WCPD 2012: Edith Feskens

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WCPD 2012: Edith Feskens

  1. 1. Coffee and the prevention of Type 2diabetesThe Epidemiological EvidenceEdith Feskens, edith.feskens@wur.nl
  2. 2. Organs involved in glucose metabolism
  3. 3. 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
  4. 4. 1st Cohort study on Coffee and T2DM
  5. 5. Coffee and Risk of T2DM (Huxley ea 2009)
  6. 6. Dose-response in Meta-Analysis Huxley ea(2009)
  7. 7. 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
  8. 8. Low risk in high coffee drinkers in theStrong Heart Study 2011 Zhang et al, 2011
  9. 9.  Coffee not associated with more chronic disease, in any case with lower TDM risk
  10. 10.  Boiled coffee from Norway works as well…
  11. 11.  A dose-response also in China…
  12. 12. Is it the caffeine? Not likely, decaf is also associated with lower risk: Huxley ea 2009
  13. 13. Is it another coffee constituent? Van Dam, 2005
  14. 14. 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
  15. 15. 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
  16. 16. What is dietary pattern?
  17. 17. 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
  18. 18. 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%
  19. 19. 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)
  20. 20. 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
  21. 21. 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)
  22. 22. 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

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