No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Association of habitual coffee consumption with obesity, sarcopenia, bone mineral density and cardiovascular risk factors: A two-year follow-up study in kidney transplant recipients
Abstract
Background & aims:
Recent evidence suggests that moderate coffee intake is associated with multiple health benefits, including lower risk of obesity, sarcopenia and cardiovascular disease (CVD) in the general population. However, to date, no study has evaluated these associations in kidney transplant recipients (KTR). The aim of the present study was to evaluate the association of habitual coffee consumption with obesity, sarcopenia, bone mineral density and CVD risk factors in KTR.
Methods:
This prospective 2 years-follow-up study included 170 KTR (59% men) aged 49.5 (42.0-57.0) years. At baseline participants were submitted to the following evaluations: clinical, laboratorial, dietary intake (including coffee), muscle strength, anthropometric and body composition by bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). After two years 163 KTR were re-evaluated by anthropometry, BIA and muscle strength. Sarcopenia was defined according to EWGSOP2. Risk factors for CVD were hypertension, diabetes mellitus, dyslipidemia, metabolic syndrome and hyperhomcysteinemia. Participants were stratified according to coffee intake: 0 or 1 time/day (Gr0-1) and 2 or 3 times/day (Gr2-3).
Results:
The median coffee consumption was 200 (150-250)mL/day and 112 (71-155)mL/1000 kcal/day. At baseline, Gr2-3 vs. Gr0-1 exhibited significantly higher values of waist circumference, waist-to-height ratio (WHtR) and presented a higher odds ratio for central obesity according to WHtR (2.68; 95%CI:1.19-6.02; p = 0.02) after adjustment for confounders. Coffee consumption (mL/1000 kcal/day) showed, even after adjustment for confounders, (1) a positive association with all parameters of body adiposity (anthropometry, BIA and DXA) and (2) a negative association with muscle quality index. After two years, coffee intake (mL/1000 kcal/day) at baseline presented a positive correlation with changes in fat mass (kg) by BIA (r = 0.22, p = 0.01) after adjustment for confounders.
Conclusion:
This study suggests that in KTR, higher coffee consumption is associated with increased adiposity, specially, central adiposity and lower muscle quality, but is not related with the other evaluated parameters.
... We appreciate the interest of Drs. Catikkas and Safer in our recently published article "Association of habitual coffee consumption with obesity, sarcopenia, bone mineral density and cardiovascular risk factors: a two-year follow-up study in kidney transplant recipients" [1]. In this study we evaluated body composition using both bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). ...
... The hydration status of patients was adequate according to bioelectrical impedance vector analysis (BIVA) which allowed us to use unbiased resistance (R) and reactance (Xc) measurements (data was not shown in order to avoid burdening the article with unrelated values to study´s main aim). To clarify in a brief description, we observed that vectors R/height and Xc/height (both sexes) median values plotted in graph were within the 50% tolerance ellipses for normal hydration as proposed by Rossini-Venturini et al. [1], also were within the newly BIVA values of Campa et al. [5] when we now made the comparison. Additionally, the phase angle was within 25th-75th percentiles, according to sex, of the reference values proposed by Campa et al. (2023) [5]. ...
... This suggests that the consumption of coffee may stimulate additional intake of sweet or fatty foods, contributing to weight gain. Moreover, Costa et al. [43] conducted a two-year prospective study revealing that coffee consumption is linked to increased obesity, particularly abdominal obesity, as well as decreased muscle quality. Mendelian randomization analyses highlighted differing effects of coffee consumption and plasma caffeine levels on BMI [44]. ...
Background: Obesity is a global health issue influenced primarily by genetic variants and environmental factors. This study aimed to examine the relationship between genetic and lifestyle factors and their interaction with obesity risk among university students. Methods: A total of 658 students from the same university participated in this study, including 531 females (mean age (SD): 21.6 (3.9) years) and 127 males (21.9 (4.6) years). Among them, 550 were classified as normal weight or underweight (456 females and 94 males), while 108 were identified as overweight or obese (75 females and 33 males). All the participants underwent anthropometric and genetic screening and completed lifestyle and sleep quality questionnaires. Results: The polygenic risk score, based on seven genetic variants (ADCY3 rs11676272, CLOCK rs1801260, GPR61 rs41279738, FTO rs1421085, RP11-775H9.2 rs1296328, SLC22A3 rs9364554, and TFAP2B rs734597), explained 8.3% (p < 0.0001) of the variance in body mass index (BMI). On the other hand, lifestyle factors—such as meal frequency, frequency of overeating, nut consumption as a snack, eating without hunger, frequency of antibiotic use in the past year, symptoms of dysbiosis, years of physical activity, sleep duration, bedtime, ground coffee consumption frequency, and evening coffee consumption time—accounted for 7.8% (p < 0.0001) of the variance in BMI. The model based on gene–environment interactions contributed 15% (p < 0.0001) to BMI variance. Conclusions: This study revealed that individuals with a higher genetic predisposition, as defined by the seven polymorphic loci, are more susceptible to becoming overweight or obese under certain lifestyle conditions.
... Coffee intake can influence adiposity, in part by stimulating the sympathetic nervous system, which can increase energy expenditure and brown adipose tissue activity, leading to weight loss [19,20]. While moderate coffee consumption can contribute to weight management, excessive intake may have negative consequences, as demonstrated by a 2-year follow up study, that found a correlation between high coffee consumption and increased body adiposity in individuals with kidney transplant [21]. A three-year follow-up study in elderly participants with metabolic syndrome demonstrated that moderate, but not high, coffee consumption was associated with a reduction in total fat tissue, trunk fat, and visceral adipose tissue. ...
Atherosclerosis, a major risk factor for cardiovascular diseases is influenced by modifiable factors such as adiposity and blood cholesterol. Diet is crucial in these areas, particularly regarding antioxidant, inflammatory, and obesity effects. Coffee, a globally popular stimulant beverage has garnered significant attention for its potential impact on cardiovascular diseases. Recent insights reinforce the need to re-examine the relationship between coffee consumption and atherosclerosis progression. Coffee’s complex composition includes polyphenols, renowned for their antioxidant and anti-inflammatory properties, as well as potential weight-reducing effects. In addition, studies have demonstrated that certain coffee compounds such as chlorogenic acid, caffeic, p-coumaric, and ferulic acid can prevent atherogenesis by preventing oxidation of low-density lipoproteins. Conversely, diterpenes, found in some coffee brews, can elevate cholesterol levels posing risk to coronary health. Notably, coffee intake has been shown to influence gut microbiota diversity, potentially contributing to anti-obesity effects. This review explores the insights from preclinical and clinical studies investigating the potential mechanisms through which coffee consumption may reduce the risk of atherosclerosis. Highlighting the potential benefits of moderate filtered-coffee consumption, as well as the potential risks associated with excessive coffee consumption. Understanding this relationship is crucial for informing public health recommendations and guiding future research.
... Because the grade of injury can range from fat infiltration to cirrhosis, early therapy must be set [48,49] and monitored to lose weight, rather than muscle mass [50][51][52]. ...
Liver steatosis is the most common chronic liver disease and affects 10–24% of the general population. As the grade of disease can range from fat infiltration to steatohepatitis and cirrhosis, an early diagnosis is needed to set the most appropriate therapy. Innovative noninvasive radiological techniques have been developed through MRI and US. MRI-PDFF is the reference standard, but it is not so widely diffused due to its cost. For this reason, ultrasound tools have been validated to study liver parenchyma. The qualitative assessment of the brightness of liver parenchyma has now been supported by quantitative values of attenuation and scattering to make the analysis objective and reproducible. We aim to demonstrate the reliability of quantitative ultrasound in assessing liver fat and to confirm the inter-operator reliability in different respiratory phases. We enrolled 45 patients examined during normal breathing at rest, peak inspiration, peak expiration, and semi-sitting position. The highest inter-operator agreement in both attenuation and scattering parameters was achieved at peak inspiration and peak expiration, followed by semi-sitting position. In conclusion, this technology also allows to monitor uncompliant patients, as it grants high reliability and reproducibility in different body position and respiratory phases.
... As many articles published in "Clinical Nutrition" to date, we read with great interest an interesting prospective follow-up study by da Costa et al. [1], which reported that higher coffee consumption was associated with increased central adiposity and lower muscle quality, but not with muscle strength, muscle mass, sarcopenia, bone mineral density, and cardiovascular risk factors in kidney transplant recipients (KTR). In the literature, some bioactive in coffee have been reported as anti-inflammatory and antioxidant, which may explain the previously observed beneficial associations between coffee and type 2 diabetes, hypertension, cardiovascular disease, certain cancers, chronic kidney disease, and mortality [2,3]. ...
To the Editor
As many articles published in “Clinical Nutrition” to date, we read with great interest an interesting prospective follow-up study by da Costa et al. [[1]], which reported that higher coffee consumption was associated with increased central adiposity and lower muscle quality, but not with muscle strength, muscle mass, sarcopenia, bone mineral density, and cardiovascular risk factors in kidney transplant recipients (KTR). In the literature, some bioactive in coffee have been reported as anti-inflammatory and antioxidant, which may explain the previously observed beneficial associations between coffee and type 2 diabetes, hypertension, cardiovascular disease, certain cancers, chronic kidney disease, and mortality [[2],[3]]. However, due to the lack of randomized clinical trials, there are conflicting results on the effect of coffee on weight status. For example, in a cohort of older adults with metabolic syndrome, moderate, but not high caffeinated coffee consumption was associated with a reduction in total body fat, trunk fat, and visceral adipose tissue [[2]]. On the other hand, the results of the study by da Costa et al. are noteworthy since an increasing number of renal transplants are performed each year and coffee is one of the most frequently consumed beverages in daily life. Although the present study provides additional evidence for the association of habitual coffee consumption with muscle and adipose tissue, some methodological issues need to be clarified.
