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Coffee Lowers risk of Gallstone Disease for Men in Major Study

Results of a large American population study suggest that regular consumption of coffee (Coffea arabica L. and C. canephora Pierre ex Froehner, Rubiaceae) may provide protection against the development of symptomatic gallbladder disease (Leitzmann et al., 1999). According to the study, men who drank two to three cups of regular (caffeinated) coffee a day had a 40 percent lower risk of developing gallstone disease, and risk was reduced by 45 percent for those who drank four or more cups a day. All brewing methods (including filtered, instant, and espresso) were associated with decreased risk. Risk also declined with increasing caffeine intake. Men in the highest category of caffeine intake (more than 800 mg a day) had a risk reduction of 45 percent, compared with those who consumed less than 25 mg of caffeine a day. Decaffeinated coffee was not associated with any risk reduction.

The coffee analysis was part of the Health Professionals Follow-up Study, a prospective cohort study that tracked the dietary habits and health histories of 51,529 male physicians, veterinarians, and dentists aged 40 to 75 between 1986 and 1996. The study assessed the consumption of coffee and other caffeinated beverages as part of a 131-item food frequency questionnaire. A total of 46,008 men were eligible for inclusion in the coffee analysis, after exclusion of those with histories of gallbladder disease, cancer, or calorie intake outside a normal range. Dietary and health histories were established with a baseline questionnaire and updated biennially through follow-up questionnaires. The main outcome measurement was new symptomatic gallstone disease (diagnosed by ultrasound or x-ray) or cholecystectomy (gallbladder removal).

The investigators speculate that a number of coffee constituents may contribute to the protective effect, citing earlier research on the metabolic effects of caffeine, cafestol, and whole-bean coffee. According to the authors, caffeine has demonstrated an ability to increase bile flow, decrease gallbladder fluid absorption, and inhibit biliary cholesterol crystallization, and cafestol (a lipid compound in coffee beans) may affect the concentration of bile cholesterol. Coffee itself has been shown to stimulate the release of cholecystokinin (a polypeptide that stimulates contraction of the gallbladder and release of pancreatic juice) and to increase gallbladder and large bowel motility. Most population studies investigating the relationship between coffee consumption and gallbladder disease have demonstrated lowered risks for people with high coffee intake, but at least three studies have suggested an increased risk. Gallstone disease is estimated to affect more than 20 million Americans and result in at least 800,000 hospitalizations a year, with direct costs of more than $2 billion. - Evelyn Leigh, HRF

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[Leitzmann MF, Willett WC, Rimm EB, Stampfer MJ, Spiegelman D, Colditz GA, Giovannucci E. A prospective study of coffee consumption and the risk of symptomatic gallstone disease in men. JAMA 1999; 281(22): 2106-2112.]

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