There seems to be one study after another about the benefits of coffee. This paper just published in the journal Digestive Diseases and Sciences verifies that coffee protects against Non-alcoholic Fatty Liver Disease (NAFLD), the most common cause of non-infectious hepatitis and a growing cause of liver failure. I very often see elevated liver enzymes on laboratory tests; no wonder, since this is commonly fueled by insulin resistance. The authors of this study began by observing…

“The benefits of coffee on abnormal liver biochemistry, cirrhosis and hepatocellular carcinoma have been reported…this study aims to investigate if coffee use has any relationship with bright liver, measured by ultrasound bright liver score (BLS), in patients with non-alcoholic fatty liver disease (NAFLD), and which relationship, if any, is present with BMI and insulin resistance.”

‘Bright liver’ refers to the appearance of a fatty liver on ultrasound imaging, and a higher BLS measurement means more fat deposits in the liver. What did they find?

“Less fatty liver involvement is present in coffee vs. non-coffee drinkers. Odds ratios show that obesity, higher insulin resistance, lower HDL cholesterol, older age and arterial hypertension are associated with a greater risk of more severe BLS; to the contrary, coffee drinking is associated with less severe BLS…Coffee use is inversely associated with the degree of bright liver, along with insulin resistance and obesity…”

Their conclusion is similar to numerous other studies:

“A possible opposite, if not antagonistic, role of coffee with regard to overweightness and insulin resistance, similar to that reported in hepatocarcinoma and cirrhosis, is envisaged in the natural history of NAFLD.”

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Parents, if your children are overweight it is prudent to protect them by having their liver enzymes measured. Non-alcoholic fatty liver disease (NAFLD) is being seen much more frequently in children due to the marked increase in metabolic syndrome associated with being overweight. This paper published in the journal GUT (International Journal of Gastroenterology and Hepatology) “aimed at determining the long-term outcomes and survival of children with NAFLD.” Liver biopsies were obtained when indicated. The investigators documented a disturbing progression to end-stage liver disease and liver transplantation: “Children with NAFLD may develop end-stage liver disease with the consequent need for liver transplantation. NAFLD in children…may be associated with a significantly shorter survival as compared to the general population.”. Their findings are encouragement to help children eat well and exercise. What is the key: “Insulin resistance is almost a universal finding in paediatric NAFLD.”

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Gut, An International Journal of Gastroenterology and Hepatology just published this alarming commentary on a paper published in the same issue that documents the penetration of non-alcoholic fatty liver disease (NAFLD) into the childhood age group. They define NAFLD: “Non-alcoholic fatty liver disease (NAFLD) is currently the most common form of chronic liver disease in both children and adults and threatens to become a serious public health problem worldwide.^{1 2} It is closely associated with obesity and insulin resistance…” and continue to observe, “This study provides the most convincing evidence thus far that NAFLD in children can be a progressive disease with the potential for progression to end-stage liver disease requiring liver transplantation (LT)…the identification and validation of non-invasive markers capable of identifying children with NAFLD and those most likely to develop advanced disease is urgently required to assist in the management of children at risk of NAFLD…before it becomes a major cause of death in the most of the Western world..” This is a natural consequence of the huge increase in obesity, metabolic syndrome and type 2 diabetes (formerly an ailment confined to adults) in children.

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