Sarcopenia, characterized by the progressive loss of skeletal muscle mass and strength, significantly impacts the people, leading to increased frailty and mortality. The atherogenic index of plasma (AIP), a biomarker for lipid imbalance, may be linked to sarcopenia due to shared pathways of inflammation and metabolic dysregulation. Data from the National Health and Nutrition Examination Survey (NHANES) 2011–2018 cycles were analyzed. The AIP was calculated as the logarithm of the ratio of triglycerides to High density lipoprotein cholesterol. Sarcopenia was defined using the appendicular skeletal muscle mass index (ASMBMI) adjusted for body mass index (BMI). Multivariable linear regression and logistic regression models were employed to assess the association between AIP and ASMBMI, as well as sarcopenia. Restrictive cubic spline curves were utilized to analyze potential nonlinear associations between AIP and outcome indicators. Additionally, subgroup analyses and intergroup interaction tests were performed. Elevated AIP levels were associated with decreased ASMBMI and an increased risk of sarcopenia. After adjusting for confounding factors, the association between AIP and ASMBMI remained significant (Beta [95% CI] = -0.02 [-0.03, -0.01], P < 0.001). AIP was significantly associated with sarcopenia (OR [95% CI] = 2.6 [1.78, 3.81], P = < 0.001). AIP is significantly associated with reduced muscle mass and potentially with sarcopenia, suggesting that lipid metabolism plays a critical role in muscle health. Identifying AIP as a modifiable risk factor could have important public health implications for managing sarcopenia.
Atherosclerosis, a major cause of cardiovascular diseases, is influenced by modifiable factors such as adiposity and blood cholesterol. Diet is crucial in these areas, particularly regarding antioxidant, inflammatory, and obesity effects. Coffee, a globally popular stimulant beverage, has garnered significant attention for its potential impact on cardiovascular diseases. Recent insights reinforce the need to re-examine the relationship between coffee consumption and atherosclerosis progression. Coffee’s complex composition includes polyphenols, renowned for their antioxidant and anti-inflammatory properties as well as potential weight-reducing effects. In addition, studies have demonstrated that certain coffee compounds such as chlorogenic acid, caffeic, p-coumaric, and ferulic acid can prevent atherogenesis by preventing the oxidation of low-density lipoproteins. Conversely, diterpenes, found in some coffee brews, can elevate cholesterol levels, posing a risk to coronary health. Notably, coffee intake has been shown to influence gut microbiota diversity, potentially contributing to anti-obesity effects. This review explores the insights from preclinical and clinical studies investigating the potential mechanisms through which coffee consumption may reduce the risk of atherosclerosis—highlighting the potential benefits of moderate filtered coffee consumption and the potential risks associated with excessive coffee consumption. Understanding this relationship is crucial for informing public health recommendations and guiding future research.
Background: Obesity remains a public health problem. Recent, novel strategies suggest thefrequent inclusion of functional foods for better management of adiposity markers and obesityprevention. Numerous epidemiological and clinical studies demonstrate specific naturalfunctional foods of the Mediterranean Diet and innovative processed foods, enhanced withbioactive compounds, that they may present a possible beneficial role on this approach. Methods: In this cross-sectional epidemiological study, 319 Greeks and Cyprians, aged 18-75years were voluntary recruited in personal interviews. A validated Functional Food Frequency ofConsumption (FFFQ) was filled out, recording the frequency of selective functional foodsconsumption, following by anthropometric and body composition evaluations. Data collectionand statistical analysis were conducted, to assess the possible association of functional foodsfrequency of consumption with adiposity markers. Results: Olive oil is a main part of the daily diet of the representative sample of Greek andCyprian population and its frequency of intake was inversely related to body weight, taking intoaccount the lifestyle pattern and social parameters. Considering general habits andsociodemographic characteristics, Body Mass Index (BMI) was directly associated with thefrequency of consumption of split peas, turmeric, cinnamon, honey, whole wheat- and gluten-free pasta, as well as of gluten-free and enhanced bakeries. These functional food groups areconsumed by majority in a monthly basis, except of honey which is weekly consumed by themajority of the study population. Conclusion: The results suggest that the daily intake of olive oil, as the main characteristic ofMediterranean Diet, may be effective on body weight management. The frequency rise ofspecific spices, honey, functional pasta and bakeries consumption, may lead to increases inmarkers of adiposity. Further research is needed to safely conclude to these claims and theimplementation of nutritional treatment programs with functional foods may prove effective inthe prevention and management of obesity. Keywords: epidemiological study; functional foods; frequency of consumption; obesity;adiposity association; Greeks; Cyprians
This study assessed the association between sarcopenic obesity (S+O+) and coffee
intake in elderly Koreans. This study obtained data from the Korea National Health and Nutrition Examination Survey (KNHANES, 2008–2011), a cross-sectional and nationally representative survey conducted by the Korean Centers for Disease Control and Prevention. Of the 2,661 participants included in this study, there was a significant difference between 5.861 (95% CI 2.024–16.971) in less than one cup of coffee, and 6.245 (95% CI 2.136–18.260) in one cup of coffee, and 4.323 (95% CI 1.457–12.824) in two cups of coffee compared to three or more than cups of coffee. In contrast, in the case of sarcopenia or obesity only (S+O- or S-O+), no significant difference was found in any model. The results suggest that the elderly who consume less than one cup of coffee per day had a greater risk of S+O+ than those who consume more than three cups per day. Furthermore, there was an association between coffee intake and sarcopenia but not with obesity. Therefore, coffee intake may have prevented musculoskeletal loss in these patients.
Background
Previous studies suggested that moderate coffee and tea consumption are associated with lower risk of mortality. However, the association between the combination of coffee and tea consumption with the risk of mortality remains unclear. This study aimed to evaluate the separate and combined associations of coffee and tea consumption with all-cause and cause-specific mortality.
Methods
This prospective cohort study included 498,158 participants (37–73 years) from the UK Biobank between 2006 and 2010. Coffee and tea consumption were assessed at baseline using a self-reported questionnaire. All-cause and cause-specific mortalities, including cardiovascular disease (CVD), respiratory disease, and digestive disease mortality, were obtained from the national death registries. Cox regression analyses were conducted to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
Results
After a median follow-up of 12.1 years, 34,699 deaths were identified. The associations of coffee and tea consumption with all-cause and cause-specific mortality attributable to CVD, respiratory disease, and digestive disease were nonlinear (all P nonlinear < 0.001). The association between separate coffee consumption and the risk of all-cause mortality was J-shaped, whereas that of separate tea consumption was reverse J-shaped. Drinking one cup of coffee or three cups of tea per day seemed to link with the lowest risk of mortality. In joint analyses, compared to neither coffee nor tea consumption, the combination of < 1–2 cups/day of coffee and 2–4 cups/day of tea had lower mortality risks for all-cause (HR, 0.78; 95% CI: 0.73–0.85), CVD (HR, 0.76; 95% CI: 0.64–0.91), and respiratory disease (HR, 0.69; 95% CI: 0.57–0.83) mortality. Nevertheless, the lowest HR (95% CI) of drinking both < 1–2 cup/day of coffee and ≥ 5 cups/day of tea for digestive disease mortality was 0.42 (0.34–0.53).
Conclusions
In this large prospective study, separate and combined coffee and tea consumption were inversely associated with all-cause and cause-specific mortality.
Few studies have examined the association between coffee consumption and muscle mass; their results are conflicting. Therefore, we examined the association between coffee consumption and low muscle mass prevalence. We also performed an exploratory investigation of the potential effect modification by demographic, health status-related, and physical activity-related covariates. This cross-sectional study included 2085 adults aged 40–87 years. The frequency of coffee consumption was assessed using a self-administered questionnaire. Muscle mass was assessed as appendicular skeletal muscle mass/height ² using a multifrequency bioelectrical impedance analyser. We defined low muscle mass using cut-offs recommended by the Asian Working Group for Sarcopenia. Multivariable-adjusted odds ratios for low muscle mass prevalence were estimated using a logistic regression model. The prevalence of low muscle mass was 5.4% ( n = 113). Compared with the lowest coffee consumption group (<1 cup/week), the multivariable-adjusted odds ratios (95% confidence intervals) of low muscle mass prevalence were 0.62 (0.30, 1.29) for 1–3 cups/week, 0.53 (0.29, 0.96) for 4–6 cups/week or 1 cup/day, and 0.28 (0.15, 0.53) for ≥2 cups/day ( P for trend <0.001). There were no significant interactions among the various covariates after Bonferroni correction. In conclusion, coffee consumption may be inversely associated with low muscle mass prevalence.
Coffee is a beverage consumed globally. Although few studies have indicated adverse effects, it is typically a beneficial health-promoting agent in a range of diseases, including depression, diabetes, cardiovascular disease, and obesity. Coffee is rich in caffeine, antioxidants, and phenolic compounds, which can modulate the composition of the gut microbiota and mitigate both inflammation and oxidative stress, common features of the burden of lifestyle diseases. This review will discuss the possible benefits of coffee on complications present in patients with diabetes, cardiovascular disease and chronic kidney disease, outwith the social and emotional benefits attributed to caffeine consumption.
Background
Habitual coffee consumption has been associated with multiple health benefits. A comprehensive analysis of disease trajectory and comorbidity networks in relation to coffee consumption is, however, currently lacking.
Objectives
We aimed to comprehensively examine the health outcomes associated with habitual coffee consumption, through clarifying its disease trajectory and comorbidity networks.
Methods
Based on the UK Biobank cohort, we included 395,539 individuals with available information on coffee intake collected at recruitment between 2006 and 2010. These individuals were categorized as having low (<1 cup per day), moderate (1–3 cups), and high (≥4 cups) levels of coffee intake, and were followed through 2020 to ascertain 496 medical conditions. Cox regression was used to assess the associations between high-level coffee intake and the risk of medical conditions with a prevalence ≥0.5% in the study population, after adjusting for multiple confounders, using low-level coffee intake as the reference. Disease-trajectory and comorbidity network analyses were then applied to visualize the temporal and nontemporal relationships between the medical conditions that had an inverse association with high-level coffee intake.
Results
During a median follow-up of 11.8 years, 31 medical conditions were found to be associated with high-level coffee intake, among which 30 showed an inverse association (HRs ranged from 0.61 to 0.94). The inverse associations were more pronounced for women, compared with men. Disease-trajectory and comorbidity network analyses of these 30 conditions identified 4 major clusters of medical conditions, mainly in the cardiometabolic and gastrointestinal systems, among both men and women; 1 cluster of medical conditions following alcohol-related disorders, primarily among men; as well as a cluster of estrogen-related conditions among women.
Conclusions
Habitual coffee consumption was associated with lower risks of many medical conditions, especially those in the cardiometabolic and gastrointestinal systems and those related to alcohol use and estrogen regulation.
