Watching the snow and sipping coffee....

 I'm sitting here watching the snow gently fall to the ground drinking my mushroom coffee and it occurs to me that I have found one of the most pleasant ways to support my immune system. I am all about having fun and finding pleasurable ways to stay healthy.

My delicious coffee is filled with healing medicinal mushrooms and it comes from Alphay.
I would like to share some of the benefits of my morning ritual with you.
Lingzhi (Ganoderma lucidum) has been used for medicinal purposes for at least 2000 years and is one of the most revered herbs in Asia. The Lingzhi mushroom was known to the ancients as "the mushroom of immortality" and for good reason. They have the reputation of promoting health and longevity, boosting the immune system, and reducing the risk of life-shortening conditions such as cardiovascular disease and cancer. Science has finally validated this traditional wisdom.

Scientific research has intensified and focused on analyzing the hundreds of unique bio-active compounds found in the medicinal Lingzhi mushroom. Lingzhi has a significant ability to stimulate brain neurons, search and destroy cancer cells and can prevent the development of new fat cells in obese individuals. Researchers using laboratory mice have detailed lifespan extensions of 9% to more than 20% - the equivalent of seven to nearly sixteen years in human terms. Now really, who doesn't want to live longer and healthier by just enjoying their morning coffee?

And if this is not enough to motivate you, how about Lingzhi's numerous compounds showing therapeutic effects on asthma, allergies, autoimmune disease, Alzheimers, Parkinson's disease, diabetes, pancreatic issues, liver disease and more.

Given Lingzhi's complex composition of bioactive compounds, I have no doubt that we will continue to discover many more health benefits. Mushrooms are also adaptogenic (helps the body's ability to deal with stress); thus relieves fatigue and builds up stamina.

And that is just one of the mushrooms in my coffee.

Here's more...

MAITAKE

• Supports immune system
• Lowers blood pressure and blood lipids
• Promotes alkalinity and good health

SHIITAKE

• Supports immunity
• Supports blood pressure
• Promotes healthy tissue and cells
• Promotes circulation

CORDYCEPS

• Restores energy, vitality, immunity
• Rich in antioxidants
• Improves kidney and lung function
• Improves balance

And then, add all the benefits of Organic chemical free Arabica Coffee that is also rich in antioxidants.  We covered the health benefits of coffee in some of our previous blogs.

Man, talk about packing a punch while admiring the snow, sipping a warm beverage.

Contact my office for more details on this magical coffee and black tea or go to our website www.getalphay.com/naturalhhaven and joins as a preferred customer.

Gratitude and thankfulness...

Gratitude and being thankful is more in the forefront at this time of year. Being grateful and experiencing the feelings of gratitude has far reaching health benefits that we do not even consider.

The feeling of gratitude when truly felt, permeates the skin and travels through our entire body, lifting our spirits and our energy. This feel good energy raises the vibrations in every cell. It literally makes every cell feel good and starts eliminating the bad stuff in the cells....The catch is that one has to start feeling this gratitude deeper and more frequently to keep the bad energy out of the cells and the body.

Feeling grateful for things we take for granted, like our breathing, our heartbeat, our legs that carry us through life, is something we can start by doing everyday. I have found that once I start with that, I find so many more things to feel grateful about and soon enough I feel really good.
I think of it as one of the tools in my arsenal for health and wellbeing.

I'm not sure if feeling thankful and grateful are the same thing, they are definitely in the same family. As long as feeling thankful is not riddled by guilt or brought on by guilt...as in, I should feel thankful for all I have and the good things in my life, because so many others have less. The guilt riddled thankfulness is a whole different, not so feel good energy.

I come from another country where there is no thanksgiving and where my family was never close, so I really do appreciate this holiday and look forward to getting together with the people I care about. What I do not care for that much is turkey, I am however thankful for the opportunity to be creative and come up with my own tradition. I am also grateful that all those participating in my first thanksgiving meal are willing to eat whatever I attempt to serve.
Now, I'm on a roll....I'm grateful that I have tons of homeopathic for achy tummies and adverse food reactions.
Don't get me wrong, I do know how to cook but just in case.

In just this simple day and all it entails I can find a million things to be grateful for.
Electricity, a fully functioning kitchen, food on the table, yummy gluten free deserts, lovely vibrant green vegetables, modern conveniences, not to mention the friends and family and all the wonderful, healthy relationships in the room. The sound of laughter and communication.

As the end of this year draws near, I am so grateful for it. I have learned and grown so much this year. I have found new experiences and discovered so many nuances within myself and I am truly grateful for all the experiences and people that participated in my discoveries and challenges. For all those that helped me grow and were mirrors, reflecting aspects that I could choose to change and embrace.
I told you I was on a roll.

I guess I have made my point. Once one starts on the road to gratitude it can be hard to stop finding things to be grateful for.

So, at this wondrous time of thanksgiving and gratitude, I am grateful you are reading this and that it just may have lifted your spirits a little. Wherever you are and whatever you are doing, I am grateful you are here and that we all get to witness another sunrise, another sunset, another snowfall and the warmth of our family and friends.

Pre-diabetes and it's link to increased cancer risks.

Prediabetes Associated With Increase in Cancer Risk

Prediabetes — even at lower levels of impaired fasting glucose (IFG) as defined by the American Diabetes Association (ADA) — is associated with a significant increase in cancer risk that is independent of the effects of obesity, according to the results of a large new meta-analysis.

Yuli Huang, MD, PhD, from First People's Hospital of Shunde, Foshan, China, and colleagues found that prediabetes was associated with a 15% increased risk for cancer overall, based on data derived from 16 prospective cohort studies, with differing risks depending on the type of cancer. The risk was particularly increased for liver cancer and stomach or colorectal cancer.

"Epidemiological studies have shown that diabetes increases the incidence of cancer and mortality from it, but we thought that maybe not only diabetes but prediabetes may be associated with an elevated cancer risk," Dr. Huang told Medscape Medical News.

"And considering the high prevalence of prediabetes as well as the robust and significant association between prediabetes and cancer we demonstrated in our study, a successful lifestyle intervention could have a major public-health impact on cancer prevention," he added.

"This information is important to health professionals and those engaged in the prevention of cancer," Dr. Huang and colleagues stress.

The study was published online September 8, 2014 in Diabetologia.

Screen for Prediabetes Using ADA Criteria for Cancer Prevention

A total of 891,426 participants from the 16 studies, 4 of which were from Asia, 11  from the United States and Europe, and 1 from Africa, were included in the meta-analysis. Prediabetes included individuals with impaired glucose tolerance (IGT), IFG, or a combination of the 2.

Over 10 years ago, the ADA lowered its definition of prediabetes to that of a fasting plasma glucose concentration ranging from 5.6 to 6.9 mmol/L, but other organizations have maintained their definition at a higher level, as a fasting plasma glucose concentration between 6.1 and 6.9 mmol/L.

The risks of site-specific cancer among individuals with prediabetes was highest for liver cancer (relative risk [RR], 2.01), followed by colorectal and stomach cancer (RR, 1.55 for both), endometrial cancer (RR, 1.60), and breast as well as pancreatic cancer (RR, 1.19 for both).

