I frequently lecture to both conventional and professional audiences. A question I am often asked, "Is coffee bad for me?" As I like to make my answers based on data, this has been difficult to answer as the
coffee research has been surprisingly inconsistent. Happily, several recent studies have finally provided clarity.
In the ongoing debate over whether coffee is good or bad for health, a number of recent studies suggest that - if you don't have high blood pressure or problems clearing caffeine - American's favorite brew may do a lot more than perk you up in the morning.
Recent epidemiological (population) studies suggest that coffee may help lessen risk of several chronic diseases, including
type 2 diabetes, Parkinson's disease and liver disease (
cirrhosis and hepatocellular carcinoma). (Higdon JV, Frei B.,Critical Review Food Science Nutrition 2006; Montella M, Polesel J, et al. Int J Cancer 2007; Kalda A, Yu L, et al. J Neurol Sci. 2006)
Data gathered on 88,259 women in the Nurses Health Study II found that coffee drinkers lowered their risk of type 2 diabetes by 13% if consuming 1 cup per day, 42% for 2-3 cups per day, and 47% for 3 cups per day, compared to non-coffee drinkers.
Interestingly, coffee's beneficial effects were not due to caffeine: these reductions in disease risk were similar for those drinking decaffeinated as well as caffeinated coffee, filtered coffee, and even instant coffee. (van Dam RM, Willett WC, et al., Diabetes Care 2006)
Although caffeine has been considered as a possible risk factor for breast cancer, research suggests otherwise - at least in premenopausal women. A study in the January 2006 issue of the Journal of Nutrition found that among premenopausal women, consumption of regular (caffeinated) coffee was associated with linear declines in breast cancer risk.
A 40% reduction in risk of breast cancer was seen in premenopausal women drinking at least 4 cups of coffee a day. On the other hand, no clear associations were seen between breast cancer risk and intake of black tea (which also contains caffeine) or decaffeinated coffee. Something else about coffee-most likely its rich concentration of heterocyclic compounds with strong antioxidant activity and polyphenols with anti-cancer actions-is responsible.
Coffee may offer special benefits as we age. If you're over 65 and don't have high blood pressure, daily coffee consumption may offer protection against both cardiovascular disease and cognitive decline:
Data collected for the first National Health and Nutrition Examination Survey Epidemiological (NHANES I) by James Greenberg and colleagues at the City and State Universities of New York (American Journal of Clinical Nutrition, 2007, 85 (2): 392- 398), revealed that those over 65 with normal blood pressure who drank at least 4 caffeinated beverages a day had a 53% reduced risk of death from cardiovascular disease. However, no cardiovascular benefit was seen from coffee consumption in participants with stage 2 hypertension or in those younger than 65.
Results of the FINE study, a long term health study that began in 1966, when 676 healthy men born between 1900 and 1920 in the Netherlands, Finland and Italy, were enrolled, suggest that coffee helps men retain their mental edge as they age (van Gelder et al. European Journal of Clinical Nutrition (2007) 61: 226-232).
Over a 10-year period, study participants' thinking ability was assessed using the Mini-Mental State Examination. Results showed that men who drank 3 cups of coffee a day had half the cognitive decline of the men who never drank coffee.
Men who consumed coffee had a 10-year cognitive decline of 1.2 points (4%). Non-consumers experienced a cognitive decline of 2.6 points. An inverse and J-shaped association was observed between the number of cups of coffee consumed and cognitive decline, with the least cognitive decline for 3 cups of coffee per day (0.6 points).
The cognitive decline seen in coffee drinkers was 1/4 the decline the decline in non-consumers.
Animal studies may explain why. In mice with the rodent equivalent of Alzheimer's disease (amyloid-beta induced brain cell atrophy), trigonelline, an active constituent of coffee beans, has been shown to regenerate brain cells (dendrites and axons), resulting in memory improvement.
The caffeine naturally present in coffee, while potentially harmful for the caffeine-sensitive, may give
athletes who tolerate it well a significant edge. A small study by UK researchers suggests that caffeine may not only improve alertness, but may boost carbohydrate delivery to cells by up to 26%, enhancing available energy and therefore potentially improving physical performance.
