- Email: [email protected]
Coffee Consumption and Body Weight Regulation
C H A P T E R
55
Coffee Consumption and Body Weight Regulation Marie-Pierre St-Onge New York Obesity Nutrition Research Center, St. Luke’s/Roosevelt Hospital, Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, NY, USA
List of Abbreviations
potential benefits for weight management,3 and others have also proposed caffeine and capsaicin,4 and ephedrine and conjugated linoleic acids.5 This chapter will focus on the relationship between coffee consumption and obesity risk as well as coffee’s potential modulating effects on energy balance regulation: energy expenditure (EE) relative to energy intake.
BMI Body mass index CGA Chlorogenic acid EE Energy expenditure GLP-1 Glucagon-like peptide 1 MOS Mannooligosaccharides NMP N-methylpyridinium PYY Peptide tyrosine tyrosine RMR Resting metabolic rate WHR Waist-to-hip ratio
55.1 INTRODUCTION
55.2 EPIDEMIOLOGICAL EVIDENCE LINKING COFFEE CONSUMPTION AND WEIGHT STATUS
It is well known that the prevalence of obesity in the United States and worldwide has increased over the past several decades from the 1980s. In the United States, the combined prevalence of overweight and obesity has reached approximately 69%,1 an overwhelming majority of the population. This has major public health implications since obesity is associated with an increased risk of type 2 diabetes, cardiovascular disease, hypertension, certain cancers, and orthopedic/mobility issues, among others. It has been estimated that a 1% point reduction in the prevalence of obesity by 2020 would equate to reductions in obesity-attributable medical expenditures of $4.0 billion (2008 US$).2 Finding tools such as dietary or pharmaceutical agents that could promote a negative energy balance and assist in the reduction of obesity would be of great public interest. Various dietary factors have been explored with respect to their relationship with weight status and potential effects on weight management. We have proposed that dairy, certain fats, tea, and nuts may have
Early studies in the 1980s examined the relationship between dietary habits and weight status. Cross-sectional studies, mostly conducted in Europe, reported contradictory findings concerning the relationship between coffee consumption and weight status (Table 55.1). For example, data from the Zutphen Study, obtained in 1965 from men aged 45–64 years, showed a negative relationship between coffee consumption and triceps and subscapular skinfold thickness,6 a measure of subcutaneous adipose tissue. However, coffee intake was not related to body mass index (BMI) and, in regression analyses, only energy balance (intake—expenditure), physical activity, and smoking had significant effects on skinfold thicknesses and BMI. Similarly, Lapidus et al.7 found no association between coffee consumption and BMI or waist-to-hip ratio (WHR) in women age 38–60 from Sweden. On the other hand, cross-sectional data from the Tromso Study, obtained in 1979–1980, showed that a high BMI was associated with high coffee intakes in both women and men.8 Participants in that study were
Coffee in Health and Disease Prevention http://dx.doi.org/10.1016/B978-0-12-409517-5.00055-3
499
© 2015 Elsevier Inc. All rights reserved.
500
55. COFFEE AND WEIGHT MANAGEMENT
TABLE 55.1 Summary of Studies Examining the Cross-sectional Association between Coffee Consumption and Weight Status Relationship between Coffee Intake and Weight Status
References
Origin
Population
Kromhout et al.6
The Netherlands
Men Age 40–59 years
Not related to body mass index (BMI) Inverse relationship with triceps and subscapular skinfold thicknesses
BMI – Skinfolds ↓
Lapidus et al.7
Sweden
Men and women Age 38–60 years
Not related to BMI Not related to waist-to-hip ratio (WHR)
BMI – WHR –
Jacobsen and Thelle8
Norway
Men and women Age 20–55 years
Positive relationship with BMI
BMI ↑
Merkus et al.9
The Netherlands
Men and women Age ∼40 years
Women who drank >7 cups/day had lower BMI than those drinking 1–3 cups/day Not related to BMI in men
BMI ↓
Troisi et al.10
US
Men Age 43–85 years
Not related to WHR
WHR –
Kamycheva et al.11
Norway
Men and women Age >24 years
Positive correlation with BMI in both sexes
BMI ↑
Wilsgaard et al.12
Norway
Men and women
Positive correlation with BMI, stronger in women than men
BMI ↑
Wu et al.14
US
Women Age ∼57 years
Inverse association with BMI
BMI ↓
Suadicani et al.15
The Netherlands
Men Age 53–75 years
Inverse association with BMI
BMI ↓
Hino et al.16
Japan
Men and women Age >40 years
Inverse association with waist circumference
Waist ↓
Bouchard et al.17
US
Men and women Age ≥18 years
Not related to BMI in either sex
BMI –
Gunes et al.18
Turkey
Men Age 18–22 years
Increased risk of obesity
BMI ↑
20–55 years of age at the time of data collection. Data from a Dutch study9 later contradicted the results of Jacobsen and Thelle8 and showed that women who drank more than seven cups of coffee a day had lower BMI than those who drank one to three cups a day. In addition, coffee consumption was an independent predictor of BMI in multiple regression analyses in women. This was not observed in men but only 34 men provided data for those analyses. An interesting aspect of this study, distinguishing it from all other studies, is that participants were obese to severely obese, with a mean BMI of approximately 41 kg/m2 for women and 38 kg/ m2 for men. Data from US samples reporting relationships between coffee consumption and weight status began to emerge in the 1990s. However, one of the first reports, from the Normative Aging Study, showed no relationship between caffeine intake and BMI or WHR in men age 43–85 years.10 That study, however, did not report on coffee consumption patterns specifically. There has been much more information reported from 2003 to the present about the relationship between coffee
Direction of Relationship
consumption and weight status. An update from the Tromso Study conducted in 1994–1995 reported a weak but significant positive correlation between BMI and coffee consumption in both women and men.11 However, later breakdown by type of coffee showed that drinking boiled coffee daily was not associated with BMI in cross-sectional analyses, although total coffee consumption was positively related.12 Similarly, in the Monitoring of Trends and Determinants in Cardiovascular Disease study, composed of a Danish population aged 30–60 years, women in the highest quartile for coffee consumption (eight cups or more a day) had significantly greater increase in waist circumference over a 6 year follow-up period than those reporting drinking four to five cups a day.13 However, no linear trend was apparent and the association was no longer significant after adjusting for BMI. In men, coffee consumption was not associated with a change in waist circumference. Data from the Nurses’ Health Study have shown that caffeinated coffee consumption, although being associated with greater energy intakes, was inversely related to BMI.14 Such an inverse association with BMI was
II. EFFECTS OF COFFEE CONSUMPTION
55.3 Impact of Coffee and Caffeine on EE
also seen in the Copenhagen Male Study15 and with waist circumference in a Japanese population.16 However, Bouchard et al.17 recently showed no relationship between coffee intake and BMI in adult men and women using 2003–2004 National Health and Nutrition Examination Survey data, and Gunes et al.18 reported an increased risk of obesity with frequent coffee consumption in first-year university students from Turkey. Epidemiological studies relating coffee beverage consumption and weight are thus quite mixed. Most studies have been conducted in Europe, where coffee consumption is high, and in mostly middle-aged adults.6,7,9,15 In these studies, BMI was either not related6,7 or inversely related with coffee consumption.9,14 US studies also show either no10,17 or inverse relationship14 with BMI. Studies that have found a positive relationship between coffee consumption and BMI have enrolled younger participants.8,11,18 Perhaps there is a critical difference in coffee consumption patterns between younger and older adults that could produce such a difference. However, one must bear in mind the cross-sectional nature of these studies. Causality cannot be inferred from these studies, and reverse causation (increased frequency of a behavior in attempt to achieve weight loss by overweight or obese individuals) is plausible given the theoretical explanations for associations between coffee consumption and obesity. Caffeine is a well-known stimulant, and studies have examined the role of coffee in raising thermogenesis. The next sections will review studies examining the impact of coffee consumption on EE and energy intake.
