Summary: Coffee is among the most consumed — and controversial — beverages in the world. While coffee should be treated with care and avoided altogether by those who metabolize it poorly, it also provides health benefits to many people. Read on to find out what they are – and how to drink coffee responsibly. |
Coffee is the second most popular drink in the world, trailing only water and, debatably, tea.
Caffeine, a key component of coffee, is a controversial compound.
With 90% of North American adults consuming caffeine daily, it is the
world’s most consumed psychoactive drug – and coffee is the delivery
method of choice.
Perhaps that’s why, in the fitness world, we’ve traditionally viewed coffee with some suspicion.
But is coffee really bad for us? Should we give up our beloved cuppa joe? If it’s bad, why does it feel so good?
Coffee’s origins
The coffee plant originated in East Africa — according to legend, a
goat herder tried coffee cherries after he noticed his goats acting much
more energetic after nibbling on the coffee bushes.
The earliest evidence of coffee drinking occurred in the 15th century in Yemen. From Yemen, coffee quickly spread to Egypt and North Africa, and by the 16th
century it was being enjoyed by the rest of the Middle East, Persia,
and Turkey and soon thereafter Italy and the rest of Europe.
Fast forward to today. Coffee is ubiquitous in our culture.
Everywhere you look, there’s a coffee shop on the corner. What effect
might our cultural love of coffee have on our health?
Short answer: Well, we’re not completely sure.
Coffee’s risks
Research on coffee’s safety is mixed, for several reasons:
- Metabolism matters. People vary genetically in how well they can process caffeine and coffee.
- Coffee interacts with many hormones and neurotransmitters in the body, such as cortisol, acetylcholine, and insulin. These relationships are complex, and often depend on timing, amount, and people’s individual makeup.
- As a crop, coffee is less like corn or soy, and more like cacao or wine grapes: It’s typically grown and processed in smaller batches by smaller-scale farmers and producers. Variations in soil and climate, as well as later roasting and brewing technique, will change the taste and chemical makeup. It’s hard to standardize the exact chemical compounds in coffee from batch to batch. (By the way, JB likes to roast his own coffee. You can follow along with his process here or see a nice PDF version here.)
So it’s hard to say definitively that coffee is “good” or “bad”; “healthy” or “unhealthy”. Let’s explore this in more depth.
What about my metabolism?
One reason that evidence on the health effects of coffee is so mixed
is that people clear caffeine at different rates. Caffeine is broken
down and cleared by the liver, and our genetic makeup shapes how quickly
and effectively we can do this.
- On one hand, “slow” metabolizers of caffeine don’t process caffeine effectively. These are people who are adversely affected by caffeine, get the jitters, and are wired for up to nine hours after consumption.
- Others just get a boost in energy and alertness for a couple of hours; they are considered “fast” metabolizers of caffeine.
Research in the emerging field of nutrigenomics shows that about half
of us have the gene variant that makes us “slow” metabolizers, while
the other half enjoy the gene variant that allows them to get away with
quad-espressos.
(For more on this, see JB’s interview with nutrigenomics researcher Ahmed El-Sohemy here.)
Thus, whether coffee is better or worse for you depends on how well and quickly you metabolize caffeine.
If you are a slow metabolizer of caffeine and coffee, steer clear (or
at least, reduce your consumption). In your case, coffee can do more
harm than good, and this may explain why high coffee consumption has
been associated with:
- higher risk of miscarriage
- disrupted sleep
- worse PMS symptoms
- increased blood pressure, even in people without hypertension
- non-fatal myocardial infarction (aka a heart attack)
On the plus side, low caffeine consumption still seems relatively
safe for most folks, so a few daily cups of tea or squares of dark
chocolate shouldn’t harm you (and in fact, may greatly boost your
wellbeing!).
And fortunately, not everyone is adversely affected. For those lucky
enough to be fast metabolizers, there is good news – and lots of
it. Fast metabolizers don’t show the same association between coffee and
disease — if you’re a fast metabolizer, coffee might even improve your health!
If you’d like to know more about how well you metabolize caffeine,
you can take a quick and easy genetic test through agencies such as 23andme.com or existencegenetics.com.
What about cortisol?
Cortisol is a hormone produced by the adrenal glands. It increases
blood pressure, spikes blood sugar and prepares the body for “fight or
flight” mode.
Coffee and caffeine tend to transiently increase cortisol levels;
however, this depends on several factors, including when you drink
coffee, how often you drink it, and whether you have high blood
pressure.
Cortisol is normally high in the morning, so if you drink some coffee
at 6 a.m. and 10 a.m., you should be fine, as cortisol is naturally
elevated at that time of day anyway. However, your body may not
appreciate coffee as much in the afternoon or evening, when cortisol
normally drops. At that point, consider tea or something decaffeinated.
