title: Diterpenes from coffee beans decrease serum levels of lipoprotein(a) in humans: results from four randomised controlled trials.
abstract: OBJECTIVE
  Unfiltered coffee raises serum LDL cholesterol in humans, owing to the presence of the diterpenes cafestol and kahweol. Norwegians with a chronic high intake of unfiltered coffee also has elevated serum levels of lipoprotein(a), an LDL-like particle which is insensitive toward dietary interventions. We now experimentally studied the influence of coffee diterpenes on lipoprotein(a) levels.
  
  
  METHODS
  Four randomised controlled trials.
  
  
  METHODS
  Healthy, normolipidemic volunteers.
  
  
  METHODS
  Coffee, coffee oil, and pure diterpenes for 4-24 weeks.
  
  
  METHODS
  The circulating level of lipoprotein(a).
  
  
  RESULTS
  In 22 subjects drinking five to six strong cups of cafetiere coffee 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), relative 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 mg/dL (P < 0.05) in two separate trials (n = 12-16 per group). A purified mixture of cafestol and kahweol, as well as cafestol alone, were also effective in reducing Lp(a) levels (n = 10). 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 mg/dL or 4% from baseline values after four weeks (n = 63).
  
  
  CONCLUSIONS
  Coffee diterpenes are among the few dietary exceptions shown to influence serum lipoprotein(a) levels. However, the Lp(a)-reducing potency of coffee diterpenes may subside in the long run, and their adverse side effects preclude their use as lipoprotein(a)-reducing agents.
authors.affiliation: Agricultural University, Department of Human Nutrition, Wageningen, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Urgert
authors.forename: M P
authors.initials: MP
authors.lastname: Weusten-van der Wouw
authors.forename: R
authors.initials: R
authors.lastname: Hovenier
authors.forename: S
authors.initials: S
authors.lastname: Meyboom
authors.forename: A C
authors.initials: AC
authors.lastname: Beynen
authors.forename: M B
authors.initials: MB
authors.lastname: Katan
mesh_terms: D000328:Adult; D003069:Coffee; D004224:Diterpenes / Q000009:adverse effects / Q000494:pharmacology*; D005260:Female; D006801:Humans; D050356:Lipid Metabolism; D017270:Lipoprotein(a) / Q000097:blood* / Q000187:drug effects*; D008297:Male
chemical_list: D003069:Coffee; D004224:Diterpenes; D017270:Lipoprotein(a); C053401:kahweol; C053400:cafestol