DITERPENES FROM COFFEE BEANS DECREASE SERUM LEVELS OF LIPOPROTEIN(A) IN HUMANS - RESULTS FROM 4 RANDOMIZED CONTROLLED TRIALS

Objective: Unfiltered coffee raises serum LDL cholesterol in humans, o wing to the presence of the diterpenes cafestol and kahweol. Norwegian s with a chronic high intake of unfiltered coffee also had elevated se rum levels of lipoprotein(a), an LDL-like particle which is insensitiv e toward dietary interventions. We now experimentally studied the infl uence of coffee diterpenes on lipoprotein(a) levels. Design: Four rand omised controlled trials. Subjects: Healthy, normolipidemic volunteers . Interventions: Coffee, coffee oil, and pure diterpenes for 4-24 week s. Main outcome measures: The circulating level of lipoprotein(a). Res ults: In 22 subjects drinking five to six strong cups of cafetiere cof fee per day, the median fall in lipoprotein(a) was 1.5 mg/dL after two months (P = 0.03), and 0.5 mg/dL after half a year (P > 0.05), relati ve to 24 filter coffee drinkers. Coffee oil doses equivalent to 10-20 cups of unfiltered coffee reduced lipoprotein(a) levels by up to 5.5 m g/dL (P < 0.05) in two separate trials (n = 12-16 per group). A purifi ed mixture of cafestol and kahweol, as well as cafestol alone, were al so effective in reducing Lp(a) levels (n = IO). Averaged over the four trials, each 10 mg/d of cafestol (plus kahweol)-the amount present in two to three cups of cafetiere coffee-decreased Lp(a) levels by 0.5 m g/dL, or 4% from baseline values after four weeks (n = 63). Conclusion s: Coffee diterpenes are among the few dietary exceptions shown to inf luence serum lipoprotein(a) levels. However, the Lp(a)-reducing potenc y of coffee diterpenes may subside in the long run, and their adverse side effects preclude their use as lipoprotein(a)-reducing agents.