But prediabetes was not associated with cancer of the bronchus, lung, prostate, ovary, kidney, or bladder.

The risks were increased even when a lower fasting plasma glucose value of 5.6 to 6.9 mmol/L was used, as well as in participants with IGT — "an interesting finding," investigators note, "and one that reaffirms the importance of screening for prediabetes using the ADA criteria with a view to cancer prevention."

As the authors point out, obesity — in itself a key risk factor for diabetes — has also been linked to cancer.

To rule out obesity as a potential confounder, the authors did a sensitivity analysis that included only studies that adjusted for body mass index (BMI).

After controlling for BMI, "we found that...the presence of prediabetes remained associated with an increased risk of cancer by 22%," they state. "So we believe that the increased risk of cancer in individuals with prediabetes is independent of obesity."

"Our study indicates that, on the basis of a snapshot blood glucose measurement, prediabetes is associated with an increased risk of cancer," they state.

Speculating on the reasons for the association between prediabetes and increased cancer risk, Dr. Huang and colleagues suggest that chronic hyperglycemia and resulting states, including chronic oxidative stress and the accumulation of advanced glycated end products, may serve as carcinogens.

Alternatively, increased insulin resistance characteristic of prediabetes increases insulin secretion, and increased insulin levels may promote the growth of cancer cells.

Certain genetic mutations may also predispose individuals with prediabetes to an elevated cancer risk, they suggest.

The study was supported by a medical scientific research grant from the Health Ministry of Guangdong, China, the Scientific Research Fund of Foshan, and the Scientific Research Fund of Shunde, both from Guangdong, China. The authors have reported no relevant financial relationships.

Diabetologia. Published online September 8, 2014

Glucose Intolerance and artificial sweeteners, the link!

Medscape Medical News

Artificial Sweeteners Linked to Glucose Intolerance 

Beth Skwarecki September 17, 2014

The artificial sweeteners aspartame, sucralose, and saccharin cause blood glucose abnormalities in mice and some humans, a team reports in an article published online September 17, 2014 in Nature. The changes in glucose tolerance seem to be driven by the microbiome and can be reproduced in germ-free mice by giving them gut microbes from a person who has consumed the sweeteners.

"We found that artificial sweeteners may drive...an exaggerated elevation in blood glucose levels, the very same condition that we often aim to prevent by consuming them," Eran Elinav, MD, PhD, from the Department of Immunology at the Weizmann Institute of Science, Rehovot, Israel, said at a press briefing.

The investigators began with experiments in mice, giving each animal 1 of 3 artificial sweeteners in its water: aspartame, sucralose, or saccharin. Because commercial preparations of these sweeteners also contain some glucose, researchers used glucose, fructose, or plain water for the control mice to ensure it was the artificial sweetener and not any added sugar that was responsible for the effect. "To our surprise, we found they all induced a blood sugar disturbance even compared to mice who drank sugary water," Dr. Elinav said. This effect occurred on both a normal diet of rat chow (P < .001) and a high-fat diet in which 60% of calories came from fat (P < .03).

Because these artificial sweeteners are not digested or absorbed by the human body, the investigators hypothesized that gut microbes were responsible for the results. They administered antibiotics to the mice: 1 group received ciprofloxacin and metronidazole, a broad-spectrum approach focusing on gram-negative bacteria, and another group received vancomycin, aimed against gram-positive bacteria. Both treatments, when given for 4 weeks, eliminated the differences in glucose tolerance between sweetener-fed mice and controls.

The symptoms could also be triggered by a microbial transplant. Microbes from mice who had been drinking saccharin were transplanted via feces into germ-free mice and caused the recipients to show impaired glucose tolerance, whereas microbes from mice who had been drinking glucose did not (P < .03). Further, to show that the microbes were responsible, and not some other component of the feces, the researchers cultured bacteria from mice who were not eating sweeteners and added saccharin to the growth media. These bacteria were then transplanted into germ-free mice, resulting in impaired glucose tolerance compared with mice that received a control culture (P < .002).

Bacterial Profiles

The researchers performed both 16S sequencing, to identify the bacteria that were over- or underrepresented in mice with impaired glucose tolerance, and metagenomic sequencing, to identify what those bacteria are doing. In the microbial ecosystems from mice that ate artificial sweeteners, the pathways that were overrepresented included several that had previously been linked to diabetes and glucose intolerance. Glycan degradation, for example, occurs when microbes digest certain chains of sugars and create short-chain fatty acids that the body can use for energy, providing extra calories. The investigators confirmed that the sweetener-fed mice had increased amounts of this end product, the short chain fatty acids, in their guts.

In Humans

Artificial sweeteners caused changes in glucose tolerance in humans, as well, but only for some participants the investigators consider to be "responders." A group of 7 healthy volunteers who do not normally consume artificial sweeteners were given saccharin for 6 days at a dose that met the US Food and Drug Administration's maximum acceptable daily intake of saccharin for humans. No participants saw improvements in glucose tolerance, but 4 showed impairment.

Even before the experiment began, the microbial ecosystems from the 4 responders were different from those of the 3 nonresponders, suggesting their microbiome was somehow more susceptible. These results, said Dr. Elinav, "point to the personalized nature of our food responses and the need to understand this personalized effect in order to fight the metabolic syndrome, which as we all know, is one of the most common and serious epidemics in all history."

Bacteria from responders, sampled at the end of the trial, were able to induce glucose intolerance when introduced into germ-free mice (P < .02), whereas baseline samples from the responders (taken before they had consumed the artificial sweeteners) did not have this effect, nor did bacteria from the nonresponders.

Trend Seen With Long-Term Consumption

A further experiment involving 381 nondiabetic participants showed that long-term consumption of artificial sweeteners was associated with measures of central obesity and glucose intolerance, even when corrected for body mass index.

The authors caution that the results from the human experiments are not yet enough to make recommendations about whether or not people should consume sweeteners. They also point out that the mechanism for the sweeteners' effect is unknown: it may be causing less desirable bacteria to thrive, or it may be poisoning certain normal bacteria, allowing detrimental species to take their place.

In an accompanying editorial, Taylor Feehley, BA, and Cathryn Nagler, PhD, both from the Department of Pathology at the University of Chicago, note that "Whether the bacterial populations or metabolic pathways altered by the consumption of [artificial sweeteners] are similar to those described in people with or developing diabetes remains to be seen."

The authors have disclosed no relevant financial relationships.

Nature. Published online September 17, 2014.

Daily consumption of diet soda linked to metabolic syndrome...

Medscape Medical News

Daily Consumption of Diet Soda Linked to Metabolic Syndrome, Type 2 Diabetes

Laurie Barclay, MD

February 11, 2009

February 11, 2009 — Drinking diet soda at least daily is associated with significantly greater risks for select incident components of the metabolic syndrome (MetSyn) and type 2 diabetes,according to the results of an observational study reported in the January 16, 2009 Online First issue of Diabetes Care.

