Coffee Talk

With lips full of passion…And coffee in bed ~Squeeze (Black Coffee in Bed, 1982)

Posted Nov 18, 2015

Teasing out the dietary effects of food is tricky business. Our food choices are intricately wound up in our lifestyles, pursuits, vocation and both define who we are and are defined by who we are. Throw in an insatiable thirst for that modern philosopher’s stone – the magic pill that bestows health, wellness and a 20-year-old’s physique – and it becomes a question that begs an answer; or at least an amuse-bouche. We seek an Epicurean Holy Grail; nutritional absolution for all our gastronomic sins. And for many of us the pursuit more resembles Monty Python than a Templar Crusade. It is sweet discussion for coffee talk.

Yet, what exactly is the truth about coffee?

For years the findings and recommendations have vacillated from detrimental and abstinence to miracle health tonic at doses only fit for the waking dead. Now the latest Dietary Guidelines Advisory Committee (DGAC) has stated that up to five cups of coffee per day, or up to 400 mg of caffeine, is not associated with long-term health risks. But the report goes even further, highlighting evidence that coffee consumption is associated with reduced risk for several diseases, including type 2 diabetes, cardiovascular disease (CVD), and neurodegenerative disorders. The final tipple is that drinking coffee results in a mortality risk reduction, with the greatest benefit seen in those consuming 3 to 5 cups per day. It made no difference as to whether you consumed caffeinated or decaffeinated coffee, but if you smoked you significantly attenuated the boon from the bean.

Such evidence suggests that your second – and third – cup of Joe is not only safe but makes a great part of a healthful approach to food and diet. A diet that according to a recent meta-analysis of over 200,000 men and women found that coffee drinkers were more likely to consume alcohol, but less likely to consume sugar sweetened beverages than those who did not drink coffee; practices also associated with health benefits. Yet, to add two lumps of confusion to the brew, coffee drinkers also ate less fruit and consumed more red meat.

Copyright Red Tail Productions, used with permission
Source: Copyright Red Tail Productions, used with permission

For those who prefer the venti whole bean, here are the details.

Just how potent that cup of java may be in improving overall health is reflected in a study published in 2012 of more than 400,000 people followed for over a period of 13 years. The researchers found that coffee consumption was associated with a 10% reduction in all-cause early mortality. This was further correlated in a more recent large, meta-analysis that found the 3 to 5 cups of coffee each day was associated with significant reductions in all-cause mortality as well as cardiovascular disease (CVD) related mortality.

The cardiovascular benefits may seem illogical at first. Coffee, primarily because of its caffeine content has been shown to increase blood pressure in the short-term. The small and transient blood pressure elevations may be balanced by the high antioxidant activity found in coffees other components. Regular coffee consumption has been shown to reduce “bad" (LDL) cholesterol, and other markers of inflammation like C-reactive protein. In addition to a decreased risk of coronary artery disease, 1 to 2 cups per day also decrease the risks of developing heart failure.

But the heart, like any pumping system has two components. It has a mechanical component; the muscle and valves that propel the blood forward and it also has an electrical component. The electrical component keeps the beat and is responsible for the rhythm of life. For decades, physicians have been telling patients to avoid coffee and other caffeine containing pleasures like chocolate to avoid rhythm irregularities.

However, data presented, at the Heart Rhythm Society in 2015 suggested that there is actually no association between caffeine and premature atrial or ventricular contractions that are often responsible for patients experiencing palpitations. The study followed over 5000 patients over the age of 65 who participated in the cardiovascular health study (CHS), which began collecting data in 1989. The researchers identified premature atrial contractions (PACs) and premature ventricular contractions (PVCs) in almost 1500 people randomly assigned to have their heart rhythm monitored for 24 hours by a Holter monitor device. This was correlated to their food and drink intake and analysis performed. There was no correlation with these irregularities and any caffeine containing compound; including coffee, tea or chocolate.

These findings are in perfect step with other evidence destroying the caffeine-heart dysrhythmia myth. A meta-analysis performed in 2014 analyzed the risk of caffeine intake in patients with known atrial fibrillation (AF). This is the rhythm abnormality associated with an increased risk of stroke and a need for continuous anticoagulation as evidenced by the endless pharmaceutical commercials on television. The researchers found that the relationship between caffeine consumption and atrial fibrillation was actually inverse. In other words, caffeine ingestion may actually reduce your risk of atrial fibrillation. A more recent meta-analysis looked specifically at coffee consumption by examining almost 18,000 cases of AF from amongst almost 250,000 individuals. The study confirmed no association between consumption of coffee at any level and the risk of developing atrial fibrillation.

