Epidemiology Research Unit, Research Centre, Centre Hospitalier de 'Universitaire de Montreal, CHUM Hotel-Dieu, Montreal, Canada.

Although there are several plausible biologic mechanisms whereby coffee consumption might influence the risk of breast cancer, epidemiologic evidence is limited. We assessed the association between coffee consumption and breast cancer risk among high-risk women who carry BRCA mutations. We performed a matched case-control analysis on 1,690 women with a BRCA1 or BRCA2 mutation from 40 centers in 4 countries. Average lifetime coffee consumption was estimated via a self-administered questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression. After adjustment for potential confounders, the ORs for breast cancer in BRCA carriers who habitually drank 0, 1-3, 4-5 and 6 or more cups of coffee were 1.00, 0.90 (95% CI 0.72-1.12), 0.75 (95% CI 0.47-1.19) and 0.31 (95% CI 0.13-0.71; p-trend = 0.02). The effect was limited to the consumption of caffeinated coffee. These results suggest that among women with BRCA gene mutation, coffee consumption is unlikely to be harmful and that high levels of consumption may in fact be related to reduced breast cancer risk.

International Journal of Cancer Published Online: 10 Oct 2005

1Department of Clinical Oncology, Hospital Maternidade De Campinas, Campinas, SP, Brazil

2Department of Medical Oncology, Hacettepe University Institute of Oncology, Ankara, Turkey

We read with great interest the article by Nkondjock et al.[1] regarding the coffee consumption and breast cancer risk among BRCA1 and BRCA2 mutation carriers. They reported that among women with BRCA gene mutation, coffee consumption is unlikely to be harmful and that high levels of consumption may in fact be related to reduce breast cancer risk. The authors suggested that the potential role of coffee for prevention of breast cancer might be through estrogen metabolism. We want to mention recent finding that coffee may play a role in reducing breast cancer risk. Hypermethylation of DNA is a key epigenetic mechanism for silencing of various genes, including those encoding the tumor suppressor proteins, DNA repair enzymes, and receptors and is a common characteristic in tumor cells. Gene-specific hypermethylation is known to be associated with inactivation of various pathways involved in the tumorigenic process, including DNA repair, cell cycle regulation, inflammatory/stress response and apoptosis. Lee and Zhu demonstrated that caffeic acid, the key ingredient of coffee, inhibits DNA methylation in cultured MCF-7 and MAD-MB-231 human breast cancer cells.[2] Moreover, one clinical study by Hayashi et al. showed that coffee potentates the effect of chemotherapy in solid metastatic tumors, including breast cancer. Taken all together, coffee may contribute to inhibition of breast cancer cells in many ways. Its intake as a preventive agent and/or concomitant use of it with chemotherapy in breast cancer should be further explored.

Yours sincerely,

Mauricio Z. Baptista, Kadri Altundag, Ozden Altundag

References

1 Nkondjock A, Ghadirian P, Kotsopoulos J, Lubinski J, Lynch H, Kim-Sing C, Horsman D, Rosen B, Isaacs C, Weber B, Foulkes W, Ainsworth P, et al. Coffee consumption and breast cancer risk among BRCA1 and BRCA2 mutation carriers. Int J Cancer 2005 Jul 19; [Epub ahead of print].

2 Lee WJ, Zhu BT. Inhibition of DNA methylation by caffeic acid and chlorogenic acid, two common catechol-containing coffee polyphenols. Carcinogenesis 2005 Aug 4; [Epub ahead of print].

3.