"Two longitudinal cohort studies have shown positive associations between diet soda consumption and incident MetSyn independent of baseline measures of adiposity," write Jennifer A. Nettleton, PhD, from the University of Texas Health Sciences Center in Houston, and colleagues. "Replication of previously observed diet soda-MetSyn associations in a distinct cohort would bolster their credibility and provide further insight into the nature of the relationship. Previous studies have not addressed associations between diet soda and individual MetSyn components or risk of type 2 diabetes nor have they fully addressed potential longitudinal mediators of these relationships, i.e., changes in adiposity status."

The goal of this study was to evaluate associations between diet soda consumption and the risk for incident MetSyn, its components, and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA).

Initial evaluation was performed from 2000 to 2002, at which time baseline food frequency questionnaires measured diet soda consumption. Three follow-up evaluations were performed from 2002 to 2003, 2004 to 2005, and 2005 to 2007. Incident type 2 diabetes was defined as fasting glucose levels of more than 126 mg/dL, self-reported type 2 diabetes, or use of diabetes medication. National Cholesterol Education Program Adult Treatment Panel 3 criteria were used to define MetSyn and its components. After adjustment for demographic, lifestyle, and dietary confounders, hazard ratios (HRs) were estimated for type 2 diabetes, MetSyn, and MetSyn components.

Compared with participants who did not drink diet soda, those who drank diet soda at least daily had a 36% greater relative risk for incident MetSyn (HR, 1.36; 95% confidence interval [CI], 1.11 - 1.66) and a 67% greater relative risk for incident type 2 diabetes (HR, 1.67; 95% CI, 1.27 - 2.20).

Of the individual components of MetSyn, only high waist circumference (men: ≥ 102 cm; women: ≥ 88 cm) and high fasting glucose levels (≥ 100 mg/dL) were prospectively associated with consumption of diet soda. Associations between diet soda intake and type 2 diabetes were independent of baseline measures of adiposity or changes in these measures. In contrast, associations between diet soda and MetSyn were not independent of these factors.

"Although these observational data cannot establish causality, consumption of diet soda at least daily was associated with significantly greater risks of select incident MetSyn components and type 2 diabetes," the study authors write.

Limitations of this study include observational design, precluding determination of causality; possible confounding by other dietary and lifestyle/behavioral factors; and difficulties in estimating intake of diet soda or artificial sweetener.

"These results corroborate findings from the ARIC [Atherosclerosis Risk in Communities] and Framingham studies and show stronger adverse associations exist between diet soda and type 2 diabetes," the study authors conclude. "Diet soda consumption, either independently or in conjunction with other dietary and lifestyle behaviors, may lead to weight gain, impaired glucose control, and eventual diabetes."

The National Heart, Lung, and Blood Institute supported this study. The study authors have disclosed no relevant financial relationships.

Diabetes Care. Published online January 16, 2009.

Heartwire

Daily quaffing of diet soda heightens vascular-event risk in cohort study

Allison Gandey

February 10, 2011

Los Angeles, CA - Artificially sweetened "diet" soda may not be the healthier alternative many had hoped: an observational study suggests the popular drinks may increase the risk of stroke, MI, and vascular death ^[1].

Dr Hannah Gardener

"People who had diet soda every day experienced a 61% higher risk of vascular events than those who reported drinking no soda," lead investigator Dr Hannah Gardener(University of Miami, FL) told reporters attending a news conference here at the International Stroke Conference 2011 sponsored by the American Stroke Associati on (ASA).

Previous studies have suggested a link between diet-soda consumption and the risk of metabolic syndrome and diabetes. But the current analysis from the Northern Manhattan Study is the first study to show such an association between diet soft drink consumption and hard vascular-disease end points, according to ASA national spokesperson Dr Larry Goldstein (Duke University Stroke Center, Durham, NC). 

"This is an observational study and not a prospective randomized trial," he pointed out. "This is an association and not yet a proven causal relationship."

Still, Goldstein said, "I think that it's always good to do things in moderation. People should look at this information and consider it in the context of their other risk factors."

More than 2500 people from the multiethnic cohort study were asked to report how much and what kind of soda they drank. Over an average follow-up of 9.3 years, there were 559 vascular events, including both ischemic and hemorrhagic strokes. 

The researchers also observed a marginally significant increased risk of vascular events among those who consumed diet soda daily and regular soda once or more a month (adjusted relative risk 1.74; 95% CI 0.96-3.16).

After researchers controlled for metabolic syndrome, peripheral vascular disease, and cardiac disease history, daily consumption of diet soda posed a 1.48 (95% CI 1.03-2.12) relative risk of vascular events compared with no soda intake.

The potential mechanisms for any association between diet soda and vascular events remain unknown, according to the investigators, who acknowledge that additional studies are needed.

References

1. Gardener H, Rundek T, Wright C, et al. Soda Consumption and risk of vascular events in the Northern Manhattan Study. International Stroke Conference 2011; February 9, 2011; Los Angeles, CA. Presentation Th P55.

Calories in, calories out...the biggest lie ever sold.

 The predominant misconception is that all fat people are just lazy overeaters.

Our body chemistry and biology has been manipulated from a young age due to the consumption of  fake over processed food. The food industry has spend millions of dollars on making our food more and more addictive and less and less nutritious. They target their advertising and packaging to innocent and impressionable children. Their food chemists work tirelessly to ensure that we remain clueless and addicted. We are an obese starving nation.

To run off a happy meal would mean running for 4 miles everyday for 7 days. Exercising off the sugary, fake, fast food most people consume would take a very, very long time and current research indicates that it would not solve the problem anyway. Add to that the fact that these fake, sugary foods only cause a spike in energy briefly and then we crash. We feel terrible after that quick high and are therefore less likely to have the desire to exercise.

There are also many skinny fat people running around due to the over consumption of fatty, fried, over processed foods. Skinny fat people can contain almost the same amount of visceral fat as obese people. It is important to note that visceral fat (the fat surrounding our organs) is the most dangerous form when it comes to chronic disease risk factors. Unfortunately this fat is also the least visible to the naked eye as it does not show on the outside but coats our organs on the inside impairing their function.

Visceral fat, also known as organ fat or intra-abdominal fat, is located inside the peritoneal cavity, packed in between internal organs and torso, as opposed to subcutaneous fat‚ which is found underneath the skin, and intramuscular fat‚ which is found interspersed in skeletal muscle. Visceral fat is composed of several adipose depots including mesenteric, epididymal white adipose tissue (EWAT) and perirenal fat.

In the late 1980s and early 1990s insightful and powerful imaging techniques were discovered that would further help advance our understanding of the health risks associated with body fat accumulation. Techniques such as computed tomography and magnetic resonance imaging made it possible to categorize mass of adipose tissue located at the abdominal level into intra-abdominal fat and subcutaneous fat.    (wikipedia)

Visceral fat has been linked to metabolic disturbances and increased risk for cardiovascular disease and type 2 diabetes. In women, it is also associated with breast cancer and the need for gallbladder surgery.

So enough of that, let's talk about calories. It is not the calories we consume as much as it is where the calories come from. Eating 160 calories in a handful of almonds as apposed to a 160 calories from a low fat, high sugar snack will not have the same effect on and in your body. The almonds have more fiber and a lower GI (Glycemic Index)than the sugary snack. This means the rise in blood sugar is slower and the liver does not need to send an alarming signal to the pancreas to bring down the blood sugar by releasing insulin (a fat storing hormone). This results in more fat being stored from the calories of empty foods (High Fructose corn syrup (HFCS), low fat, processed foods) and simple carbohydrates, than high fiber nutritious foods. 