55.3 IMPACT OF COFFEE AND CAFFEINE ON EE Caffeine is the most widely studied coffee component, particularly for its thermogenic effect. In 1980, Acheson et al.19 reported the results of a trial assessing the impact of caffeine on metabolic rate. Six normal-weight participants took 8 mg of caffeine/kg body weight in capsule form, or placebo. Caffeine increased resting metabolic rate (RMR) by 16% compared to 3% for placebo, although there was considerable individual variation. Fat oxidation was also increased to a greater extent after caffeine compared to placebo. The effects of caffeine on postprandial EE were also compared between lean, obese, and post-obese participants assessed at weight maintenance 3 months after weight loss.20 Obese and lean women had a similar increase in EE after caffeine administration of 4 mg/kg ideal body weight, but post-obese women had one-third the response of the obese women. That study only enrolled women, but another study by Dulloo et al.21 examined the thermic effects of caffeine tablets in normal weight and post-obese men and women. Post-obese participants were previously overweight but had been normal weight for
501
5–6 months prior to testing. Participants underwent four different test days held 3 days apart in which the thermic effect of 600 mg caffeine tablets was compared to water, a 300 kcal liquid meal, and a 300 kcal liquid meal with 600 mg caffeine. All participants had their EE measured for 2.5 h; another group was tested in a 24 h metabolic chamber where caffeine tablets of 100 mg each, or placebo tablets, were taken every 2 h over 12 h. Postprandial EE was increased by 3–4% with caffeine alone in both normalweight and post-obese participants. However, there were differences between groups when caffeine was administered with a meal: EE was increased by 12% compared to the no-caffeine meal in normal-weight participants (not significant) and by 25–30% in the post-obese. Twenty-four hour EE was increased by 5.5% in both normal-weight and post-obese relative to placebo when assessed in the metabolic chamber. This rise in EE occurred solely over the period of caffeine intake; there was no residual or lasting effect over the night-time period. These authors suggested that the sub-normal diet-induced thermogenesis observed in post-obese individuals is ameliorated or partially corrected by caffeine consumption. Just as the thermic effect of caffeine was compared between normal-weight, overweight, and post-obese individuals, studies have compared its effects in young and older individuals.22,23 It is known that EE decreases with increasing age, and this may be a contributing factor to the aging-related changes in body composition.24 Arciero et al.22 compared the thermic effects of 5 mg caffeine/kg fat-free mass to lactose placebo pills in weight-stable young (age 19–26 years) and older (age 65–80 years) men. All participants were within 15% ideal body weight for age based on the 1959 MetLife tables. Caffeine increased EE equally by 10–12% over baseline in both groups. A similar study by the same group was conducted in women of the following age groups: 18–22 and 50–66 years.23 In this case, although caffeine increased RMR in both groups, the response was blunted in older compared to younger women (7.8% vs 15.4% over RMR, respectively). Therefore, in women, but not in men, age may be an important factor to take into consideration when describing caffeine’s thermogenic effects. Previous studies have tested the effects of relatively large doses of caffeine on RMR. The potential dose– response effect of caffeine intake on RMR has been evaluated in young normal-weight men and women.25 Doses of 100, 200, and 400 mg of caffeine were compared to placebo. The thermogenic response to caffeine over placebo was 9.2 kcal/h for the 100 mg dose and 7.2 and 32.4 kcal/h for the 200 and 400 mg doses, respectively. The effect was measured over 3 h, somewhat longer than previous studies which assessed post-intake EE over 1.5–2.5 h but the authors commented that this measurement period length was not sufficient since EE had not returned to baseline by that time.
II. EFFECTS OF COFFEE CONSUMPTION
502
55. COFFEE AND WEIGHT MANAGEMENT
From studies published to date, it can be concluded that caffeine administration raises EE by approximately 5–10% over RMR relative to placebo in both men and women. Caffeine’s thermogenic effects may be enhanced when taken with a meal, but this is possibly affected by weight status.21 Moreover, the role of caffeine in counteracting weight loss or aging-related declines in EE remains to be determined. One study reported a reduced response to caffeine in post-obese women20 while Dulloo et al.21 reported that caffeine could ameliorate the blunted diet-induced thermogenesis in obese individuals. Similarly in aging, sex may play a role in modulating the thermic response to caffeine.22,23 However, as described in detail in other chapters of this book, coffee is more than simply caffeine and there may be other functional ingredients in coffee that could affect EE. Acheson and colleagues19 compared the thermogenic effects of caffeinated (4 mg/kg body weight) or decaffeinated instant coffee in seven normal-weight and six obese participants. In normal-weight participants, both types of coffee significantly increased EE relative to baseline by 12% and 5%, respectively, and increased fat oxidation, whereas in the obese, only caffeinated coffee increased EE by 10% over RMR. Decaffeinated coffee had no effect on EE and substrate oxidation was not changed. Moreover, when given with a meal in normal-weight individuals, the rise in EE was 33% with coffee and 23% with decaffeinated coffee, corresponding to a thermic effect (postprandial EE—RMR) of 9% and 6%, respectively. The authors proposed that the benefit of caffeinated coffee for weight loss could be related to changes in body composition, such as reduction in fat stores, in normalweight individuals whereas in the obese, this could be independent of fat stores mobilization. Using a lower caffeine dose (100 mg from caffeinated coffee), Hollands et al.26 also observed a significantly greater rise in EE with caffeinated relative to decaffeinated coffee over 2 h post-ingestion. In that study, EE was 21.5% higher in the hour immediately after ingestion and 10% higher in the next hour, compared to decaffeinated coffee. The rise in EE with coffee consumption is, for the most part, similar to that observed in studies of caffeine tablets or pills. For example, in studies by Tagliabue et al.26 and Koot and Deurenberg,28 coffee providing 4 mg/kg body weight caffeine27 or 200 mg caffeine27 raised EE by approximately 7–8% over RMR values. Both studies enrolled normal-weight participants, but Koot and Deurenberg28 included women as well as men. As for studies of caffeine, postprandial EE was measured for 2–3 h, which was insufficient to capture the entire postprandial EE curve as values were still above baseline after 3 h.28 This was somewhat addressed with a chamber study in which 10 normal-weight and 10 obese women, age 20–35 years, participated.29 During each test day, the women consumed five cups of coffee: one at
each meal and additionally at 1030 and 1630 h. The coffee contained 3.63% caffeine, providing a dose of 4 mg/ kg body weight per cup of coffee. In normal-weight women, actual body weight was used to calculate the coffee dose, whereas in obese women, normalized body weight, calculated from a BMI of 22.5 kg/m2, was used. This BMI value corresponded to the average BMI of the normal-weight women. The control test day provided decaffeinated instant coffee. Twenty-four hour EE was 174 kcal/day higher in the caffeinated coffee condition relative to decaffeinated coffee in normal-weight women and 98 kcal/day higher in obese women. These values corresponded to a rise in EE of 7.6% and 4.9% relative to decaffeinated coffee in normal-weight and obese women, respectively. Basal metabolic rate measured the following morning was not affected by type of coffee consumed the previous day, although respiratory quotient was reduced after the caffeinated coffee test day, indicating an increase in fat oxidation.
55.4 EFFECTS OF COFFEE CONSUMPTION ON APPETITE REGULATION Contrary to the effects of coffee on EE, there have been much fewer studies examining the effects of coffee consumption on appetite and food intake regulation. In a small study of six participants, Douglas et al.30 reported that caffeinated and decaffeinated coffee increased cholecystokinin release similarly, suggesting a potential satiating effect of coffee. Johnston et al.31 also found that caffeinated and decaffeinated coffee could affect gastrointestinal hormones involved in glucose metabolism and appetite regulation such as glucose-dependent insulinotropic polypeptide and glucagon-like peptide 1 (GLP-1), and they suggested that constituents in coffee produced a hormonal profile consistent with delayed glucose absorption. However, a recent study by Gavrieli et al.32 has yielded somewhat contradictory results. Gavrieli et al.32 conducted a three-way, randomized, crossover study testing the acute effects of caffeinated and decaffeinated coffee, relative to water, on appetite ratings and hormones, as well as food intake, in healthy young men. On each test day, participants consumed a standardized meal with instant coffee (either caffeinated or decaffeinated) or water. Caffeinated coffee provided 3 mg/kg body weight of caffeine, approximately 240 mg caffeine for an 80-kg person. Blood samples were taken over 3 h and an ad libitum buffet lunch was served thereafter. Participants could eat as much as they liked over a 30 min period. There was no treatment effect on satiety ratings, although there was a lower desire to eat at 180 min after caffeinated coffee consumption relative to decaffeinated coffee and water as well as a lower incremental area under the curve for desire to eat. However,
II. EFFECTS OF COFFEE CONSUMPTION
55.5 Effects of Coffee Consumption in Weight Loss
appetite-regulating hormones, ghrelin, GLP-1, and peptide tyrosine tyrosine (PYY), were not different between test days and neither was food intake at lunch. The authors concluded that coffee consumption, in amounts generally consumed, does not affect appetite regulation and food intake in the short term in healthy men. These conclusions contrast those of Greenberg and Geliebter33 who also examined the acute effects of coffee consumption on hunger, satiety, and hormonal controls of appetite. Their study was also conducted in young, healthy men and consisted of four separate laboratory visits: caffeine dissolved in water, caffeinated coffee, decaffeinated coffee, and water. The caffeine and caffeinated coffee beverages both provided 6 mg of caffeine/kg body weight, roughly equivalent to the amount of caffeine in two cups of regular coffee. The caffeine concentration was 0.73 mg/ml. Appetite and hunger ratings, along with blood samples, were obtained over 3 h. Decaffeinated coffee resulted in lower hunger levels than water and caffeine dissolved in water. The area under the curve for hunger ratings was also lower. Caffeinated coffee resulted in a similar pattern as decaffeinated coffee but differences failed to reach statistical significance for comparisons with water and caffeine. Satiety ratings mirrored those of hunger but were not statistically different between beverages. PYY, an anorectic hormone, was significantly higher after decaffeinated coffee consumption than water and caffeine over the initial 90 min postingestion. When levels were examined over the entire 3 h measurement period, there was a trend for PYY to be higher after decaffeinated coffee intake compared to caffeine dissolved in water. There were no beverage effects on ghrelin, a hormone involved in food intake initiation, and leptin. These authors concluded that one or more biological agents in coffee, that is not caffeine, could act to acutely reduce hunger and increase PYY. Chlorogenic acid (CGA) and caffeic acid were proposed. However, food intake was not assessed in this study and it cannot be assumed that decaffeinated coffee would have reduced subsequent food intake. Certainly these studies31,33 provide grounds for further research as they were both conducted in young, healthy, normal-weight men and had relatively small sample sizes. Whether similar results would be observed in women, overweight and obese participants, or older adults remains to be determined. Furthermore, standardized coffee brewing methods should be developed to improve cross-study comparisons. In the study by Greenberg and Geliebter,33 coffee was prepared using a drip-filter coffee maker using 40 g of ground caffeinated coffee and 57 g of ground decaffeinated coffee with eight cups of water. In the study by Gavrieli et al.,32 participants consumed 200 ml of instant coffee. It is possible that differences in brewing methods and preparation
503
of instant formulations could alter the concentration of functional ingredients that could affect appetite-regulating hormones and food intake.
