Coffee and Its Biologically Active Components: Is There a Connection to Breast, Endometrial, and Ovarian Cancer? – a Review
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Pol. J. Food Nutr. Sci., 2020, Vol. 70, No. 3, pp. 207–222 DOI: 10.31883/pjfns/120017 http://journal.pan.olsztyn.pl Review article Nutritional Research Section Coffee and its Biologically Active Components: Is There a Connection to Breast, Endometrial, and Ovarian Cancer? – a Review Anna M. Witkowska*, Iwona Mirończuk-Chodakowska, Katarzyna M. Terlikowska, Kamila Kulesza, Małgorzata E. Zujko Department of Food Biotechnology, Faculty of Health Sciences, Medical University of Bialystok, Szpitalna 37, 15–295 Bialystok, Poland Key words: coffee, caffeine, breast cancer, ovarian cancer, endometrial cancer Coffee is an important dietary source of biologically active components, not to mention caffeine, phenolic acids, and diterpenes. It has been sug- gested that selected coffee secondary metabolites may benefi cially modulate several mechanisms of anti-cancer protection. This literature review was intended to present current knowledge related to coffee and its components and hormone-dependent female cancers, such as breast, endometrial and ovarian cancer, and to identify gaps in research that may be exploited in the future. The search for studies was conducted through electronic data- bases. Publications on coffee composition, coffee preparation and brewing methods, in vitro and in vivo experiments with the use of substances naturally present in coffee, observational studies, and meta-analyses were collected. In population studies, the greatest attention has been paid to the anticancer effect of caffeinated coffee and/or caffeine. In general, most studies and meta-analyses indicated that there was no clear correlation between coffee and breast cancer or ovarian cancer. Some subgroups of women may benefi t from coffee consumption. This is the case for post-menopausal women with regard to the risk of breast cancer and obese women with regard to the risk of endometrial cancer. This paper identifi es a number of issues for future research, related to a better understanding of the anti-cancer mechanisms of coffee compounds and further research that would focus on specifi c target groups, taking into account both the different methods of coffee preparation and lifestyle factors that may infl uence the results. INTRODUCTION rity of DNA by decreasing spontaneous DNA strand breaks [Bakuradze et al., 2015]. Coffee is one of the most popular beverages in the world Cancers in women are a serious global health prob- because of its taste, aroma and stimulating properties, but lem and a leading cause of death. They are responsible for the perception of coffee as a potentially health-promoting a quarter of the deaths of women in Europe [European component of the diet is not very high in the global popu- Commission, 2019] and a fi fth in the USA [Centers for lation [Sa moggia & Riedel, 2019]. Except some cases, like Disease Control and Prevention, 2019]. In sex hormone- pregnancy or sensitivity to some coffee compounds, coffee -dependent cancers, abnormal estrogen and progester- can offer many benefi cial health effects [Grosso et al., 2016, one levels are among the risk factors [Brown & Hankin- 2017a; Poole et al., 2017; Wierzejska, 2016]. Interestingly, son, 2015; Diep et al., 2015]. With 24.2% incidence, breast a recent exploratory study has shown that coffee consumption cancer cases are the most common in women [Bray et al., may modulate the expression of 297 genes in healthy women 2018]. In the global incidence of female cancers, endometri- in different ways [Barnung et al., 2018], thus affecting meta- al (4.4%) and ovarian cancers (3.4%) rank sixth and eighth, bolic and infl ammatory pathways. Several lines of evidence respectively [Bray et al., 2018]. have linked coffee consumption to a reduced risk of car- Coffee is a source of biologically active compounds, many diovascular diseases [Poole et al., 2017; Rodríguez-Artalejo of which have anti-cancer properties. However, observational & López-García, 2018], cancer [Gapstur et al., 2017; Grosso studies with humans, which focus mainly on coffee consump- et al., 2017a], neurodegenerative diseases [Liu et al., 2016; tion (caffeinated or decaffeinated) and caffeine intake, show Qi & Li, 2014], and diabetes [Ding et al., 2014], as well as rather confl icting results for breast, uterine, and ovarian can- to a lower cancer mortality and all-cause mortality [Grosso cer. This literature review aims to present current research re- et al., 2017b; Gunter et al., 2017; Poole et al., 2017]. On a mo- lated to coffee and its components and hormone-dependent lecular basis, regular coffee consumption preserves the integ- female cancers, such as breast, endometrial, and ovarian cancer, and to identify gaps in research that may be exploited in the future. * Corresponding Author: Tel.: 85 6865090; Fax: 85 6865089 E-mail: [email protected] © Copyright by Institute of Animal Reproduction and Food Research of the Polish Academy of Sciences © 2020 Author(s). This is an open access article licensed under the Creative Commons Attribution-NonCommercial-NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/3.0/). 