Coffee breakthrough ▸

There is little evidence based nutritional advice to provide to patients with chronic liver disease. Ruhl and Everhart analysed data from the Third National Health and Nutrition Examination Survey (NHANES III) to investigate whether coffee intake is protective in subjects at risk for liver injury. Of 23 258 patients aged ⩾20 years, 16 573 attended an examination, including 5944 subjects considered high risk (any of the following: >2 alcohol drinks/day, positive hepatitis B or C serology, transferring saturation >50%, haemoglobin A₁C >6.5%, diabetes, body mass index ⩾26.9 kg/m², and waist to hip ratio ⩾0.94). Elevated serum alanine aminotransferase levels (ALT >43 U/l) were found in 4.1% of the whole group and 8.7% of the high risk group. The risk of elevated ALT declined with increasing coffee and caffeine intake in both the high risk group (adjusted for other risk factors) and in the whole NHANES III sample. Subjects who drank more than 2 cups/day were less likely to have raised ALT compared …