Declining physical functioning covers a prominent span of later life and, as a modifiable driver to be leveraged, lifestyle plays a critical role. This research aimed to undertake a systematic review investigating the association between levels of coffee consumption and declining conditions of physical functioning during aging, such as sarcopenia, frailty, weakness, falls, and disability, while trying to explain the underlying mechanisms, both from a metabolic and social angle. The literature was reviewed from inception to May 2022 using different electronic databases, not excluding the grey literature. Two independent researchers assessed the eligibility of 28 retrieved articles based on inclusion criteria; only 10 met the eligibility requirements. Different levels of coffee consumption were considered as exposure(s) and comparator(s) according to PECO concepts, while middle age was an inclusion criterion (40+ years). No limitations were set on the tool(s) assessing physical functioning, type of dietary assessment(s), study setting, general health status, country, and observational study design (cohort, cross-sectional). The cross-sectional design outnumbered the longitudinal (90%, n = 9/10). The overall quality rating was judged poor (70%) to good (30%). It was found that higher exposure to coffee drinking is strongly associated with better physical functioning outcomes, and the findings showed consistency in the direction of association across selected reports. Countering physical decline is a considerable challenge in easing the burden of population aging. For preventive models that aim to allow a better lifestyle, it has to be kept in mind that increased coffee consumption does not lead to poor physical functioning.
The ingestion of non-caloric sweeteners from food and/or drink was intended to reduce caloric intake without compromising palatability. However, the inconclusive relation between non-caloric sweeteners and body weight may partially relate to their form of ingestion (solid or liquid). Thus, two paralleled experiments (Aspartame and Sucralose) were conducted. In each, Sprague Dawley rats (7-week-old male) were randomly divided into 4 groups. In experiment 1, aspartame (0.05%) was added to the diet (AD) or drinking water (AW) or both diet and water (ADW), and a control group (C) was given a non-sweetened diet with plain water. In experiment 2, sucralose (0.016%) was similarly provided in the diet (SD) or drinking water (SW) or both diet and water (SDW), with a control group (C). All rats had free access to food and water for 7 weeks. Energy intake, body weight, and body composition were monitored and blood metabolites were determined. Results showed that aspartame ingestion significantly increased body weight and fat mass mainly due to an increase in energy efficiency. The effect was related to the amount rather than the form of ingestion. Additionally, aspartame ingestion was associated with glucose intolerance. Sucralose ingestion had a similar impact to that of aspartame though to a lesser extent. In conclusion, 7-week ingestion of aspartame and sucralose had adverse effects on body measures that were not related to the form of ingestion.
PurposeHigh coffee consumption is associated with low risk of mortality and morbidity, but the causality remains unclear. This review aims to discuss findings from observational studies on coffee consumption in context of Mendelian randomization studies.Methods
The PubMed database was searched for all Mendelian randomization studies on coffee consumption and corresponding observational studies.ResultsHigh coffee consumption is associated with low risk of all-cause and cardiovascular mortality in observational studies (HRs of 0.85–0.90 vs. no/low consumers), with no support of causality in Mendelian randomization studies. Moderate/high consumption is associated with low risk of cardiometabolic diseases, including ischemic heart disease (HRs of 0.85–0.90 vs. no/low consumption), stroke (HRs of approximately 0.80 vs. no/low consumption), type 2 diabetes (HRs of approximately 0.70 vs. no/low consumption) and obesity in observational studies, but not in Mendelian randomization studies. High consumption is associated with low risk of endometrial cancer and melanoma and high risk of lung cancer in observational studies, but with high risk of colorectal cancer in Mendelian randomization studies. In observational and Mendelian randomization studies, high coffee consumption is associated with low risk of gallstones (HRs of 0.55–0.70 for high vs. no/low self-reported and 0.81 (0.69–0.96) for highest vs. lowest genetic consumption).Conclusion
High coffee consumption is associated with low risk of mortality, cardiometabolic diseases, some cancers and gallstones in observational studies, with no evidence to support causality from Mendelian randomization studies for most diseases except gallstones.
Background:
Sarcopenia can predispose individuals to falls, fractures, hospitalization, and mortality. The prevalence of sarcopenia depends on the population studied and the definition used for the diagnosis.
Objective:
This systematic review and meta-analysis aimed to investigate the association between sarcopenia and mortality and if it is dependent on the population and sarcopenia definition.
Methods:
A systematic search was conducted in MEDLINE, EMBASE, and Cochrane from 1 January 2010 to 6 April 2020 for articles relating to sarcopenia and mortality. Articles were included if they met the following criteria - cohorts with a mean or median age ≥18 years and either of the following sarcopenia definitions: Asian Working Group for Sarcopenia (AWGS and AWGS2019), European Working Group on Sarcopenia in Older People (EWGSOP and EWGSOP2), Foundation for the National Institutes of Health (FNIH), International Working Group for Sarcopenia (IWGS), or Sarcopenia Definition and Outcomes Consortium (SDOC). Hazard ratios (HR) and odds ratios (OR) were pooled separately in meta-analyses using a random-effects model, stratified by population (community-dwelling adults, outpatients, inpatients, and nursing home residents). Subgroup analyses were performed for sarcopenia definition and follow-up period.
Results:
Out of 3,025 articles, 57 articles were included in the systematic review and 56 in the meta-analysis (42,108 participants, mean age of 49.4 ± 11.7 to 86.6 ± 1.0 years, 40.3% females). Overall, sarcopenia was associated with a significantly higher risk of mortality (HR: 2.00 [95% CI: 1.71, 2.34]; OR: 2.35 [95% CI: 1.64, 3.37]), which was independent of population, sarcopenia definition, and follow-up period in subgroup analyses.
Conclusions:
Sarcopenia is associated with a significantly higher risk of mortality, independent of population and sarcopenia definition, which highlights the need for screening and early diagnosis in all populations.
Worldwide, there are millions of people who have been diagnosed with osteoporosis, a bone disease that increases the risk of fracture due to low bone mineral density and deterioration of bone architecture. In the US alone, there are approximately ten million men and women diagnosed with osteoporosis and this number is still growing. Diagnosis is made by measuring bone mineral density. Medications used for the treatment of osteoporosis are bisphosphonates, denosumab, raloxifene, and teriparatide. Recently, romosozumab has been added as well. In recent years, a number of advances have been made in the field of diagnostic methods and the diverse treatment options for osteoporosis. Despite these advances and a growing incidence of osteoporosis, there is a large group being left undertreated or even untreated. This group of the under/untreated has been called the treatment gap. Concerns regarding rare side effects of the medications, such as osteonecrosis of the jaw, have been reported to be one of the many causes for the treatment gap. Also, this group seems not to be sufficiently informed of the major benefits of the treatment and the diversity in treatment options. Knowledge of these could be very helpful in improving compliance and hopefully reducing the gap. In this paper, we summarize recent evidence regarding the efficacy of the various treatment options, potential side effects, and the overall benefit of treatment.
Osteoporosis is a metabolic disease of the skeletal system which currently affects over 200 million patients worldwide. The WHO criteria define osteoporosis as low bone mineral density, with a T-score ≤ -2.5 found in the spine, the neck of the femur, or during a full hip examination. Osteoporosis considerably reduces a patient's quality of life. QoL should be carefully evaluated before fractures occur to enable the development of an appropriate treatment plan. The progression of osteoporosis may be significantly inhibited by following a proper diet, leading a healthy lifestyle, taking dietary supplements, and receiving appropriate treatment. Education and the prevention of the disease play a major role. Potentially modifiable risk factors for osteoporosis are vitamin D deficiency, smoking, alcohol consumption, low calcium intake, low or excessive phosphorus intake, protein deficiency or a high-protein diet, excessive consumption of coffee, a sedentary lifestyle or lack of mobility, and insufficient exposure to the sun. Pharmaceutical treatment for osteoporosis involves bisphosphonates, calcium and vitamin D3, denosumab, teriparatide, raloxifene, and strontium ranelate. Data indicates that 30%-50% of patients do not take their medication correctly. Other methods of treatment include exercise, kinesitherapy, treatment at a health resort, physical therapy, and diet.
The global obesity epidemic is well established, with increases in obesity prevalence for most countries since the 1980s. Obesity contributes directly to incident cardiovascular risk factors, including dyslipidemia, type 2 diabetes, hypertension, and sleep disorders. Obesity also leads to the development of cardiovascular disease and cardiovascular disease mortality independently of other cardiovascular risk factors. More recent data highlight abdominal obesity, as determined by waist circumference, as a cardiovascular disease risk marker that is independent of body mass index. There have also been significant advances in imaging modalities for characterizing body composition, including visceral adiposity. Studies that quantify fat depots, including ectopic fat, support excess visceral adiposity as an independent indicator of poor cardiovascular outcomes. Lifestyle modification and subsequent weight loss improve both metabolic syndrome and associated systemic inflammation and endothelial dysfunction. However, clinical trials of medical weight loss have not demonstrated a reduction in coronary artery disease rates. In contrast, prospective studies comparing patients undergoing bariatric surgery with nonsurgical patients with obesity have shown reduced coronary artery disease risk with surgery. In this statement, we summarize the impact of obesity on the diagnosis, clinical management, and outcomes of atherosclerotic cardiovascular disease, heart failure, and arrhythmias, especially sudden cardiac death and atrial fibrillation. In particular, we examine the influence of obesity on noninvasive and invasive diagnostic procedures for coronary artery disease. Moreover, we review the impact of obesity on cardiac function and outcomes related to heart failure with reduced and preserved ejection fraction. Finally, we describe the effects of lifestyle and surgical weight loss interventions on outcomes related to coronary artery disease, heart failure, and atrial fibrillation.
To explore the role of coffee on health outcomes in the United States, where coffee consumption is common, we conducted a meta-analysis of prospective studies investigating the magnitude (any compared with no consumption) and the dose-response shape (cups per day) of the associations between caffeinated coffee consumption and incidence/mortality of cardiovascular disease (CVD), as well as incidence of type 2 diabetes (T2D), hepatocellular carcinoma (HCC), endometrial cancer, melanoma, and nonmelanoma skin cancer. We selected the desirable health outcomes that have been shown to be positively associated with coffee consumption. Studies were identified by searching PubMed/Embase databases up to September 2019. Inclusion criteria included prospective studies that investigated the relation of ≥3 categories of caffeinated coffee consumption and the outcomes of interest. Twenty-six studies (42 distinct cohorts), with 93,706 cases/deaths and 3,713,932 participants, met the inclusion criteria. In any coffee consumers, there was a significant inverse association with the risk of CVD (RR = 0.90; 95% CI: 0.84, 0.96), T2D (RR = 0.90; 95% CI: 0.85, 0.96), endometrial cancer (RR = 0.85; 95% CI: 0.78, 0.92), melanoma (RR = 0.89; 95% CI: 0.80, 0.99), and nonmelanoma skin cancer (RR = 0.92; 95% CI: 0.89, 0.95). Coffee consumption was also inversely associated with HCC (RR = 0.93; 95% CI: 0.80, 1.08), without reaching statistical significance. The dose-response relation was nonlinear uniquely for CVD (P-nonlinearity = 0.01). In particular, the largest risk reduction was observed for 3-4 cups/d (∼120 mL/cup) and no reduction thereafter. For other outcomes, the risk decreased linearly over the whole coffee consumption range. Current patterns of consumption in the United States would account for a fraction of avoided cases/deaths ranging from 6% to 12% according to the outcome considered. This study confirms the beneficial health effects of caffeinated coffee consumption in the US population on the health outcomes considered, and quantifies their possible magnitude.
