97). Tea consumption was related to some components but not to MetS in general. Inverse association between coffee consumption and MetS may reflect the content of the antioxidants that offer cardiovascular protection. However, weak relation of tea with components of MetS points toward the potential importance of composition of polyphenols and the types of tea consumed.

Adherence to the Mediterranean diet is inversely associated with metabolic syndrome occurrence: a meta-analysis of observational studies

Diet plays a role in the onset and progression of metabolic disorders, including metabolic syndrome (MetS). We aimed to systematically review and conduct a quantitative meta-analysis of results from observational cross-sectional and prospective cohort studies on adherence to the Mediterranean dietary pattern and risk of MetS. Literature databases including PubMed, SCOPUS and EMBASE were searched from the beginning to May 2016. Eight cross-sectional and four prospective studies were included in this meta-analysis, accounting for a total of 33,847 individuals and 6342 cases of MetS. High adherence to the Mediterranean diet was associated with a risk of MetS (RR: 0.81, 95%CI: 0.71, 0.92). Regarding individual components of the MetS, the inverse associations were significant for waist circumference, blood pressure and low HDL-C levels. In conclusion, adoption of a Mediterranean dietary pattern was associated with lower risk of the MetS and it can be proposed for the primary prevention of the MetS.

Sleep Quality, Perceived Stress, and Caffeinated Drinks Intake in Psychiatry Residents: A Cross-Sectional Study

Background: Medical residencies are highly demanding and stressful and have been associated with mental and emotional problems. Studies that evaluated this relationship in Italian psychiatry residents are scarce. In this study, we examined sleep quality and its association with perceived stress and caffeinated beverages consumption in Italian psychiatry residents.

Methods: Seventy-two PGY1–5 psychiatry residents at two University Hospitals in Italy were asked to complete an anonymous questionnaire. The Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale were used to determine the sleep quality and the level of daytime sleepiness (EDS). In addition, we investigated perceived stress and caffeinated drinks consumption (coffee, tea, soda, energy drinks).

Results: Seventy psychiatry residents responded to the survey (97.2% response rate) (M = 34.3%, F = 65.7%; mean age = 30.5 ± 4.2 SD years). 44.3% had poor sleep quality and 15.7% had abnormal EDS. 64.3% reported significant perceived stress. Perceived stress score and coffee consumption were associated with greater likelihood of poor sleep quality.

Conclusions: Psychiatry residents have high prevalence of poor sleep quality. Future longitudinal studies are needed to investigate causality and identify appropriate coping strategies and lifestyle changes aimed to improve mental health in psychiatry trainees.

Impact of Mediterranean diet on metabolic syndrome, cancer and longevity

Obesity symbolizes a major public health problem. Overweight and obesity are associated to the occurrence of the metabolic syndrome and to adipose tissue dysfunction. The adipose tissue is metabolically active and an endocrine organ, whose dysregulation causes a low-grade inflammatory state and ectopic fat depositions. The Mediterranean Diet represents a possible therapy for metabolic syndrome, preventing adiposopathy or "sick fat" formation.The Mediterranean Diet exerts protective effects in elderly subjects with and without baseline of chronic diseases. Recent studies have demonstrated a relationship between cancer and obesity. In the US, diet represents amount 30-35% of death causes related to cancer. Currently, the cancer is the second cause of death after cardiovascular diseases worldwide. Furthermore, populations living in the Mediterranean area have a decreased incidence of cancer compared with populations living in Northern Europe or the US, likely due to healthier dietary habits. The bioactive food components have a potential preventive action on cancer. The aims of this review are to evaluate the impact of Mediterranean Diet on onset, progression and regression of metabolic syndrome, cancer and on longevity.