Division of Epidemiology, Department of Family and Preventive Medicine, University of California San Diego

PURPOSE: Three recent studies report that coffee drinkers are at reduced risk for type 2 diabetes. The present study expands this analysis by using an oral glucose tolerance test for the diagnosis of type 2 diabetes. METHODS: In this prospective study, 910 nondiabetic adults aged 50 or older at baseline were followed from 1972 to 1987, for an

average of 8 years after the assessment of caffeinated coffee intake. Logistic regression was used to investigate baseline coffee habits and risk of incident diabetes adjusting for sex, age, physical activity, body mass index, smoking, alcohol, hypertension, and baseline fasting plasma glucose. Further analyses were conducted in participants with normal (n Z 593) and impaired glucose (n Z 317) at baseline. RESULTS: Non-diabetic past and current coffee drinkers were at a similar significantly reduced risk for developing diabetes (OR Z 0.38; CI: 0.17Ð0.87; OR Z 0.36, CI: 0.19Ð 0.68; respectively)

compared to those who never drank coffee. Participants with baseline impaired glucose who were past (OR Z 0.31; CI: 0.11Ð0.87) or current (OR Z 0.36; CI: 0.16Ð0.83) coffee drinkers were also at reduced risk.

CONCLUSION: This study confirms recent findings of a striking independent protective effect of caffeinated coffee against incident diabetes based on clinical diagnosis.

Coffee consumption induces GSTP in plasma and protects lymphocytes against (+/-)-anti-benzo[a]pyrene-7,8-dihydrodiol-9,10-epoxide induced DNA-damage: Results of controlled human intervention trials. Steinkellner H, Hoelzl C, Uhl M, Cavin C, Haidinger G, Gsur A, Schmid R, Kundi M, Bichler J, Knasmuller S. Mutat Res. 2005 Aug 11; [Epub ahead of print]

Institute of Cancer Research, Medical University of Vienna, Borschkegasse 8a, A-1090 Vienna, Austria.

A number of animal studies indicate that coffee protects against chemical induction of cancer; also human studies suggest that coffee consumption is inversely related with the incidence of different forms of cancer. The protective effects were attributed to induction of glutathione-S-transferases (GSTs) and aim of the present human study was to find out if coffee causes induction of GSTs and protects against DNA-damage caused by (+/-)-anti-B[a]P-7,8-dihydrodiol-9,10-epoxide (BPDE), the DNA-reactive metabolite of benzo(a)pyrene. Ten participants consumed 1L unfiltered coffee/d over 5 days. Before and after the intervention, saliva and blood were collected and the overall GST activity was measured with 1-chloro-2,4-dinitrobenzene (CDNB). Additionally, GSTP and GSTA were determined in plasma with immunoassays. In blood, only weak (p=0.042) induction of GST (CDNB) was found. Furthermore, pronounced (three-fold) induction of GSTP was observed in blood, whereas GSTA was not altered. No correlations were seen between induction of GST (CDNB) and GSTP activities and the GSTP1 genotypes of the participants. Also clinical parameters (creatinine, alanine, aminotransferase, aspartate aminotransferase, alkaline phosphatase), which are markers for organ damage, were monitored. None of them was altered by coffee, but serum cholesterol levels were slightly (not significantly) enhanced. In a second trial (n=7), GSTP induction by unfiltered and paper filtered coffees, differing in cafestol and kahweol contents, were compared. The participants consumed 1L coffee/d over 3 days. Again significant (three-fold) induction of GSTP was observed. The effects seen with the two coffees were identical, indicating that the diterpenoid concentrations are not responsible for the effects. In a further trial (n=7), the effect of coffee (unfiltered, 1L/d, 5 days) on BPDE induced DNA-migration was studied in comet assays. A 45% reduction effect was observed. Our findings show that coffee induces GSTP in humans and indicate that consumption may lead to protection towards polycyclic aromatic hydrocarbons.

Yamaji T, Mizoue T, Tabata S, Ogawa S, Yamaguchi K, Shimizu E, Mineshita M, Kono S. Diabetologia. 2004 Dec;47(12):2145-51.

Department of Preventive Medicine, Faculty of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka 812-8582, Japan.