Previous meta-analyses that found an inverse association between coffee consumption and metabolic syndrome pooled data from cross-sectional and longitudinal studies, which could lead to potentially misleading conclusions. Hence, this work aimed to reassess this association by analyzing data from the 2 types of studies separately and including recent studies. Online databases including PubMed, Scopus, Embase, The Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus, and Science Direct were searched for relevant studies published up to July 2020. Both cross-sectional and longitudinal studies were included if published after 1999, reported both effect estimates and CIs, and presented results adjusted for confounding variables. Data of the highest coffee consumption level in each study, as well as those of medium consumption levels in studies with ≥3 consumption categories, were pooled using random-effect models, with sex-stratified and sex-adjusted results being analyzed separately. Results were obtained based on data from 13 cross-sectional studies involving 280,803 participants and 2 longitudinal studies involving 17,014 participants. The overall sex-adjusted association of the highest consumption level was not significant (n = 9 studies; OR: 0.88; 95% CI: 0.70, 1.10; I2: 91.5%) and the 2 longitudinal studies both yielded no association. Subgroup analysis revealed inverse associations in both males and females, as well as in Caucasians with medium coffee consumption (n = 4 studies, OR: 0.88; 95% CI: 0.84, 0.93; I2: 0%). Although residual confounding could affect the results of this meta-analysis, our findings suggested with a low certainty that coffee consumption may not be associated with metabolic syndrome, a finding that is different from those of previous meta-analyses and could be due to variation in characteristics of study participants. More longitudinal studies are also needed to further assess the temporal association between coffee consumption and metabolic syndrome. This meta-analysis was registered at https://www.crd.york.ac.uk/prospero as CRD42018110650.
Sarcopenia is of important clinical relevance for loss of independence in older adults. The prevalence of obesity in combination with sarcopenia (“sarcopenic-obesity”) is increasing at a rapid rate. However, whilst the development of sarcopenia is understood to be multi-factorial and harmful to health, the role of obesity from a protective and damaging perspective on skeletal muscle in aging, is poorly understood. Specifically, the presence of obesity in older age may be accompanied by a greater volume of skeletal muscle mass in weight-bearing muscles compared with lean older individuals, despite impaired physical function and resistance to anabolic stimuli. Collectively, these findings support a potential paradox in which obesity may protect skeletal muscle mass in older age. One explanation for these paradoxical findings may be that the anabolic response to weight-bearing activity could be greater in obese vs. lean older individuals due to a larger mechanical stimulus, compensating for the heightened muscle anabolic resistance. However, it is likely that there is a complex interplay between muscle, adipose, and external influences in the aging process that are ultimately harmful to health in the long-term. This narrative briefly explores some of the potential mechanisms regulating changes in skeletal muscle mass and function in aging combined with obesity and the interplay with sarcopenia, with a particular focus on muscle morphology and the regulation of muscle proteostasis. In addition, whilst highly complex, we attempt to provide an updated summary for the role of obesity from a protective and damaging perspective on muscle mass and function in older age. We conclude with a brief discussion on treatment of sarcopenia and obesity and a summary of future directions for this research field.
Background
Habitual coffee drinking has been associated with lower risk of various chronic diseases linked to poor physical performance.Objective
We explored cross-sectional associations between coffee consumption and physical performance among oldest-old community-dwelling men in the Helsinki Businessmen Study (HBS).MethodsA random sample of HBS survivors (n = 126, mean age 87 years) attended a clinic visit in 2017/2018, including measurements of body composition, physical performance [Short Physical Performance Battery (SPPB)], and cognition. Coffee consumption was retrieved from 3-day food diaries.ResultsCoffee consumption was positively associated with higher gait speed (p = 0.003), SPPB score (p = 0.035), and chair rise points (p = 0.043). Association of coffee with gait speed remained after adjustment for age, waist circumference, physical activity, pulse rate, and high-sensitivity C-reactive protein.Conclusion
Higher coffee consumption was independently associated with better physical performance reflected as faster gait speed in oldest-old men.
Background
Coffee is among the most popular daily beverages in the United States. Importantly, coffee consumption has been associated with a lower risk of multiple health outcomes including a reduction in adiposity. DXA is a means to assess body fat and distribution.
Objectives
The aim of this study was to examine the relation between coffee consumption and DXA-assessed adiposity and adiposity distribution.
Methods
Cross-sectional data from the NHANES were used. Participants were adults aged 20–69 y from the 2003–2004 and 2005–2006 waves. Information on coffee consumption was assessed through the FFQ (categorized as no coffee, 0 to <0.25 cup/d, 0.25 to <1 cup/d, 1 cup/d, 2–3 cups/d, or ≥4 cups/d). Both caffeinated and decaffeinated coffee consumption were included. Trunk fat and total fat percentage were measured via whole-body DXA scans. The association between coffee consumption and body fat was investigated using age-adjusted and multivariable-adjusted linear regression models which accounted for sample weights.
Results
Higher coffee consumption was associated with significantly lower total body fat percentage and trunk body fat percentage in a dose-response manner (all P values < 0.05) among women. Although this dose–response relation was nonsignificant among men, men aged 20–44 y who drank 2–3 cups/d had 1.3% (95% CI: −2.7%, 0.1%) less total fat and 1.8% (95% CI: −3.3%, −0.4%) less trunk fat than those who did not consume coffee. Furthermore, the association between coffee consumption and body fat percentage exhibited for both caffeinated and decaffeinated coffee among women (all P for trend < 0.001) but not among men (all P for trend > 0.05).
Conclusions
The present study found a significant association between higher coffee consumption and lower DXA-measured adiposity. Moreover, a gender difference in this association in the general US adult population was also observed.
Background: Muscle quality (i.e., the expression of muscle function per unit of muscle mass) has been proposed as a clinically-relevant measure to detect individuals at risk of functional incapacity. Individuals with obesity might be at an increased risk of having poor muscle quality. Thus, we aimed to analyze the prevalence of poor muscle quality in obese individuals, to determine associated variables, and to provide normative values for this population. Methods: 203 individuals with obesity (103 women, age: 18–75 years, body mass index (BMI): 35–64 kg·m− 2) participated in this cross-sectional study. Their muscle strength (handgrip dynamometry), muscle power (sit-to-stand test) and muscle mass (bioelectrical impedance analysis) were measured, and muscle quality (strength/power to muscle mass ratio) was compared with reference values obtained in young healthy individuals. Muscle quality was individually categorized as normal, low or poor based on specific muscle strength and power (i.e., strength and power per unit of muscle mass, respectively). Sex and age-specific normative values of specific muscle strength and power were computed for the whole cohort.
Results: Age and being a woman were inversely associated with specific muscle strength, with age being also inversely associated with specific muscle power. A small proportion of participants (6%) presented with an impaired (i.e., low/poor) specific muscle power while most of them (96%) had impaired specific muscle strength. Eventually, 84% of the participants were deemed to have poor muscle quality. Being a woman (odds ratio [OR]: 18.09, 95% confidence intervals [CI]: 4.07–80.38), age (OR: 1.06, 95%CI: 1.03–1.10) and BMI (OR: 1.22, 95%CI: 1.07–1.38) were independently associated with a higher risk of poor muscle quality in adjusted analyses.
Conclusions: These findings show a high prevalence of poor muscle quality among individuals with obesity, with age, sex and BMI being independent predictors.
Many studies have explored the relationship between coffee-one of the most commonly consumed beverages today-and obesity. Despite inconsistent results, the relationship has not been systematically summarized. Thus, we conducted a meta-analysis by compiling data from 12 epidemiologic studies identified from PubMed and Embase through February 2019. The included studies assessed obesity by body mass index (BMI, a measure of overall adiposity) or waist circumference (WC, a measure of central adiposity); analyzed the measure as a continuous outcome or binary outcome. Using random effects model, weighted mean difference (WMD) and 95% confidence interval (CI) were obtained for continuous outcomes; summary relative risk (RR) and 95% CI for the highest vs. lowest categories of coffee intake were estimated for binary outcome. For BMI, WMD was -0.08 (95% CI -0.14, -0.02); RR was 1.49 (95% CI 0.97, 2.29). For WC, WMD was -0.27 (95% CI -0.51, -0.02) and RR was 1.07 (95% CI 0.84, 1.36). In subgroup analysis by sex, evidence for an inverse association was more evident in men, specifically for continuous outcome, with WMD -0.05 (95% CI -0.09, -0.02) for BMI and -0.21 (95% CI -0.35, -0.08) for WC. Our meta-analysis suggests that higher coffee intake might be modestly associated with reduced adiposity, particularly in men.
Sarcopenia is a progressive and generalized skeletal muscle disorder, associated with adverse outcomes. Aging causes primary sarcopenia, while secondary causes include chronic kidney disease (CKD), long-term use of glucocorticoids and obesity. The aim of this study was to evaluate: the prevalence of sarcopenia using guidelines recommended by The European Working Group on Sarcopenia in Older People (EWGSOP,2010; EWGSOP2,2018) and the Foundation of the National Institutes of Health (FNIH); and analyse the relationship between sarcopenia and body adiposity in adult renal transplant recipients (RTR) . This was a cross-sectional study in adult RTR (body mass index (BMI) ≥18.5kg/m ² ). Body composition was evaluated by dual energy x-ray absorptiometry (DXA) and anthropometry. Glomerular filtration rate was estimated (eGFR) by CKD-EPI equation. The prevalence of sarcopenia in adult RTR (n=185; 57% men, 50 years and eGFR 55.80±1.52ml/min.) was 7% (FNIH), 11% (EWGSOP2) and 17% (EWGSOP). Low muscle mass, muscle function, and physical performance affected respectively up to 28%, 46% and 10% of the participants. Body adiposity evaluated by anthropometry and by DXA (% trunk fat) was lower in participants with sarcopenia according to EWGSOP and EWGSOP2. Conversely, according to FNIH criteria, RTR with sarcopenia presented higher waist-to-height-ratio. This study suggests that: adult RTR sarcopenia prevalence varies according to the diagnostic criteria; low muscle mass, low muscle function and low physical performance are common conditions; body adiposity association with sarcopenia depends on the criteria used to define this syndrome; and FNIH criteria detected higher adiposity in individuals with sarcopenia.