55.5 EFFECTS OF COFFEE CONSUMPTION IN WEIGHT LOSS Since data suggest that coffee consumption could play a role in energy balance regulation via increased EE and increased satiety/reduced appetite, it would seem that changes in coffee consumption patterns could then modulate changes in body weight. Longitudinal data from the Nurses’ Health Study and the Health Professionals Follow-Up Study in fact showed that participants who increased their intake of caffeine between 1986 and 1998 had lower mean weight gain than those who decreased their intake.34 Furthermore, an increase in coffee consumption was inversely associated with weight gain in women but less so in men. The authors also observed a modest inverse association between decaffeinated coffee consumption and weight change, suggesting that the effects of coffee on changes in body weight over time could be due to compounds other than caffeine. In fact, intervention studies examining the potential impact of coffee consumption for weight management have focused on potential functional constituents not related to caffeine (Table 55.2). Bakuradze et al.35 tested the effects of a special roasted and blended Arabica coffee rich in green and roasted bean constituents, especially N-methylpyridinium (NMP) and CGA on body weight in young men, age 20–44 years and BMI 19–32 kg/m2. All participants started on a 4 week washout period during which they consumed 750 ml of water daily. This was followed by an active phase of 4 weeks during which participants drank 750 ml/day of freshly brewed filtered coffee providing 72 mg/l NMP, 580 mg/l caffeoylquinic acid, and 720 mg/l caffeine, and a second washout period with water. Coffee consumption led to significant reductions in body weight and body fat of 0.62 and 0.68 kg, respectively. The losses in body weight and fat were more distinct in those with BMI <25 compared to those with BMI >25 kg/m2 at baseline. During the second washout period, there was a slight regain in weight and fat mass. These changes in weight were likely the result of a significant reduction in energy intakes with coffee consumption relative to the first washout period. During the second washout, energy intakes rose but did not reach the levels measured in the first washout period. This led the authors to propose that there may be a prolonged or lasting effect of coffee treatment that extends beyond the active consumption period. The effects of CGA in coffee for weight management were specifically studied by Thom37 in overweight and obese men and women. Participants were randomly
II. EFFECTS OF COFFEE CONSUMPTION
504
55. COFFEE AND WEIGHT MANAGEMENT
TABLE 55.2 Impact of Coffee Active Ingredients for Weight Management Study Length
Effect on Body Weight and Body Composition
Healthy men Age 20–44 years BMI 19–32 kg/m2
4 weeks
Significant reduction in body weight and body fat compared to water
Light roast: high NMP and low CGA Dark roast: low NMP and high CGA
Healthy men and women Age 19–44 years BMI 19–29.5 kg/m2
4 weeks
Light roast: slight but significant increase in body weight Dark roast: significant reduction in body weight
Thom37
CGA
Healthy men and women BMI 27.5–32 kg/m2
12 weeks
Significant reductions in body weight and body fat in active group compared to placebo (decaffeinated coffee)
Salinardi et al.38
MOS
Healthy men and women Age 19–65 years BMI 27–33 kg/m2
12 weeks
Significant reductions in subcutaneous and visceral adipose tissue in men but not women, relative to placebo
St-Onge et al.39
MOS
Healthy men and women Age 19–65 years BMI 27–33 kg/m2
12 weeks
Significant reductions in body weight, total, subcutaneous and visceral adipose tissue in men but not women, relative to placebo
References
Active Compound
Population
Bakuradze et al.35
CGA and NMP
Kotyczka et al.36
Abbreviations: BMI, body mass index; CGA, chlorogenic acid; MOS, mannooligosaccharides; NMP, N-methylpyridinium.
assigned to consume either five cups a day of decaffeinated instant coffee or instant coffee supplemented with 200 mg/cup of green coffee extract rich in CGA (45–50% CGA by weight) for 12 weeks. Participants in the active treatment group lost 5.4 kg compared to 1.7 kg for those in the control group. Change in percentage body fat was also significantly different between groups and those in the active group had a reduction in body fat from 27.2% to 23.6%; those in the control group went from 26.9% to 26.2% body fat (not statistically significant). This study suggests that CGA could be a functional agent for weight management. However, these results have been challenged by another study comparing the effects of light and dark roast coffees for weight management.36 In this crossover study, participants consumed a low polyphenol diet for 12 weeks. The first 12 weeks consisted of a washout period. This was followed by 4 weeks of consuming a light roast coffee, a mid-study 2 week washout, and another 4 weeks of consuming a dark roast coffee. Both coffees were of the Arabica Brazil variety, but the light roast had a high CGA and low NMP content whereas the dark roast was rich in NMP and low in CGA. Coffee was prepared using a common drip-filter machine with 30 g of coffee roast powder and 600 ml of water. Energy intakes were lower with dark roast coffee consumption relative to washout and light roast coffee. Accordingly, body weight was reduced by 0.6 kg with dark roast coffee consumption. The change in body weight was mostly driven by a significant reduction in body weight in overweight participants; participants who were normal weight at baseline did not experience any change in body weight. Light roast coffee consumption resulted in a slight but statistically significant increase in body
weight of 0.2 kg. Future studies are therefore necessary to clarify whether NMP or CGA or yet other functional coffee constituents are chiefly responsible for the effects of coffee on body weight. In addition, studies examining the mechanism by which these coffee constituents could affect energy balance should be conducted. Another ingredient that could be responsible for the weight loss effects of coffee could be coffee mannooligosaccharides (MOS). In a series of studies, it was shown that MOS, extracted from coffee, could improve body composition in overweight men in particular.38,39 In both studies, men and women, age 19–65 years and BMI 27–33 kg/m2, supplemented their diets with either a MOS-enriched coffee beverage or a placebo beverage, twice daily, for a period of 12 weeks. The active beverages provided 2 g of MOS each for a total of 4 g/day (two sachets to be reconstituted with water and consumed with meals). When consumed as part of their free-living, weight maintenance diet, MOS consumption reduced total body volume, assessed by magnetic resonance imaging, relative to placebo in men but not women.38 In men, there was a significant beverage by time interaction on subcutaneous and visceral adipose tissue such that MOS tended to reduce these fat depots relative to placebo. Men in the MOS group had a 1.7% reduction in body weight compared to 0.3% for the placebo group, although neither value was statistically significant. Similar sex differences were observed when the study was conducted in the context of a weight loss program.39 In that study, participants supplemented their diets with either active MOS or placebo beverages and attended weekly weight loss counseling sessions to reduce their energy intakes by 500 kcal/day. Men who consumed
II. EFFECTS OF COFFEE CONSUMPTION
505
References
ingredients exerted a greater thermic effect than simply the sum of each part. Finally, obesity continues to be a major public health concern and recommendations remain to improve lifestyle behaviors such as diet and activity to achieve a healthy weight. Coffee is well poised to act as a functional beverage to improve energy balance regulation through its known effects on EE (caffeine) but also potentially by improving appetite regulation (Figure 55.1). Studies are needed to expand our knowledge of the functional ingredients in coffee that could be of benefit for body weight regulation.
FIGURE 55.1 Coffee consumption could lead to improvements in body weight regulation via increased energy expenditure (EE) and/or enhanced satiety. Caffeine is known to raise EE. Other components of coffee, such as chlorogenic acid, caffeic acid, and N-methylpyridinium may lead to enhanced satiety.
MOS as part of their weight loss diet lost almost twice as much weight as those consuming the placebo beverage (5.6 vs 2.9 kg, respectively). Women lost an equivalent amount of weight regardless of the beverage supplement. Similarly, men, but not women, had significantly greater loss of total, subcutaneous, and visceral adipose tissue with MOS consumption relative to placebo. These studies show that MOS may be an effective coffee-derived weight loss agent in men but not in women. Future studies should therefore explore sex differences when assessing the role of potential functional ingredients for weight management. As case in point, opposite sex differences were observed in the Netherlands Cohort Study on diet and cancer where women in the highest quintile of flavonoid and catechin intakes had a lower increase in BMI over 14 years of follow-up (0.40 and 0.31 kg/m2, respectively) compared to women in the lowest quintile (0.95 and 0.77 kg/m2); no effect was observed in men.40 There are therefore data to suggest that coffee consumption and specific components of coffee could play a beneficial role in weight management. However, data are conflicted on which coffee compound exerts the effect. Differences in brewing methods, types of coffee, and study design and population could all contribute to the variability in study results. Future studies should be done to establish which components of coffee are important for weight management and to determine whether synergistic effects between caffeine, coffee polyphenols, or oligosaccharides, or other functional ingredients, exist. Rudelle et al.41 showed that combining green tea catechins, caffeine, and calcium leads to greater EE than a triple placebo beverage. However, the authors did not test each “functional” ingredient separately and it is unknown if the combination of all three
55.6 SUMMARY POINTS • C ross-sectional studies of coffee consumption and weight status show mixed results. • There may be differences in thermic effect of coffee consumption by age and weight status. • Studies assessing the role of coffee components suggest that compounds in coffee, such as NMP and CGA, could affect appetite regulation. • Weight loss studies with coffee administration suggest that coffee consumption could assist with weight loss. • Some studies suggest that certain coffee compounds have preferential benefits for weight management in men, specifically. • Future studies should identify coffee compounds that could impact energy balance: EE > Energy intake. • Future studies should assess the synergistic effect of functional ingredients from coffee and other plant materials for energy balance regulation and weight management.