AIMS/HYPOTHESIS: Several studies have reported that coffee has a protective effect against the development of type 2 diabetes. However, few of these studies used the standard glucose tolerance test to diagnose type 2 diabetes. The aim of this study was to investigate the relationship between coffee and green tea consumption and glucose tolerance status as determined using a 75-g OGTT. METHODS: We performed a cross-sectional study of 3224 male officials of the self-defence forces. Glucose tolerance status was determined in accordance with the 1998 World Health Organization criteria, and average intakes of coffee and green tea over the previous year were assessed by a self-administered questionnaire. The figures obtained were adjusted for BMI, physical activity and other factors. RESULTS: A total of 1130 men were identified as having glucose intolerance (IFG, IGT or type 2 diabetes). Compared with those who did not consume coffee on a daily basis, fasting and 2-h post-load plasma glucose levels were 1.5% and 4.3% lower in those who drank 5 cups of coffee or more per day respectively. The adjusted odds ratios of glucose intolerance for categories of <1, 1-2, 3-4 and >/=5 cups of coffee per day were 1.0 (referent), 0.8 (95% CI 0.6-1.0), 0.7 (95% CI 0.6-0.9) and 0.7 (95% CI 0.5-0.9) respectively (p=0.0001 for trend). No clear association was observed between green tea drinking and glucose tolerance status. CONCLUSIONS/INTERPRETATION: Coffee consumption may inhibit postprandial hyperglycaemia and thereby protect against the development of type 2 diabetes mellitus.

Department of Cardiology, Aarhus Sygehus, Aarhus University Hospital, Aarhus, Denmark.

BACKGROUND: It is not known whether the consumption of caffeine is associated with excess risk of atrial fibrillation. OBJECTIVE: We evaluated the risk of atrial fibrillation or flutter in association with daily consumption of caffeine from coffee, tea, cola, cocoa, and chocolate. DESIGN: We prospectively examined the association between the amount of caffeine consumed per day and the risk of atrial fibrillation or flutter among 47 949 participants (x age: 56 y) in the Danish Diet, Cancer, and Health Study. Subjects were followed in the Danish National Registry of Patients and in the Danish Civil Registration System. The consumption of caffeine was analyzed by quintiles with Cox proportional-hazard models. RESULTS: During follow-up (x: 5.7 y), atrial fibrillation or flutter developed in 555 subjects (373 men and 182 women). When the lowest quintile of caffeine consumption was used as a reference, the adjusted hazard ratios (95% CIs) in quintiles 2, 3, 4, and 5 were 1.12 (0.87, 1.44), 0.85 (0.65, 1.12), 0.92 (0.71, 1.20), and 0.91 (0.70, 1.19), respectively. CONCLUSION: Consumption of caffeine was not associated with risk of atrial fibrillation or flutter.

Defence R&D Canada - Toronto, 1133 Sheppard Avenue West, P.O. Box 2000, Toronto, Ontario, Canada M3M 3B9.

PURPOSE: The purpose of this study was to examine the effects of caffeine (CAF) on physical, vigilance, and marksmanship tasks in soldiers during a sustained 55-h field exercise. METHODS: There were 30 soldiers (23.6 +/- 4.5 yr, 81.8 +/- 10.3 kg) who were divided into a placebo (PLAC) and a CAF group. After a period of restricted sleep of 3 h during the first night, a period of sustained wakefulness began that ended at 11:00 of the third day. PLAC or CAF doses of 100 mg, 200 mg, 100 mg, and 200 mg were administered at 21:45, 23:45, 01:45, and 03:45, respectively. At 22:00 of day 2, subjects began two cycles of marksmanship, urban operations vigilance, and psychomotor vigilance (PVT) testing which ended at 06:00 of day 3. RESULTS: CAF maintained marksmanship vigilance at 85% throughout the second night as compared with PLAC, who significantly declined to 61.4 +/- 28.2% overnight. Marksmanship accuracy also decreased significantly in PLAC from 95.1 +/- 8.3% to 83.3 +/- 19.2%, but no change was observed in CAF. Urban operations vigilance decreased for both groups over the night, but the decrease was less for CAF (81.2 +/- 14.4% to 63.4 +/- 24.1%) compared with PLAC (77.6 +/- 19.2% to 44.0 +/- 30.2%). Reaction time and the number of major and minor lapses with the PVT significantly increased in PLAC but were unaffected in CAF. CONCLUSIONS: It was concluded that CAF was an effective strategy to sustain vigilance and psychomotor performance during military operations involving sleep deprivation.

