COFFEE, DIABETES & WEIGHT LOSS James Greenberg, PhD., Brooklyn College of the City University of New...

COFFEE, DIABETES & WEIGHT LOSS James Greenberg, PhD., Brooklyn College of the City University of New York.

. gaps in the knowledge base;

OUTLINE

. coffee promises to decrease diabetes risk;

. biological mechanisms that may explain coffee’s promise;

. coffee can be hazardous to persons with diabetes;

. coffee constituents that may explain coffee’s promise;

. weight loss may also play a role;

. Conclusions.

COFFEE PROMISES TO DECREASE DIABETES RISK.

. Based on results of about 20 epidemiological studies; (Greenberg et al, 2006; Pereira et al, 2006; Paynter et al, 2006);

. both caffeinated & decaf coffee exhibit the effect;

. non-caffeine constituents & maybe caffeine appear to be involved.

. Most Americans drink coffee (Lundberg, 1998);

. estimated 24 million diabetics & 57 million prediabetics in U.S. in 2005 (Amer Diabetes Assoc);. Diabetes incidence increased >200% between 1980 & 2005;. sixth leading cause of death in the U.S. in 2002;. serious complications including CVD, blindness, kidney failure, and limb amputations.

. diabetes is widespread & burgeoning (CDC, 2005; CDC, 2006).

There is considerable interest in investigating & harnessing coffee’s potential to decrease diabetes risk .

COFFEE PROMISES TO DECREASE DIABETES RISK.

COFFEE CAN BE HAZARDOUS TO PERSONS WITH DIABETES AND PREDIABETES.

. caffeine & caffeinated coffee acutely impair glucose metabolism (Greenberg et al, 2006; Lane et al, 2008);

. causes repeated bouts of poor glycemic control;

from Battram et al (2006)


Some types of decaf may acutely impair glucose Metabolism:

. Battram et al (2006) found that ground decaf acutely enhanced glucose metabolism;

. four human trials found that instant decaf had no acute effects on glucose metabolism (Johnston et al, 2003; Thom, 2007; van Dijk et al, 2009; Louie et al, 2008);

. Greenberg et al (2009) found that ground decaf acutely impaired glucose metabolism.

from Battram et al (2006)

FIGURE 1. Glucose vs Time.Glucose values represent change from baseline at t=0 min.Beverage ingested at t=0 mins. 75 gm glucose ingested at t=60 mins.

Glucose was higher for DECAF than PLACEBO between t=60 & 90 min (p<0.05), by 2-way ANOVA.

Error bars are standard error of the mean, n=11.

TIME (mins)

-30 0 30 60 90 120 150 180

GLU

CO

SE

(m

g/d

L)

0

20

40

60

80

CAFFCOFF

CAFFEINE

PLACEBO

DECAF

from Greenberg et al (2009)


It is possible that some types of decaf have:

. higher concentrations of constituents that enhance glucose metabolism;

. lower concentrations of constituents that impair glucose metabolism.

BIOLOGICAL MECHANISMS THAT MAY EXPLAIN COFFEE’S PROMISE

. adiponectin, an adipokine polypeptide. Caffeinated coffee increased adiponectin in an epidemiological study (e.g. Williams et al, 2008);

. inflammation. Caffeinated & decaffeinated coffee decreased markers of inflammation in epidemiological studies (e.g. Lopez-Garcia et al, 2006; Kotani et al, 2008);

. oxidative Stress. Coffee is a major source of antioxidants (Halvorsen et al, 2006);

COFFEE CONSTITUENTS THAT MAY EXPLAIN COFFEE’S PROMISE

. chlorogenic acids, polyphenols, e.g. 5-caffeoylquinic acid (e.g. van Dijk et al, 2009; Thom, 2007);

. trigonelline a nonphenolic phytochemical, N-methylnicotinic acid (e.g. van Dijk et al, 2009; Mishkinsky et al, 1967);

from van Dijk et al (2009).


. chlorogenic acids, polyphenols, e.g. 5-caffeoylquinic acid (e.g. van Dijk et al, 2009; Thom, 2007);

. trigonelline a nonphenolic phytochemical, N-methylnicotinic acid (e.g. van Dijk et al, 2009; Mishkinsky et al, 1967);

. quinides, nonacidic quinolactones, e.g. the synthetic quinidine, 3,4- diferuloyl-1,5-quinide (e.g. Shearer et al, 2003);

. magnesium (e.g. Lopez-Ridaura et al, 2004; Rodriguez-Moran &

Guerrero-Romero, 2003);

. Some possible biological mechanisms:

. chlorogenic acid (e.g. Johnston et al, 2003) & quinides (e.g. Shearer et al, 2003) may decrease hepatic glucose production by inhibiting glucose-6-phosphatase;

. chlorogenic acid may decrease intestinal glucose absorption (e.g. Bassoli et al, 2008) & preserve beta-cell function by antioxidant action (e.g. McCarty, 2004);

. magnesium may increases tyrosine kinase activity in muscle cells and adipocytes (e.g. Yokota et a, 2004);


There is empirical evidence:

. caffeinated & decaf coffee drinking => decrease in diabetes risk, only for subjects with prior weight loss & it was a dose-response relation (Greenberg et al, 2005);

WEIGHT LOSS MAY ALSO PLAY A ROLE.

from Greenberg et al (2005).