References 1. Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA 2012;307(5):491–7. 2. Finkelstein EA, Khavjou MA, Thompson H, et al. Obesity and severe obesity forecasts through 2030. Am J Prev Med 2012;42:563–70. 3. St-Onge MP. Dietary fats, teas, dairy, and nuts: potential functional foods for weight control? Am J Clin Nutr 2005;81(1):7–15. 4. Hursel R, Westerterp-Plantenga MS. Thermogenic ingredients and body weight regulation. Int J Obes (Lond) 2010;34(4):659–69. 5. Kovacs EM, Mela DJ. Metabolically active functional food ingredients for weight control. Obes Rev 2006;7(1):59–78. 6. Kromhout D, Saris WH, Horst CH. Energy intake, energy expenditure, and smoking in relation to body fatness: the Zutphen Study. Am J Clin Nutr 1988;47(4):668–74. 7. Lapidus L, Bengtsson C, Hallstrom T, Bjorntorp P. Obesity, adipose tissue distribution and health in women–results from a population study in Gothenburg, Sweden. Appetite 1989;13(1):25–35. 8. Jacobsen BK, Thelle DS. The Tromso Heart Study: the relationship between food habits and the body mass index. J Chronic Dis 1987;40(8):795–800.
II. EFFECTS OF COFFEE CONSUMPTION
506
55. COFFEE AND WEIGHT MANAGEMENT
9. Merkus MP, Mathus-Vliegen LM, Broekhoff C, Heijnen AM. Extreme obesity: sociodemographic, familial and behavioural correlates in The Netherlands. J Epidemiol Community Health 1995;49(1):22–7. 10. Troisi RJ, Heinold JW, Vokonas PS, Weiss ST. Cigarette smoking, dietary intake, and physical activity: effects on body fat distribution– the Normative Aging Study. Am J Clin Nutr 1991;53(5):1104–11. 11. Kamycheva E, Joakimsen RM, Jorde R. Intakes of calcium and vitamin d predict body mass index in the population of Northern Norway. J Nutr 2003;133(1):102–6. 12. Wilsgaard T, Jacobsen BK, Arnesen E. Determining lifestyle correlates of body mass index using multilevel analyses: the Tromso Study, 1979–2001. Am J Epidemiol 2005;162(12):1179–88. 13. Halkjaer J, Sorensen TIA, Tjonneland A, Togo P, Holst C, Heitmann BL. Food and drinking patterns as predictors of 6-year BMIadjusted changes in waist circumference. Brit J Nutr 2004;92:735–48. 14. Wu T, Willett WC, Hankinson SE, Giovannucci E. Caffeinated coffee, decaffeinated coffee, and caffeine in relation to plasma C-peptide levels, a marker of insulin secretion, in U.S. women. Diabetes Care 2005;28(6):1390–6. 15. Suadicani P, OleHein H, Gyntelberg F. Lifestyle, social class, and obesity-the Copenhagen Male Study. Eur J Cardiovasc Prev Rehabil 2005;12(3):236–42. 16. Hino A, Adachi H, Enomoto M, et al. Habitual coffee but not green tea consumption is inversely associated with metabolic syndrome: an epidemiological study in a general Japanese population. Diabetes Res Clin Pract 2007;76(3):383–9. 17. Bouchard DR, Ross R, Janssen I. Coffee, tea and their additives: association with BMI and waist circumference. Obes Facts 2010;3(6):345–52. 18. Gunes FE, Bekiroglu N, Imeryuz N, Agirbasli M. Relation between eating habits and a high body mass index among freshman students: a cross-sectional study. J Am Coll Nutr 2012;31(3):167–74. 19. Acheson KJ, Zahorska-Markiewicz B, Pittet P, Anantharaman K, Jequier E. Caffeine and coffee: their influence on metabolic rate and substrate utilization in normal weight and obese individuals. Am J Clin Nutr 1980;33(5):989–97. 20. Jung RT, Shetty PS, James WP, Barrand MA, Callingham BA. Caffeine: its effect on catecholamines and metabolism in lean and obese humans. Clin Sci (Lond) 1981;60(5):527–35. 21. Dulloo AG, Geissler CA, Horton T, Collins A, Miller DS. Normal caffeine consumption: influence on thermogenesis and daily energy expenditure in lean and postobese human volunteers. Am J Clin Nutr 1989;49(1):44–50. 22. Arciero PJ, Gardner AW, Calles-Escandon J, Benowitz NL, Poehlman ET. Effects of caffeine ingestion on NE kinetics, fat oxidation, and energy expenditure in younger and older men. Am J Physiol 1995;268(6 Pt 1):E1192–8. 23. Arciero PJ, Bougopoulos CL, Nindl BC, Benowitz NL. Influence of age on the thermic response to caffeine in women. Metabolism 2000;49(1):101–7. 24. St-Onge MP, Gallagher D. Body composition changes with aging: the cause or the result of alterations in metabolic rate and macronutrient oxidation? Nutrition 2010;26(2):152–5. 25. Astrup A, Toubro S, Cannon S, Hein P, Breum L, Madsen J. Caffeine: a double-blind, placebo-controlled study of its thermogenic, metabolic, and cardiovascular effects in healthy volunteers. Am J Clin Nutr 1990;51(5):759–67.
26. Hollands MA, Arch JR, Cawthorne MA. A simple apparatus for comparative measurements of energy expenditure in human subjects: the thermic effect of caffeine. Am J Clin Nutr 1981;34(10):2291–4. 27. Tagliabue A, Terracina D, Cena H, Turconi G, Lanzola E, Montomoli C. Coffee induced thermogenesis and skin temperature. Int J Obes Relat Metab Disord 1994;18(8):537–41. 28. Koot P, Deurenberg P. Comparison of changes in energy expenditure and body temperatures after caffeine consumption. Ann Nutr Metab 1995;39(3):135–42. 29. Bracco D, Ferrarra JM, Arnaud MJ, Jequier E, Schutz Y. Effects of caffeine on energy metabolism, heart rate, and methylxanthine metabolism in lean and obese women. Am J Physiol Endocrinol Metab 1995;269:E671–8. 30. Douglas BR, Jansen JB, Tham RT, Lamers CB. Coffee stimulation of cholecystokinin release and gallbladder contraction in humans. Am J Clin Nutr 1990;52(3):553–6. 31. Johnston KL, Clifford MN, Morgan LM. Coffee acutely modifies gastrointestinal hormone secretion and glucose tolerance in humans: glycemic effects of chlorogenic acid and caffeine. Am J Clin Nutr 2003;78(4):728–33. 32. Gavrieli A, Yannakoulia M, Fragopoulou E, et al. Caffeinated coffee does not acutely affect energy intake, appetite, or inflammation but prevents serum cortisol concentrations from falling in healthy men. J Nutr 2011;141(4):703–7. 33. Greenberg JA, Geliebter A. Coffee, hunger, and peptide YY. J Am Coll Nutr 2012;31(3):160–6. 34. Lopez-Garcia E, van Dam RM, Rajpathak S, Willett WC, Manson JE, Hu FB. Changes in caffeine intake and long-term weight change in men and women. Am J Clin Nutr 2006;83(3):674–80. 35. Bakuradze T, Boehm N, Janzowski C, et al. Antioxidant-rich coffee reduces DNA damage, elevates glutathione status and contributes to weight control: results from an intervention study. Mol Nutr Food Res 2011;55(5):793–7. 36. Kotyczka C, Boettler U, Lang R, et al. Dark roast coffee is more effective than light roast coffee in reducing body weight, and in restoring red blood cell vitamin E and glutathione concentrations in healthy volunteers. Mol Nutr Food Res 2011;55(10):1582–6. 37. Thom E. The effect of chlorogenic acid enriched coffee on glucose absorption in healthy volunteers and its effect on body mass when used long-term in overweight and obese people. J Int Med Res 2007;35(6):900–8. 38. Salinardi TC, Rubin KH, Black RM, St-Onge MP. Coffee mannooligosaccharides, consumed as part of a free-living, weight-maintaining diet, increase the proportional reduction in body volume in overweight men. J Nutr 2010;140(11):1943–8. 39. St-Onge MP, Salinardi T, Herron-Rubin K, Black RM. A weightloss diet including coffee-derived mannooligosaccharides enhances adipose tissue loss in overweight men but not women. Obesity (Silver Spring) 2012;20(2):343–8. 40. Hughes LA, Arts IC, Ambergen T, et al. Higher dietary flavone, flavonol, and catechin intakes are associated with less of an increase in BMI over time in women: a longitudinal analysis from the Netherlands Cohort Study. Am J Clin Nutr 2008;88(5):1341–52. 41. Rudelle S, Ferruzzi MG, Cristiani I, et al. Effect of a thermogenic beverage on 24-hour energy metabolism in humans. Obesity (Silver Spring) 2007;15(2):349–55.