Centre for Occupational and Health Psychology, Cardiff University, 63 Park Place, Cardiff CF10 3AS, UK.

RATIONALE: Evidence for the behavioural effects of caffeine is prevalent in the literature. It is associated with increased subjective alertness, improved reaction time and enhanced encoding of new information. However, there is an on-going debate as to whether such changes are in fact improvements or merely a reversal of the negative effects of caffeine withdrawal. Using participants who had consumed their normal daily quota of caffeine this study alleviated this potential confound as all participants were not withdrawn at the time of testing. OBJECTIVES: To determine whether caffeine influenced the mood and performance of non-withdrawn volunteers. METHODS: Sixty eight volunteers, all of whom were regular caffeine consumers, consumed their normal amount of caffeine over the course of the day. Baseline measures of mood and performance were then carried out followed by double-blind administration of caffeine (2 mg/kg) or placebo. The test battery was repeated again 30 min after ingestion of the drink. RESULTS: Our findings showed improvements comparable to previous research. Mood was improved and performance on a number of cognitive measures was improved. The findings are discussed in relation to both noradrenergic and cholinergic neurotransmitter systems. CONCLUSIONS: This study provided evidence against the argument that behavioural changes due to caffeine are merely the reversal of negative withdrawal effects. Copyright (c) 2004 John Wiley & Sons, Ltd.

Department of Nutrition and Health, Faculty of Earth and Life Sciences, Vrije University Amsterdam, de Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands.

AIMS/HYPOTHESIS: Coffee contains several substances that may affect glucose metabolism. The aim of this study was to evaluate the relationship between habitual coffee consumption and the incidence of IFG, IGT and type 2 diabetes. METHODS: We used cross-sectional and prospective data from the population-based Hoorn Study, which included Dutch men and women aged 50-74 years. An OGTT was performed at baseline and after a mean follow-up period of 6.4 years. Associations were adjusted for potential confounders including BMI, cigarette smoking, physical activity, alcohol consumption and dietary factors. RESULTS: At baseline, a 5 cup per day higher coffee consumption was significantly associated with lower fasting insulin concentrations (-5.6%, 95% CI -9.3 to -1.6%) and 2-h glucose concentrations (-8.8%, 95% CI -11.8 to -5.6%), but was not associated with lower fasting glucose concentrations (-0.8%, 95% CI -2.1 to 0.6%). In the prospective analyses, the odds ratio (OR) for IGT was 0.59 (95% CI 0.36-0.97) for 3-4 cups per day, 0.46 (95% CI 0.26-0.81) for 5-6 cups per day, and 0.37 (95% CI 0.16-0.84) for 7 or more cups per day, as compared with the corresponding values for the consumption of 2 or fewer cups of coffee per day (p=0.001 for trend). Higher coffee consumption also tended to be associated with a lower incidence of type 2 diabetes (OR 0.69, CI 0.31-1.51 for >/=7 vs </=2 cups per day, p=0.09 for trend), but was not associated with the incidence of IFG (OR 1.35, CI 0.80-2.27 for >/=7 vs </=2 cups per day, p=0.49 for trend). CONCLUSIONS/INTERPRETATION: Our findings indicate that habitual coffee consumption can reduce the risk of IGT, and affects post-load rather than fasting glucose metabolism.

Department of Experimental and Applied Medicine, Chair of Hygiene, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.