The Mediterranean healthy eating, ageing, and lifestyle (MEAL) study: rationale and study design

There is accumulating evidence suggesting that Mediterranean lifestyles, including nutrition and sleeping patterns as well as social integration, may play a role in reducing age-related diseases. However, the literature is mostly deficient of evidence provided by Italian Mediterranean islands that more closely adhered to the originally described lifestyles. In this paper, we described the rationale and the study design of the Mediterranean healthy Eating, Ageing, and Lifestyle (MEAL) study, a prospective population-based cohort established in Sicily, southern Italy. The main exposures investigated are classical determinants of health, including demographic, nutritional habits, smoking and physical activity status, as well as eating-related behaviors, sleeping habits, sun exposure, social resources, and perceived stress. Anthropometric measurements will be collected. The main outcomes included depression, quality of life, and, after the follow-up period, also cardiovascular disease and cancer. The MEAL study may provide important data to increase our knowledge regarding the prevalence, incidence, and risk factors of age-related disorders in the Mediterranean region.

Coffee consumption and the occurrence and intensity of metabolic syndrome: a cross-sectional study

The objective of the study was to investigate associations between coffee consumption and the occurrence of metabolic syndrome (MetS) and its components in individuals with a normal BMI, as well in those who are overweight and obese. The analysis was based on the data of 10,367 participants. The studies included a questionnaire interview, anthropometric measurements, blood pressure measurements and analyses of collected fasting-blood samples. In the overweight and obese participants, lower coffee consumption, compared with higher consumption was correlated with a significantly higher risk of abdominal obesity, hypertension, an abnormal glucose concentration, HDL cholesterol, triglycerides and MetS (p < .05). In the participants with a normal BMI, lower coffee consumption was related to the abdominal obesity, HDL cholesterol and MetS (p < .05). Individuals with a normal BMI may react slightly differently to nutritional factors modifying metabolism such as coffee, compared with those with excessive body mass.

Coffee consumption and risk of all-cause, cardiovascular, and cancer mortality in smokers and non-smokers: a dose-response meta-analysis

Coffee consumption has been associated with several benefits toward human health. However, its association with mortality risk has yielded contrasting results, including a non-linear relation to all-cause and cardiovascular disease (CVD) mortality and no association with cancer mortality. As smoking habits may affect the association between coffee and health outcomes, the aim of the present study was to update the latest dose-response meta-analysis of prospective cohort studies on the association between coffee consumption and mortality risk and conduct stratified analyses by smoking status and other potential confounders. A systematic search was conducted in electronic databases to identify relevant studies, risk estimates were retrieved from the studies, and dose-response analysis was modeled by using restricted cubic splines. A total of 31 studies comprising 1610,543 individuals and 183,991 cases of all-cause, 34,574 of CVD, and 40,991 of cancer deaths were selected. Analysis showed decreased all-cause [relative risk (RR) = 0.86, 95 % confidence interval (CI) = 0.82, 0.89)] and CVD mortality risk (RR = 0.85, 95 % CI = 0.77, 0.93) for consumption of up to 4 cups/day of coffee, while higher intakes were associated with no further lower risk. When analyses were restricted only to non-smokers, a linear decreased risk of all-cause (RR = 0.94, 95 % CI = 0.93, 0.96), CVD (RR = 0.94, 95 % CI = 0.91, 0.97), and cancer mortality (RR = 0.98, 95 % CI = 0.96, 1.00) for 1 cup/day increase was found. The search for other potential confounders, including dose-response analyses in subgroups by gender, geographical area, year of publication, and type of coffee, showed no relevant differences between strata. In conclusion, coffee consumption is associated with decreased risk of mortality from all-cause, CVD, and cancer; however, smoking modifies the observed risk when studying the role of coffee on human health.

Mediterranean diet and nonalcoholic fatty liver disease: molecular mechanisms of protection

Nutritional habits modifications have shown an important impact in preventing and ameliorating metabolic alterations, such as nonalcoholic fatty liver disease (NAFLD). Among several dietary approaches that exert positive effects in NAFLD patients, the Mediterranean dietary pattern has shown notable benefits. This review explores the molecular mechanisms through which the Mediterranean diet would improve risk factors associated with metabolic syndrome and NAFLD. The main features of the Mediterranean diet acting on metabolism are represented by its whole-grain and low glycemic index cereal-based items, its fatty acid profile, and its content in phytochemical compounds. Carbohydrate-rich foods high in dietary fiber inducing low glycemic response are able to interact with glucose and insulin metabolism. Unsaturated fatty acids are associated with better hepatic lipid metabolism. Finally, phytochemical compounds, such as dietary polyphenols, are thought to ameliorate inflammation, which is considered one of the mechanisms through which NALFD may evolve into nonalcoholic steatohepatitis (NASH).