It does not take a rocket scientist to see that foods high in fiber and nutrients, like vegetables and fruits are a better use of your calories than foods that fill you briefly but ultimately leave you feeling empty and addicted.

When eating fiber rich, nutritious, healthy, real food, we feel better, look healthier and do not over eat. We feel satiated and there is not a crash in energy after eating. The calories we consume should be energizing not exhausting and as all calories are not created equal, chose wisely.

Here's a thought....if you are what you eat, then don't be cheap, easy or fake!

(I also highly recommend the documentary FED UP...discusses this topic in more detail)

Are you an addict?

As it turns out, for most of us the answer is yes. Most Americans and westernized cultures consume tons of sugar on a daily basis.
Sugar has been researched to be more addictive than cocaine and the same centers in the brain that light up from cocaine, light up for sugar.
In actual fact when cocaine addicted mice were given the choice between cocaine and sugar water, most chose the sugar water. Sugar is actually 8 times more addictive than cocaine, so you tell me, are you an addict?

Everything processed and in a box, bottle or can has added sugar.  The major shift from fat to low fat foods happened around the 70's eliciting additional sugar being added to "the new low fat foods" to make them palatable and thus kicking of our addiction years and the consistent rise in obesity.

Like with any other addictive drug, sugar and processed foods cause a temporary high followed by a crash, leading to a vicious cycle of abuse as we tend to eat more for another high and so on. Food addicts, as research shows, are no different from alcoholics or cocaine addicts. Their lives become increasingly out of control, as does their health.

Here are some of the sugar facts and diabesity:

• Sugar consumption: 152 pounds/year up from 40 lbs in 1980
• Flour consumption: 146 lbs/yr (GI 100) FYI: flour causes an even higher blood sugar spike than consuming straight sugar.
• Added sugars:    - 600,000 products and 80% with added sugar, HFCS (high fructose corn syrup) the biggest source of calories in diet.
• Children sugar consumption facts: 34 tsp a day 

                          - Lustig, R, Nature, Feb 2012, volume 482, 27-29

20 ounces of soda = 15 teaspoons of sugar
A yoplait light yogurt = 1 can of pepsi

Teenage pre-diabetes and diabetes increased from 9% to 23% from 2000 to 2008

Sugar Sweetened Beverages:

• 60% increased risk of obesity in kids with 1 can of soda a day
• 80% increased risk of type 2 DM (Diabetes Mellitus) in women with 1 soda a day
• Sugar sweetened beverages increases risk of Cardio Vascular Disease (CVD), the number one killer in the US

Drinking Soda:

• spikes blood sugar
• raises triglycerides
• lowers "good cholesterol"
• raises blood pressure
• lowers testosterone
• makes men lose body hair
• makes women infertile
• makes women bald
• makes women grow facial hair

This is just soda, not to mention other sweetened beverages. Fruit juice is basically just sugar water and has a very high Glycemic Index (GI)and thus is not the healthier choice.
We tend to forget that all simple carbohydrates act the same way when it enters the mouth...it converts to sugar. When you eat cookies, flour, grains, pasta, white potato etc. these all convert to sugar and should thus be added to your sugar consumption of the day.
HFCS is added to everything...bacon, sausages, processed meats, boxed foods, gum, sweets....the list is endless.

If you eat fast, easy and cheap food, you are an addict and at risk for premature death. This is not a threat, it's a fact. We have had a flood of an extra 700 calories per person per day since 1970 mostly in the form of HFCS from corn and trans fats. This is a major problem and it is time for all of us to pay attention, read food labels, become informed and educated about our food and health.
It has become more and more important to get off sugar and start eating real food. Our health and the lives of future generations depend on this. For the first time ever the next generation is not expected to outlive us.

The food industry has hijacked our taste buds, our brain chemistry, our biology, but it is still up to us to get of the sugar train, to break free of cravings and life-destroying food addictions and to take our health into our own hands. We have no choice but to make healthier food choices and detox from sugar. Only then can we move forward into a healthier, happier future.

Read more about this in greater detail...The blood sugar solution (10 day detox diet) by Dr. Mark Hyman
and more about the food industry and their ploy to keep you addicted: Michael Moss...Salt, sugar, fat

The ALS Ice Bucket challenge....a worthy cause or just fun for all.

The question remains whether these social media crazes actually help or not...
The ALS Ice Bucket challenge did take the social media market by storm and we saw thousand of people covered in ice and water, but did it educate us to the challenges of ALS and the signs and symptoms or even the possible nutritional implications leading to such a disease?
The answer is no, many people took the challenge because they were nominated. It did raise an enormous amount of money that really just goes into the pockets of the people running the non- profits, as most of it does, in these situations.
Rarely does the money go to further education and awareness or to help those that need it the most, the patients and their families.


Follow this link to learn more about the ALS debacle and the implications of pledging money to non profit organizations.


http://www.bewellbuzz.com/experts/dr-beck-on-als-ice-bucket-challenge/

Coffee is good for you...PART 3....Mushrooms in your coffee or tea....WHAT???

Now coffee can be even better. Please contact me via...naturalhealthhaven@gmail.com for more info and your free sample of the coffee and tea discussed here...

There is a new mushroom coffee in town and I am absolutely in love with it. Not only is it organic but it is the highest quality mushrooms and a company filled with heart and integrity and has only your health and best interest in mind.
ALPHAY has ensured that every individual that drinks coffee or tea can now get their Immune boosting mushrooms in their daily favorite drink.

Alphay is a Chinese company that has done most of the research on the health benefits of mushrooms. They use only the highest quality and best most nutritional parts of the mushroom..the cap, and a small part of the stem. The chairman, Hiu Chen, is a modest man full of Integrity and a world renowned expert on mycology. He wanted to ensure that every human on this planet can enjoy the benefits of healing mushrooms and financial freedom.

I would like to briefly explain the benefits of the mushrooms...

EDIBLE AND MEDICINAL MUSHROOMS

Health Benefits of Medicinal Mushrooms and Fungi
For thousands of years mushrooms have been valued in different cultures for their medicinal and psychedelic properties. They were used by shamans and medicine men and found a way to highly organized medical systems such as the Traditional Chinese Medicine. The ancient Chinese believed that mushrooms were longevity tonics and used them to strengthen the body and prevent disease. Modern research shows that mushrooms, especially the species known in China and Japan, contain active compounds which are able to enhance the immune system and fight tumors in the body.

            About Mushrooms

• More than 14,000 different types of mushrooms have been identified around the world
  
• 3,000 are edible
  
• About 700 different mushrooms have medicinal properties
  
  Edible Mushrooms
  

• Source of fiber, protein, B vitamins, vitamin D, and minerals, especially copper, iron, magnesium, phosphorus, potassium, and selenium
  
• Rich in polysaccharides, especially the immune system enhancing beta glucans
  
• Consist mostly of water - between 80 and 90 per cent, and are used in many cuisines for their
  nutritional value, texture, and aroma.
  