BACKGROUND/AIMS: The role of coffee in the development of hepatocellular carcinoma (HCC) is debated. The aim of this study was to investigate the role of coffee in HCC, taking the main risk factors into account. METHODS: A hospital-based case-control study was conducted in an area of northern Italy. We recruited 250 HCC cases and 500 controls hospitalized for any reasons other than neoplasms, and liver and alcohol-related diseases. Subjects were interviewed on their lifetime history of coffee consumption using a standardized questionnaire. RESULTS: Coffee consumption in the decade before the interview was associated with a decreasing risk of HCC with a clear dose-effect relation. With respect to non-drinking subjects, the odds ratios (ORs) were: 0.8, (95% CI 0.4-1.3) for 1-2 cups/day, 0.4 (95% CI 0.2-0.8) for 3-4 cups/day and 0.3 (95% CI 0.1-0.7) for 5 or more cups/day. The ORs for HCC decreased for drinking >2, compared to 0-2 cups/day of coffee, for an alcohol intake >80 g/day (OR from 5.7 to 3.3), for presence of hepatitis B virus infection (OR from 16.4 to 7.3) or hepatitis C virus infection (OR from 38.2 to 9.0). CONCLUSIONS: Coffee drinking was inversely associated with HCC regardless of its aetiology.

Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Pavia, via Taramelli 12, 27100 Pavia, Italy.

Green and roasted coffees of the two most used species, Coffea arabica and Coffea robusta, several commercial coffee samples, and known coffee components were analyzed for their ability to interfere with Streptococcus mutans' sucrose-independent adsorption to saliva-coated hydroxyapatite (HA) beads. All coffee solutions showed high antiadhesive properties. The inhibition of S. mutans' adsorption to HA beads was observed both when coffee was present in the adsorption mixture and when it was used to pretreat the beads, suggesting that coffee active molecules may adsorb to a host surface, preventing the tooth receptor from interacting with any bacterial adhesions. Among the known tested coffee components, trigonelline and nicotinic and chlorogenic acids have been shown to be very active. Dialysis separation of roasted coffee components also showed that a coffee component fraction with 1000 Da < MW < 3500 Da, commonly considered as low MW coffee melanoidins, may sensibly contribute to the roasted coffee's antiadhesive properties. The obtained results showed that all coffee solutions have antiadhesive properties, which are due to both naturally occurring and roasting-induced molecules.

Queensland Institute of Medical Research, PO Royal Brisbane Hospital, QLD 4029, Australia.

OBJECTIVE: Studies evaluating the relationships between coffee, tea and caffeine and ovarian cancer risk have given inconsistent results. We have examined these associations using data from an Australian population-based case-control study. METHODS: Women with epithelial ovarian cancer (EOC) (n = 696) and control women selected from the Electoral Roll (n = 786) provided comprehensive reproductive and lifestyle data and completed a food frequency questionnaire. RESULTS: Increasing coffee consumption was associated with a decreased risk of invasive EOC ( p trend = 0.009) with an odds ratio (OR) of 0.51 (95% confidence interval (CI) 0.32-0.80) for consumption of >/=4 cups of coffee per day compared to non-drinkers. The association was significant only for serous and endometrioid/clear cell histological subtypes. There was no association with borderline tumours (OR: 1.20, 95% CI: 0.58-2.47). An inverse relationship was also seen between caffeine intake and EOC but tea consumption was not related to EOC (OR: 1.10 95% CI: 0.76-1.61 for >/=4 cups/day versus none). CONCLUSIONS: As tea contributed significantly to caffeine intake in this population we conclude that the association we observed with coffee is not due to caffeine, but to other components within coffee. We suggest future studies consider the type as well as the amount of each beverage consumed.

Division of Gastroenterology, Department of Medicine, Kaiser Permanente Medical Center, Oakland, California 94611, USA.

