By John Maher, DC, DCBCN, BCIM

Several epidemiologic studies have shown that a three- to four-cup daily consumption of coffee, whether caffeinated or decaffeinated, reduces the risk of developing insulin resistance, metabolic syndrome and type 2 diabetes, as well as being effective in weight management.1-3 The science strongly suggests that the phytonutrient chlorogenic acid is the major reason for these effects.4 Chlorogenic acid is also found in high amounts in cherries and plums, but coffee is its greatest dietary source.5

Of course, levels of the phytonutrient will vary widely in different processed roasted coffee beans. Still, the dried raw green bean of the coffee fruit, especially the Robusta bean, is the richest source.

In vitro studies show that chlorogenic acid (5-caffeoylquinic acid) inhibits glucose uptake in the small intestine, while also inhibiting the enzyme glucose-6-phosphatase, which intervenes in blood glucose regulation.6 Doing so shuts down the glucose pathway, causing the body to burn fat and use it as energy.

Nonetheless, scientists emphasize the synergic effect of coffee’s components rather than one constituent. Fortunately, an all-natural water-soluble extract of raw, decaffeinated green coffee beans can be obtained by a traditional extraction method. This is important, as up to 70 percent of chlorogenic acids can be destroyed by roasting. Raw, dried, green coffee-fruit extracts can now be utilized as an ingredient in nutraceuticals and functional foods and drinks.

A high-quality, standardized extract of 400 mg has the chlorogenic content of up to seven cups of coffee, yet is free of some of the harmful acids in coffee (cafestol and kahweol), with only 25 percent of the caffeine. Raw green coffee bean extracts also contain quinic and caffeic acid, which possess strong antioxidant power, notably limiting the oxidation of lipids in the liver.7,8 Indeed, raw green coffee beans have approximately twice the antioxidant power of chocolate.9 The extracts have been tested with an oxygen absorbance capacity rating (ORAC) of almost 9,000 per gram.

In a recent clinical study using 400 mg of green coffee bean extract versus a placebo and involving 50 people,10 participants who received the bean extract lost 5.7% of their initial weight after 60 days of supplementation, corresponding to an average weight loss of 11 pounds. The placebo group lost 2.8 percent of initial weight. These effects are believed to be related to the reduction of up to half of post-prandial glycemia, secondary to a decrease of intestinal glucose absorption and an inhibition of glucose-6-phosphatase, as well as an increase of the release of energy stored as fatty acids in adipose tissue.

Based on this information, it is easy to make a latte with significant amounts of coffee antioxidants to support healthy blood sugar levels and healthy weight-loss programs. The recipe is as follows:

Brew 8 ounces of a robust, bold coffee blend (caffeinated or decaf).
Blend 8-10 grams of whey protein powder and ¼ tsp cinnamon with 2-4 ounces milk.
Stir cinnamon, milk and whey blend into coffee.
If added sweetness is desired, add stevia to taste.
The strong coffee provides a significant amount of chlorogenic acids and, if caffeinated, boosts metabolism. The lean protein from whey has a strong satiating effect. This will be even stronger if the whey protein also provides fiber. The herb cinnamon is an insulin mimetic, meaning it works like insulin. Specifically, it tends to lower insulin resistance that occurs at cell walls, allowing our own natural insulin to get sugar inside cells to burn for energy.11 And stevia, a natural, zero-calorie sweetener made from crystallized stevia leaves, has produced fair evidence that it helps support healthy blood sugar levels. Enjoy hot or cold!

References

Salazar-Martinez E, Willett WC, Ascherio A, et al. Coffee consumption and risk for type 2 diabetes mellitus. Ann Intern Med, 2004 Jan 6;140(1):1-8.
Blum J, Lemaire B, Lafay S. Effect of a green decaffeinated coffee extract on glycemia: a pilot prospective clinical study. NUTRAfoods, 2007;6(3):13-7.
Nardon K, Lemaire B, Lafay S. Green coffee extract Svetol® can manage weight: a review. AgroFOOD, 2007;18(5 Suppl):37-9.
Ario WJ, Canfield WK, Ramos FC, et al. Chlorogenic acid and hydroxynitrobenzaldehyde: new inhibitors of hepatic glucose 6-phosphatase. Arch Biochem Biophys, 1997;339(2):315-22.
Clifford MN. Chlorogenics acids and other cinnamates: nature, occurrence and dietary burden. J Sci Food Agric, 1999;362-72.
Hemmerle H, Burger HJ, Below P, et al. Chlorogenic acid derivatives: novel inhibitors of hepatic glucose- 6- phosphate translocase. J Med Chem;40(2):137-45.
Chen JH, Ho CT. Antioxidant activities of caffeic acid and its related hydroxycinnamic acid compounds. J Agric Food Chem, 1997;45(7):2374-8.
Natella F, Nardini M, Giannetti I, et al. Coffee drinking influences plasma antioxidant capacity in humans. J Agric Food Chem;50(21):6211-6.
Richelle M, Tavazzi I, Offord E. Comparison of the antioxidant activity of commonly consumed polyphenolic beverages (coffee, cocoa, and tea) prepared per cup serving. J Agric Food Chem, 2001;49:3438-42.
Dellalibera SO, Lemaire B, Lafay S. Le Svetol®, un extrait de café vert décaféiné, induit une perte de poids et augmente le ratio masse maigre sur masse grasse chez des volontaires en surcharge pondérale. Phytothérapie, 2006;4:1-4.
Huang DW, Shen SC, Wu JS. Effects of caffeic acid and cinnamic acid on glucose uptake in insulin-resistant mouse hepatocytes. J Agric Food Chem, 2009 Sep 9;57(17):7687-92.