The benefits of the heart, as the poets have long noted, are not lost on the brain. A meta-analysis done in 2011 looking at 1 to 6 cups of coffee per day demonstrated a 17% risk reduction in the likelihood of having a stroke. Another study followed women in Sweden for over 10 years and found a 22%-25% risk reduction in suffering a cerebrovascular accident for those enjoying a little java juice. A broader meta-analysis presented at the 2012 European Meeting on Hypertension and Cardiovascular Protection found that one to three cups of coffee per day reduces the risk of stroke for both men and women. A 2013 study of over 80,000 Japanese adults examined caffeine consumption and those who drank coffee or green tea for a mean duration of 13 years. Those consuming these elixirs of morning cognition reduced their risk of stroke by 20% compared to those who didn’t.

But the cerebral benefits go well beyond stroke reduction, as anyone who’s woken up foggy eyed and reached for a noggin warming mug knows. Coffee makes you smarter. Its ability to enhance short-term cognitive function is well-documented. Yet the effects of regular coffee consumption may leave a lasting impression. A 2012 study reported that patients with mild cognitive impairment who consumed approximately three to five cups of coffee per day were able to avoid progression to dementia over the following 2-4 years.

 A different study shed some light on why that may be so by demonstrating that caffeine consumption appears to enhance memory consolidation. Animal studies, particularly rodent studies, suggest that caffeine suppresses enzymes involved in amyloid-beta production; amyloid beta is the protein found in increased concentration in those who suffer from such neurodegenerative conditions like Alzheimer’s type dementia.

Regular coffee consumption also boosts granulocyte colony-stimulation factor, interleukin-10, and interleukin-6 levels. These cytokines are hypothesized to contribute to neural protection. Other research in those suffering from Parkinson disease found that coffee consumption may prevent the formation of Lewy bodies. These clumps of alpha-synuclein and ubiquitin protein deposit in in the brain and are a pathognomonic finding in those with such dementia. Other work suggests that coffee consumption exerts its effect through a variant in the glutamate-receptor gene GRIN2A. This gene may also be involved in multiple sclerosis.

When you’re healthier, you feel better. And if coffee makes you healthier, it should make you feel better. It does. A study in 2011 examined women who drank 2 to 3 cups of coffee per day and found they had a 15% decreased risk of depression compared to those who drank less than 1 cup per week. Drink four or more cups per day and your risk is reduced by 20%. In the short term, the happy juice may work by altering serotonin and dopamine activity. The long-term effects may be related to the antioxidant components found in coffee and its overall anti-inflammatory effect.

Such a positive anti-inflammatory effect also bestows benefit in terms of a reduction in the likelihood of those chronic diseases associated with ongoing low-level continuous inflammation. These are conditions like diabetes and metabolic syndrome. Many studies have clearly demonstrated that regular coffee consumption is associated with an improvement in glucose metabolism and insulin secretion; the result is a significantly reduced risk for the development of diabetes. One recent, long-term study published in the European Journal of Clinical Nutrition suggested that the risk reduction in developing type II diabetes may be as much as 54%.

One hypothesis, highlights the role of chlorogenic acid; a powerful phytogenic antioxidant that reduces glucose absorption. Other possible players include lignans, quinides, trigonelline, and magnesium; all compounds found in coffee that act to reduce insulin resistance and systematic inflammation.

These powerful phytochemicals in our morning beverage may also reduce the risk for any number of cancers. Four or more cups per day has been associated with a reduced risk of endometrial, basal cell, and head and neck cancer. Five to six cups per day is associated with a reduction in prostate, melanoma and breast cancer. And while the work to metabolize all that coffee falls to the liver, it turns out that the coffee may confer some hepatic protection as well. Studies have demonstrated a reduced risk of hepatocellular carcinoma (liver cancer) in patients with hepatitis C and alcoholic cirrhosis. Coffee also protects those with nonalcoholic fatty liver disease (NAFLD) from liver fibrosis and reduces the risk of developing NAFLD in the first place.

And while all the benefits associated with caffeine and coffee consumption in particular is quite a heady brew, there is a caveat in the creamer. The caffeine concentration found in natural products like coffee, chocolate, and tea are fairly minuscule compared to that found in energy drinks and other artificially constructed consumables. These manufactured beverages are often also loaded with sugar and other additives. Overconsumption of these has been associated with a number of health issues and can raise caffeine to literally toxic levels. It seems that while once again nature has perfectly proportioned our favorite caffeinated concoction, we fail to see that the poison is in the dose. Beware the industrialized substitutes that continue to promote the miscalculation that if a little is good, more is always better.

So go ahead, wake up, smell the coffee and have that second cup….


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