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