By David Seaman, DC, MS, DABCN

If you have followed my articles over the years, you know that I focus on inflammation reduction. This is not because I am fixated on inflammation due to a personal obsession, but rather because the subjection of inflammation demands our attention. That said, at first glance, the notion that the brain can be inflamed may appear silly. This is because we typically view inflammation in the context of swelling after an injury. However, the contemporary view of inflammation is that it reflects a manner of cellular communication and need not involve any of the classic signs of inflammation, such as redness, swelling, heat and pain. In fact, one can be systemically inflamed and have no symptoms at all.

The Consequences of Inflammation

For example, type 2 diabetes is caused by chronic inflammation, and its development is without the signs and symptoms classically associated with “inflammation.” Consider the following statement by a researcher in this area: “Unequivocal experimental, epidemiological and clinical evidence produced during the past decade causally links inflammation, or the molecules and networks integral to inflammatory responses, to the development of these metabolic diseases and/or the complications that emerge from these pathologies, particularly in the context of obesity and type 2 diabetes.”1

Table 1 lists the predictors for the presence of metabolic syndrome X, which exists before a patient is obese or has type 2 diabetes. If a patient has three of these predictors, they have the metabolic syndrome and are inflamed.

Table 1: Diagnostic Predictors for Insulin Re-sistance Metabolic Syndrome X2
Predictor Abnormal Value
Blood sugar > 100 mg/dL
Triglycerides > 150 mg/dL
HDL cholesterol < 50 for women; < 40 for men
Blood pressure > 130/85 mmHg
Waist circumference > 36 inches for women; >= 40 inches for men
The reason for our detour into the metabolic syndrome, obesity and diabetes is because the cytokine-mediated inflammatory state that causes these conditions1,3-4 is also what leads to hypothalamic inflammation.5 Indeed, a high-calorie, fat-rich diet causes cytokines to be expressed in the hypothalamus, contributing to the activation of intracellular inflammatory signal transduction. The outcome is insulin resistance within the hypothalamus and a reduction in satiety signaling, leading to overeating and weight gain.5 In other words, the brain of an overeater is inflamed.

Dietary and Supplemental Deflaming of the Brain

The reduction of systemic inflammation can begin at the next meal. A diet rich in vegetables, fruit and lean meat reduces systemic inflammation.4 Additional calories can come from nuts and seeds, particularly chia and hemp. Grains, legumes and dairy should be consumed in modest amounts. Foods that should be avoided included refined sugar, flour and oils, as they are all highly inflammatory and yet, at this point they represent approximately 60 percent of the calories consumed by Americans.6

Supplements that help to reduce the inflammatory state include a multivitamin, magnesium, omega-3 fish oils, and vitamin D.7-10 Supplements that can specifically help improve insulin sensitivity and help reduce inflammation include chromium and lipoic acid.11-12

While the notion of brain inflammation might be new, the approach to reduce systemic inflammation is quite straightforward. Operationally, many patients only need to lose 5 percent to 20 percent of body weight to reduce or eliminate the metabolic syndrome,13 which means that reducing systemic and brain inflammation can be realized by all of your patients.

References

Hotamisligil GS. Inflammation and metabolic disorders. Nature, 2006;444:860-67.
American Heart Association. Description of the metabolic syndrome. www.americanheart.org/presenter.jhtml?identifier=4756
Grimble RF. Inflammatory status and insulin resistance. Curr Opin Clin Nutr Metab Care, 2003;5:551-59.
O’Keefe JH, Gheewala NM, O’Keefe JO. Dietary strategies for improving post-prandial glucose, lipids, inflammation, and cardiovascular health. J Am Coll Cardiol, 2008;51:249-55.
Velloso LA, Araujo EP, de Souza CT. Diet-induced inflammation of the hypothalamus in obesity. Neuroimmunomodulation, 2008;15:189-93.
Cordain L, Eaton SB, Sebastian A, et al. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr, 2005;81:341-54.
Church TS, Earnest CP, Wood KA, Kampert JB. Reduction of C-reactive protein levels through use of a multivitamin. Am J Med, 2003;115:702-707.
King DE, Mainous AG, Geesey ME, Egan BM, Rehman S. Magnesium supplement intake and C-reactive protein levels in adults. Nutr Res, 2006;26:193-96.
Simopoulos AP. The importance of the omega-6/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases. Exp Biol Med, 2008;233:674-88.
Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr, 2008;87(suppl):1080S-86S.
Cefalu WT, Rood J Patricia Pinsonat P, et al. Characterization of the metabolic and physiologic response to chromium supplementation in subjects with type 2 diabetes mellitus. Metab Clin Exper, 2010;59:755-62.
Shay KP, Moreau RF, Smith EJ, Smith AR, Hagen TM. Alpha-lipoic acid as a dietary supplement: molecular mechanisms and therapeutic potential. Biochim Biophys Acta, 2009;1790:1149-60.
Tzotzas T, Evangelou P, Kiortsis DN. Obesity, weight loss and conditional cardiovascular risk factors. Obesity Rev, Nov. 3, 2010. [Epub ahead of print]