wcpd 2012: edith feskens
TRANSCRIPT
Coffee and the prevention of Type 2
diabetes
The Epidemiological Evidence
Edith Feskens, [email protected]
Organs involved in glucose metabolism
Annual Coffee use per capita (kg)
1 Finland 12.0 kg
2 Norway 9.9 kg
3 Iceland 9.0 kg
4 Denmark 8.7 kg
5 Netherlands 8.4 kg
6 Sweden 8.2 kg
7 Switzerland 7.9 kg
8 Belgium Luxembourg 6.8 kg
9 Canada 6.5 kg
10 Bosnia and Herzegovina 6.2 kg
22 Spain 4.5 kg
23 Estonia 4.5 kg
24 Portugal 4.3 kg
25 United States 4.2 kg
1st Cohort study on Coffee and T2DM
Coffee and Risk of T2DM (Huxley ea 2009)
Dose-response in Meta-Analysis Huxley ea
(2009)
Coffee and T2DM risk factors
Wu et al 2005: associations with lower C-peptide, especially in overweight/obese
Williams et al 2008: associated with higher adiponectin, and lower levels of inflammatory markers
Bidel et al 2008: effect higher in those with high serum gammaGT
Low risk in high coffee drinkers in the
Strong Heart Study 2011
Zhang et al, 2011
Coffee not associated with more chronic disease, in any case with lower TDM risk
Boiled coffee from Norway works as well…
A dose-responsealso in China…
Is it the caffeine?
Not likely, decaf is also associated with lower risk:
Huxley ea 2009
Is it another coffee constituent?
Van Dam, 2005
Coffee, T2DM and dietary antioxidant
capacity – The Rotterdam Study
Coffee consumption (cups/day)
≤ 2 >2 – 3 >3 – 4 >4
Age (y) 70.0±8.0 68.5±7.7 67.3±7.3 64.4±6.8
Men (%) 34.4 36.5 39.9 49.6
Body mass index (kg/m²) 26.1±3.6 26.1±3.5 26.5±3.6 26.3±3.6
Waist circumference (cm)
Men
Women
93.2±9.5
86.9±11.0
93.9±8.9
86.6±11.1
94.0±9.2
87.3±11.0
94.6±9.4
85.9±11.3
Results – The Rotterdam Study (2)
Coffee consumption (cups/day)
≤ 2 >2 – 3 >3 – 4 >4
Smoking status (%)
Current
Former
Never
12.4
43.1
44.5
17.3
43.3
39.3
21.5
44.5
34.0
38.1
41.1
20.8
Alcoholic drinks (%)
0 g/day
>0-10 g/day
>10-20 g/day
>20 g/day
24.3
47.7
11.2
16.7
18.4
45.9
18.3
17.4
18.0
47.1
16.0
18.9
18.2
42.3
17.1
22.4
Diet prescription (%) 12.0 12.3 10.1 8.4
Educational level (%)
Low
Moderate
High
35.3
50.5
14.2
33.9
54.4
11.8
33.9
56.3
9.8
34.2
53.4
12.5
Family history of diabetes (%) 27.4 27.8 27.4 28.2
What is dietary pattern?
Results - The Rotterdam Study (3)
Coffee consumption (cups/day)
≤ 2 >2 – 3 >3 – 4 >4
Energy (kcal/day) 1896 1919 1981 2077
Carbohydrates (energy-%) 44.1±7.3 43.6±6.7 43.4±6.5 42.8±6.9
Protein (energy-%) 16.6±3.0 16.8±3.0 16.8±3.0 16.7±3.1
Fat (energy-%) 36.0±6.3 36.1±6.1 36.2±6.0 36.5±6.2
Saturated fat (energy-%) 14.2±3.4 14.3±3.2 14.3±3.1 14.5±3.1
Fibre (g/day) 16.2±5.6 16.5±5.1 16.8±4.6 17.7±5.1
Tea (cups/day)* 3.5 3.0 3.0) 2.0
Total FRAP score (mmol/day) 15.2±3.9 18.1±3.3 21.0±3.0 25.8±4.8
What is FRAP?
FRAP=Ferric iron Antioxidant Reducing Power
FRAP assay: method that assesses antioxidant capacity of individual food items by measuring the ability of antioxidants in food items to reduce ferric iron (Fe3+) to ferrous iron (Fe2+)
2010: Food table by Rune Blomhoff’s group (Oslo, Norway)
Food table for Rotterdam Study prepared with Elizabeth Devore (US)
Contribution by coffee 51%; tea 17%; oranges etc <4%
Relative Risks coffee according to FRAP
adjustment – The Rotterdam Study
0.00
0.50
1.00
1.50
RR
Adjusted (p-trend=0.03)
Incl FRAP (p-trend=0.96)
≤ 2 ≥2 -3 ≥3-4 > 4
Coffee (cups per day)
Adjusted RRs for dietary FRAP scores
0.00
0.50
1.00
1.50
RR
Total FRAP (p-trend<0.01)
FRAP wo Coffee/Tea p=0.05
Q1 Q2 Q3 Q4
Interpretation Rotterdam data
Again, coffee consumption is independently associated with a lower risk of type 2 diabetes
Dietary antioxidant activity was also inversely associated with the risk of type 2 diabetes
Mainly due to the contribution of coffee (and tea)
Acknowledgment
Thanks to all collaborators and funders!
Collaborators: Rob van Dam, Anouk Engelen, Anneleen Kuijsten, Truus van Woudenbergh and various MSc students;
Rotterdam Study: Jacqueline Witteman,Frank van Rooij, Oscar Franco and Albert Hofman;
Funding: ao. EU-FP6 INTERACT project