The Cedars-Sinai Health Sciences University study, published in Clinical Gastroenterology and Hepatology, also uncovered biological patterns that could help explain why coffee consumption has repeatedly been associated with healthier livers.

“Previous studies suggested that coffee might benefit the liver, but most were smaller or looked at only one piece of the puzzle,” said hepatologist Hyunseok Kim, MD, MPH, PhD, assistant professor of Medicine at Cedars-Sinai and corresponding author of the study. “We followed hundreds of thousands of people for more than a decade and looked at their health outcomes along with liver MRI scans and blood protein analyses. Together, those findings help explain the biological mechanisms behind coffee’s association with better liver health.”

Study Followed Nearly 355,000 Adults

Researchers examined data from 354,957 UK Biobank participants who had no history of cirrhosis or liver cancer when the study began. Using linked medical records, the team tracked new cases of cirrhosis, liver cancer, and liver-related death over a median period of 13 years.

The results showed that coffee drinkers generally experienced better liver outcomes than people who did not drink coffee.

Participants who consumed five or more cups per day had a 32% lower risk of cirrhosis, a 47% lower risk of liver cancer, and a 42% lower risk of dying from liver disease compared with non-coffee drinkers.

Coffee Linked to Less Liver Damage

The researchers also examined liver MRI scans and blood protein measurements to look for physical and molecular signs of liver health.

People who drank more coffee had lower levels of liver fat, excess liver iron, fibrosis, and liver inflammation on MRI scans. Their blood samples also contained higher levels of proteins associated with healthy liver function and lower levels of proteins connected to inflammation and tissue scarring.

Together, these findings provide biological support for the long-observed relationship between coffee consumption and lower liver disease risk.

Although risk generally declined as coffee intake increased, the researchers found signs of benefit even among people who drank only one or two cups per day. The strongest associations appeared at about three to four cups daily.

The researchers stressed that although the group consuming the most coffee (five or more cups daily) also showed benefits, they are not advising people to raise their intake specifically to that amount.

Decaf Showed Similar Associations

Both caffeinated and decaffeinated coffee were linked to better liver outcomes. This suggests that caffeine is probably not the only substance responsible for the association.

Coffee contains numerous naturally occurring compounds, some of which may influence inflammation, liver scarring, and other biological processes involved in liver disease.

However, the study was observational. It identified associations but cannot establish that coffee directly prevents cirrhosis, liver cancer, or liver-related death.

The researchers also emphasized that drinking coffee should complement, not replace, well-established approaches to protecting liver health.

“Our findings support moderate coffee consumption for people who already enjoy and tolerate it well,” said study senior author Ju Dong Yang, MD, medical director of the Liver Cancer Program at Cedars-Sinai.

“However, we would not recommend that someone begin drinking coffee solely for liver protection based on this study alone. Prevention should continue to focus on maintaining a healthy weight, limiting alcohol, exercising regularly, and managing blood sugar, blood pressure and cholesterol.”

Coffee Is Not Appropriate for Everyone

Caffeine may not be suitable for some people. Those with uncontrolled high blood pressure, certain heart rhythm disorders, severe anxiety, insomnia, or other conditions that require caffeine restriction should speak with a healthcare provider before increasing their coffee intake.

Future research will focus on identifying which substances in coffee may be responsible for the liver-related associations observed in the study.

“The next step in our research is to identify the specific compounds in coffee that are responsible for these liver-protective associations,” said study author Shelly Lu, MD, the Women’s Guild Chair in Gastroenterology and director of the Karsh Division of Gastroenterology and Hepatology at Cedars-Sinai. “Our findings point to biological pathways involving inflammation and scarring and highlight molecular targets that future research can explore to better understand how coffee may influence liver health and who stands to benefit the most.”

Additional Cedars-Sinai authors include Yufeng Wang, Abdelrahman M. Attia, Minsun Kwak, Seungwon Burm, Derin Celtik, Daniel Legaspi, Osama Khattab, Naomy Kim, Beza M. Mengistu, Kelsey N. Larios, Walid Ayoub, Alexandar Kuo, Paul Martin, Aarshi Vipani, Yun Wang, Debiao Li and Stephen Pandol.

Other authors include Mohammad Saeid Rezaee-Zavareh, David Sooik Kim and Suthat Liangpunsakul.

Conflicts of Interest: Ju Dong Yang reports the following conflicts of interest: consulting service for AstraZeneca, Eisai, Exact Sciences, and Fujifilm Medical Sciences.