Coffee consumption and mortality in three Eastern European countries: results from the HAPIEE (Health, Alcohol and Psychosocial factors In Eastern Europe) study

OBJECTIVE

To test the association between coffee consumption and risk of all-cause, CVD and cancer death in a European cohort.

DESIGN

Prospective cohort study. Cox proportional hazards models with adjustment for potential confounders to estimate multivariable hazard ratios (HR) and 95 % CI were used.

SETTING

Czech Republic, Russia and Poland.

SUBJECTS

A total of 28561 individuals followed for 6·1 years.

RESULTS

A total of 2121 deaths (43·1 % CVD and 35·7 % cancer mortality) occurred during the follow-up. Consumption of 3-4 cups coffee/d was associated with lower mortality risk in men (HR=0·83; 95 % CI 0·71, 0·99) and women (HR=0·63; 95 % CI 0·47, 0·84), while further intake showed non-significant reduced risk estimates (HR=0·71; 95 % CI 0·49, 1·04 and HR=0·51; 95 % CI 0·24, 1·10 in men and women, respectively). Decreased risk of CVD mortality was also found in men (HR=0·71; 95 % CI 0·54, 0·93) for consumption of 3-4 cups coffee/d. Stratified analysis revealed that consumption of a similar amount of coffee was associated with decreased risk of all-cause (HR=0·61; 95 % CI 0·43, 0·87) and cancer mortality (HR=0·59; 95 % CI 0·35, 0·99) in non-smoking women and decreased risk of all-cause mortality for >4 cups coffee/d in men with no/moderate alcohol intake.

CONCLUSIONS

Coffee consumption was associated with decreased risk of mortality. The protective effect was even stronger when stratification by smoking status and alcohol intake was performed.

Dietary polyphenols are inversely associated with metabolic syndrome in Polish adults of the HAPIEE study

Purpose

The aim of this study was to evaluate the association between total and individual classes and subclasses of dietary polyphenol intake and prevalence of metabolic syndrome (MetS) in the Polish arm of the Health, Alcohol and Psychosocial factors In Eastern Europe cohort study.

Methods

A cross-sectional population-based survey including 8821 adults (51.4 % female) was conducted in Kraków, Poland. Dietary polyphenol intake was evaluated using food frequency questionnaires and matching food consumption data with the Phenol-Explorer database. MetS was defined according to the International Diabetes Federation definition. Linear and logistic regression models were performed to estimate odds ratios (ORs) and confidence intervals (CIs).

Results

Significant differences in age and energy intake among different categories of total dietary polyphenol intake were found. Body mass index (BMI), waist circumference (WC), blood pressure, and triglycerides were significantly lower among individuals in the higher quartiles of polyphenol intake, but a linear association was found only for BMI and WC. After adjusting for potential confounding factors, individuals in the highest quartile of polyphenol intake were less likely to have MetS (OR 0.80; 95 % CI 0.64, 0.98 and OR 0.70; 95 % CI 0.56, 0.86 for both men and women, respectively). High total polyphenol intake was negatively associated with WC, blood pressure, high lipoprotein cholesterol, and triglycerides in women, and fasting plasma glucose in both genders. Among individual classes of polyphenols, phenolic acids and stilbenes were significantly associated with MetS; lignans and stilbenes with WC; phenolic acids with blood pressure and triglycerides; and flavonoids with fasting plasma glucose. Among specific subclasses of polyphenols, hydroxycinnamic acids, flavanols, and dihydrochalcones had the most relevant role.

Conclusions

Total and individual classes and subclasses of dietary polyphenols were inversely associated with MetS and some of its components.

Electronic supplementary material

The online version of this article (doi:10.1007/s00394-016-1187-z) contains supplementary material, which is available to authorized users.

Coffee consumption and risk of hypertension in the Polish arm of the HAPIEE cohort study

BACKGROUND/OBJECTIVES

Coffee consumption has been hypothesized to be associated with blood pressure (BP), but previous findings are not homogeneous. The aim of this study was to evaluate the association between coffee consumption and the risk of developing hypertension.