The causal associations of smoking and alcohol and coffee intake with fracture and bone mineral density are unknown. We investigated the associations using Mendelian randomization (MR). Summary-level data from UK Biobank for bone fractures (main outcome) (53,184 cases; 373,611 non-cases) and estimated bone mineral density (eBMD) (n = 426,824 individuals) were used. Single-nucleotide polymorphisms associated with smoking initiation (n = 378) and alcohol (n = 99) and coffee (n = 15) intake at the genome-wide significance threshold (P = 5 × 10⁻⁸) were identified from published genome-wide association studies. Univariable and multivariable inverse-variance weighted, weighted median, MR-Egger, and MR-PRESSO methods were used for statistical analyses. Genetic predisposition to smoking initiation was associated with fracture but not eBMD. The odds ratio of fracture per one-unit increase in log odds of smoking was 1.09 (95% confidence interval 1.04, 1.15; P = 8.58 × 10⁻⁴) after adjustment for alcohol intake in the multivariable MR analysis. The association remained in complementary analyses. Genetically predicted alcohol and coffee intake was not associated with fracture or eBMD. Nevertheless, genetic liability to alcohol dependence, based on variants in the ALD1B gene, was associated with fracture and lower eBMD. The odds ratio was 1.06 (95% confidence interval 1.01, 1.12; P = 0.018) per genetically predicted one-unit higher log odds of liability to alcohol dependence. This MR study strengthens the causal inference on an association between smoking and higher fracture risk but found no linear association of modestly higher alcohol and coffee intake with fracture or BMD. However, alcohol dependence may increase fracture risk.
Objectives: Although low muscle quality is a strong predictor of sarcopenia, defining sarcopenia using muscle quality remains unknown. This study investigated the cut-points to define sarcopenia using muscle quality index (MQI) in the young reference population. Methods: Fifty healthy young (20 to 29 years) and forty elderly adults (60 to 79 years) were recruited in this study. Dual-energy X-ray absorptiometry was used to assess appendicular skeletal muscle mass. Hand grip and leg dynamometers were used to measure muscle strengths in the arm and leg. Muscle quality in the arm (MQI Arm, kg/kg) and leg (MQI Leg , Nm/kg) were computed as muscle strength per lean mass in the arm and leg, respectively. Total muscle quality (MQI Total) was computed as the combination of MQI Arm and MQI Leg , while standardized muscle quality (MQI Std) was computed as the combination of z-scores in MQI Arm and MQI Leg. Sarcopenia was defined as ≤2 SD below from the mean values in the young reference group. Results: The cut-points for defining sarcopenia using MQI Arm , MQI Leg , MQI Total , and MQI Std in men were ≤8.37, ≤12.07, 22.06, and <-3.35, and in women were ≤10.09, ≤13.97, 28.22, and <-2.25, respectively. In the elderly adults, the frequencies of sarcopenia using MQI Arm , MQI Leg , MQI Total , and MQI Std were 15%, 27.5%, 32.5%, and 35%, respectively. Conclusion: This study establishes new values for defining sarcopenia using MQIs. The proposed new MQI cut-points may be a role in detecting sarcopenia across individual and population level.
Brown adipose tissue (BAT) is able to rapidly generate heat and metabolise macronutrients, such as glucose and lipids, through activation of mitochondrial uncoupling protein 1 (UCP1). Diet can modulate UCP1 function but the capacity of individual nutrients to promote the abundance and activity of UCP1 is not well established. Caffeine consumption has been associated with loss of body weight and increased energy expenditure, but whether it can activate UCP1 is unknown. This study examined the effect of caffeine on BAT thermogenesis in vitro and in vivo. Stem cell-derived adipocytes exposed to caffeine (1 mM) showed increased UCP1 protein abundance and cell metabolism with enhanced oxygen consumption and proton leak. These functional responses were associated with browning-like structural changes in mitochondrial and lipid droplet content. Caffeine also increased peroxisome proliferator-activated receptor gamma coactivator 1-alpha expression and mitochondrial biogenesis, together with a number of BAT selective and beige gene markers. In vivo, drinking coffee (but not water) stimulated the temperature of the supraclavicular region, which co-locates to the main region of BAT in adult humans, and is indicative of thermogenesis. Taken together, these results demonstrate that caffeine can promote BAT function at thermoneutrality and may have the potential to be used therapeutically in adult humans.
Coffee consumption has been associated with decreased mortality in previous studies. As aging, obesity, and lifestyle factors affect the risk of mortality, the association between coffee and mortality needs to be examined in various subpopulations by characteristics of subjects. To quantitatively assess this association, we conducted an updated meta-analysis including stratified analyses by potential modifiers. We searched in the PubMed and Web of Science databases through March 8, 2019, and conducted meta-analysis including linear and non-linear dose–response analyses. We identified 40 studies including 3,852,651 subjects and 450,256 all-cause and cause-specific deaths. Non-linear inverse associations between coffee consumption and mortality from all-causes, cardiovascular disease (CVD), and cancers were found. The lowest relative risk (RR) was at intakes of 3.5 cups/day for all-cause mortality (RR = 0.85, 95% CI 0.82–0.89), 2.5 cups/day for CVD mortality (RR = 0.83, 95% CI 0.80–0.87), and 2 cups/day for cancer mortality (RR = 0.96, 95% CI 0.94–0.99), while additional intakes were not associated with further lower mortality. An inverse association between coffee consumption and all-cause mortality was maintained irrespective of age, overweight status, alcohol drinking, smoking status, and caffeine content of coffee. By region, Europe and Asia showed stronger inverse associations than US. A non-linear inverse association was found for mortality from respiratory disease and diabetes, while linear inverse association was found for mortality from non-CVD, non-cancer causes. Moderate coffee consumption (e.g. 2–4 cups/day) was associated with reduced all-cause and cause-specific mortality, compared to no coffee consumption. The inverse association between coffee and all-cause mortality was consistent by potential modifiers except region.
Background
Results from studies investigating the association between coffee consumption and osteoporosis or bone mineral density (BMD) have been inconsistent. This longitudinal study was performed to assess the effect of coffee drinking on bone health of Taiwanese adults.
Methods
Data were retrieved from the Li-Shin (Landseed) Hospital in Taoyuan City. In 2006, 6152 participants completed a questionnaire on coffee drinking and other lifestyle factors. In 2014, 5077 of them were followed up. Nonetheless, a total of 2395 participants with incomplete data were excluded. The final analyses included 2682 participants comprising 1195 men and 1487 women (706 premenopausal and 781 postmenopausal). T-scores were derived from the osteo-sono assessment index (OSI) which is a surrogate of BMD. Coffee drinking was categorized as “no, medium, and high” based on the number of cups that were consumed per week in both 2006 and 2014.
Results
In general, medium and high coffee drinking were associated with higher T-scores. However, significant results were observed only among high drinkers (β = 0.158; P = 0.0038). Nonetheless, the test for linear trend was significant (P = 0.0046). After stratification by sex, medium and high coffee drinking were associated with higher T-scores. However, significant results were prominent only among high male drinkers (β = 0.237; P = 0.0067) and the test for trend was significant (P = 0.0161). Based on menopausal status, coffee drinking was associated with higher T-scores. Nevertheless, significant results were found only among premenopausal women (β = 0.233; P = 0.0355 and β = 0.234; P = 0.0152 for medium and high coffee drinking, respectively. The test for linear trend was significant (P = 0.0108).
Conclusion
Coffee drinking was significantly associated with higher T-scores hence, a lower risk of osteoporosis in men and premenopausal women.
Objectives
This study aims to review the evidence of sarcopenia as a predictor of all-cause mortality among nursing home residents.
Design
Systematic review and meta-analysis of observational cohort studies.
Data sources
PubMed, EMBASE and the Cochrane Library databases were searched for relevant articles.
Participants
Nursing home residents.
Primary and secondary outcome measures
All-cause mortality.
Data analysis
Summary-adjusted HRs or risk ratios (RRs) were calculated by fixed-effects model. The risk of bias was assessed by Newcastle-Ottawa Scale.
Results
Of 2292 studies identified through the systematic review, six studies (1494 participants) were included in the meta-analysis. Sarcopenia was significantly associated with a higher risk for all-cause mortality among nursing home residents (pooled HR 1.86, 95% CI 1.42 to 2.45, p<0.001, I ² =0). In addition, the subgroup analysis demonstrated that sarcopenia was associated with all-cause mortality (pooled HR 1.87,95% CI 1.38 to 2.52, p<0.001) when studies with a follow-up period of 1 year or more were analysed; however, this was not found for studies with the follow-up period less than 1 year. Furthermore, sarcopenia was significantly associated with the risk of mortality among older nursing home residents when using bioelectrical impedance analysis to diagnosis muscle mass (pooled HR 1.88, 95% CI 1.39 to 2.53, p<0.001); whereas, it was not found when anthropometric measures were used to diagnosis muscle mass.
Conclusion
Sarcopenia is a significant predictor of all-cause mortality among older nursing home residents. Therefore, it is important to diagnose and treat sarcopenia to reduce mortality rates among nursing home residents.
PROSPERO registration number
CRD42018081668
Successful kidney transplantation offers patients with end-stage renal disease the greatest likelihood of survival. However, cardiovascular disease poses a major threat to both graft and patient survival in this cohort. Transplant recipients are unique in their accumulation of a wide range of traditional and non-traditional cardiovascular risk factors. Hypertension, diabetes, dyslipidaemia and obesity are highly prevalent in patients with end-stage renal disease. These risk factors persist following transplantation and are often exacerbated by the drugs used for immunosuppression in organ transplantation. Additional transplant-specific factors such as poor graft function and proteinuria are also associated with increased cardiovascular risk. However, these transplant-related factors remain unaccounted for in current cardiovascular risk prediction models, making it challenging to identify transplant recipients with highest risk. With few interventional trials in this area specific to transplant recipients, strategies to reduce cardiovascular risk are largely extrapolated from other populations. Aggressive management of traditional cardiovascular risk factors remains the cornerstone of prevention, though there is also a potential role for selecting immunosuppression regimens to minimise additional cardiovascular injury.