II. EFFECTS OF COFFEE CONSUMPTION
55
Coffee Consumption and Body Weight Regulation Marie-Pierre St-Onge New York Obesity Nutrition Research Center, St. Luke’s/Roosevelt Hospital, Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, NY, USA
List of Abbreviations
potential benefits for weight management,3 and others have also proposed caffeine and capsaicin,4 and ephedrine and conjugated linoleic acids.5 This chapter will focus on the relationship between coffee consumption and obesity risk as well as coffee’s potential modulating effects on energy balance regulation: energy expenditure (EE) relative to energy intake.
BMI Body mass index CGA Chlorogenic acid EE Energy expenditure GLP-1 Glucagon-like peptide 1 MOS Mannooligosaccharides NMP N-methylpyridinium PYY Peptide tyrosine tyrosine RMR Resting metabolic rate WHR Waist-to-hip ratio
55.1 INTRODUCTION
55.2 EPIDEMIOLOGICAL EVIDENCE LINKING COFFEE CONSUMPTION AND WEIGHT STATUS
It is well known that the prevalence of obesity in the United States and worldwide has increased over the past several decades from the 1980s. In the United States, the combined prevalence of overweight and obesity has reached approximately 69%,1 an overwhelming majority of the population. This has major public health implications since obesity is associated with an increased risk of type 2 diabetes, cardiovascular disease, hypertension, certain cancers, and orthopedic/mobility issues, among others. It has been estimated that a 1% point reduction in the prevalence of obesity by 2020 would equate to reductions in obesity-attributable medical expenditures of $4.0 billion (2008 US$).2 Finding tools such as dietary or pharmaceutical agents that could promote a negative energy balance and assist in the reduction of obesity would be of great public interest. Various dietary factors have been explored with respect to their relationship with weight status and potential effects on weight management. We have proposed that dairy, certain fats, tea, and nuts may have
Early studies in the 1980s examined the relationship between dietary habits and weight status. Cross-sectional studies, mostly conducted in Europe, reported contradictory findings concerning the relationship between coffee consumption and weight status (Table 55.1). For example, data from the Zutphen Study, obtained in 1965 from men aged 45–64 years, showed a negative relationship between coffee consumption and triceps and subscapular skinfold thickness,6 a measure of subcutaneous adipose tissue. However, coffee intake was not related to body mass index (BMI) and, in regression analyses, only energy balance (intake—expenditure), physical activity, and smoking had significant effects on skinfold thicknesses and BMI. Similarly, Lapidus et al.7 found no association between coffee consumption and BMI or waist-to-hip ratio (WHR) in women age 38–60 from Sweden. On the other hand, cross-sectional data from the Tromso Study, obtained in 1979–1980, showed that a high BMI was associated with high coffee intakes in both women and men.8 Participants in that study were
Coffee in Health and Disease Prevention http://dx.doi.org/10.1016/B978-0-12-409517-5.00055-3
499
© 2015 Elsevier Inc. All rights reserved.
500
55. COFFEE AND WEIGHT MANAGEMENT
TABLE 55.1 Summary of Studies Examining the Cross-sectional Association between Coffee Consumption and Weight Status Relationship between Coffee Intake and Weight Status
References
Origin
Population
Kromhout et al.6
The Netherlands
Men Age 40–59 years
Not related to body mass index (BMI) Inverse relationship with triceps and subscapular skinfold thicknesses
BMI – Skinfolds ↓
Lapidus et al.7
Sweden
Men and women Age 38–60 years
Not related to BMI Not related to waist-to-hip ratio (WHR)
BMI – WHR –
Jacobsen and Thelle8
Norway
Men and women Age 20–55 years
Positive relationship with BMI
BMI ↑
Merkus et al.9
The Netherlands
Men and women Age ∼40 years
Women who drank >7 cups/day had lower BMI than those drinking 1–3 cups/day Not related to BMI in men
BMI ↓
Troisi et al.10
US
Men Age 43–85 years
Not related to WHR
WHR –
Kamycheva et al.11
Norway
Men and women Age >24 years
Positive correlation with BMI in both sexes
BMI ↑
Wilsgaard et al.12
Norway
Men and women
Positive correlation with BMI, stronger in women than men
BMI ↑
Wu et al.14
US
Women Age ∼57 years
Inverse association with BMI
BMI ↓
Suadicani et al.15
The Netherlands
Men Age 53–75 years
Inverse association with BMI
BMI ↓
Hino et al.16
Japan
Men and women Age >40 years
Inverse association with waist circumference
Waist ↓
Bouchard et al.17
US
Men and women Age ≥18 years
Not related to BMI in either sex
BMI –
Gunes et al.18
Turkey
Men Age 18–22 years
Increased risk of obesity
BMI ↑
20–55 years of age at the time of data collection. Data from a Dutch study9 later contradicted the results of Jacobsen and Thelle8 and showed that women who drank more than seven cups of coffee a day had lower BMI than those who drank one to three cups a day. In addition, coffee consumption was an independent predictor of BMI in multiple regression analyses in women. This was not observed in men but only 34 men provided data for those analyses. An interesting aspect of this study, distinguishing it from all other studies, is that participants were obese to severely obese, with a mean BMI of approximately 41 kg/m2 for women and 38 kg/ m2 for men. Data from US samples reporting relationships between coffee consumption and weight status began to emerge in the 1990s. However, one of the first reports, from the Normative Aging Study, showed no relationship between caffeine intake and BMI or WHR in men age 43–85 years.10 That study, however, did not report on coffee consumption patterns specifically. There has been much more information reported from 2003 to the present about the relationship between coffee
Direction of Relationship
consumption and weight status. An update from the Tromso Study conducted in 1994–1995 reported a weak but significant positive correlation between BMI and coffee consumption in both women and men.11 However, later breakdown by type of coffee showed that drinking boiled coffee daily was not associated with BMI in cross-sectional analyses, although total coffee consumption was positively related.12 Similarly, in the Monitoring of Trends and Determinants in Cardiovascular Disease study, composed of a Danish population aged 30–60 years, women in the highest quartile for coffee consumption (eight cups or more a day) had significantly greater increase in waist circumference over a 6 year follow-up period than those reporting drinking four to five cups a day.13 However, no linear trend was apparent and the association was no longer significant after adjusting for BMI. In men, coffee consumption was not associated with a change in waist circumference. Data from the Nurses’ Health Study have shown that caffeinated coffee consumption, although being associated with greater energy intakes, was inversely related to BMI.14 Such an inverse association with BMI was
II. EFFECTS OF COFFEE CONSUMPTION
55.3 Impact of Coffee and Caffeine on EE
also seen in the Copenhagen Male Study15 and with waist circumference in a Japanese population.16 However, Bouchard et al.17 recently showed no relationship between coffee intake and BMI in adult men and women using 2003–2004 National Health and Nutrition Examination Survey data, and Gunes et al.18 reported an increased risk of obesity with frequent coffee consumption in first-year university students from Turkey. Epidemiological studies relating coffee beverage consumption and weight are thus quite mixed. Most studies have been conducted in Europe, where coffee consumption is high, and in mostly middle-aged adults.6,7,9,15 In these studies, BMI was either not related6,7 or inversely related with coffee consumption.9,14 US studies also show either no10,17 or inverse relationship14 with BMI. Studies that have found a positive relationship between coffee consumption and BMI have enrolled younger participants.8,11,18 Perhaps there is a critical difference in coffee consumption patterns between younger and older adults that could produce such a difference. However, one must bear in mind the cross-sectional nature of these studies. Causality cannot be inferred from these studies, and reverse causation (increased frequency of a behavior in attempt to achieve weight loss by overweight or obese individuals) is plausible given the theoretical explanations for associations between coffee consumption and obesity. Caffeine is a well-known stimulant, and studies have examined the role of coffee in raising thermogenesis. The next sections will review studies examining the impact of coffee consumption on EE and energy intake.
