WCPD 2012: Edith Feskens
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WCPD 2012: Edith Feskens

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WCPD 2012: Edith Feskens WCPD 2012: Edith Feskens Presentation Transcript

  • Coffee and the prevention of Type 2diabetesThe Epidemiological EvidenceEdith Feskens, edith.feskens@wur.nl
  • 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 View slide
  • 1st Cohort study on Coffee and T2DM View slide
  • 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 theStrong 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-response also 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 antioxidantcapacity – The Rotterdam Study Coffee consumption (cups/day) ≤2 >2 – 3 >3 – 4 >4Age (y) 70.0±8.0 68.5±7.7 67.3±7.3 64.4±6.8Men (%) 34.4 36.5 39.9 49.6Body mass index (kg/m²) 26.1±3.6 26.1±3.5 26.5±3.6 26.3±3.6Waist circumference (cm) Men 93.2±9.5 93.9±8.9 94.0±9.2 94.6±9.4 Women 86.9±11.0 86.6±11.1 87.3±11.0 85.9±11.3
  • Results – The Rotterdam Study (2) Coffee consumption (cups/day) ≤2 >2 – 3 >3 – 4 >4 Smoking status (%) Current 12.4 17.3 21.5 38.1 Former 43.1 43.3 44.5 41.1 Never 44.5 39.3 34.0 20.8 Alcoholic drinks (%) 0 g/day 24.3 18.4 18.0 18.2 >0-10 g/day 47.7 45.9 47.1 42.3 >10-20 g/day 11.2 18.3 16.0 17.1 >20 g/day 16.7 17.4 18.9 22.4 Diet prescription (%) 12.0 12.3 10.1 8.4 Educational level (%) Low 35.3 33.9 33.9 34.2 Moderate 50.5 54.4 56.3 53.4 High 14.2 11.8 9.8 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 FRAPadjustment – The Rotterdam Study 1.50 1.00 Adjusted (p- trend=0.03) RR 0.50 Incl FRAP (p- trend=0.96) 0.00 ≤2 ≥2 -3 ≥3-4 >4 Coffee (cups per day)
  • Adjusted RRs for dietary FRAP scores 1.50 1.00 Total FRAP (p- trend<0.01) RR 0.50 FRAP wo Coffee/Tea p=0.05 0.00 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)
  • AcknowledgmentThanks to all collaborators and funders!Collaborators: Rob van Dam, Anouk Engelen, AnneleenKuijsten, Truus van Woudenbergh and various MScstudents;Rotterdam Study: Jacqueline Witteman,Frank van Rooij, Oscar Franco andAlbert Hofman;Funding: ao. EU-FP6 INTERACT project