Again, there’s individual variation: Habitual consumers of coffee
seem to be less affected by the cortisol bump, while those with
hypertension seem to be more affected.
If cortisol levels are a problem for you, keep your coffee intake to
first thing in the morning, and otherwise consume more tea. (Not only
does tea have less caffeine, it also has other beneficial, calming
compounds such as L-theanine.
What about pesticides?
C
offee plants are heavily sprayed with pesticides, which pose obvious
health concerns. Fortunately, the plant’s structure offers some
protection. While the outer “berry” does receive a lot of exposure, it’s
the interior bean that is roasted and used for coffee, and its exposure
is far less. In addition, the roasting process destroys the majority
of pesticide residues.
If you’re especially wary of pesticides, choose organically grown
coffee. (Hey, it can’t hurt.) And while you’re at it, look for the Fair
Trade label, which helps insure that family farmers are paid a fair wage
for their crops.
What about my insulin sensitivity?
While a high dose of caffeine tends to decrease insulin sensitivity
and glucose tolerance acutely, it doesn’t seem to cause chronic
problems. While those at risk of developing diabetes may want to be
cautious, overall coffee consumption is actually associated with a 35%
decreased risk of developing type II diabetes.
What about my kids?
There’s no clear guideline on when kids can safely consume coffee.
Guidelines on caffeine consumption are based mostly on the size of the
child, rather than their chronological ages.
Nevertheless, Health Canada recommends:
- no more than 45 milligrams a day for kids aged 4 to 6;
- 62.5 milligrams for kids age 7 to 9;
- 85 milligrams for kids age 10 to 12; and
- no more than 2.5 milligrams per kilogram (2.2 pounds) of body weight for adolescents 13 and up.
All this means that a 110 pound adolescent should not have more than
125 milligrams of caffeine a day — about one 6-8 oz cup of coffee.
Bear in mind, too, that kids may be getting plenty of caffeine from soft drinks, bottled tea, etc.
Coffee’s benefits
Caffeine & dehydration
For years, fitness enthusiasts worried that coffee would dehydrate
them. However, a recent review of 10 studies found that consuming up to
550 mg of caffeine per day (or about five 8-oz cups) does not cause
fluid-electrolyte imbalances in athletes or fitness enthusiasts.
In another review, researchers concluded that consuming
caffeine-containing beverages as part of a normal lifestyle does not
lead to fluid losses exceeding the volume of fluid consumed (intake and
output were roughly equal), nor is it associated with poor hydration
status.
Take-home: Don’t drink coffee as your only beverage, and drink enough water, and you’ll be fine.
Coffee & performance
Let’s be honest — that first morning coffee can transform us from
beast to philosopher (or at least, slightly more awake and nicer beast).
Coffee, and more specifically its caffeine content, provide many noted
mental and physical performance benefits.
Caffeine reduces our rate of perceived exertion, so it doesn’t feel
like we’re working as hard as we actually are. People who regularly
drink coffee perform better on tests of reaction time, verbal memory,
and visuo-spatial reasoning.
Another study found that women over the age of 80 performed
significantly better on tests of cognitive function if they had
regularly consumed coffee over the course of their lifetimes.
Take-home: A little bit of coffee/caffeine before important tasks requiring alertness and energy can be a good thing.
Coffee & Parkinson’s
Parkinson’s disease is a fatal and incurable brain disease that
affects 1 percent to 2 percent of people over 65. Amazingly, at least
six studies have found that regular coffee drinkers are up to 80% less likely to develop Parkinson’s.
Researchers have identified a gene called GRIN2A that appeared to
protect people who drank coffee from developing Parkinson’s. GRIN2A is
linked to glutamate, a compound that is suspected of killing the brain
cells that die off in Parkinson’s patients. Glutamate can be affected
by another compound called adenosine, and coffee interferes with this
process.
However: Only about 25% of the population has the gene variant of GRIN2A that boosts the protective effect of coffee.
Take-home: Coffee may lower Parkinson’s risk, but only in a small subset of people.
Coffee & Alzheimer’s
Speaking of neurodegenerative disorders, Alzheimer’s disease is the
most common form of dementia. There is no cure for the disease, which
gets progressively worse over time, and eventually leads to death.
What separates the research on Alzheimer’s from most of the other
information covered in this article is that it derived from directly
controlled trials versus simple observation.
Here, research indicates that people who drink about three cups of
coffee a day show a marked reduction in cognitive impairment compared to
non-drinkers. Once you got up to four or more cups per day, though,
the associated protection disappears.
This protection was not seen with tea or decaf coffee, so the benefit
seems to be from the combination of the caffeine and some of coffee’s
bioactive compounds.