Electronic supplementary material
The online version of this article (10.1007/s40620-018-0549-4) contains supplementary material, which is available to authorized users.
Background:
in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings.
Objectives:
to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia.
Recommendations:
sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia.
Conclusions:
EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.
The risk of mineral and bone disorders among patients with chronic kidney disease is substantially elevated, owing largely to alterations in calcium, phosphorus, vitamin D, parathyroid hormone, and fibroblast growth factor 23. The interwoven relationship among these minerals and hormones results in maladaptive responses that are differentially affected by the process of kidney transplantation. Interpretation of conventional labs, imaging, and other fracture risk assessment tools are not standardized in the post-transplant setting. Post-transplant bone disease is not uniformly improved and considerable variation exists in monitoring and treatment practices. A spectrum of abnormalities such as hypophosphatemia, hypercalcemia, hyperparathyroidism, osteomalacia, osteopenia, and osteoporosis are commonly encountered in the post-transplant period. Thus, reducing fracture risk and other bone-related complications requires recognition of these abnormalities along with the risk incurred by concomitant immunosuppression use. As kidney transplant recipients continue to age, the drivers of bone disease vary throughout the post-transplant period among persistent hyperparathyroidism, de novo hyperparathyroidism, and osteoporosis. The use of anti-resorptive therapies require understanding of different options and the clinical scenarios that warrant their use. With limited studies underscoring clinical events such as fractures, expert understanding of MBD physiology, and surrogate marker interpretation is needed to determine ideal and individualized therapy.
Context
Type 2 diabetes (T2D) is a major health problem worldwide that is associated with increased morbidity and mortality. There is increased interest in the value of different nutrition-based strategies for preventing the development of T2D.
Objective
This review aims to cover current knowledge regarding the effects of coffee consumption on development of T2D or modulation of adverse complications. A meta-analysis on coffee consumption and the risk of T2D was conducted. Moreover, bioactive components in coffee, polymorphisms, and potential underlying mechanism(s) in relation to T2D and adverse complications are discussed.
Data sources
PubMed was searched up to December 1, 2017, and prospective cohort and nested case–control studies of the association between coffee consumption and T2D risk were selected.
Data extraction
Two investigators independently extracted data from included studies.
Results
A total of 30 prospective studies with 1 185 210 participants and 53 018 incident T2D cases were included in the meta-analysis. The pooled relative risk (RR) was 0.71 (95% confidence interval [CI], 0.67–0.76) for the highest category of coffee consumption (median consumption, 5 cups/d) vs the lowest category (median consumption, 0 cups/d). The risk of T2D decreased by 6% (RR = 0.94; 95%CI, 0.93–0.95) for each cup-per-day increase in coffee consumption. Results were similar for caffeinated coffee consumption (per additional cup of coffee per day: RR = 0.93; 95%CI, 0.90–0.96) and decaffeinated coffee consumption (corresponding RR = 0.94; 95%CI, 0.90–0.98).
Conclusions
Available evidence indicates that coffee consumption is inversely associated with risk of T2D. Possible mechanisms behind this association include thermogenic, antioxidative, and anti-inflammatory effects; modulation of adenosine receptor signaling; and microbiome content and diversity.
Purpose:
Habitual coffee consumption has been associated with lower risk of type 2 diabetes and cardiovascular disease. Since these diseases are main determinants of functional limitations, we have tested the hypothesis that coffee intake is associated with lower risk of physical function impairment, frailty and disability in older adults. We focused on women and those with obesity, hypertension or type 2 diabetes because they are at higher risk of functional limitations.
Methods:
Prospective study with 3289 individuals ≥ 60 years from the Seniors-ENRICA cohort. In 2008-2010 coffee consumption was measured through a validated dietary history. Participants were followed up until 2015 to ascertain incident impaired physical function, frailty and disability, assessed by both self-report and objective measures.
Results:
Compared with non-drinking coffee, consumption of ≥ 2 cups of coffee/day was associated with lower risk of impaired agility in women (hazard ratio [HR] 0.71, 95% confidence interval [CI] 0.51-0.97, P trend 0.04) and in those with obesity (HR 0.60; 95% CI 0.40-0.90, P trend 0.04). Intake of ≥ 2 cups of coffee/day was also linked to reduced risk of impaired mobility in women (HR 0.66; 95% CI 0.46-0.95, P trend 0.02) and among individuals with hypertension (HR 0.70, 95% CI 0.48-1.00, P trend 0.05). Moreover, among subjects with diabetes, those who consumed ≥ 2 cups/day had lower risk of disability in activities of daily living (HR 0.30, 95% CI 0.11-0.76, P trend 0.01).
Conclusions:
In older people, habitual coffee consumption was not associated with increased risk of functional impairment, and it might even be beneficial in women and those with hypertension, obesity or diabetes.
Background & aims:
Higher consumption of coffee and caffeine has been linked to less weight gain and lower body mass index in prospective cohort studies. The aim of the study was to longitudinally assess the association of changes in coffee and caffeine intake with changes in fat tissue, in particular, visceral adipose tissue (VAT) using dual x-ray absorptiometry (DXA).
Methods:
In the setting of a large, randomized trial of Mediterranean diet and physical activity intervention, we evaluated 1483 participants with metabolic syndrome (MetS). Repeated measurements of coffee consumption from validated food frequency questionnaires (FFQ) and DXA measurements of adipose tissue were collected at baseline, 6 months, 12 months and 3 years of follow-up. DXA-derived measurements of total and regional adipose tissue expressed as % of total body weight were transformed into sex-specific z-scores. Linear multilevel mixed-effect models were used to investigate the relationship between changes in coffee consumption and corresponding concurrent changes in fat tissue during a 3-year follow-up.
Results:
After adjustment for intervention group, and other potential confounders, an increase in caffeinated coffee consumption from no or infrequent consumption (≤3 cups/month) to moderate consumption (1-7 cups/week) was associated with reductions in total body fat (Δ z-score: -0.06; 95% CI: -0.11 to -0.02), trunk fat (Δ z-score: -0.07; 95% CI: -0.12 to -0.02), and VAT (Δ z-score: -0.07; 95% CI: -0.13 to -0.01). Neither changes from no or infrequent consumption to high levels of caffeinated coffee consumption (>1 cup/day) nor any changes in decaffeinated coffee consumption showed significant associations with changes in DXA measures.
Conclusions:
Moderate changes in the consumption of caffeinated coffee, but not changes to high consumption, were associated with reductions in total body fat, trunk fat and VAT in a Mediterranean cohort with MetS. Decaffeinated coffee was not linked to adiposity indicators. Moderate consumption of caffeinated coffee may be part of a weight management strategy.
Trial registration:
The trial was registered at the International Standard Randomized Controlled Trial (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.
The American Diabetes Association (ADA) “Standards of Care in Diabetes” includes the ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA’s clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
Background:
Females with a history of gestational diabetes mellitus (GDM) are at higher risk of developing type 2 diabetes mellitus (T2D) later in life.
Objective:
This study prospectively examined whether greater habitual coffee consumption was related to a lower risk of T2D among females with a history of GDM.
Methods:
We followed 4522 participants with a history of GDM in the NHS II for incident T2D between 1991 and 2017. Demographic, lifestyle factors including diet, and disease outcomes were updated every 2-4 y. Participants reported consumption of caffeinated and decaffeinated coffee on validated FFQs. Fasting blood samples were collected in 2012-2014 from a subset of participants free of diabetes to measure glucose metabolism biomarkers (HbA1c, insulin, C-peptide; n = 518). We used multivariable Cox regression models to calculate adjusted HRs and 95% CIs for the risk of T2D. We estimated the least squares mean of glucose metabolic biomarkers according to coffee consumption.
Results:
A total of 979 participants developed T2D. Caffeinated coffee consumption was inversely associated with the risk of T2D. Adjusted HR (95% CI) for ≤1 (nonzero), 2-3, and 4+ cups/d compared with 0 cup/d (reference) was 0.91 (0.78, 1.06), 0.83 (0.69, 1.01), and 0.46 (0.28, 0.76), respectively (P-trend = 0.004). Replacement of 1 serving/d of sugar-sweetened beverage and artificially sweetened beverage with 1 cup/d of caffeinated coffee was associated with a 17% (risk ratio [RR] = 0.83, 95% CI: 0.75, 0.93) and 9% (RR = 0.91, 95% CI: 0.84, 0.99) lower risk of T2D, respectively. Greater caffeinated coffee consumption was associated with lower fasting insulin and C-peptide concentrations (all P-trend <0.05). Decaffeinated coffee intake was not significantly related to T2D but was inversely associated with C-peptide concentrations (P-trend = 0.003).
Conclusions:
Among predominantly Caucasian females with a history of GDM, greater consumption of caffeinated coffee was associated with a lower risk of T2D and a more favorable metabolic profile.
Background:
Recommendations and guidance from scientific bodies do not provide clear messages about potential health risks or benefits of coffee consumption. Numerous studies have demonstrated inverse (beneficial) effects of coffee consumption for many adverse outcomes such as cancer and cardiovascular disease; fewer studies demonstrate risks. However, the risk-benefit relationship has not yet been fully assessed using quantitative metrics preferred by policy makers (disability-adjusted life years [DALYs]).
Objective:
Conduct a quantitative analysis of the risk-benefit for coffee consumption and all-cause mortality using the Benefit-Risk Analysis for Foods (BRAFO) framework and the DALY as a quantitative metric.
Method:
A systematic search and appraisal of meta-analyses investigating coffee consumption and all-cause mortality was conducted. Using the BRAFO framework, evidence was assessed in context of potential risks or benefits associated with the reference scenario - coffee consumption (assessed by varying the consumption level in three analyses) in adults aged 15+ versus the alternative scenario of no coffee consumption. DALYs were used to quantify risks and benefits based on risk ratios from meta-analyses with populations from the United States.
Results:
Meta-analyses consistently report an inverse (beneficial) relationship between coffee consumption and all-cause mortality; subsequently, even while varying consumption amounts and prevalence of coffee consumption, DALYs calculated consistently demonstrated findings in the direction of prevention of healthy years of life lost with variable magnitude. More than 3.5 million DALYs, or ∼3.35% of estimated years of healthy life lost could be prevented by consuming one cup of coffee per day, up to 4.7% of estimated years of healthy life lost could be prevented at current consumption rates ranging from 1-8 cups/day, and even more benefit could be seen (prevention of an estimated 6% of years of healthy life lost) if consumers all drank 3 cups of coffee per day.
