title: Cholesterol-raising diterpenes in types of coffee commonly consumed in Singapore, Indonesia and India and associations with blood lipids: a survey and cross sectional study.
abstract: BACKGROUND
  To measure the content of cholesterol-raising diterpenes in coffee sold at the retailer level in Singapore, Indonesia and India and to determine the relationship of coffee consumption with lipid levels in a population-based study in Singapore.
  
  
  METHODS
  Survey and cross-sectional study in local coffee shops in Singapore, Indonesia and India to measure the diterpene content in coffee, and a population-based study in Singapore to examine the relationship of coffee consumption and blood lipid levels. Interviews and coffee samples (n=27) were collected from coffee shops in Singapore, Indonesia and India. In addition, 3000 men and women who were Chinese, Malay, and Indian residents of Singapore participated in a cross-sectional study.
  
  
  CONCLUSIONS
  The traditional 'sock' method of coffee preparation used in Singapore resulted in cafestol concentrations comparable to European paper drip filtered coffee (mean 0.09±SD 0.064 mg/cup). This amount would result in negligible predicted increases in serum cholesterol and triglyceride concentrations. Similarly low amounts of cafestol were found in Indian 'filter' coffee that used a metal mesh filter (0.05±0.05 mg/cup). Coffee samples from Indonesia using the 'sock' method (0.85±0.41 mg/cup) or a metal mesh filter (0.98 mg/cup) contained higher amounts of cafestol comparable to espresso coffee. Unfiltered coffee from Indonesia contained an amount of cafestol (4.43 mg/cup) similar to Scandinavian boiled, Turkish and French press coffee with substantial predicted increases in serum cholesterol (0.33 mmol/l) and triglycerides (0.20 mmol/l) concentrations for consumption of 5 cups per day. In the Singaporean population, higher coffee consumption was not substantially associated with serum lipid concentrations after adjustment for potential confounders [LDL-cholesterol: 3.07 (95% confidence interval 2.97-3.18) for <1 cup/week versus 3.12 (2.99-3.26) for ≥3 cups/day; p trend 0.12].
  
  
  CONCLUSIONS
  Based on the low levels of diterpenes found in traditionally prepared coffee consumed in Singapore and India, coffee consumption in these countries does not appear to be a risk factor for elevation of serum cholesterol, whereas samples tested from Indonesia showed mixed results depending on the type of preparation method used.
authors.affiliation: Centre for Molecular Epidemiology, Yong Loo Lin School of Medicine, National University of Singapore, #05-02, 28 Medical Drive, 117456, Singapore. cmenn@nus.edu.sg
authors.forename: Nasheen
authors.initials: N
authors.lastname: Naidoo
authors.forename: Cynthia
authors.initials: C
authors.lastname: Chen
authors.forename: Salome A
authors.initials: SA
authors.lastname: Rebello
authors.forename: Karl
authors.initials: K
authors.lastname: Speer
authors.forename: E Shyong
authors.initials: ES
authors.lastname: Tai
authors.forename: Jeanette
authors.initials: J
authors.lastname: Lee
authors.forename: Sandra
authors.initials: S
authors.lastname: Buchmann
authors.forename: Isabelle
authors.initials: I
authors.lastname: Koelling-Speer
authors.forename: Rob M
authors.initials: RM
authors.lastname: van Dam
mesh_terms: D000328:Adult; D002784:Cholesterol / Q000097:blood*; D003069:Coffee / Q000737:chemistry*; D003430:Cross-Sectional Studies; D004224:Diterpenes / Q000009:adverse effects* / Q000032:analysis; D005260:Female; D005511:Food Handling / Q000379:methods; D006801:Humans; D007194:India; D007214:Indonesia; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D028321:Plant Preparations / Q000032:analysis / Q000737:chemistry; D011446:Prospective Studies; D012846:Singapore; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood
chemical_list: D003069:Coffee; D004224:Diterpenes; D028321:Plant Preparations; D014280:Triglycerides; C053401:kahweol; D002784:Cholesterol; C053400:cafestol