SUBJECTS/METHODS

Data on coffee consumption, BP and use of anti-hypertensive medicament were derived from 2725 participants of the Polish arm of the HAPIEE project (Health, Alcohol and Psychosocial factors In Eastern Europe) who were free of hypertension at baseline and followed up for an average of 5 years. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by multivariate logistic regression analyses and stratified for potential confounding factors.

RESULTS

Coffee consumption was related to decreased age, smoking status and total energy intake. Compared with persons who drink <1 cup coffee per day, systolic BP was significantly associated with coffee consumption and the risk of hypertension was lower for individuals consuming 3-4 cups per day. Despite the analysis stratified by gender showed that the protective effect of coffee consumption on hypertension was significant only in women, the analysis after stratification by smoking status revealed a decreased risk of hypertension in non-smokers drinking 3-4 cups of coffee per day in both sexes (OR 0.41, 95% CI: 0.21, 0.79 for men and OR 0.54, 95% CI: 0.29, 0.99 for women). Upper category coffee consumption (>4 cups per day) was not related to significant increased risk of hypertension.

CONCLUSIONS

Relation between coffee consumption and incidence of hypertension was related to smoking status. Consumption of 3-4 cups of coffee per day decreased the risk of hypertension in non-smoking men and women only.

Natural antioxidants for non-alcoholic fatty liver disease: molecular targets and clinical perspectives

Non-alcoholic steatohepatitis (NASH), the progressive form of non-alcoholic fatty liver disease (NAFLD), is emerging as a main health problem in industrialized countries. Lifestyle modifications are effective in the treatment of NAFLD; however, the long-term compliance is low. Therefore, several pharmacological treatments have been proposed but none has shown significant efficacy or long-term safety. Natural polyphenols are a heterogeneous class of polyphenolic compounds contained in vegetables, which are being proposed for the treatment of different metabolic disorders. Although the beneficial effect of these compounds has traditionally related to their antioxidant properties, they also exert several beneficial effects on hepatic and extra-hepatic glucose and lipid homeostasis. Furthermore, natural polyphenols exert antifibrogenic and antitumoural effects in animal models, which appear relevant from a clinical point of view because of the association of NASH with cirrhosis and hepatocellular carcinoma. Several polyphenols, such anthocyanins, curcumin and resveratrol and those present in coffee, tea, soy are available in the diet and their consumption can be proposed as part of a healthy diet for the treatment of NAFLD. Other phenolic compounds, such as silymarin, are commonly consumed worldwide as nutraceuticals or food supplements. Natural antioxidants are reported to have beneficial effects in preclinical models of NAFLD and in pilot clinical trials, and thus need clinical evaluation. In this review, we summarize the existing evidence regarding the potential role of natural antioxidants in the treatment of NAFLD and examine possible future clinical applications.

Coffee, tea, caffeine and risk of depression: A systematic review and dose-response meta-analysis of observational studies

SCOPE

The aim of the study was to systematically review and analyze results from observational studies on coffee, caffeine, and tea consumption and association or risk of depression.

METHODS AND RESULTS

Embase and PubMed databases were searched from inception to June 2015 for observational studies reporting the odds ratios or relative risks (RRs) and 95% confidence intervals (CI) of depression by coffee/tea/caffeine consumption. Random effects models, subgroup analyses, and dose-response analyses were performed. Twelve studies with 23 datasets were included in the meta-analysis, accounting for a total of 346 913 individuals and 8146 cases of depression. Compared to individuals with lower coffee consumption, those with higher intakes had pooled RR of depression of 0.76 (95% CI: 0.64, 0.91). Dose-response effect suggests a nonlinear J-shaped relation between coffee consumption and risk of depression with a peak of protective effect for 400 mL/day. A borderline nonsignificant association between tea consumption and risk of depression was found (RR 0.70, 95% CI: 0.48, 1.01), while significant results were found only for analysis of prospective studies regarding caffeine consumption (RR = 0.84, 95% CI: 0.75, 0.93).

CONCLUSION

This study suggests a protective effect of coffee and, partially, of tea and caffeine on risk of depression.