Protection of liver, reduction in diabetes, inflammation, cancer, aging. Leading liver diseases expert from Boston reviews benefits of drinking coffee. Coffee can reduce liver enzyme levels [good thing], increase telomere length [longer life?], and reduce risks of diabetes and heart disease. Get a cup of coffee and see Dr. Sanjiv Chopra discuss coffee’s health effects. Dr. Chopra, you spoke about and wrote in your books that coffee is one of the most important protectors of health. Could you please expand on your idea? Dr. Anton Titov, MD. Could you talk about the coffee's effect on health? Dr. Anton Titov, MD. That's a great question! Dr. Sanjiv Chopra, MD. As you mentioned, I'm a liver expert. I got very intrigued about 25 years ago when I read that coffee drinkers have low levels of liver enzymes in the blood. Dr. Sanjiv Chopra, MD. When we go see our primary care physician once a year, they do a battery of blood tests and amongst them they test for two liver enzymes, ALT and AST. This was an observation that people who drank coffee had lower levels [of ALT and AST]. When somebody has elevated levels [of ALT / AST], it is almost always indicative of liver disease. Dr. Sanjiv Chopra, MD. This is intriguing. But what does it mean? Dr. Anton Titov, MD. Maybe there is something in coffee that interferes with the assay. So you get lower levels. But then studies came out that coffee drinkers have less hepatic fibrosis. Coffee drinkers have less scar tissue in the liver. Sometimes there is lots of scar tissue in the liver. Scars totally distort the liver architecture, with islands of liver cells totally surrounded by scar tissue, fibrosis. We call it cirrhosis. Dr. Sanjiv Chopra, MD. Coffee drinkers had low levels of liver enzymes, they had less fibrosis. Then a study in Journal of Gastroenterology that people who drank two cups of regular coffee a day had a 50% reduction in hospitalization and mortality from chronic liver disease. It turns out that primary liver cancer, cancer rising in the liver, is now the third leading cause of cancer mortality in the world. Multiple studies and a meta-analysis have shown that people who drink two cups of regular coffee have 40% reduction in primary liver cancer mortality. Dr. Sanjiv Chopra, MD. Low liver enzymes, less scarring, less fibrosis, less hospitalization less mortality, less liver cancer. It turns out that coffee drinkers also have a lower risk of four other common cancers. They are metastatic prostate cancer, colon cancer, skin cancer, including malignant melanoma. It is a very deadly skin cancer. Endometrial cancer. Dr. Sanjiv Chopra, MD. Five cancers - people who drink coffee have a lower incidence. Low risk of Parkinson's disease, low risk of cognitive decline and early dementia, lower risk of Type 2 diabetes. For type 2 diabetes, one has to drink six cups of coffee, regular or decaf. Then there is a 40 to 54% reduction in risk of developing Type 2 diabetes. When somebody already has type 2 diabetes and they drink two cups of coffee a day, regular or decaf, there is a 30% reduction in cardiovascular mortality. Dr. Sanjiv Chopra, MD. Pretty impressive! There are mechanistic explanations: coffee drinkers have low levels of CRP, low levels of TNF alpha. Coffee reduces inflammation? Dr. Anton Titov, MD. Yes, that may be the mechanism how coffee decreases many conditions, the risk of developing them or even cancer. This we now know is linked with inflammation. C-Reactive Proteinis a sensitive marker for inflammation. True, so true! Dr. Sanjiv Chopra, MD. A study appeared in the New England Journal of Medicine about four years ago. That day I got about a hundred plus emails from colleagues around the country. "Sanjiv, you have been talking about coffee all these years and its potential health benefits. You are vindicated!" the study in the New England Journal of Medicine said this. "Men and women who drink coffee have lower total and cause-specific mortality." Then about six or eight months ago, an article in one of the nutrition journals showed that people who drink coffee have longer telomeres. Dr. Sanjiv Chopra, MD. Telomeres were described by Elizabeth Blackburn, an Australian scientist. She got the Nobel Prize in Medicine or Physiology in 2009 with two other colleagues. Shortened telomeres are linked with accelerated cellular aging. Dr. Sanjiv Chopra, MD. Who has shortened telomeres? Dr. Anton Titov, MD. Mothers of chronically disabled children, caregivers of people with Alzheimer’s disease. Who has longer telomeres? By inference they may live longer. We think they live longer. People who exercise, people on the Mediterranean diet, people who meditate. Then the recent study showed that people who drink coffee have longer telomeres. Does it matter which coffee to drink? How much coffee one should drink? What is the frequency of coffee consumption for health benefits? It is a great question! The studies have simply asked. "Do you drink coffee? Yes or no?" If you drink coffee, how many cups do you drink? What is the size of the cup? Do you drink regular or decaf?" My take on it is this. Drink regular coffee if you can. It has more benefits than decaf. Don't add cream or sugar substitutes. I like to drink it black, make it simple. Dr. Sanjiv Chopra, MD. I don't have to worry about sugar and Splenda. Do I put milk? is milk cold? and it is going to make my coffee cold. Dr. Sanjiv Chopra, MD. I drink black coffee. Sometimes somebody wants to sweeten it, add sugar. Don't use artificial substitutes. Artificial sugars are turning out to produce worse glucose intolerance, because it changes the microbiome in the intestines. This is one of the hottest topics in medicine, gut microbiome. Microbiome has been called "the second human genome, the inner bacterial rainforest." There are trillions of bacteria in our intestines. In aggregate their weight is 3 pounds. It is a newly discovered organ! Dr. Sanjiv Chopra, MD. If you want to have a Coca Cola, have a Coca Cola. Maybe have one third, savor it, enjoy it, rather than have a Diet Coke. This has only one calorie but has many injurious health effects.