  History of Mushrooms
  

• Ever since Alexander Fleming isolated penicillin from the fungus Penicillium chrysogenum 1924, laboratories all over the world are researching medicinal properties of mushrooms and fungi
  
• In 1976 the first statin drug was isolated from Penicillium citrinum
  
• Ongoing research suggests mushrooms are effective in the treatment of certain cancers as well as
  in the treatment of a weak immune system and auto-immune diseases
  
• Some of the species are known to regulate blood sugar
  
  Ganoderma lucidum or Lingzhi (Reish)
  

• Used in Asia for thousands of years
  
• A powerful immune system modulator and helps to heal allergies and autoimmune diseases
  
• Shows a very strong anti-tumor activity and is successfully used in alternative and complementary
  cancer therapies
  
• Promotes cardiovascular health and regulates blood cholesterol and blood sugar levels
  
• Reduces inflammation in the body and has very strong anti-viral, anti-bacterial, and anti-fungal
  properties
  
• Protects the liver and the urinary tract
  
• It is adaptogenic (helps in the body’s ability to deal with stress); thus it relieves fatigue and builds
  up stamina
  
• Reishi (Ganoderma Lucidum) mushrooms have been used as a cure for disease for over 2,000
  years
  

References
According to The Medicinal Benefits of Mushrooms by William H. Lee, R.Ph., Ph.D., Reishi increases vitality, improves coronary arteries, inhibits platelet aggregation, normalizes blood pressure, relieves stress and asthma and prevents and treats certain types of cancer and other degenerative diseases. The beta-glucans found in Reishi support the body's immune system in fighting cancer cells and countering the effects of aging.
According to Jones in Reishi: Ancient Herb for Modern Times, Reishi is even more effective in fighting cancer when supplemented by vitamin C. Reishi also works as an antihistamine by inhibiting agents that cause cold symptoms, hay fever, asthma, and allergies and promotes respiratory health.

            Mycotherapy

• There are many more species of mushrooms with medicinal properties
  
• Ongoing research is discovering new compounds that can be used to enhance the immune
  system, regulate blood sugar and treat diabetes, prevent cancer, inhibit the growth and destroy
  existing tumors
  
• Mycotherapy has a long tradition in Asia and it has a promising future as a branch of the
  alternative medicine in the West as well 
  
  
  
  

Coffee is good for you...PART 2

And here is more reasons to relax and enjoy your coffee today....

Liver International

Impact of Coffee on Liver Diseases

A Systematic Review

Sammy Saab, Divya Mallam, Gerald A. Cox II, Myron J. Tong

Liver International. 2014;34(4):495-504. 

Abstract and Introduction

Abstract

Coffee is one of the most commonly consumed beverages in the world. Its health benefits including improved overall survival have been demonstrated in a variety of disease states. To examine the association of coffee consumption with liver disease, a systematic review of studies on the effects of coffee on liver associated laboratory tests, viral hepatitis, nonalcoholic fatty liver disease (NAFLD), cirrhosis and hepatocellular carcinoma (HCC) was performed. Coffee consumption was associated with improved serum gamma glutamyltransferase, aspartate aminotransferase and alanine aminotransferase values in a dose dependent manner in individuals at risk for liver disease. In chronic liver disease patients who consume coffee, a decreased risk of progression to cirrhosis, a lowered mortality rate in cirrhosis patients, and a lowered rate of HCC development were observed. In chronic hepatitis C patients, coffee was associated with improved virologic responses to antiviral therapy. Moreover, coffee consumption was inversely related to the severity of steatohepatitis in patients with non-alcoholic fatty liver disease. Therefore, in patients with chronic liver disease, daily coffee consumption should be encouraged.

Introduction

Coffee is a commonly consumed beverage worldwide. In the United States, over 50% of Americans consume coffee on a daily basis.^[1] The commonly cited reasons for coffee consumption are its stimulatory effects, taste and aroma.^[2,3] Recent data suggests that coffee consumption may have health benefits in a number of medical ailments. Long-term coffee drinkers may be at a decrease risk for type II diabetes, symptomatic gallstone disease, Parkinson's disease, heart disease and stroke.^[2,4–7] Moreover, coffee consumption is associated with decreased all-cause mortality.^[8,9] In a recent analysis of the NIH-AARP Diet and Health Study data, a dose-dependent inverse association between coffee consumption and total mortality was described.^[9] Men and women who drank 6 or more cups daily had a 10% and 15% decreased risk of death, respectively.

Chronic liver disease is major health burden in the United States, ranking 12th amongst the leading causes of death and accounting for over 30 000 deaths in 2009 alone.^[10] Chronic liver disease affects approximately 15% of the US population and is a major economic strain through direct healthcare expenditures as well by indirect costs related to lost income due to premature death or disability.^[11,12]Treatments for liver disease is often viewed with suspicion, and many patients often seek alternative therapies for their liver disorders.^[13–15]

Given the potential health benefits in a variety of medical conditions and its impact on survival, we explored the impact of coffee consumption on patients with liver ailments. A systematic, comprehensive review on the interaction between coffee consumption and liver associated tests, viral hepatitis, nonalcoholic Fatty Liver Disease (NAFLD), cirrhosis and hepatocellular carcinoma (HCC) was performed and is presented herein.

Methods

We searched MEDLINE and PubMed for all studies published on coffee and liver diseases from 1986 to September 2012. We used a combination of the keywords 'coffee', 'caffeine', 'liver disease', 'cirrhosis', 'fibrosis', 'hepatitis B', 'hepatitis C', 'non-alcoholic fatty liver disease', 'fatty liver', 'hepatocellular carcinoma', 'liver cancer', 'alcoholic liver disease', and 'alcoholic hepatitis'. We analyzed all studies published in scientific journals including observational studies and case-controlled studies. Bibliographies of identified studies were searched for relevant articles.

Liver-associated Laboratory Tests

A number of studies noted a beneficial effect of increased coffee consumption on liver-associated laboratory tests. This benefit was reported in a variety of populations at risk for liver disease, including those with excessive alcohol intake, obesity, smokers, and those with chronic viral hepatitis. These studies demonstrated that increased coffee consumption was associated with aspartate-aminotransferase (AST), alanine-aminotransferase (ALT), and Gamma-glutamyltransferase (GGT) levels in a dose-dependent manner.