In fact, new research from the University of South Florida found that
this combination boosts blood levels of a critical growth factor called
GCSF (granulocyte colony stimulating factor) that seems to prevent the
formation of Alzheimer’s disease. People with Alzheimer’s disease have
less GCSF than the rest of the population. Increasing GCSF in mice
improves their memory.
In the U of South Florida study, the researchers compared the effects
of regular and decaf coffee to those of caffeine alone. In both
Alzheimer’s mice and normal mice, treatment with regular coffee
dramatically increased blood levels of GCSF; neither caffeine alone nor
decaf coffee provided this effect.
GCSF seems to improve memory performance in the Alzheimer’s mice in three ways:
- It recruits stem cells from bone marrow to enter the brain and remove the harmful beta-amyloid protein that initiates the disease.
- It creates new connections between brain cells.
- It increases the birth of new neurons in the brain.
As the lead researcher, neuroscientist Dr. Chuanhai Cao,
remarked: “Coffee is inexpensive, readily available, easily gets into
the brain, appears to directly attack the disease process, and has few
side-effects for most of us”.
According to the researchers, no other Alzheimer’s therapy being developed comes close to meeting all these criteria.
Take-home: Coffee seems to contain compounds that may reduce
Alzheimer’s risk; and may also be part of a treatment protocol in the
future.
Coffee, antioxidants & cancer
While dark chocolate and green tea gather a lot of acclaim for their
antioxidant content, coffee actually outshines them both in this
department.
In fact, the antioxidants in coffee may make up as much as 50-70% of
the total antioxidant intake of the average American! (Which is not
necessarily a good thing, because it means that there are a lot of
vegetables not getting eaten…)
Despite some general worries about the health effects of coffee,
coffee consumption is associated with an overall decreased risk of
cancer. In particular coffee consumption has been shown to be
associated with a lower risk for oral, esophageal, pharyngeal, breast
(in post-menopausal women), liver, colon, and aggressive prostate
cancer.
When it comes to the prostate, researchers recently found that men
who drank the most coffee (6 or more cups per day) were nearly 60% less likely
to develop advanced prostate cancer than non-coffee drinkers. Other
research has shown that people who regularly consume two or more cups
per day may have a 25% decreased risk of colon cancer.
Again, the research is mixed in part because of the variation in response to coffee.
Take-home: Coffee may lower your cancer risk, but don’t count
on it as your only health strategy. And eat some vegetables already.
Coffee & cardiovascular health
Drinking unfiltered types of coffee can increase your levels of LDL
(aka “bad”) cholesterol. But overall the data seems to indicate that
coffee consumption may moderately reduce your risk of dying from
cardiovascular complications.
Take-home: Research is mixed on cardiovascular disease and coffee.
Coffee & overall mortality
A recent study in The New England Journal of Medicine showed
that drinking two to three cups of coffee per day was associated with a
10% decreased risk of death for men at any age, and a 13% decreased
risk of death for women at any age.
In general, coffee drinkers were less likely to die from heart or
respiratory disease, stroke, diabetes, injuries, accidents or
infections. (Which makes us wonder… what do they die of? Espresso steamer mishaps?)
Take-home: Coffee appears to generally lower overall premature mortality slightly.
Summary & recommendations
Coffee’s not for everyone. And it’s not a magic bullet. Still, it
seems to have significant health benefits for those who can tolerate it.
This includes:
- better athletic and mental performance
- possibly lower rates of some types of cancer, neurodegenerative diseases, and Type 2 diabetes
- possibly some prevention of premature mortality and cardiovascular disease
Most of the research on coffee is epidemiological. This means studies
look at associations rather than cause and effect. Simply because
coffee is associated with particular risks and benefits doesn’t necessarily mean that coffee causes all of these risks or benefits.
Just as with all foods (and nutrients for that matter), dosage
matters. While some studies have found large intakes (5-6 cups) to have
significant benefits, other research suggests that drinking that much
coffee is counter-productive.
In general, it appears that drinking some coffee is good, but more
might not be better, especially if you are a slow metabolizer. For
those who are greatly affected by coffee and caffeine, avoid it
altogether or cut down your consumption.
Want a quick and easy test of your coffee consumption? Ask yourself
how you feel physically, mentally, and emotionally a few hours after you
drink some… as well as if you miss your daily dose.
Also, go black if possible. Pumping your coffee full of cream, sugar,
and other exotic additives reduces any potential health benefits by
adding unnecessary calories and artificial flavours and sweeteners. (And
Frappucinos or chocolate covered coffee beans? C’mon.)
Taking all the data into consideration, it seems that your best bet
is about 1-3 cups of coffee (8-24 oz) per day. This will maximize the
benefits while minimizing the risk.