55.3 IMPACT OF COFFEE AND CAFFEINE ON EE Caffeine is the most widely studied coffee component, particularly for its thermogenic effect. In 1980, Acheson et al.19 reported the results of a trial assessing the impact of caffeine on metabolic rate. Six normal-weight participants took 8 mg of caffeine/kg body weight in capsule form, or placebo. Caffeine increased resting metabolic rate (RMR) by 16% compared to 3% for placebo, although there was considerable individual variation. Fat oxidation was also increased to a greater extent after caffeine compared to placebo. The effects of caffeine on postprandial EE were also compared between lean, obese, and post-obese participants assessed at weight maintenance 3 months after weight loss.20 Obese and lean women had a similar increase in EE after caffeine administration of 4 mg/kg ideal body weight, but post-obese women had one-third the response of the obese women. That study only enrolled women, but another study by Dulloo et al.21 examined the thermic effects of caffeine tablets in normal weight and post-obese men and women. Post-obese participants were previously overweight but had been normal weight for
501
5–6 months prior to testing. Participants underwent four different test days held 3 days apart in which the thermic effect of 600 mg caffeine tablets was compared to water, a 300 kcal liquid meal, and a 300 kcal liquid meal with 600 mg caffeine. All participants had their EE measured for 2.5 h; another group was tested in a 24 h metabolic chamber where caffeine tablets of 100 mg each, or placebo tablets, were taken every 2 h over 12 h. Postprandial EE was increased by 3–4% with caffeine alone in both normalweight and post-obese participants. However, there were differences between groups when caffeine was administered with a meal: EE was increased by 12% compared to the no-caffeine meal in normal-weight participants (not significant) and by 25–30% in the post-obese. Twenty-four hour EE was increased by 5.5% in both normal-weight and post-obese relative to placebo when assessed in the metabolic chamber. This rise in EE occurred solely over the period of caffeine intake; there was no residual or lasting effect over the night-time period. These authors suggested that the sub-normal diet-induced thermogenesis observed in post-obese individuals is ameliorated or partially corrected by caffeine consumption. Just as the thermic effect of caffeine was compared between normal-weight, overweight, and post-obese individuals, studies have compared its effects in young and older individuals.22,23 It is known that EE decreases with increasing age, and this may be a contributing factor to the aging-related changes in body composition.24 Arciero et al.22 compared the thermic effects of 5 mg caffeine/kg fat-free mass to lactose placebo pills in weight-stable young (age 19–26 years) and older (age 65–80 years) men. All participants were within 15% ideal body weight for age based on the 1959 MetLife tables. Caffeine increased EE equally by 10–12% over baseline in both groups. A similar study by the same group was conducted in women of the following age groups: 18–22 and 50–66 years.23 In this case, although caffeine increased RMR in both groups, the response was blunted in older compared to younger women (7.8% vs 15.4% over RMR, respectively). Therefore, in women, but not in men, age may be an important factor to take into consideration when describing caffeine’s thermogenic effects. Previous studies have tested the effects of relatively large doses of caffeine on RMR. The potential dose– response effect of caffeine intake on RMR has been evaluated in young normal-weight men and women.25 Doses of 100, 200, and 400 mg of caffeine were compared to placebo. The thermogenic response to caffeine over placebo was 9.2 kcal/h for the 100 mg dose and 7.2 and 32.4 kcal/h for the 200 and 400 mg doses, respectively. The effect was measured over 3 h, somewhat longer than previous studies which assessed post-intake EE over 1.5–2.5 h but the authors commented that this measurement period length was not sufficient since EE had not returned to baseline by that time.
II. EFFECTS OF COFFEE CONSUMPTION
502
55. COFFEE AND WEIGHT MANAGEMENT
From studies published to date, it can be concluded that caffeine administration raises EE by approximately 5–10% over RMR relative to placebo in both men and women. Caffeine’s thermogenic effects may be enhanced when taken with a meal, but this is possibly affected by weight status.21 Moreover, the role of caffeine in counteracting weight loss or aging-related declines in EE remains to be determined. One study reported a reduced response to caffeine in post-obese women20 while Dulloo et al.21 reported that caffeine could ameliorate the blunted diet-induced thermogenesis in obese individuals. Similarly in aging, sex may play a role in modulating the thermic response to caffeine.22,23 However, as described in detail in other chapters of this book, coffee is more than simply caffeine and there may be other functional ingredients in coffee that could affect EE. Acheson and colleagues19 compared the thermogenic effects of caffeinated (4 mg/kg body weight) or decaffeinated instant coffee in seven normal-weight and six obese participants. In normal-weight participants, both types of coffee significantly increased EE relative to baseline by 12% and 5%, respectively, and increased fat oxidation, whereas in the obese, only caffeinated coffee increased EE by 10% over RMR. Decaffeinated coffee had no effect on EE and substrate oxidation was not changed. Moreover, when given with a meal in normal-weight individuals, the rise in EE was 33% with coffee and 23% with decaffeinated coffee, corresponding to a thermic effect (postprandial EE—RMR) of 9% and 6%, respectively. The authors proposed that the benefit of caffeinated coffee for weight loss could be related to changes in body composition, such as reduction in fat stores, in normalweight individuals whereas in the obese, this could be independent of fat stores mobilization. Using a lower caffeine dose (100 mg from caffeinated coffee), Hollands et al.26 also observed a significantly greater rise in EE with caffeinated relative to decaffeinated coffee over 2 h post-ingestion. In that study, EE was 21.5% higher in the hour immediately after ingestion and 10% higher in the next hour, compared to decaffeinated coffee. The rise in EE with coffee consumption is, for the most part, similar to that observed in studies of caffeine tablets or pills. For example, in studies by Tagliabue et al.26 and Koot and Deurenberg,28 coffee providing 4 mg/kg body weight caffeine27 or 200 mg caffeine27 raised EE by approximately 7–8% over RMR values. Both studies enrolled normal-weight participants, but Koot and Deurenberg28 included women as well as men. As for studies of caffeine, postprandial EE was measured for 2–3 h, which was insufficient to capture the entire postprandial EE curve as values were still above baseline after 3 h.28 This was somewhat addressed with a chamber study in which 10 normal-weight and 10 obese women, age 20–35 years, participated.29 During each test day, the women consumed five cups of coffee: one at
each meal and additionally at 1030 and 1630 h. The coffee contained 3.63% caffeine, providing a dose of 4 mg/ kg body weight per cup of coffee. In normal-weight women, actual body weight was used to calculate the coffee dose, whereas in obese women, normalized body weight, calculated from a BMI of 22.5 kg/m2, was used. This BMI value corresponded to the average BMI of the normal-weight women. The control test day provided decaffeinated instant coffee. Twenty-four hour EE was 174 kcal/day higher in the caffeinated coffee condition relative to decaffeinated coffee in normal-weight women and 98 kcal/day higher in obese women. These values corresponded to a rise in EE of 7.6% and 4.9% relative to decaffeinated coffee in normal-weight and obese women, respectively. Basal metabolic rate measured the following morning was not affected by type of coffee consumed the previous day, although respiratory quotient was reduced after the caffeinated coffee test day, indicating an increase in fat oxidation.
55.4 EFFECTS OF COFFEE CONSUMPTION ON APPETITE REGULATION Contrary to the effects of coffee on EE, there have been much fewer studies examining the effects of coffee consumption on appetite and food intake regulation. In a small study of six participants, Douglas et al.30 reported that caffeinated and decaffeinated coffee increased cholecystokinin release similarly, suggesting a potential satiating effect of coffee. Johnston et al.31 also found that caffeinated and decaffeinated coffee could affect gastrointestinal hormones involved in glucose metabolism and appetite regulation such as glucose-dependent insulinotropic polypeptide and glucagon-like peptide 1 (GLP-1), and they suggested that constituents in coffee produced a hormonal profile consistent with delayed glucose absorption. However, a recent study by Gavrieli et al.32 has yielded somewhat contradictory results. Gavrieli et al.32 conducted a three-way, randomized, crossover study testing the acute effects of caffeinated and decaffeinated coffee, relative to water, on appetite ratings and hormones, as well as food intake, in healthy young men. On each test day, participants consumed a standardized meal with instant coffee (either caffeinated or decaffeinated) or water. Caffeinated coffee provided 3 mg/kg body weight of caffeine, approximately 240 mg caffeine for an 80-kg person. Blood samples were taken over 3 h and an ad libitum buffet lunch was served thereafter. Participants could eat as much as they liked over a 30 min period. There was no treatment effect on satiety ratings, although there was a lower desire to eat at 180 min after caffeinated coffee consumption relative to decaffeinated coffee and water as well as a lower incremental area under the curve for desire to eat. However,
II. EFFECTS OF COFFEE CONSUMPTION
55.5 Effects of Coffee Consumption in Weight Loss
appetite-regulating hormones, ghrelin, GLP-1, and peptide tyrosine tyrosine (PYY), were not different between test days and neither was food intake at lunch. The authors concluded that coffee consumption, in amounts generally consumed, does not affect appetite regulation and food intake in the short term in healthy men. These conclusions contrast those of Greenberg and Geliebter33 who also examined the acute effects of coffee consumption on hunger, satiety, and hormonal controls of appetite. Their study was also conducted in young, healthy men and consisted of four separate laboratory visits: caffeine dissolved in water, caffeinated coffee, decaffeinated coffee, and water. The caffeine and caffeinated coffee beverages both provided 6 mg of caffeine/kg body weight, roughly equivalent to the amount of caffeine in two cups of regular coffee. The caffeine concentration was 0.73 mg/ml. Appetite and hunger ratings, along with blood samples, were obtained over 3 h. Decaffeinated coffee resulted in lower hunger levels than water and caffeine dissolved in water. The area under the curve for hunger ratings was also lower. Caffeinated coffee resulted in a similar pattern as decaffeinated coffee but differences failed to reach statistical significance for comparisons with water and caffeine. Satiety ratings mirrored those of hunger but were not statistically different between beverages. PYY, an anorectic hormone, was significantly higher after decaffeinated coffee consumption than water and caffeine over the initial 90 min postingestion. When levels were examined over the entire 3 h measurement period, there was a trend for PYY to be higher after decaffeinated coffee intake compared to caffeine dissolved in water. There were no beverage effects on ghrelin, a hormone involved in food intake initiation, and leptin. These authors concluded that one or more biological agents in coffee, that is not caffeine, could act to acutely reduce hunger and increase PYY. Chlorogenic acid (CGA) and caffeic acid were proposed. However, food intake was not assessed in this study and it cannot be assumed that decaffeinated coffee would have reduced subsequent food intake. Certainly these studies31,33 provide grounds for further research as they were both conducted in young, healthy, normal-weight men and had relatively small sample sizes. Whether similar results would be observed in women, overweight and obese participants, or older adults remains to be determined. Furthermore, standardized coffee brewing methods should be developed to improve cross-study comparisons. In the study by Greenberg and Geliebter,33 coffee was prepared using a drip-filter coffee maker using 40 g of ground caffeinated coffee and 57 g of ground decaffeinated coffee with eight cups of water. In the study by Gavrieli et al.,32 participants consumed 200 ml of instant coffee. It is possible that differences in brewing methods and preparation
503
of instant formulations could alter the concentration of functional ingredients that could affect appetite-regulating hormones and food intake.