The first studies to demonstrate a relationship between coffee intake and liver-associated test values were two Norwegian reports which revealed an inverse association between coffee consumption and serum GGT values.^[16,17] The results were further illustrated in a 7 year longitudinal study of a subset of the Tromsø Study by Nilssen et al..^[18] Their findings have since been confirmed in multiple population studies in Japan,^[19–22] Italy,^[24,25] and Finland^[26] ( Table 1 ). Another study from Norway also found coffee consumption inversely related to serum GGT.^[26] The results of a randomized study, however, showed that cafetière increased liver enzymes.^[28]

In one of the largest studies including over 12 000 health examinees in Japan, Tanaka et al. described that increased coffee consumption had a strong and independent association with decreased GGT activity in male alcohol drinkers (P < 0.0001).^[19] However, consumption of coffee was only weakly associated with lowered GGT levels among women. Using the data from the Self-Defense Forces Fukuo Hospital, Honjo et al. further confirmed earlier observations which demonstrated that coffee consumption was associated with lowered serum GGT levels.^[20–22]

Population studies in Italy, Japan, and the United States also have reported an inverse relation of coffee consumption with serum aminotransferase levels. In a cohort study of over 2000 Italian patients aged 65 or older, Casiglia et al. observed that ALT values were 10.3% lower in those who drank three or more cups of coffee daily (P = 0.0160).^[24] In a Japanese study of 12,020 middle-aged and elderly male participants, a strong inverse association between coffee consumption and elevated ALT values also were noted.^[29]

The results of the third National Health and Nutrition Examination Survey (NHANES) found that coffee consumption and caffeine were associated with a decreased risk of elevated ALT levels amongst persons at high risk for liver injury in the United States, such as persons who were overweight, had viral hepatitis, impaired glucose metabolism, iron overload or excessive alcohol intake.^[30] In an unadjusted analysis, a lowered ALT activity was associated with an increasing consumption of coffee (P = 0.001) and caffeine (P= 0.001).

Chronic Liver Disease and Cirrhosis

Chronic Liver Disease. Coffee intake has also been associated with a decreased incidence of chronic liver disease ( Table 2 ). The histologic benefit of coffee was first demonstrated by Modi et al. who examined the association between daily caffeine intake and severity of hepatic fibrosis amongst persons with chronic liver diseases.^[31] The authors described that daily caffeine intake above two cups of coffee was associated with lower rates of hepatic fibrosis (OR 0.33, 95% CI .14–0.8, P = 0.015). The observed protective relationship persisted after controlling for age, sex, race, liver disease, BMI, alcohol intake, and hepatitis C viral infection (HCV) infection. Of note was the fact that caffeine intake from non-coffee sources was not associated with decreased hepatic fibrosis. In a large cross sectional US study, intake of regular ground coffee and caffeine intake was associated with a decreased risk of chronic liver disease.^[32] Persons included in the report were those with hepatitis B, hepatitis C, iron overload, impaired glucose metabolism, and excessive alcohol intake (>2 alcoholic beverages per day). In the study, participants were followed for a median of 19 years, and those who drank greater than two cups of coffee daily had less than half the rate of chronic liver disease than those who drank less than one cup daily.

Cirrhosis and Mortality. In addition to the decreased risk of chronic liver disease, coffee consumption has been associated with a decreased risk of cirrhosis ( Table 2 ). Two Italian hospital-based case-control studies found that coffee may delay the development of cirrhosis. The first study by Corrao et al. found a dose-dependent inverse relationship between caffeine intake and risk of cirrhosis.^[33] The odds ratios of cirrhosis development decreased from 1.0 (lifetime non-coffee drinkers) to 0.47 (95% CI 0.2–1.10), 0.23 (0.10–0.53), 0.21 (0.06–0.74), and 0.16 (0.05–0.50) in those ingesting 1, 2, 3, and 4 or more cups of coffee daily respectively. A longer term follow up in the same cohort confirmed earlier observations.^[35]The second study by Gallus et al. found an inverse relationship between coffee consumption and cirrhosis [odds ratio (OR) 0.54 for coffee drinkers compared to non-coffee drinkers; OR 0.29 for 3 or more cups daily]. An inverse relationship with duration of coffee consumption and cirrhosis also was observed (OR 0.45 for 40 years or more of coffee consumption).^[34]

The results of a large 10-year cohort follow-up study in the US revealed that coffee may be protective against both hospitalization and death from alcoholic cirrhosis.^[36] Subsequently, Klatsky et al. reported that coffee consumption may lead to a decreased mortality risk from nonalcoholic and alcoholic cirrhosis; the relative risk per cup of coffee daily was 0.77 (95% CI 0.67, 0.89).^[37] Further expanding upon their original cohort study from 1992, Klatsky et al. presented a 22-year follow-up report in which they provided further evidence that increased coffee intake led to a decreased risk of alcoholic cirrhosis; with greater coffee intake associated with a lower relative risk of cirrhosis [1–3 cups, 0.6 (95% CI, 0.4–0.8; P < 0.001; 4 or more cups, 0.2 (95% CI, 0.1–0.4, P < 0.001)].^[38] There was no relationship between tea intake and the development of alcohol-related cirrhosis.

The inverse association between coffee intake and mortality from cirrhosis also was supported by a Norwegian cohort study by Tverdal et al.^[39] In the study, mortality rates were lower for persons drinking 3 or more cups of coffee daily compared to those drinking 2 or less cups. After adjusting for age, sex, alcohol use and other cardiovascular risk factors, similar benefits of coffee were also observed among patients with alcoholic cirrhosis. The relative risk of cirrhosis associated with an increase of two cups of coffee was 0.6 (95% CI, 0.5–0.8).^[39]

Chronic Hepatitis B and Hepatitis C

There are limited published data on the association between caffeine consumption and chronic viral hepatitis ( Table 3 ). Only one report assessed the association in chronic hepatitis B, and found no benefit from coffee consumption on severity of hepatitis B as measured by transient elastography.^[40] Since most participants who consumed alcohol were also mostly coffee drinkers, the benefit of caffeine intake may have been confounded by the deleterious effects of alcohol consumption. Furthermore, the use of transient elastography, while proven to be accurate in diagnosing histological advanced fibrosis in chronic Hepatitis B viral infection (HBV)-infected patients, may be of limited utility in patients with elevated serum transaminase levels.^[41]

Several studies have examined the impact of coffee consumption on fibrosis severity in patients with chronic hepatitis C ( Table 3 ). Modi et al. demonstrated the beneficial impact of coffee consumption on fibrosis severity in patients with hepatitis C (OR 0.19, 95% CI 0.05–0.66, P = 0.009).^[31] The patients in this study completed detailed caffeine questionnaires on three occasions over a six-month period of time. Freedman et al. also found that regular coffee intake was associated with decreased rates of liver disease progression amongst chronic hepatitis C patients enrolled in the HALT-C Trial.^[42] The rates of liver disease progression declined with increasing coffee intake (P = 0.0011). Compared to non-coffee drinkers, the relative risks for reaching pre-defined endpoints indicating disease progression were 1.11 for less than 1 cup daily (CI 0.76–1.61), 0.7 for 1 to <3 0.27="" 0.47="" 0.48="" 3="" and="" cups="" daily="" em="" for="" more="" nbsp="" or="">P

 = 0.0003). Utilizing data from the HALT-C trial, Freedman et al. also explored the relationship between coffee consumption and response to antiviral therapy.^[43] The authors demonstrated that greater than 3 cups of coffee daily was an independent predictor of improved virologic response to retreatment with peg-interferon plus ribavirin in patients with hepatitis C who failed initial treatment. Consumption of 3 or more cups daily was associated with a higher tolerance for the full dose of peg-IFN (60.6% compared to 50.4% of noncoffee drinkers).

