New biological clues behind coffee’s benefit to liver health

In one of the most comprehensive studies of coffee and liver health to date, Cedars-Sinai Health Sciences University investigators linked higher coffee consumption with a lower risk of cirrhosis, liver cancer and liver-related death. The findings, published in Clinical Gastroenterology and Hepatology, also provide new biological evidence that may help explain those associations.

“Previous studies suggested that coffee might benefit the liver, but most were smaller or looked at only one piece of the puzzle,” said hepatologist Hyunseok Kim, MD, MPH, Ph.D., assistant professor of medicine at Cedars-Sinai and corresponding author of the study. “We followed hundreds of thousands of people for more than a decade and looked at their health outcomes along with liver MRI scans and blood protein analyses. Together, those findings help explain the biological mechanisms behind coffee’s association with better liver health.”

A Cedars-Sinai study of more than 355,000 adults found that drinking coffee was associated with lower risks of cirrhosis, liver cancer and liver-related death. The investigators analyzed data from 354,957 UK Biobank participants who did not have cirrhosis or liver cancer at the start of the study. Over a median follow-up of 13 years, researchers tracked new diagnoses of cirrhosis, liver cancer and liver-related death through linked health records.

Compared with people who did not drink coffee, those who drank five or more cups of coffee a day had a 32% lower risk of cirrhosis, a 47% lower risk of liver cancer and a 42% lower risk of liver-related death. Participants who drank more coffee also had lower levels of liver fat, liver iron, fibrosis and liver inflammation in MRI scans. And coffee drinkers’ blood tests showed higher levels of proteins tied to healthy liver function and lower levels of proteins linked to scarring and inflammation.

While liver health risk decreased as coffee consumption increased, researchers noted that benefits were seen even at one to two cups per day and appeared strongest around three to four cups per day. They emphasized that while the highest intake group (five or more cups daily) showed benefit, they would not recommend increasing consumption to that level specifically.

Similar protective associations were observed for caffeinated and decaffeinated coffee, suggesting that caffeine itself is unlikely to be the only active component and that other naturally occurring compounds in coffee may contribute to the benefits. Because the study was observational, investigators noted it does not prove that coffee itself prevents liver disease. And they emphasized that coffee should complement—not replace—established strategies for preventing liver disease.

“Our findings support moderate coffee consumption for people who already enjoy and tolerate it well,” said study senior author Ju Dong Yang, MD, medical director of the Liver Cancer Program at Cedars-Sinai.

“However, we would not recommend that someone begin drinking coffee solely for liver protection based on this study alone. Prevention should continue to focus on maintaining a healthy weight, limiting alcohol, exercising regularly, and managing blood sugar, blood pressure and cholesterol.”

Because caffeine isn’t appropriate for everyone, people with uncontrolled high blood pressure, certain heart rhythm disorders, severe anxiety, insomnia or other conditions that require limiting caffeine should consult their health care provider before increasing their coffee consumption.

“The next step in our research is to identify the specific compounds in coffee that are responsible for these liver-protective associations,” said study author Shelly Lu, MD, the Women’s Guild Chair in Gastroenterology and director of the Karsh Division of Gastroenterology and Hepatology at Cedars-Sinai. “Our findings point to biological pathways involving inflammation and scarring and highlight molecular targets that future research can explore to better understand how coffee may influence liver health and who stands to benefit most.”

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