Impact:
Policy that directs consumers to avoid drinking coffee may be a detriment to the overall health of the population given the substantial potential benefits of coffee consumption on all-cause mortality for adults.
Coffee consumption has been associated with the reduction of several chronic diseases, including type 2 diabetes mellitus (T2DM) and obesity. The aim of this review was to summarize the research conducted in the last five years (or older, when appropriate) on the relationship between the consumption of coffee bioactive compounds, obesity, and T2DM. A bibliographic search was performed using the Web of Sciences, Scopus, and Google Scholar. Keywords used were “caffeine,” “coffee,” “coffee consumption,” “coffee extraction,” “coffee bioactive components,” “chlorogenic acid,” “obesity,” “antidiabetic,” and “antiadipogenic.” Epidemiological, clinical, animal, and cell culture studies were reviewed. Caffeine, chlorogenic acid, and diterpenes have been identified as potential bioactive compounds in coffee that exhibit antiadipogenic and antidiabetic effects. The concentration of these compounds in coffee depends on the coffee preparation method. The relationship between coffee consumption and obesity risk is inconsistent, as not all results report a positive association. The addition of sugar and cream may be responsible for these mixed results. The consumption of coffee and its constituents is consistently associated with a lower T2DM risk. Caffeine, chlorogenic acids, and diterpenes have antidiabetic properties and are associated with these effects. The available data do not allow us to draw a conclusion on the effect of coffee or its constituents on adipogenesis. Therefore, more tightly controlled human intervention studies are required for a deeper understanding about this relationship.
Caffeine is a regular part of the diet of many adults (coffee, tea, soft drinks, and energy drinks). Multiple molecular effects of caffeine suggest that it may promote bone loss. Given the extensive consumption of caffeine worldwide, any impact of caffeine consumption on bone strength and/or density would have large population health implications. The most well-established pharmacological effect of caffeine is non-specific antagonism of adenosine receptors. Adenosine regulates bone metabolism in a complex manner, with in vitro studies suggesting that direct stimulation of adenosine A2A and A2B receptors induces bone formation by activating osteoblasts and suppressing osteoclast differentiation and function. Thus, competitive inhibition of adenosine A2 receptors by caffeine may inhibit bone formation and promote bone resorption. However, antagonism of adenosine A1 receptors may have opposing effects. Caffeine has also been suggested to affect bone through derangement of calcium metabolism, alteration of vitamin D responses, and other mechanisms. In clinical and population-based studies, the impact of caffeine consumption on bone metabolism offers a mixed picture, with some but not all studies suggesting a potential link between caffeine intake and reduced bone mineral density or increased fracture risk. Differences in methodology, selected populations, and duration/timing of the studies may account for study outcome discrepancies. The in vitro effects of caffeine on cells involved in bone metabolism suggest that caffeine intake may promote osteoporosis, and some but not all clinical studies support a modest adverse caffeine impact. Herein, we describe the basic biology of caffeine as it pertains to bone, review the clinical literature to date, and consider the implications of the current data on clinical practice and future studies.
An umbrella review and meta-analysis were conducted to summarize evidence for the association between dietary factors and the incidence of osteoporosis in adults. Only systematic reviews or meta-analyses were eligible for this study. Two researchers independently performed reading, data extraction, and quality evaluation of the included literature. The outcomes included in this study were all associated with osteoporosis, including osteoporotic fractures and low bone density. A total of 54 studies were included in this study, with 83 adjusted hazard ratios on diet, dairy group (n = 13), alcohol (n = 2), tea (n = 6), coffee (n = 3), micronutrient (n = 31), dietary pattern (n = 21), and foods (n = 7) regarding the incidence of osteoporosis. Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) quality assessment method was used in this study. The high, medium, low and very low quality studies accounted for 27.7, 41, 21.7 and 9.6% of this study, respectively. Based on the included literature studies in this umbrella review, it was found that dietary factors have a relevant impact on the incidences of human osteoporosis, appropriate consumption of dairy products, vegetables, fruits, and micronutrients, as well as reduced intake of alcohol and coffee, can reduce the risk of osteoporosis.
Aims
Coffee consumption has been suggested, in animal studies, to inhibit the progression of sarcopenia, possibly through its anti-inflammatory effects; however, few studies have been carried out in humans. We aimed to examine whether coffee consumption was related to indicators of sarcopenia in a Japanese population, and whether the association was mediated by reduced inflammation.
Methods
This study was a cross-sectional design. Participants were community residents (n = 6369) aged 45–74 years. We measured skeletal muscle mass index (SMI; kg/m²) by a bioelectrical impedance method, and grip strength with a Smedley-type dynamometer. Habitual coffee consumption was assessed by a self-administered questionnaire. Serum high-sensitivity C-reactive protein was measured as an inflammatory marker. The association between habitual coffee consumption and SMI or grip strength was analyzed with a linear regression model adjusted for covariates.
Results
A significant positive association was found between coffee consumption and SMI (men: β = 0.023; Ptrend = 0.004, women: β = 0.011; Ptrend = 0.012). Further adjustment for high-sensitivity C-reactive protein did not materially alter the results (men: β = 0.023; Ptrend = 0.005, women: β = 0.009; Ptrend = 0.024). The relationship between coffee consumption and grip strength did not reach statistical significance; however, a positive trend was observed (men: β = 0.208; Ptrend = 0.085, women: β = 0.092; Ptrend = 0.167).
Conclusions
We found that coffee consumption was positively associated with SMI independently of inflammation in middle-aged and older Japanese people. Reduced inflammation by coffee does not seem to be an important mediator, and further investigations are required to explore the mechanisms of this association. Geriatr Gerontol Int 2021; ••: ••–••.
Rationale and Objective
Low muscle mass relative to fat mass (relative sarcopenia) has been associated with mortality and disability but has not been examined following transplantation. We studied how measures of body composition change after receipt of a kidney allograft.
Study Design
Prospective longitudinal cohort study.
Setting and Participants
60 kidney transplant recipients (ages 20-60 years) at the University of Pennsylvania.
Exposure
Kidney transplantation.
Outcomes
DXA measures of fat mass index (FMI) and appendicular lean mass index (ALMI; representing muscle mass), CT measures of muscle density (low density represents increased intramuscular adipose tissue), dynamometer measures of leg muscle strength, and physical activity. ALMI relative to FMI (ALMFMI) is an established index of relative sarcopenia.
Analytical Approach
Measures expressed as age, sex, and race-specific Z-scores for transplant recipients were compared to 327 healthy controls. Regression models were used to identify correlates of change in outcome Z-scores and compare transplant recipients to controls.
Results
At transplantation, ALMI, ALMIFMI, muscle strength and muscle density Z-scores were lower vs. controls (all p≤0.001). Transplant recipients received glucocorticoids throughout. The prevalence of obesity increased from 18 to 45%. Although ALMI increased following transplantation (p<0.001) and was comparable to controls from 6 months onward, gains were outpaced by increases in FMI, resulting in persistent ALMIFMI deficits (mean Z-score -0.31 at 24 months, p=0.02 vs controls). Muscle density improved following transplantation despite gains in FMI (p = 0.02). Muscle strength relative to ALMI also improved (p = 0.04) but remained low compared with controls (p=0.01). Exercise increased in the early months following transplantation (p<0.05) but remained lower than controls (p=0.02).
Limitations
Lack of muscle biopsies precluded assessment of muscle histology and metabolism.
Conclusions
The two-year interval following kidney transplantation was characterized by gains in muscle mass and strength that were outpaced by gains in fat mass resulting in persistent relative sarcopenia.
Aims
To evaluate the long-term consequences of coffee drinking in patients with type 2 diabetes.
Data synthesis
PubMed, Scopus, and Web of Sciences were searched to November 2020 for prospective cohort studies evaluating the association of coffee drinking with risk of cardiovascular disease (CVD) and mortality in patients with type 2 diabetes. Two reviewers extracted data and rated the certainty of evidence using GRADE approach. Random-effects models were used to estimate the hazard ratios (HRs) and 95% CIs. Dose-response associations were modeled by a one-stage mixed-effects meta-analysis. Ten prospective cohort studies with 82,270 cases were included. Compared to those with no coffee consumption, the HRs for consumption of 4 cups/d were 0.79 (95%CI: 0.72, 0.87; n=10 studies) for all-cause mortality, 0.60 (95%CI: 0.46, 0.79; n=4) for CVD mortality, 0.68 (95%CI: 0.51, 0.91; n=3) for coronary heart disease (CHD) mortality, 0.72 (95%CI: 0.54, 0.98; n=2) for CHD, and 0.77 (95%CI: 0.61, 0.98; n=2) for total CVD events. There was no significant association for cancer mortality and stroke. There was an inverse monotonic association between coffee drinking and all-cause and CVD mortality, and inverse linear association for CHD and total CVD events. The certainty of evidence was graded moderate for all-cause mortality, and low or very low for other outcomes.
Conclusions
Drinking coffee may be inversely associated with the risk of mortality in patients with type 2 diabetes. However, more research is needed considering type of coffee, sugar and cream added to coffee, and history of CVD to present more confident results.
Registry and registry number
The protocol of this systematic review was registered at Open Science Framework (https://osf.io/8uaf3, registered form: osf.io/xur76, registration DOI: 10.17605/OSF.IO/8UAF3).
Background
An inverse relationship between coffee intake and mortality has been observed in several population cohorts, but rarely within Mediterranean countries. Moreover, the biological pathways mediating such an association remain unclear.
Objectives
We assessed the associations between coffee consumption and total and cause-specific mortality and examined the mediating roles of N-terminal pro B–type natriuretic peptide (NTproBNP), high-sensitivity Troponin I, blood glucose, lipid metabolism, and selected biomarkers of inflammation and renal function.
Methods
We longitudinally analyzed data on 20,487 men and women (35–94 years old at baseline) in the Moli-sani Study, a prospective cohort established in 2005–2010. Individuals were free from cardiovascular disease (CVD) and cancer and were followed-up for a median of 8.3 years. Dietary data were collected by a 188-item semi-quantitative FFQ. Coffee intake was standardized to a 30-mL Italian espresso cup size. HRs with 95% CIs were calculated by multivariable Cox regression.