A prospective cohort study done in France by Costentin et al. evaluated the effect of coffee consumption on treatment-naïve chronic hepatitis C patients.^[44] In the report, multivariate analysis showed that daily caffeine consumption equivalent to 3 cups of coffee was associated with a decreased necroinflammatory activity [OR 0.32, Confidence Interval (CI) 0.12–0.85]. Of note, caffeine intake in this study was not limited to coffee alone, but included caffeinated coffee, tea, and caffeine-containing sodas. Carrieri et al. evaluated whether coffee intake improved the tolerability of peginterferon alfa-2a and ribavirin in HIV-HCV co-infected patients.^[45] The authors found that those patients drinking 3 or more cups of coffee daily were less likely to report adverse effects compared to coffee nondrinkers (OR 0.19, CI .05–0.78, P = 0.02). These findings remained significant after adjustments for gender, age, cirrhosis, and history of opioid use.

Nonalcoholic Fatty Liver Disease

Several studies have assessed the association between coffee consumption and NAFLD ( Table 4 ). In an analysis of four continuous cycles (2001–2008) of the Nat-ional Health and Nutrition Examination Survey (NHANES), a dietary intake questionnaire collected by the National Center for Health Statistics of the Centers for Disease Control and Prevention revealed that caffeine intake was independently associated with a decreased risk of development of NAFLD (OR 0.931, CI 0.900–0.964).^[46]

Two case–control studies have suggested the beneficial effect of coffee on the risk of NAFLD as defined by abdominal imaging.^[47,48] Catalano et al. found that a decrease in fatty liver severity in coffee drinkers as compared to non-coffee drinkers (β = −2.585, P = 0.011, CI −0.133 to 0.018). Also, coffee drinking was inversely associated with obesity and insulin resistance.^[47] A case control study performed in Mexico showed similar results with a dose-dependent reduction in coffee intake with increasing severity of hepatic steatosis.^[48] In addition, a cross-sectional study demonstrated that coffee consumption was associated with a significant decrease in the risk of hepatic fibrosis among patients with nonalcoholic steatohepatitis (NASH).^[49] In the study, an inverse relationship was found between coffee consumption and hepatic fibrosis (r = −9.215, P = 0.035). There was a significant difference between coffee consumption in patients with bland steatosis/not-NASH (P = 0.005), NASH Stage 0–1, and between NASH stage 0–1 and NASH stage 2–4 (P = 0.005).

The results of a recent European study provided further evidence regarding the protective effects of coffee in morbidly obese persons with NAFLD.^[50] Regular coffee consumption was associated with decreased liver fibrosis in morbidly obese women with NAFLD undergoing bariatric surgery (OR 0.752, CI 0.578–0.98, P = 0.035).^[50] However, regular filtered coffee, but not espresso coffee, was found to be associated with the decreased likelihood of fibrosis.

Hepatocellular Carcinoma

Decreased Risk of Hepatocellular Carcinoma. The relationship between coffee and the development of HCC was initially unsettled ( Table 5 ). Two early case-control studies found no association between coffee consumption and the risk of HCC.^[51,52] However, the results of a follow up study combining both data sets indicated that coffee was indeed protective against HCC.^[50,52,53] Additional more recent reports indicate a potential benefit of coffee on the incidence of hepatocellular carcinoma. Several case-control studies also demonstrated that coffee drinking was associated with decreasing HCC risk with a dose-effect relationship. Gelatti et al. found that compared to non-coffee drinkers, the odds ratio for HCC development was 0.4 (95% CI 0.2–0.8) for those consuming 3–4 cups daily regardless of the underlying liver disease cause.^[54] Tanaka et al. reported on coffee use either during the last 1–2 years or 10 years using three different control groups (hospital, community, and patients with chronic liver disease).^[55]Coffee use during the last 1–2 years was associated with decreased risk of HCC against all three control groups. Coffee use over the last 10 years was associated with decreased risk of HCC in reference to community controls or patients with chronic liver disease. The results of another case-control study by Montella et al. also found a dose-effect relationship between coffee intake and risk for HCC for persons who consumed 4 or more cups daily (OR = 0.4, 95% CI 0.2–1.1); the inverse relationship was maintained amongst both HBV and HCV-infected individuals.^[56]

Several studies support the hypothesis that coffee consumption leads to decreased risk of liver cancer.^[57]In a Japanese pooled analysis of two prospective cohort studies, a significant inverse relationship was found between coffee consumption and risk of liver cancer in patients with liver disease.^[58] Compared to nondrinkers, those with coffee intake of 1 or more cups daily had a relative risk 0.58 (CI 0.36–0.96).^[58]Another Japanese prospective cohort of 18,815 subjects with 110 incident cases of liver cancer found increased coffee consumption to be associated with reduced liver cancer risk (hazard ratio for <1 0.025="" 0.49="" 0.54="" 0.67="" 1="" 3="" cups="" daily="" more="" or="" p="" style="font-size: 0.85em; line-height: 0;" sup="" trend="">[59,60]

 A similar risk tendency was observed in patients with HBV and/or HCV infections.

The results of a large population-based cohort study by Hu et al. performed in Finland supported the finding that coffee drinking led to a decreased liver cancer risk in a dose-response manner.^[61]Multivariable-adjusted hazards ratios of liver cancer in participants who drank 0–1, 2–3, 4–5, 6–7, and 8 or more cups of coffee daily were 1.00, 0.66, 0.44, 0.38, and 0.32 (P = 0.003), respectively. The operational definition of 'liver cancer' in the study included a diagnosis of HCC, cholangiocarcinoma, adenocarcinoma, and primary liver cancer of unspecified etiology.

A Japanese cohort study also showed that those who drank coffee on a daily or almost daily basis had a lower HCC risk than those who almost never drank coffee with a dose-response effect [HR for 3–4 cups daily: 0.48 (95% CI 0.28–0.83)].^[60] The risk of HCC in subjects who never or occasionally drank coffee was 547.2 cases per 100 000 over 10 years, but was 214.6 cases per 100 000 in those who drank coffee regularly. Findings from a Singapore prospective cohort study found that compared with coffee non-drinkers, persons who drank 3 or more cups of coffee daily had a 44% risk reduction of HCC (HR 0.56, 95% CI 0.31–1.00, P = 0.049), after adjustment for confounding variables and tea intake.^[62] A Hong Kong case-control study found that moderate coffee intake led to a reduction in HCC risk by almost half in daily coffee drinkers with chronic HBV infection compared to non-drinkers (OR 0.54, 95% CI 0.3–0.97), with a dose-response effect (P = 0.02).^[63]

The results of several studies analyzing data from the Japan Collaborative Cohort Study indicated the beneficial effects of coffee consumption on the incidence of HCC deaths.^[64–66] All three studies found a statistically significant decrease in risk of death from HCC in persons consuming one or more cups of coffee daily. Kurozawa et al. found that in persons aged 60–79 with a history of liver disease, drinking one or more cups of coffee daily had a significant inverse relationship with mortality due to HCC (men: HR 0.44, CI 0.19–0.90, women: 0.30, 0.10–0.89). No significant relationship was found for men and women aged 40–59.^[64] In another case-control study by Kurozawa et al., coffee was again found to be protective against HCC mortality.^[65] Hazard ratio for one or more cups per day compared to non-coffee drinkers was 0.5 (95% CI 0.31–0.79). The HCC mortality Hazard Ratio was significantly reduced in men who drank one or more cups of coffee daily, but not in women. The authors did not control for HBV or HCV infection.

