COFFEE, DIABETES

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COFFEE, DIABETES WEIGHT LOSS
James Greenberg, PhD.,
Brooklyn College of the City University of New
York.
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OUTLINE
. coffee promises to decrease diabetes risk
. coffee can be hazardous to persons with
diabetes
. biological mechanisms that may explain coffees
promise
. coffee constituents that may explain coffees
promise
. weight loss may also play a role
. gaps in the knowledge base
. Conclusions.
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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.
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COFFEE PROMISES TO DECREASE DIABETES RISK.
There is considerable interest in investigating
harnessing coffees potential to decrease
diabetes risk.
. Most Americans drink coffee (Lundberg, 1998)
. diabetes is widespread burgeoning (CDC,
2005 CDC, 2006).
. estimated 24 million diabetics 57 million
prediabetics in U.S. in 2005 (Amer Diabetes
Assoc)
. Diabetes incidence increased gt200 between 1980
2005
. sixth leading cause of death in the U.S. in
2002
. serious complications including CVD, blindness,
kidney failure, and limb amputations.
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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
6
from Battram et al (2006)
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COFFEE CAN BE HAZARDOUS TO PERSONS WITH DIABETES
AND PREDIABETES.
Some types of decaf may acutely impair 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)
. Battram et al (2006) found that ground decaf
acutely enhanced glucose metabolism
. Greenberg et al (2009) found that ground decaf
acutely impaired glucose metabolism.
8
from Battram et al (2006)
9
from Greenberg et al (2009)
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COFFEE CAN BE HAZARDOUS TO PERSONS WITH DIABETES
AND PREDIABETES.
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.
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BIOLOGICAL MECHANISMS THAT MAY EXPLAIN
COFFEES 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)
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COFFEE CONSTITUENTS THAT MAY EXPLAIN
COFFEES 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)
13
from van Dijk et al (2009).
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COFFEE CONSTITUENTS THAT MAY EXPLAIN
COFFEES 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)
. quinides, nonacidic quinolactones, e.g. the
synthetic quinidine, 3,4- diferuloyl-1,5-quini
de (e.g. Shearer et al, 2003)
. magnesium (e.g. Lopez-Ridaura et al, 2004
Rodriguez-Moran
Guerrero-Romero, 2003)
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COFFEE CONSTITUENTS THAT MAY EXPLAIN
COFFEES PROMISE
. 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)
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WEIGHT LOSS MAY ALSO PLAY A ROLE.
There is empirical evidence
. caffeinated decaf coffee drinking gt decrease
in diabetes risk, only for subjects with prior
weight loss it was a dose-response relation
(Greenberg et al, 2005)
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from Greenberg et al (2005).
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WEIGHT LOSS MAY ALSO PLAY A ROLE.
There is empirical evidence
. caffeinated decaf coffee drinking gt decrease
in diabetes risk, only for subjects with prior
weight loss it was a dose-response relation
(Greenberg et al, 2005)
. Increase in caffeinated decaf coffee drinking
ltgt moderate weight loss over 12-years
(Lopez-Garcia et al, 2006)
. a large trial (N1,079) found that a relatively
small weight loss of 5.3 body weight gt 55
decrease in diabetes risk in a 3.2 yr follow
up (Hamman et al, 2006)
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WEIGHT LOSS MAY ALSO PLAY A ROLE.
There is randomized human trial evidence
. a French trial (N50) found that a decaf
extract of green coffee beans, high in
chlorogenic acid gt weight loss of 2.8 of
body weight in 60 days (Dellalibaria et al, 2006)
. a Norwegian trial (N32) found that the same
decaf extract gt weight loss of 4.3 of body
weight in 84 days (Thom, 2007)
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WEIGHT LOSS MAY ALSO PLAY A ROLE.
An empirically-based hypothesis. Weight loss gt
. decrease in risk of diabetes (e.g. Hamman et
al, 2006)
. increase in adiponectin (e.g. Heinonen et al,
2009)
. decrease in inflammation (e.g.
Barinas-Mitchell et al, 2006)
. decrease in oxidative stress (e.g. Rector et
al, 2007)
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WEIGHT LOSS MAY ALSO PLAY A ROLE.
Coffees 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 decreases longevity (Fontaine et al,
2003) quality of life (Fontaine et al,
2000), increases medical costs (CDC, 2005)
. obesity is a serious burgeoning world-wide
public health problem (WHO, 2009)
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GAPS IN THE KNOWLEDGE BASE
We lack adequate knowledge of which
constituents which underlying biological
mechanisms explain
. coffees acute effects on glucose metabolism
long-term effects on diabetes risk
. coffees acute and long-term effects on
appetite, food intake body weight
. differences between the acute and long-term
effects
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CONCLUSION
We need more research on coffees constituents.
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