Caffeine, polyphenols and other components of coffee may help reduce the severity of non-alcoholic fatty liver disease (NAFLD) in people with type 2 diabetes with overweight, according to a study by the University of Coimbra in Portugal. The study was published in Nutrients.

Though not caused by excess alcohol consumption, NAFLD can result in the buildup of fat in the liver, which can lead to liver fibrosis, cirrhosis and liver cancer.

The study found that participants with higher coffee intake had healthier livers. What’s more, those with higher caffeine levels were less likely to develop liver fibrosis, and higher levels of non-caffeine coffee components correlated with reduced fatty liver index scores. The study also suggested that higher coffee intake in patients with type 2 diabetes and overweight could result in less severe NAFLD.

“Due to changes in modern diet and lifestyle, there is an increase in obesity rates and incidence of both [type 2 diabetes] and NAFLD, which can ultimately develop into more severe and irreversible conditions, burdening health care systems,” said study corresponding author John Griffith Jones, PhD, a senior researcher at the University of Coimbra in a Coffee & Health article.

According to the European Food Safety Authority, moderate coffee consumption can be defined as three to five cups per day.

Researchers surveyed 156 middle-age borderline-obese participants about their coffee intake; of these, 98 had type 2 diabetes and submitted 24-hour urine samples. The samples were used to measure caffeine and non-caffeine metabolites, or natural by-products resulting from the body’s breakdown of coffee.

Researchers found that caffeine is associated with “modest but significant protection against NAFLD.” They further concluded, “Our study indicates that higher cumulative amounts of both caffeine and non-caffeine metabolites measured in a 24 hour urine collection are associated with a less severe NAFLD profile. Finally, the profile of urine caffeine metabolites is sensitive to NAFLD severity and may serve as a noninvasive marker of hepatic CYP2E1 expression, an important driver of NAFLD progression.”

“Our research is the first to observe that higher cumulative amounts of both caffeine and non-caffeine metabolites in urine are associated with a reduced severity of NAFLD in overweight people with [type 2 diabetes],” Jones said.