Results
In comparison with no/rare coffee consumption (up to 1 cup/d), HRs for all-cause mortality across categories of coffee consumption (>1 to ≤2, >2 to ≤3, >3 to ≤4 and >4 cups/d) were 0.79 (95% CI, 0.65–0.95), 0.84 (95% CI, 0.69–1.03), 0.72 (95% CI, 0.57–0.92), and 0.85 (95% CI, 0.62–1.12), respectively. For CVD mortality, a nonlinear (P for non-linearity = 0.021) J-shaped association was found (magnitude of the relative reduction = 37%; nadir at 3–4 cups/d). Circulating levels of NTproBNP explained up to 26.4% of the association between coffee and all-cause mortality, while systolic blood pressure was likely to be on the pathway between coffee and CVD mortality, although to a lesser extent.
Conclusions
In this large cohort of Italian adults, moderate consumption (3–4 cups/d) of Italian-style coffee was associated with lower risks of all-cause and, specifically, of CVD mortality. Among the known biomarkers investigated here, NTproBNP likely mediates the relationship between coffee intake and all-cause mortality.
Background
Coffee is one of the most widely consumed beverages around the world. Dietary habits, specifically, coffee consumption has long been a suspected cause of hypertension. However, previous findings on coffee consumption and its association with the incidence of hypertension are not homogeneous and still inconsistent.
Purpose
To examine the association of habitual coffee consumption with the risk of developing hypertension in a middle-aged Brazilian cohort.
Methods
Data were from the multicenter prospective cohort “Brazilian Longitudinal Study for Adult Health - ELSA-Brasil”. The cohort comprises 15,105 civil servants, aged 35 to 74 years at baseline, who were sampled from universities located in six Brazilian cities. For the present study, we analyzed data from 8,780 participants initially free of hypertension during a mean follow-up of 3.9 years. The consumption of coffee was obtained at baseline using a previously validated semi-quantitative food frequency questionnaire (FFQ). Subsequently coffee intake was categorized into four categories (cups/day): never/almost never, ≤1, 1-3, and >3. Hypertension status was defined as a systolic blood pressure ≥140 mmHg or a diastolic blood pressure ≥90 mmHg, use of antihypertensive drug treatment, or both. Poisson regression model with a robust variance was performed to estimate relative risk (RR) and 95% confidence intervals (95% CI) for hypertension according to baseline coffee consumption. The effect of interaction between coffee consumption and smoking status was assessed.
Results
Most participants (90%) drank coffee, and the median total coffee intake was 150 mL/day. A total of 1,285 participants developed hypertension. Compared to participants who never or almost never drink coffee, the risk of hypertension was lower for individuals consuming 1-3 cups/day (RR 0.82; 95% CI: 0.68, 0.97) ( P for interaction=0.018). After stratification by smoking status the analysis revealed a decreased risk of hypertension in never smokers drinking 1-3 cups of coffee per day (RR 0.79; 95% CI: 0.64, 0.98), whereas the hypertension risk among former and current smokers was not associated with coffee consumption significantly. Moreover, upper category of coffee drinking (>3 cups/day) the association was not significant for risk of hypertension.
Conclusion
The association between coffee consumption and incidence of hypertension was related to smoking status. The beneficial effect of moderate coffee intake (1 to 3 cups/day) on risk of hypertension was observed only in never smokers.
Background
Coffee is the most commonly consumed beverage in the world after water, however the debate as to whether coffee consumption is beneficial or detrimental to health continues. Current evidence of the link between coffee and health outcomes is predominately observational, thus subject to methodological issues such a confounding and reverse causation.
Methods
This Mendelian randomisation phenome-wide association study (MR-PheWAS) used information from up to 333,214 participants of White-British ancestry in the UK Biobank to examine the causal association between genetically instrumented habitual coffee consumption and the full range of disease outcomes. We constructed a genetic risk score for habitual coffee consumption and screened for associations with disease outcomes across 963 case-control series. All signals under false discovery rate controlled threshold (5.2x10⁻⁴) were followed by Mendelian randomisation (MR) analyses, with replication in independent data sources where possible.
Results
The initial phenome-wide association analysis identified signals for 10 outcomes representing five distinct diseases. The strongest signal was seen for gout (P =1.3x10⁻¹¹), but there was notable pleiotropy (Pdistortion <0.001) and MR analyses did not support an association with habitual coffee consumption (inverse variance weighted MR OR 0.34, 95%CI 0.06 to 2.05, P=0.24). Support for a possible causal relationship between habitual coffee consumption was only obtained for three distinct disease outcomes, including an increased odds of osteoarthrosis (OR 1.26, 95%CI 1.12 to 1.43) and obesity (OR 1.28, 95%CI 1.06 to 1.54), and a lower odds of postmenopausal bleeding (OR 0.74, 95%CI 0.65, 0.85). Evidence for an association between habitual coffee consumption and these three diseases was also supported by phenotypic associations with self-reported coffee consumption.
Conclusions
This large-scale MR-PheWAS provided little evidence for notable harm or benefit with respect to higher habitual coffee consumption. The only evidence for harm was seen with respect to osteoarthrosis and obesity.
The total polyphenolic content and the antioxidant activity have been analyzed in ground beans of green, light, medium and dark roasted coffee by UV-VIS spectrometry. Water coffee extracts showed the highest levels of polyphenols in green and light roasted coffees where the total polyphenolic content (TPC) ranged from 49.19 ± 0.70 to 74.05 ± 0.28 and from 59.79 ± 1.45 to 38.34 ± 1.26 g GAE.kg⁻¹, respectively. In medium roast samples it ranged from 43.90 ± 3.07 to 74.05 ± 0.28g GAE.kg⁻¹ and in dark roast from 37.44 ± 0.63 to 47.41 ± 0.69 g GAE.kg⁻¹. The total antioxidant capacity (TAC) reached the highest values (DPPH inhibition ranging from 69.08 ± 1.33% to 78.55 ± 0.89%) in light roasted coffees. Dark roasted coffees showed both the lowest content of polyphenols as well as the total antioxidant capacity. In case of TPC, statistically significant differences (P˂0.001) have been identified between green coffee and other roasted degrees. Also, dark coffee showed statistically noticeable differences (P˂0.001) in TPC in relation to other roasted stages. Statistically important difference (P˂0.001) has been discovered between the total antioxidant capacity of dark roasted coffee and other roasting levels. The results demonstrated that roasting process affects both the oxidative activity as well as polyphenolic content.
Sarcopenia is a progressive and generalised skeletal muscle disorder involving the accelerated loss of muscle mass and function that is associated with increased adverse outcomes including falls, functional decline, frailty, and mortality. It occurs commonly as an age-related process in older people, influenced not only by contemporaneous risk factors, but also by genetic and lifestyle factors operating across the life course. It can also occur in mid-life in association with a range of conditions. Sarcopenia has become the focus of intense research aiming to translate current knowledge about its pathophysiology into improved diagnosis and treatment, with particular interest in the development of biomarkers, nutritional interventions, and drugs to augment the beneficial effects of resistance exercise. Designing effective preventive strategies that people can apply during their lifetime is of primary concern. Diagnosis, treatment, and prevention of sarcopenia is likely to become part of routine clinical practice.
Kidney transplantation is associated with improvement in quality of life and mortality as compared to remaining on dialysis. It is therefore the optimal treatment for kidney failure for most patients. While transplantation nephrologists typically care for the patient in the first 6 months posttransplantation, general nephrologists and internists often care for kidney transplant recipients after this period. Medical management of the kidney transplant recipient can be challenging, and primary care physicians and nephrologists may be unfamiliar with the medical nuances of caring for these patients. This includes drug interactions, which are common and can result in drug toxicities, rejection, and graft injury. Infections and malignancies related to long-term immunosuppression may pose diagnostic and treatment challenges. In this article, we review the mechanisms of immunosuppression, types of rejection, complications of recurrent disease, common infectious diseases, and the nonrenal complications commonly encountered in the kidney transplant recipient.
Results from studies investigating the association between coffee consumption and the metabolic syndrome in Koreans have been inconsistent and remain controversial. We examined coffee intake in relation to the metabolic syndrome using data from the Korea National Health and Nutrition Examination Survey 2012–2015, with 8387 adults aged 19–64 years. Furthermore, we conducted a stratified analysis by obesity status (BMI <25 v . ≥25 kg/m ² ) to examine whether the association varied by obesity status. A 112-item FFQ was used to assess diet. Multivariable logistic regression models were used to determine the association of coffee consumption (<1, 1–2, 3–4 and ≥5 times/d) and the metabolic syndrome. Compared to people who consumed <1 time/d of coffee, the OR for the metabolic syndrome in those who consumed 3–4 times/d of coffee was 0·75 (95 % CI 0·58, 0·97). However, ≥5 times/d of coffee consumption was not significantly associated with the metabolic syndrome. By obesity status, in non-obese people, those consuming more coffee had lower odds of the metabolic syndrome, showing a significant linear trend ( P -trend=0·0248). In obese people, the OR for the metabolic syndrome in people with 3–4 times/d of coffee consumption v . <1 time/d was 0·68 (95 % CI 0·50, 0·93), but ≥5 times/d of coffee consumption showed a non-significant positive association. Our findings suggest that moderate coffee consumption of 3–4 times/d is inversely associated with the metabolic syndrome in Korean adults. The association between heavy coffee consumption of ≥5 times/d and the metabolic syndrome varied by obesity status.
Chronic kidney disease (CKD) is a global public health burden. Dialysis is not only costly but may not be readily available in developing countries. Even in highly developed nations, many patients may prefer to defer or avoid dialysis. Thus, alternative options to dialysis therapy or to complement dialysis are needed urgently and are important objectives in CKD management that could have huge clinical and economic implications globally. The role of nutritional therapy as a strategy to slow CKD progression and uremia was discussed as early as the late 19th and early 20th century, but was only seriously explored in the 1970s. There is a revival of interest recently owing to encouraging data as well as the increase of precision medicine with an emphasis on a personalized approach to CKD management. Although part of the explanation for the inconclusive data may relate to variations in study design and dietary prescription, diversity in genetic make-up, variations in the non-nutritional management of CKD, intra-individual variations in responses to dietary and nondietary treatment, psychosocial factors, and dietary compliance issues, these all may contribute to the heterogeneous data and responses. This brings in the evolving concept of precision medicine, in which disease management should be tailored and individualized according not only to clinical manifestations but also to the genetic make-up and biologic responses to therapy, which may vary depending on genetic composition. Precision nutrition management also should take into account patient demographics, social, psychological, education, and compliance factors, which all may influence the therapeutic needs and responses to the nutritional therapy prescribed. In this review, we provide a novel concept of precision medicine in nutritional management in end-stage kidney disease with a transition to dialysis and propose how this may be the way forward for nutritional therapy in the CKD population.