Researchers from Cedars-Sinai Health Sciences University analyzed data from nearly 355,000 adults that were followed for a median of 13 years. In addition to tracking rates of cirrhosis, hepatocellular carcinoma (HCC) and liver-related mortality, the researchers evaluated MRI markers of liver fat, fibroinflammation and iron, along with about 2,900 circulating proteins to better understand the biological pathways linked to coffee consumption.
Previous research has shown an association between coffee and lower liver disease risk, but many were limited by smaller sample size, fewer outcomes or lack of mechanistic data, said hepatologist Hyun-Seok Kim, MD, MPH, PhD, assistant professor of Medicine at Cedars-Sinai and corresponding author of the study.
“Our study adds several layers: a large prospective UK Biobank cohort, long-term clinical outcomes, objective MRI-based liver imaging, and proteomic profiling,” he said. “This allowed us to connect epidemiologic findings with measurable liver fat, fibroinflammation, iron, and circulating proteins related to fibrosis and inflammation.”
Findings
Compared to non-coffee drinkers, those who consumed five or more cups of coffee a day had a 32% lower risk of cirrhosis, a 47% lower risk of liver cancer and a 42% lower risk of liver-related death. MRI scans also showed lower levels of liver fat, liver iron and fibroinflammation among participants with higher coffee intake. Additionally, blood tests revealed higher levels of proteins tied to healthy liver function and lower levels of proteins linked to scarring and inflammation in coffee-drinking participants.
“This strengthens the idea that coffee may be linked not only to fewer liver-related events, but also to healthier liver biology before advanced disease develops,” Dr. Kim told NutraIngredients.
He added that the strongest associations were observed among participants consuming three to four cups per day and those drinking five or more cups daily, suggesting a dose-response relationship.
“I would not recommend that everyone try to drink very high amounts of coffee,” he said. “A practical interpretation is that moderate coffee intake, particularly unsweetened coffee, may be reasonable as part of a liver-healthy lifestyle for people who already tolerate coffee well.”
Asked what surprised the team most, Dr. Kim told NI that it was the consistency of the molecular findings across multiple biological pathways.
“What stood out was how biologically coherent the protein signature was,” he said. “Higher coffee intake was associated with higher levels of proteins reflecting hepatic synthetic function and antioxidant or complement-related pathways, and lower levels of proteins linked to fibrosis, macrophage activation, endothelial remodeling and extracellular matrix activity. The consistency across these pathways was striking.”
‘Non-caffeine compounds deserve more attention’
Another notable finding was that caffeine did not appear to be the sole active component, suggesting that decaf and regular coffee contain other naturally occurring compounds that may contribute to health benefits.
“The similar findings for caffeinated and decaffeinated coffee suggest caffeine is unlikely to be the only explanation,” Dr. Kim said. “Non-caffeine compounds deserve more attention, including chlorogenic acids, polyphenols, diterpenes, and other antioxidant and anti-inflammatory compounds. These may influence oxidative stress, hepatic fat accumulation, stellate cell activation and fibrotic signaling.”
The findings were generally consistent across demographic groups, including age and sex, Dr. Kim said. The one subgroup that stood out was people with diabetes, where coffee’s association with a lower risk of cirrhosis was somewhat weaker, although associations with reduced liver cancer and liver-related mortality persisted.
Looking ahead, the research team plans to identify the specific bioactive compounds responsible for coffee’s apparent liver health benefits while further investigating the molecular pathways involved in inflammation and fibrosis. Researchers also see potential for MRI biomarkers, including PDFF and cT1, to serve as non-invasive tools for evaluating whether dietary interventions alter liver biology before clinical outcomes emerge, although prospective intervention studies will be needed to confirm their utility.
Source: Clinical Gastroenterology and Hepatology; DOI: doi.org/10.1016/j.cgh.2026.04.035 “Coffee Consumption and Improved Liver Outcomes: Clinical, Imaging, and Proteomic Evidence From the UK Biobank.” Authors: H.-S. Kim, et al.