In one study, bicyclists underwent 3 two-hour exercise sessions, cycling at approximately 64% of their maximum output. During each session, the cyclists consumed one of three beverages. All beverages tasted the same, but one contained sugar (glucose), another contained glucose and caffeine, and the third, a control drink, was flavored water (no calories or caffeine). Samples of blood and expired air were taken from the athletes at 15 minute intervals to measure how quickly they absorbed and utilized the carbohydrate. When drinking the beverage containing caffeine, the athletes' carbohydrate oxidation (ability to burn sugar to produce energy) increased by 26%.
While caffeine is present not only in coffee, but in chocolate, drugs, and cola, this study suggests that a cup of coffee with a little sweetener-we prefer honey since it provides other benefits besides glucose-before your workout may improve your performance.
Coffee CaveatsPersons with or at increased risk of developing high cholesterol levels should drink only filtered coffee. Epidemiological studies have linked consumption of boiled, but not filtered, coffee with increased risk for cardiovascular disease (CVD). Moderate daily consumption of filtered coffee, however, has not been associated with any adverse cardiovascular effects.
Why should unfiltered coffee increase CVD risk while filtered coffee does not? Coffee contains two diterpene compounds, cafestol and kahweol, which promote an increase in blood levels of cholesterol but are removed when the coffee is filtered. (Ranheim T, Halvorsen B., Molecular Nutrition and Food Research, 2005)
If you are sensitive to caffeine-if coffee gives you the jitters or a cup of coffee in the afternoon keeps you up half the night-caffeinated coffee can increase your risk of a
heart attack.
Caffeine is metabolized by an enzyme in the liver called cytochrome P450 1A2 (CYP1A2). There are different versions of the gene for this enzyme, one of which is associated with slow and the other with a fast rate of clearance of caffeine from the body. Individuals who have inherited the gene variant CYP1A2*1F allele metabolize caffeine slowly-these are the folks who get speedy and stay awake all night after a couple of cups of coffee or a piece of chocolate-while individuals with the gene variant CYP1A2*1A allele metabolize caffeine rapidly-these people can top off a night out with an espresso and a chocolate mousse and fall asleep an hour later.
Researchers from the University of Toronto, Canada, investigated whether this genetic variation in the gene that detoxifies caffeine could explain the inconsistency in studies, some of which show risk of non-fatal heart attack increases with coffee consumption while others do not. The team determined the genotype and assessed the intake of caffeine from coffee between 1994 and 2004 in 4,018 subjects from Costa Rica: 2,014 who were patients who had had a first acute non-fatal heart attack and 2,014 controls.
Results indicted that 55% of patients and 54% of controls carried the slow *1F allele. Carriers of this allele older than age 59 who consumed 2-3 cups of coffee per day had a 36% increased risk of heart attack, and those who drank 4 or more cups per day had a 64% increased risk.
However, among carriers of the rapid *1A genotype older than 59, coffee consumption resulted in a reduced risk of 25% for those consuming 1 cup, 22% for those consuming 2-3 cups, and 1% for those drinking 4 or more cups daily.
Even more pronounced increases and decreases in risk were seen in individuals younger than 59 years of age:
Among younger individuals with the slow *1F allele, consuming 1 cup of coffee daily increased heart attack risk by 24%, 2-3 cups increased risk by 67%, and 4 or more cups increased risk 133%!
Correspondingly, individuals younger than 59 with the rapid *1A genotype lowered their risk of heart attack by 52% when drinking 1 cup of coffee daily; 2-3 cups a day lowered risk by 43%, and 4 or more cups daily resulted in a reduction in heart attack risk of 17%.
Women who are trying to conceive or are pregnant should play it safe and avoid caffeine, including that found in tea, chocolate, sodas and some over-the-counter medications, as well as regular coffee.
Once again, the reason lies in our genes. Women who carry the Val/Val polymorphism of a detoxification enzyme called CYP450 1B1 are at increased risk for first-trimester miscarriage, and, particularly in smokers, caffeine consumption further increases this risk.
CYP450 1B1 is not a major player in the processing of caffeine in the liver, but instead plays a role in the metabolism of caffeine among pregnant women via action in the uterus. Smoking increases risk since it is known to induce production of CYP450 1B1.
The CYP1B1 Val/Val polymorphism is very common, so avoiding caffeine is a good idea for women who are trying to conceive or are pregnant.
And giving up coffee while pregnant may be easy, even for those who ordinarily love it. An increased aversion to coffee is, along with nausea and vomiting, a consistent early feature of a healthy pregnancy.