There is empirical evidence:

. Increase in caffeinated & decaf coffee drinking <=> moderate weight loss over 12-years (Lopez-Garcia et al, 2006);


. a large trial (N=1,079) found that a relatively small weight loss of 5.3% body weight => 55% decrease in diabetes risk in a 3.2 yr follow up (Hamman et al, 2006);

. caffeinated & decaf coffee drinking => decrease in diabetes risk, only for subjects with prior weight loss & it was a dose-response relation (Greenberg et al, 2005);

There is randomized human trial evidence:

. a French trial (N=50) found that a decaf extract of green coffee beans, high in chlorogenic acid => weight loss of 2.8% of body weight in 60 days (Dellalibaria et al, 2006);

. a Norwegian trial (N=32) found that the same decaf extract => weight loss of 4.3% of body weight in 84 days (Thom, 2007);


An empirically-based hypothesis.

Weight loss =>

. increase in adiponectin (e.g. Heinonen et al, 2009);

. decrease in inflammation (e.g. Barinas-Mitchell et al, 2006);

. decrease in risk of diabetes (e.g. Hamman et al, 2006);

. decrease in oxidative stress (e.g. Rector et al, 2007);


Coffee’s potential to induce weight loss is important:

. about 2/3 of Americans are overweight and about 1/3 are obese (Flegal et al, 2002);

. obesity is a serious burgeoning world-wide public health problem (WHO, 2009);

. obesity decreases longevity (Fontaine et al, 2003) & quality of life (Fontaine et al, 2000), & increases medical costs (CDC, 2005);


GAPS IN THE KNOWLEDGE BASE

We lack adequate knowledge of which constituents& which underlying biological mechanisms explain:

. coffee’s acute effects on glucose metabolism & long-term effects on diabetes risk;

. coffee’s acute and long-term effects on appetite, food intake & body weight;

. differences between the acute and long-term effects;

CONCLUSION

We need more research on coffee’s constituents.

REFERENCES. American Diabetes Association. http://www.diabetes.org/about-diabetes.jsp.. Barinas-Mitchell E, Kuller LH, Sutton-Tyrrell K, Hegazi R, Harper P, Mancino J, Kelley DE. Effect of weight loss and nutritional intervention on arterial stiffness in type 2 diabetes. Diabetes Care. 2006 Oct;29(10):2218-22.. Bassoli BK, Cassolla P, Borba-Murad GR et al. (2008) Chlorogenic acid reduces theplasma glucose peak in the oral glucose tolerance test: effects on hepatic glucose release and glycaemia. Cell Biochem Funct 26, 320-328.. Battram DS, Arthur R, Weekes A et al. (2006) The glucose intolerance induced by caffeinated coffee ingestion is less pronounced than that due to alkaloid caffeine in men. J Nutr 136, 1276-80.. Centers for Disease Control and Prevention. National Diabetes Fact Sheet: General Information and National Estimates on Diabetes in the United States, 2005. Rev Ed. Atlanta (GA): US Department of Health and Human Services, Centers for Disease Control and Prevention; 2005. . Centers for Disease Control and Prevention. Diabetes: Disabling, Deadly, and on the Rise, 2006. Rev Ed. Atlanta (GA): US Department of Health and Human Services, Centers for Disease Control and Prevention; 2006.. Dellalibera O, Lemaire B, Lafay S.Le Svetol, un extrait de caf vert decafine, induit une perte de poids et augmente le ratio masse maigre sur masse grasse chez des volontaires en surcharge ponderale.. Phytotherapie 2006;4:194-197.

REFERENCES (continued). Flegal, KM, Carroll MD, Oglen CI, Johnson CI. Prevalence and trends in obesity among US adults, 1999-2000. JAMA 2002;288(14):1723-1727.. Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB. Years of life lost due to obesity. JAMA 2003;289:187-193.. Fontaine KR, Bartlett SJ, Barofsky I. Health-related quality of life among obese persons seeking and not currently seeking treatment. Int J Eat Disord 2000;27(1):101-105.. Greenberg JA, Owen DR, Geliebter A. Coffee, glucose metabolism and diabetes, a randomized clinical trial (in review, 2009). Greenberg JA, Geliebter A Boozer CN. Coffee and diabetes: a review of the literature. Am. J. Clin. Nutrition 2006;84:682-693.. Greenberg JA, Axen KV, Schnoll R et al. (2005) Coffee, tea and diabetes: the role of weight loss and caffeine. Int J Obes Relat Metab Disord 29, 1121-9.. Hamman RF, Wing RR, Edelstein SL, Lachin JM, Bray GA, Delahanty L, Hoskin M, Kriska AM, Mayer-Davis EJ, Pi-Sunyer X, Regensteiner J, Venditti B, Wylie-Rosett J. Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes Care. 2006;29(9):2102-7.. Halvorsen BL, Carlsen MH, Phillips KM, Bohn SK, Holte K, Jacobs DR Jr, Blomhoff R. Content of redox-active compounds (ie, antioxidants) in foods consumed in the United States. Am J Clin Nutr 2006;84:95-135.