208 Biologically Active Components of Coffee vs. Cancers SEARCH STRATEGY et al., 1997; Zhang et al., 2012]. Others, such as caffeine, can be found in tea, cola-type beverages, and chocolate. From the point of view of current knowledge, the search for studies from the last decade, i.e. from 2010 to 2019, was con- Caffeine ducted through the electronic databases: Medline and Web Caffeine is a heat-stable methylxanthine alkaloid (Fig- of Science. Publications on coffee composition, coffee prepa- ure 1) present mainly in coffee, tea, guarana, cola-type soft ration and brewing methods, in vitro and in vivo experiments drinks, cacao, and chocolate. It is very soluble in boiling wa- with the use of substances naturally present in coffee, obser- ter. Depending on the type of coffee preparation (ground, vational studies, and meta-analyses were collected. In some instant) or brewing methods (boiling, fi ltering, French press- cases, with the exception of case-control and epidemiologi- ing,), coffee may contain 19–803 mg caffeine per serving cal studies, studies that were important for this review, but (Table 1). Decaffeinated coffee, in turn, presents considerably outside the search period, were described as well. The search reduced caffeine content <9 mg/serving. terms were multiple with “coffee” as a broad search term, Several benefi cial or adverse biological effects are at- and in combination with “breast cancer”, “ovarian cancer”, tributable to caffeine. As an adenosine receptor antagonist, and “endometrial cancer” as the most critical for this review. it is a central nervous system stimulant and anti-infl ammato- The articles published in English that were relevant for this ry agent [Madeira et al., 2017]. In vitro studies have demon- review were selected. strated cell cycle modulating and apoptotic properties of caf- feine, mediated through various mechanisms, that can lead BIOACTIVE COMPOUNDS OF COFFEE to tumor suppression [He et al., 2003; Ito et al., 2003; Saiki et al., 2011]. Caffeine also exhibits antiproliferative activity Roasted coffee beans are composed of several substanc- in ovarian cancer cells, even several times higher than that es derived from different chemical groups, not to mention of chlorogenic acid and caffeic acid [Tai et al., 2010]. Besides, caffeine, phenolic acids, and diterpenes. Their contents it may possibly alter circulating levels of luteal estrogens in a coffee brew depend, to a large extent, on the type of cof- and sex hormone-binding globulin (SHBG), and thereby af- fee bean (Coffea arabica vs. Coffea canephora var. robusta), fect the development of cancers [Kotsopoulos et al., 2009]. roasting parameters, as well as the methods of brewing. Variants in cytochrome P-450 (CYP) genes involved in caf- A coffee brew contains substances that are only specifi c to feine metabolism may increase or decrease the risk of ovarian coffee, such as diterpenes – cafestol and kahweol [Gross cancer development [Kotsopoulos et al., 2009]. It has been FIGURE 1. Chemical structure of major coffee compounds. A.M. Witkowska et al. 209 TABLE 1. Caffeine contents in varied coffee infusions*. one [Huber & Parzefall, 2005]. Consequently, conjugates are eliminated. Several lines of evidence connect coffee-specifi c Caffeine content Caffeine content Coffee infusion type (mg/L) (mg per serving**) diterpenes with anticancer properties. In male F344 rats, kah- weol and cafestol (1:1) or only cafestol caused an increase Boiled/ Turkish 850–2330 201–552 in the level of hepatic O(6)-methylguanine-DNA methyltrans- Decaffeinated 1–37 0.24–8.77 ferase (MGMT), an enzyme which is involved in the reversal Espresso 722–5334 19–144 of precarcinogenic damage of O(6)-alkylguanine, a DNA ad- duct formed by alkylating agents in a dose-dependent man- Filtered 397–2008 81–416 ner [Huber et al., 2003]. Anticancerogenic activity of coffee French press 520–1564 123–371 diterpenes was observed in several cancer cell lines. Most of the papers on female cancers in conjunction with coffee Instant 390–2690 92–638 diterpenes have so far been limited to mammary tumors. Mocha 924–2268 327–803 Antitumor activity of kahweol was tested in a few cancer cell *adopted from: [dePaula & Farah, 2019]; **serving size for coffee: boiled/ lines. It has been shown to be manifested in both inhibited Turkish, French press, instant, decaffeinated, 237 mL; espresso 27 mL; tumor cell growth and clonogenicity, and a decreased survival fi ltered 207 mL; mocha 354 mL. of cancer cells [Cárdenas et al., 2014]. These effects were mostly pronounced in estrogen-negative human breast can- cer cells MDA-MB231, and were accompanied by the activa- suggested that caffeine from coffee may protect against endo- tion of caspases 3/7 and 9, and the release of cytochrome c. metrial cancer [Hashibe et al., 2015]. Kahweol increased the production of reactive oxygen species (ROS) and their cytotoxicity against breast cancer cells, but Coffee diterpenes it did not affect the healthy cells [Cárdenas et al., 2014].