OBJECTIVES: We studied relationships of cigarette smoking and coffee drinking to risk of pancreatitis. METHODS: This was a cohort study among 129,000 prepaid health plan members who supplied data about demographics and habits in 1978-85. Among 439 persons subsequently hospitalized for pancreatitis, probable etiologic associations were cholelithiasis (168/439 = 38%), alcohol (125/439 = 29%), idiopathic (110/430 = 25%), and miscellaneous (36/439 = 8%). Cox proportional hazards models with seven covariates (including alcohol intake) yielded relative risk estimates for smoking and coffee use. RESULTS: Increasing smoking was strongly related to increased risk of alcohol-associated pancreatitis, less related to idiopathic pancreatitis, and unrelated to gallstone-associated pancreatitis. Relative risks (95% confidence intervals, CI) of one pack per day (vs never) smokers for pancreatitis groups were: alcohol = 4.9 (2.2-11.2, p < 0.001), idiopathic = 3.1 (1.4-7.2, p < 0.01), and gallstone = 1.3 (0.6-3.1). The relationship of smoking to alcohol-associated pancreatitis was consistent in sex and race subsets. Drinking coffee, but not tea, was weakly inversely related to risk only of alcohol-associated pancreatitis, with relative risk (95% CI) per cup per day = 0.85 (0.77-0.95; p= 0.003). Male sex, black ethnicity, and lower-educational attainment were other predictors of alcohol-associated pancreatitis. CONCLUSIONS: Cigarette smoking is an independent risk factor for alcohol-associated and idiopathic pancreatitis. Coffee drinking is associated with reduced risk of alcohol-associated pancreatitis. The data are compatible with the hypotheses that smoking may be toxic to the pancreas or may potentiate other pancreatic toxins while some ingredient in coffee may have a modulating effect.

School of Pharmaceutical Sciences, Kinki University, Kowakae, Higashi-Osaka, Osaka 577-8502, Japan.

In an attempt to reuse food waste for useful purposes, we investigated the possibility of using coffee grounds to remove lead ions from drinking water. We studied the lead ion adsorption characteristics of coffee beans and grounds by measuring their fat and protein content, adsorption isotherms for lead ions, and adsorption rates for lead ions. The number of lead ions adsorbed by coffee grounds did not depend on the kind of coffee beans or the temperature at which adsorption tests were performed. The rate of lead ion adsorption by coffee grounds was directly proportional to the amount of coffee grounds added to the solution. When coffee grounds were degreased or boiled, the number of lead ions decreased. When proteins contained in coffee grounds were denatured, the lead ion adsorption was considerably reduced. The lead ion adsorption capacity of coffee grounds decreased with increased concentration of perchloric acid used for treating them and disappeared with 10% perchloric acid. The experiments demonstrated that proteins contained in coffee beans depend upon the adsorption of lead ion. The present study gave an affirmative answer to the possibility of using coffee grounds, an abundant food waste, for removing lead ions from drinking water.

Department of Internal Medicine, Cardiology Unit, University Hospital Zurich, Zurich, Switzerland.

Intake of coffee, one of the most common beverages worldwide, is often reported as a cardiovascular risk factor; however, definitive data are lacking. Acute intake of coffee or beverages containing caffeine can increase blood pressure, heart minute volumes, and cardiac index, as well as activate the sympathetic nervous system in nonhabitual coffee drinkers. Interestingly, this is not observed in habitual coffee drinkers. Restriction of coffee or caffeinated beverages is no longer indicated in the seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guidelines for the treatment of hypertension. In fact, no clear association between coffee and the risk of hypertension, myocardial infarction, or other cardiovascular diseases has been demonstrated. In contrast to early studies, recent research indicates that habitual moderate coffee intake does not represent a health hazard and may even be associated with beneficial effects on cardiovascular health.

Purpose: Coffee is a widely consumed beverage and small health effects of substances in coffee may have large public health consequences. It has been suggested that caffeine in coffee increases the risk of hypertension. We performed a meta-analysis of randomized controlled trials of coffee or caffeine and blood pressure (BP).