55.5 EFFECTS OF COFFEE CONSUMPTION IN WEIGHT LOSS Since data suggest that coffee consumption could play a role in energy balance regulation via increased EE and increased satiety/reduced appetite, it would seem that changes in coffee consumption patterns could then modulate changes in body weight. Longitudinal data from the Nurses’ Health Study and the Health Professionals Follow-Up Study in fact showed that participants who increased their intake of caffeine between 1986 and 1998 had lower mean weight gain than those who decreased their intake.34 Furthermore, an increase in coffee consumption was inversely associated with weight gain in women but less so in men. The authors also observed a modest inverse association between decaffeinated coffee consumption and weight change, suggesting that the effects of coffee on changes in body weight over time could be due to compounds other than caffeine. In fact, intervention studies examining the potential impact of coffee consumption for weight management have focused on potential functional constituents not related to caffeine (Table 55.2). Bakuradze et al.35 tested the effects of a special roasted and blended Arabica coffee rich in green and roasted bean constituents, especially N-methylpyridinium (NMP) and CGA on body weight in young men, age 20–44 years and BMI 19–32 kg/m2. All participants started on a 4 week washout period during which they consumed 750 ml of water daily. This was followed by an active phase of 4 weeks during which participants drank 750 ml/day of freshly brewed filtered coffee providing 72 mg/l NMP, 580 mg/l caffeoylquinic acid, and 720 mg/l caffeine, and a second washout period with water. Coffee consumption led to significant reductions in body weight and body fat of 0.62 and 0.68 kg, respectively. The losses in body weight and fat were more distinct in those with BMI <25 compared to those with BMI >25 kg/m2 at baseline. During the second washout period, there was a slight regain in weight and fat mass. These changes in weight were likely the result of a significant reduction in energy intakes with coffee consumption relative to the first washout period. During the second washout, energy intakes rose but did not reach the levels measured in the first washout period. This led the authors to propose that there may be a prolonged or lasting effect of coffee treatment that extends beyond the active consumption period. The effects of CGA in coffee for weight management were specifically studied by Thom37 in overweight and obese men and women. Participants were randomly
II. EFFECTS OF COFFEE CONSUMPTION
504
55. COFFEE AND WEIGHT MANAGEMENT
TABLE 55.2 Impact of Coffee Active Ingredients for Weight Management Study Length
Effect on Body Weight and Body Composition
Healthy men Age 20–44 years BMI 19–32 kg/m2
4 weeks
Significant reduction in body weight and body fat compared to water
Light roast: high NMP and low CGA Dark roast: low NMP and high CGA
Healthy men and women Age 19–44 years BMI 19–29.5 kg/m2
4 weeks
Light roast: slight but significant increase in body weight Dark roast: significant reduction in body weight
Thom37
CGA
Healthy men and women BMI 27.5–32 kg/m2
12 weeks
Significant reductions in body weight and body fat in active group compared to placebo (decaffeinated coffee)
Salinardi et al.38
MOS
Healthy men and women Age 19–65 years BMI 27–33 kg/m2
12 weeks
Significant reductions in subcutaneous and visceral adipose tissue in men but not women, relative to placebo
St-Onge et al.39
MOS
Healthy men and women Age 19–65 years BMI 27–33 kg/m2
12 weeks
Significant reductions in body weight, total, subcutaneous and visceral adipose tissue in men but not women, relative to placebo
References
Active Compound
Population
Bakuradze et al.35
CGA and NMP
Kotyczka et al.36
Abbreviations: BMI, body mass index; CGA, chlorogenic acid; MOS, mannooligosaccharides; NMP, N-methylpyridinium.
assigned to consume either five cups a day of decaffeinated instant coffee or instant coffee supplemented with 200 mg/cup of green coffee extract rich in CGA (45–50% CGA by weight) for 12 weeks. Participants in the active treatment group lost 5.4 kg compared to 1.7 kg for those in the control group. Change in percentage body fat was also significantly different between groups and those in the active group had a reduction in body fat from 27.2% to 23.6%; those in the control group went from 26.9% to 26.2% body fat (not statistically significant). This study suggests that CGA could be a functional agent for weight management. However, these results have been challenged by another study comparing the effects of light and dark roast coffees for weight management.36 In this crossover study, participants consumed a low polyphenol diet for 12 weeks. The first 12 weeks consisted of a washout period. This was followed by 4 weeks of consuming a light roast coffee, a mid-study 2 week washout, and another 4 weeks of consuming a dark roast coffee. Both coffees were of the Arabica Brazil variety, but the light roast had a high CGA and low NMP content whereas the dark roast was rich in NMP and low in CGA. Coffee was prepared using a common drip-filter machine with 30 g of coffee roast powder and 600 ml of water. Energy intakes were lower with dark roast coffee consumption relative to washout and light roast coffee. Accordingly, body weight was reduced by 0.6 kg with dark roast coffee consumption. The change in body weight was mostly driven by a significant reduction in body weight in overweight participants; participants who were normal weight at baseline did not experience any change in body weight. Light roast coffee consumption resulted in a slight but statistically significant increase in body
weight of 0.2 kg. Future studies are therefore necessary to clarify whether NMP or CGA or yet other functional coffee constituents are chiefly responsible for the effects of coffee on body weight. In addition, studies examining the mechanism by which these coffee constituents could affect energy balance should be conducted. Another ingredient that could be responsible for the weight loss effects of coffee could be coffee mannooligosaccharides (MOS). In a series of studies, it was shown that MOS, extracted from coffee, could improve body composition in overweight men in particular.38,39 In both studies, men and women, age 19–65 years and BMI 27–33 kg/m2, supplemented their diets with either a MOS-enriched coffee beverage or a placebo beverage, twice daily, for a period of 12 weeks. The active beverages provided 2 g of MOS each for a total of 4 g/day (two sachets to be reconstituted with water and consumed with meals). When consumed as part of their free-living, weight maintenance diet, MOS consumption reduced total body volume, assessed by magnetic resonance imaging, relative to placebo in men but not women.38 In men, there was a significant beverage by time interaction on subcutaneous and visceral adipose tissue such that MOS tended to reduce these fat depots relative to placebo. Men in the MOS group had a 1.7% reduction in body weight compared to 0.3% for the placebo group, although neither value was statistically significant. Similar sex differences were observed when the study was conducted in the context of a weight loss program.39 In that study, participants supplemented their diets with either active MOS or placebo beverages and attended weekly weight loss counseling sessions to reduce their energy intakes by 500 kcal/day. Men who consumed
II. EFFECTS OF COFFEE CONSUMPTION
505
References
ingredients exerted a greater thermic effect than simply the sum of each part. Finally, obesity continues to be a major public health concern and recommendations remain to improve lifestyle behaviors such as diet and activity to achieve a healthy weight. Coffee is well poised to act as a functional beverage to improve energy balance regulation through its known effects on EE (caffeine) but also potentially by improving appetite regulation (Figure 55.1). Studies are needed to expand our knowledge of the functional ingredients in coffee that could be of benefit for body weight regulation.
FIGURE 55.1 Coffee consumption could lead to improvements in body weight regulation via increased energy expenditure (EE) and/or enhanced satiety. Caffeine is known to raise EE. Other components of coffee, such as chlorogenic acid, caffeic acid, and N-methylpyridinium may lead to enhanced satiety.
MOS as part of their weight loss diet lost almost twice as much weight as those consuming the placebo beverage (5.6 vs 2.9 kg, respectively). Women lost an equivalent amount of weight regardless of the beverage supplement. Similarly, men, but not women, had significantly greater loss of total, subcutaneous, and visceral adipose tissue with MOS consumption relative to placebo. These studies show that MOS may be an effective coffee-derived weight loss agent in men but not in women. Future studies should therefore explore sex differences when assessing the role of potential functional ingredients for weight management. As case in point, opposite sex differences were observed in the Netherlands Cohort Study on diet and cancer where women in the highest quintile of flavonoid and catechin intakes had a lower increase in BMI over 14 years of follow-up (0.40 and 0.31 kg/m2, respectively) compared to women in the lowest quintile (0.95 and 0.77 kg/m2); no effect was observed in men.40 There are therefore data to suggest that coffee consumption and specific components of coffee could play a beneficial role in weight management. However, data are conflicted on which coffee compound exerts the effect. Differences in brewing methods, types of coffee, and study design and population could all contribute to the variability in study results. Future studies should be done to establish which components of coffee are important for weight management and to determine whether synergistic effects between caffeine, coffee polyphenols, or oligosaccharides, or other functional ingredients, exist. Rudelle et al.41 showed that combining green tea catechins, caffeine, and calcium leads to greater EE than a triple placebo beverage. However, the authors did not test each “functional” ingredient separately and it is unknown if the combination of all three
55.6 SUMMARY POINTS • C ross-sectional studies of coffee consumption and weight status show mixed results. • There may be differences in thermic effect of coffee consumption by age and weight status. • Studies assessing the role of coffee components suggest that compounds in coffee, such as NMP and CGA, could affect appetite regulation. • Weight loss studies with coffee administration suggest that coffee consumption could assist with weight loss. • Some studies suggest that certain coffee compounds have preferential benefits for weight management in men, specifically. • Future studies should identify coffee compounds that could impact energy balance: EE > Energy intake. • Future studies should assess the synergistic effect of functional ingredients from coffee and other plant materials for energy balance regulation and weight management.