Practical Tip:
For adults with normal blood pressure who have no difficulty clearing caffeine-those with the CYP1A2*1A allele-consuming moderate amounts of coffee (3-4 cups/d providing 300-400 mg/d of caffeine), may offer a number of health benefits.
References - Hancock DB, Martin ER, Stajich JM, Jewett R, Stacy MA, Scott BL, Vance JM, Scott WK. Smoking, caffeine, and nonsteroidal anti-inflammatory drugs in families with Parkinson disease.Arch Neurol. 2007 Apr;64(4):576-80.
PMID: 17420321
- Kalda A, Yu L, Oztas E, Chen JF. Novel neuroprotection by caffeine and adenosine A(2A) receptor antagonists in animal models of Parkinson's disease. J Neurol Sci. 2006 Oct 25;248(1-2):9-15. Epub 2006 Jun 27. PMID: 16806272
Higdon JV, Frei B. Coffee and health: a review of recent human research. Crit Rev Food Sci Nutr. 2006;46(2):101-23. PMID: 16507475
- Montella M, Polesel J, La Vecchia C, Dal Maso L, Crispo A, Crovatto M, Casarin P, Izzo F, Tommasi LG, Talamini R, Franceschi S. Coffee and tea consumption and risk of hepatocellular carcinoma in Italy. Int J Cancer. 2007 Apr 1;120(7):1555-9. PMID: 17205531
- Ranheim T, Halvorsen B. Coffee consumption and human health--beneficial or detrimental?--Mechanisms for effects of coffee consumption on different risk factors for cardiovascular disease and type 2 diabetes mellitus. Mol Nutr Food Res. 2005 Mar;49(3):274-84. PMID: 15704241
- van Dam RM, Willett WC, Manson JE, Hu FB. Coffee, caffeine, and risk of type 2 diabetes: a prospective cohort study in younger and middle-aged U.S. women. Diabetes Care. 2006 Feb;29(2):398-403. PMID: 16443894
Baker JA, Beehler GP, Sawant AC, Jayaprakash V, McCann SE, Moysich KB. Consumption of coffee, but not black tea, is associated with 40% decreased risk of premenopausal breast cancer. J Nutr. 2006 Jan;136(1):166-71. PMID: 16365077
- Greenberg JA, Dunbar CC, Schnoll R, Kokolis R, Kokolis S, Kassotis J. Caffeinated beverage intake and the risk of heart disease mortality in the elderly: a prospective analysis. Am J Clin Nutr. 2007 Feb;85(2):392-8.
- van Gelder BM, Buijsse B, Tijhuis M, Kalmijn S, Giampaoli S, Nissinen A, Kromhout D. Coffee consumption is inversely associated with cognitive decline in elderly European men: the FINE Study. Eur J Clin Nutr. 2007 Feb;61(2):226–232. Epub 2006 Aug 16. PMID: 16929246
- Tohda C, Kuboyama T, Komatsu K. Search for natural products related to regeneration of the neuronal network. Neurosignals. 2005;14(1-2):34-45. PMID: 15956813
Yeo SE, Jentjens RL, Wallis GA, Jeukendrup AE. Caffeine increases exogenous carbohydrate oxidation during exercise. J Appl Physiol. 2005 Sep;99(3):844-50. Epub 2005 Apr 14. PMID: 15831802
- Cornelis MC, El-Sohemy A, Kabagambe EK, Campos H. Coffee, CYP1A2 genotype, and risk of myocardial infarction. JAMA. 2006 Mar 8;295(10):1135-41. PMID: 16522833
- Karypidis AH, Soderstrom T, Nordmark A, Granath F, Cnattingius S, Rane A. Association of cytochrome P450 1B1 polymorphism with first-trimester miscarriage. Fertil Steril. 2006 Nov;86(5):1498-503. Epub 2006 Sep 14. PMID: 16978616
- Cnattingius S, Signorello LB, Anneren G, Clausson B, Ekbom A, Ljunger E, Blot WJ, McLaughlin JK, Petersson G, Rane A, Granath F. Caffeine intake and the risk of first-trimester spontaneous abortion. N Engl J Med. 2000 Dec 21;343(25):1839-45. PMID: 11117975
- Hey E. Coffee and pregnancy. BMJ. 2007 Feb 24;334(7590):377. PMID: 17322215
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