Data identification: BP trials of coffee or caffeine published between January 1966 and January 2003 were identified through literature databases and manual serach.

Study selection: A total of 16 studies with a randomized, controlled design and at least 7 days of intervention was selected, comprising 25 strata and 1010 subjects.

Data extraction: Two persons independently obtained data on sample size, type and duration of intervention, changes in BP and heart rate (HR), and subjects' characteristics for each trial. Meta-analysis was performed using a random-effects model.

Results: A significant rise of 2.04 mmHg [95% confidence interval (CI), 1.10-2.99] in systolic BP and 0.73 mmHg (95% CI, 0.14-1.31) in diastolic BP was found after pooling of coffee and caffeine trials. When coffee trials (n = 18, median intake: 725 ml/day) and caffeine trials (n = 7, median dose: 410 mg/day) were analysed separately, BP elevations appeared to be larger for caffeine [systolic: 4.16 mmHg (2.13-6.20); diastolic: 2.41 mmHg (0.98-3.84)] than for coffee [systolic: 1.22 mmHg (0.52-1.92) and diastolic: 0.49 mmHg (-0.06-1.04)]. Effects on HR were negligible.

Conclusions: Although regular caffeine intake does increase BP, when ingested through coffee, however, the blood pressure effect of caffeine is small.

Department of Nutrition, Faculdade de Ciencias da Saude, Universidade de Brasilia, Brazil.

Definitions of functional food vary but are essentially based on foods' ability to enhance the quality of life, or physical and mental performance, of regular consumers. The worldwide use of coffee for social engagement, leisure, enhancement of work performance and well-being is widely recognised. Depending on the quantities consumed, it can affect the intake of some minerals (K, Mg, Mn, Cr), niacin and antioxidant substances. Epidemiological and experimental studies have shown positive effects of regular coffee-drinking on various aspects of health, such as psychoactive responses (alertness, mood change), neurological (infant hyperactivity, Alzheimer's and Parkinson's diseases) and metabolic disorders (diabetes, gallstones, liver cirrhosis), and gonad and liver function. Despite this, most reviews do not mention coffee as fulfilling the criteria for a functional food. Unlike other functional foods that act on a defined population with a special effect, the wide use of coffee-drinking impacts a broad demographic (from children to the elderly), with a wide spectrum of health benefits. The present paper discusses coffee-drinking and health benefits that support the concept of coffee as a functional food.

Department of Bone Metabolic Diseases, Institute of Agricultural Medicine, Lublin, Poland.

In various epidemiological and clinical studies, bone quality, bone mineral density (BMD), as well as risk of falling have been associated with lifestyle and anthropometric/demographic characteristics. The objective of this study was to evaluate the osteoporosis risk factors occurrence and its association with BMD in rural and urban women from the Lublin Region in Poland. A cross-sectional study of risk factors of osteoporosis and fracture was carried out in a cohort of 900 rural and urban women aged 30-79 years, representative of the general population the Lublin Region. Data pertaining to osteoporosis risk factors as well as medical history were taken using a specially designed 31 item questionnaire divided in seven sections: social history, past medical history, reproductive history, drug history, family history of osteoporosis, nutritional habits and lifestyle factors. The lumbar spine (L(2)-L(4)) was examined in a-p position using the dual X-ray absorptiometry- DXA (LUNAR Corp.). The differences between urban and rural women in the appearance of particular osteoporosis risk factors, such as gynecological, dietary calcium intake, smoking and coffee consumption, was noticeable. Age, years of menopause and family history of osteoporosis (in mothers) were found to have strong negative independent associations with lumbar spine BMD. Body Mass Index (BMI) was found to have strong positive association with BMD. Dietary calcium intake, coffee consumption and level of physical activity had noticeable positive and independent, but not significant association with BMD.