In a nested case-control study, the multivariate-adjusted OR(with 95% CI) for HCC mortality in daily coffee drinkers (1 or more cups daily) in contrast to nondrinkers was 0.49(0.25–0.96) in all participants, 0.31 (0.11–0.85) in HCV-positive patients, and 0.75 (0.29–1.92) in HCV-negative patients.^[66] This study supports previous findings in case-control studies by Gelatti et al. and Ohfuji et al. that coffee has a protective effect amongst HCV-infected persons.^[54,67] However, another report did not find a protective effect of coffee consumption among HCV-infected individuals.^[56]

Discussion

Coffee is one of the most commonly consumed beverages in the world.^[2] There is increasing evidence that daily consumption of 2–3 cups of coffee has significant health benefits. Not only has coffee been associated with a decrease in a number of liver diseases, but its consumption may also decrease mortality.^[9]Thus, coffee appears to have 'hepatoprotective' health benefits.^[68] Coffee is composed of over one hundred compounds, any of which could be responsible for its beneficial effects.^[50] It is possible not one compound in particular, but the synergistic effect of multiple compounds, which provides the health benefits described.

Not all types of coffee may be beneficial in liver disease. Numerous studies have shown a hepatoprotective role for filtered coffee, and a potentially deleterious effect for unfiltered coffee.^[26,28] It was postulated that this difference is due to the presence of kahweol and cafestol, which are caffeine diterpenes that are released from ground coffee beans but removed by paper filters.^[28,69] Moreover, another study found that espresso coffee had no beneficial effect on liver disease, particularly in NAFLD.^[50] In the US, filtered coffee is one of the main types of coffee consumed, whereas in Europe, espresso coffee is more commonly consumed.^[50] Anty et al. postulated that perhaps espresso coffee was not found to be beneficial in NAFLD because of the sucrose added to the coffee.^[50] Sucrose is composed of glucose and fructose, and fructose has been associated with increased severity of hepatic fibrosis in NASH.^[79]

There are a number of proposed mechanisms for the hepatoprotective effects of caffeine ( Table 6 ). In rat studies, methylxanthine caffeine has been implicated in the hepatic fibrinogenesis pathway by (i) downregulating transforming growth factor beta-1 (TGFB-1)-induced connective tissue growth factor (CTGF) production in hepatocytes via promotion of breakdown of SMAD2 (a TGF-B effector protein), (ii) inhibition of SMAD3 phosphorylation, and (iii), by upregulation of the PPAR-gamma receptor.^[70] The antioxidant hepatoprotective effects of coffee may also be induced by UDP glucoronosyltransferases (UGT1A).^[71] Caffeine has also been implicated to have antifibrotic effects via its influence on hepatic stellate cells (HSC) through inhibition of focal adhesion kinase (FAK) and actin synthesis, stimulation of HSC apoptosis, induction of intracellular F-actin and cAMP expression, and via inhibition of procollagen type 1C and alpha-smooth muscle actin expression.^[72]

Caffeine as well as cafestol and kahweol may have anticarcinogenic effects by upregulation of antioxidant-responsive element (ARE)-regulating signaling ( Table 6 ).^[73,74] The ARE sequence plays a key role in carcinogenesis as it has been found on the promoter of numerous genes involved in detoxification processes. Furthermore, animal models and in-vitro studies indicate that kahweol and cafestol may deregulate enzymes involved in detoxification of carcinogens.^[75,76] These compounds also induce glutathione-S-transferase and gamma-glutamylcysteine synthetase (GCS), leading to protection against mutagenesis, and inhibit N-acetyltransferase.^[75,78]

Although caffeine is a major component of coffee, studies evaluating non-coffee caffeinated sources have revealed inconsistent evidence of hepatoprotective effects.^[30,33] With regards to tea consumption, studies have found no statistically significant association between tea intake and risk of cirrhosis,^[33,34]death from cirrhosis,^[36] chronic liver disease,^[32] HCC,^[58] or death due to HCC.^[56,64,80] Most studies did not specify which type of tea participants consumed. However, Inoue et al. studied green tea and Kurozawa et al. studied green, black, and oolong tea.^[60,64]

Coffee preparation methods include filtered, unfiltered, and espresso, and can also vary in its roast profile (medium vs. dark). Differences in preparation method (filtered, unfiltered, espresso) as well as type of roast play a role in the composition of coffee. Filtered coffee does not contain cafestol and kahweol; however, filtration of coffee better preserves chlorogenic acids than the barista method of espresso preparation.^[50] The various degrees of roast refer to the internal bean temperatures found during roasting. Darker roasts have had higher roasting temperatures. Caffeine content also varies between types of coffee [generic brewed coffee (95–200 mg per 8 oz), espresso (40–75 mg per 1 oz), generic instant coffee (27–173 per 8 oz)].

There are numerous limitations when interpreting the studies regarding the health benefits of coffee. Many of the larger studies, including those by Freedman et al., Modi et al., Hu et al., and Molloy et al., did not necessarily account for differences in socioeconomic status or other dietary factors.^{[31,42,49,61]}Although one would argue that perhaps patients who had greater coffee intake were likely healthier, Freedman et al. found that coffee drinkers tended to have poorer overall health (P = 0.29) and vitality scores (P = 0.018) compared to non-coffee drinkers. In addition, participants who drank coffee may have had higher cigarette use and alcohol consumption.^[42] Also, many studies collected data on coffee intake at only one time point, thus, the coffee intake noted may not have accurately reflected participants' intake over time.^{[30,34,36,38]} If it is assumed that caffeine is indeed responsible for the hepatoprotective effects of coffee, then another potential limitation is the variation of caffeine content of coffee within and among coffee shops.^[80] Furthermore, many studies failed to define coffee cup size.^{[24,30,33,36]} Although it is clear that coffee intake has hepatoprotective effects, the lack of standardization of coffee cup size amongst various studies leads to ambiguity regarding how much coffee intake is necessary for these effects.

Our study is limited in that it is based mostly upon observational studies with inherent biases, including recall bias in retrospective studies, as well as selection bias and unmeasurable confounding factors amongst all non-randomized controlled studies.^[81] Cross-sectional studies, such as NHANES III, are limited in that they cannot establish a temporal association between coffee intake and study findings.^[30,81]

Numerous epidemiological studies suggest that consumption of approximately 3 or more cups of coffee daily will reduce the risk for and severity of hepatotoxicity due to a variety of underlying pathologic processes. While the aforementioned studies provide compelling evidence to suggest that coffee is useful as an alternative medicine in the treatment of the most common types of liver disease, blinded randomized controlled trials must be performed to provide evidence for causation, and to eliminate confounding variables and various types of bias inherent in cross-sectional, cohort, and case-control studies. Additional animal and cell culture studies are also warranted to further elucidate the biochemical basis for the potential beneficial effects of coffee in liver disease patients.

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