REFERENCES (continued). Heinonen MV, Laaksonen DE, Karhu T, Karhunen L, Laitinen T, Kainulainen S, Rissanen A, Niskanen L, Herzig KH. Effect of diet-induced weight loss on plasma apelin and cytokine levels in individuals with the metabolic syndrome. Nutr Metab Cardiovasc Dis. 2009 Mar 9. [Epub ahead of print]. Johnston KL, Clifford MN, Morgan LM (2003) Coffee acutely modifies gastrointestinal hormone secretion and glucose tolerance in humans: glycemic effects of chlorogenic acid and caffeine. Am J Clin Nutr 78, 728 33. .Kotani K, Tsuzaki K, Sano Y, Maekawa M, Fujiwara S, Hamada T, Sakane N. The relationship between usual coffee consumption and serum C-reactive protein level in a Japanese female population. Clin Chem Lab Med. 2008;46(10):1434-7.. Lane JD, Feinglos MN, Surwit RS. Caffeine increases ambulatory glucose and postprandial responses in coffee drinkers with type 2 diabetes. Diabetes Care 2008;31(2):221-222.. Lopez-Garcia E, van Dam RM, Qi L, Hu FB. Coffee consumption and markers of inflammation and endothelial dysfunction in healthy and diabetic women. Am J Clin Nutr. 2006;84(4):888-93.. Lopez-Ridaura R, Willett WC,Rimm EB,et al. Magnesium intake and risk of type 2 diabetes in men and women. Diabetes Care 2004;27:134–40.. Louie JC, Atkinson F, Petocz P, Brand-Miller JC. Delayed effects of coffee, tea and sucrose on postprandial glycemia in lean, young, healthy adults. Asia Pac J Clin Nutr. 2008;17(4):657-62.

REFERENCES (continued). Lundsberg LS. Caffeine consumption. In: Spiller GA, ed. Caffeine. Boca Raton, FL: CRC Press, 1998:199–224.McCarty, M. F. (2005). A chlorogenic acid-induced increase in GLP-1 production may mediate the impact of heavy coffee consumption on diabetes risk [Electronic version]. Medical Hypotheses, 64, 848-853.. Mishkinsky J, Joseph B, Sulman FG et al. (1967) Hypoglycaemic effect of trigonelline. Lancet 2, 1311-1312.. Pereira MA, Parker ED, Folsom AR. Coffee consumption and risk of type 2 diabetes mellitus: an 11-year prospective study of 28 812 postmenopausal women. Arch Intern Med. 2006;166(12):1311-6.. Paynter NP, Yeh HC, Voutilainen S, Schmidt MI, Heiss G, Folsom AR, Brancati FL, Kao WH. Coffee and sweetened beverage consumption and the risk of type 2 diabetes mellitus: the atherosclerosis risk in communities study. Am J Epidemiol. 2006;164(11):1075-84.. Rector RS, Warner SO, Liu Y, Hinton PS, Sun GY, Cox RH, Stump CS, Laughlin MH, Dellsperger KC, Thomas TR. Exercise and diet induced weight loss improves measures of oxidative stress and insulin sensitivity in adults with characteristics of the metabolic syndrome. Am J Physiol Endocrinol Metab. 2007 Aug;293(2):E500-6. Epub 2007 May 1.

REFERENCES (continued). Rodriguez-Moran M, Guerrero-Romero F: Oral magnesium supplementation improves insulin sensitivity and metabolic control in type 2 diabetic subjects: a randomized double-blind controlled trial. Diabetes Care 2003;26:1147-1152.. Shearer J, Farah A, de Paulis R, et al. Quinides of roasted coffee enhance insulin action in conscious rats. J Nutr 2003;133:3529–3532. . Thom E. The Effect of Chlorogenic Acid enriched coffee on glucose absorption in healthy volunteers and its effect on body mass. J Int Med Res 2007;35:900-908.. van Dijk AE, Olthof MR, Meeuse JC, Seebus E, Rob J Heine RJ, Rob M van Dam RM. Acute Effects Of Decaffeinated Coffee And The Major Coffee Components Chlorogenic Acid And Trigonelline On Glucose Tolerance. Diabetes Care 2009;. Williams CJ, Fargnoli JL, Hwang JJ, van Dam RM, Blackburn GL, Hu FB, Mantzoros CS. Coffee consumption is associated with higher plasma adiponectin concentrations in women with or without type 2 diabetes: a prospective cohort study. Diabetes Care. 2008;31(3):504-7. . W.H.O., http://www.who.int/dietphysicalactivity/publications/facts/obesity/en/. Yokota K, Kato M, Lister F, Ii H, Hayakawa T, Kikuta T, Kageyama S, Tajima N. Clinical efficacy of magnesium supplementation in patients with type 2 diabetes. J Am Coll Nutr. 2004 Oct;23(5):506S-509S.

COFFEE, DIABETES & WEIGHT LOSS James Greenberg, PhD., Brooklyn College of the City University of New...

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