References 1. Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA 2012;307(5):491–7. 2. Finkelstein EA, Khavjou MA, Thompson H, et al. Obesity and severe obesity forecasts through 2030. Am J Prev Med 2012;42:563–70. 3. St-Onge MP. Dietary fats, teas, dairy, and nuts: potential functional foods for weight control? Am J Clin Nutr 2005;81(1):7–15. 4. Hursel R, Westerterp-Plantenga MS. Thermogenic ingredients and body weight regulation. Int J Obes (Lond) 2010;34(4):659–69. 5. Kovacs EM, Mela DJ. Metabolically active functional food ingredients for weight control. Obes Rev 2006;7(1):59–78. 6. Kromhout D, Saris WH, Horst CH. Energy intake, energy expenditure, and smoking in relation to body fatness: the Zutphen Study. Am J Clin Nutr 1988;47(4):668–74. 7. Lapidus L, Bengtsson C, Hallstrom T, Bjorntorp P. Obesity, adipose tissue distribution and health in women–results from a population study in Gothenburg, Sweden. Appetite 1989;13(1):25–35. 8. Jacobsen BK, Thelle DS. The Tromso Heart Study: the relationship between food habits and the body mass index. J Chronic Dis 1987;40(8):795–800.
II. EFFECTS OF COFFEE CONSUMPTION
506
55. COFFEE AND WEIGHT MANAGEMENT
9. Merkus MP, Mathus-Vliegen LM, Broekhoff C, Heijnen AM. Extreme obesity: sociodemographic, familial and behavioural correlates in The Netherlands. J Epidemiol Community Health 1995;49(1):22–7. 10. Troisi RJ, Heinold JW, Vokonas PS, Weiss ST. Cigarette smoking, dietary intake, and physical activity: effects on body fat distribution– the Normative Aging Study. Am J Clin Nutr 1991;53(5):1104–11. 11. Kamycheva E, Joakimsen RM, Jorde R. Intakes of calcium and vitamin d predict body mass index in the population of Northern Norway. J Nutr 2003;133(1):102–6. 12. Wilsgaard T, Jacobsen BK, Arnesen E. Determining lifestyle correlates of body mass index using multilevel analyses: the Tromso Study, 1979–2001. Am J Epidemiol 2005;162(12):1179–88. 13. Halkjaer J, Sorensen TIA, Tjonneland A, Togo P, Holst C, Heitmann BL. Food and drinking patterns as predictors of 6-year BMIadjusted changes in waist circumference. Brit J Nutr 2004;92:735–48. 14. Wu T, Willett WC, Hankinson SE, Giovannucci E. Caffeinated coffee, decaffeinated coffee, and caffeine in relation to plasma C-peptide levels, a marker of insulin secretion, in U.S. women. Diabetes Care 2005;28(6):1390–6. 15. Suadicani P, OleHein H, Gyntelberg F. Lifestyle, social class, and obesity-the Copenhagen Male Study. Eur J Cardiovasc Prev Rehabil 2005;12(3):236–42. 16. Hino A, Adachi H, Enomoto M, et al. Habitual coffee but not green tea consumption is inversely associated with metabolic syndrome: an epidemiological study in a general Japanese population. Diabetes Res Clin Pract 2007;76(3):383–9. 17. Bouchard DR, Ross R, Janssen I. Coffee, tea and their additives: association with BMI and waist circumference. Obes Facts 2010;3(6):345–52. 18. Gunes FE, Bekiroglu N, Imeryuz N, Agirbasli M. Relation between eating habits and a high body mass index among freshman students: a cross-sectional study. J Am Coll Nutr 2012;31(3):167–74. 19. Acheson KJ, Zahorska-Markiewicz B, Pittet P, Anantharaman K, Jequier E. Caffeine and coffee: their influence on metabolic rate and substrate utilization in normal weight and obese individuals. Am J Clin Nutr 1980;33(5):989–97. 20. Jung RT, Shetty PS, James WP, Barrand MA, Callingham BA. Caffeine: its effect on catecholamines and metabolism in lean and obese humans. Clin Sci (Lond) 1981;60(5):527–35. 21. Dulloo AG, Geissler CA, Horton T, Collins A, Miller DS. Normal caffeine consumption: influence on thermogenesis and daily energy expenditure in lean and postobese human volunteers. Am J Clin Nutr 1989;49(1):44–50. 22. Arciero PJ, Gardner AW, Calles-Escandon J, Benowitz NL, Poehlman ET. Effects of caffeine ingestion on NE kinetics, fat oxidation, and energy expenditure in younger and older men. Am J Physiol 1995;268(6 Pt 1):E1192–8. 23. Arciero PJ, Bougopoulos CL, Nindl BC, Benowitz NL. Influence of age on the thermic response to caffeine in women. Metabolism 2000;49(1):101–7. 24. St-Onge MP, Gallagher D. Body composition changes with aging: the cause or the result of alterations in metabolic rate and macronutrient oxidation? Nutrition 2010;26(2):152–5. 25. Astrup A, Toubro S, Cannon S, Hein P, Breum L, Madsen J. Caffeine: a double-blind, placebo-controlled study of its thermogenic, metabolic, and cardiovascular effects in healthy volunteers. Am J Clin Nutr 1990;51(5):759–67.
26. Hollands MA, Arch JR, Cawthorne MA. A simple apparatus for comparative measurements of energy expenditure in human subjects: the thermic effect of caffeine. Am J Clin Nutr 1981;34(10):2291–4. 27. Tagliabue A, Terracina D, Cena H, Turconi G, Lanzola E, Montomoli C. Coffee induced thermogenesis and skin temperature. Int J Obes Relat Metab Disord 1994;18(8):537–41. 28. Koot P, Deurenberg P. Comparison of changes in energy expenditure and body temperatures after caffeine consumption. Ann Nutr Metab 1995;39(3):135–42. 29. Bracco D, Ferrarra JM, Arnaud MJ, Jequier E, Schutz Y. Effects of caffeine on energy metabolism, heart rate, and methylxanthine metabolism in lean and obese women. Am J Physiol Endocrinol Metab 1995;269:E671–8. 30. Douglas BR, Jansen JB, Tham RT, Lamers CB. Coffee stimulation of cholecystokinin release and gallbladder contraction in humans. Am J Clin Nutr 1990;52(3):553–6. 31. Johnston KL, Clifford MN, Morgan LM. Coffee acutely modifies gastrointestinal hormone secretion and glucose tolerance in humans: glycemic effects of chlorogenic acid and caffeine. Am J Clin Nutr 2003;78(4):728–33. 32. Gavrieli A, Yannakoulia M, Fragopoulou E, et al. Caffeinated coffee does not acutely affect energy intake, appetite, or inflammation but prevents serum cortisol concentrations from falling in healthy men. J Nutr 2011;141(4):703–7. 33. Greenberg JA, Geliebter A. Coffee, hunger, and peptide YY. J Am Coll Nutr 2012;31(3):160–6. 34. Lopez-Garcia E, van Dam RM, Rajpathak S, Willett WC, Manson JE, Hu FB. Changes in caffeine intake and long-term weight change in men and women. Am J Clin Nutr 2006;83(3):674–80. 35. Bakuradze T, Boehm N, Janzowski C, et al. Antioxidant-rich coffee reduces DNA damage, elevates glutathione status and contributes to weight control: results from an intervention study. Mol Nutr Food Res 2011;55(5):793–7. 36. Kotyczka C, Boettler U, Lang R, et al. Dark roast coffee is more effective than light roast coffee in reducing body weight, and in restoring red blood cell vitamin E and glutathione concentrations in healthy volunteers. Mol Nutr Food Res 2011;55(10):1582–6. 37. Thom E. The effect of chlorogenic acid enriched coffee on glucose absorption in healthy volunteers and its effect on body mass when used long-term in overweight and obese people. J Int Med Res 2007;35(6):900–8. 38. Salinardi TC, Rubin KH, Black RM, St-Onge MP. Coffee mannooligosaccharides, consumed as part of a free-living, weight-maintaining diet, increase the proportional reduction in body volume in overweight men. J Nutr 2010;140(11):1943–8. 39. St-Onge MP, Salinardi T, Herron-Rubin K, Black RM. A weightloss diet including coffee-derived mannooligosaccharides enhances adipose tissue loss in overweight men but not women. Obesity (Silver Spring) 2012;20(2):343–8. 40. Hughes LA, Arts IC, Ambergen T, et al. Higher dietary flavone, flavonol, and catechin intakes are associated with less of an increase in BMI over time in women: a longitudinal analysis from the Netherlands Cohort Study. Am J Clin Nutr 2008;88(5):1341–52. 41. Rudelle S, Ferruzzi MG, Cristiani I, et al. Effect of a thermogenic beverage on 24-hour energy metabolism in humans. Obesity (Silver Spring) 2007;15(2):349–55.
II. EFFECTS OF COFFEE CONSUMPTION