And keep this in mind…while there is positive data on coffee, these benefits don’t necessarily
include things like energy drinks and caffeine pills. There are many
antioxidants and bioactive compounds in coffee that are interacting with
its caffeine content to provide the benefits. So, unfortunately, Red
Bull doesn’t count.
References
John K. Francis. Coffea arabica L. RUBIACEAE. Factsheet of U.S. Department of Agriculture, Forest Service.
Freedman N, et al. Association of Coffee Drinking with Total and Cause-Specific Mortality. N Engl J Med 2012; 366:1891-1904
Hamza TH, et al. Genome-wide gene-environment study identifies
glutamate receptor gene GRIN2A as a Parkinson’s disease modifier gene
via interaction with coffee. PLoS Genet. 2011 Aug;7(8):e1002237.
Gavrieli A, et al. Caffeinated coffee does not acutely affect energy
intake, appetite, or inflammation but prevents serum cortisol
concentrations from falling in healthy men. J Nutr. 2011 Apr
1;141(4):703-7.
Cornelis MC, et al. Coffee, CYP1A2 Genotype, and Risk of Myocardial Infarction. JAMA. 2006;295(10):1135-1141
Wisborg K, et al. Maternal consumption of coffee during pregnancy and
stillbirth and infant death in first year of life: prospective study.
BMJ. 2003 326 (7386): 420.
Richelle M, et al. Comparison of the Antioxidant Activity of Commonly
Consumed Polyphenolic Beverages (Coffee, Cocoa, and Tea) Prepared per
Cup Serving. J. Agric. Food Chem., 2001, 49 (7), pp 3438–3442
Leitzmann WF, et al. A prospective study of coffee consumption and the risk of symptomatic gallstone disease in men. JAMA. 1999 281:2106-12
Leitzmann MF, et al. Coffee intake is associated with lower risk of symptomatic gallstone disease in women. Gastroenterology. 2002 Dec;123(6):1823-30
Webster Ross G, et al. Association of Coffee and Caffeine Intake With the Risk of Parkinson Disease. JAMA. May 24, 2000, 283:20
Hancock DB, et al. Smoking, Caffeine, and Nonsteroidal
Anti-inflammatory Drugs in Families With Parkinson Disease. Arch Neurol.
2007;64(4):576-580.
Klatsky AL, et al. Coffee, Cirrhosis, and Transaminase Enzymes. Arch Intern Med. 2006;166:1190-1195.
van Dam RM, Hu FB. Coffee consumption and risk of type 2 diabetes: a systematic review. JAMA. 2005 Jul 6;294(1):97-104.
Tavani, A, et al. Coffee and tea intake and risk of oral, pharyngeal and esophageal cancer. Oral Oncol. 2003 39 (7): 695-700.
Ganmaa D, Willett WC, Li TY, et al. Coffee, tea, caffeine and risk of
breast cancer: a 22-year follow-up. Int J Cancer 2008 122 (9): 2071-6.
Inoue M, Yoshimi I, Sobue T, Tsugane S. Influence of Coffee Drinking
on Subsequent Risk of Hepatocellular Carcinoma: A Prospective Study in
Japan. JNCI Journal of the National Cancer Institute 97 (4): 293-300
Nkondjock A. Coffee consumption and the risk of cancer: an overview. Cancer Lett. 2009 May 18;277(2):121-5.
Arab L. Epidemiologic evidence on coffee and cancer. Nutr Cancer. 2010;62(3):271-83.
Somoza V, et al. Activity-Guided Identification of a Chemopreventive
Compound in Coffee Beverage Using in Vitro and in Vivo Techniques. J
Agric Food Chem. 2003 51 (23), pp 6861–6869
American Association for Cancer Research Frontiers in Cancer Prevention Research Conference, Houston, Dec. 6-8, 2009.
Jarvis MJ. Does caffeine intake enhance absolute levels of cognitive
performance? Psychopharmacology. 2 December 2005, 110:1-2, 45-52.
Johnson-Kozlow M, et al. Coffee Consumption and Cognitive Function among Older Adults. Am J Epidemiol 2002; 156:842-850
Lopez-Garcia E, et al. The Relationship of Coffee Consumption with
Mortality. Annals of Internal Medicine 2008 Jun 17;148(12):904-14.
Koizumi A, Mineharu Y, Wada Y, Iso H et al. Coffee, green
tea, black tea and oolong tea consumption and risk of mortality from
cardiovascular disease in Japanese men and women. Journal of
Epidemiology and Community Health 2011 65: 230-240.
Armstrong LE. Caffeine, body fluid-electrolyte balance, and exercise performance. Int J Sport Nutr Exer Metab. 2002 Jun;12(2):189-206.
Maughan RJ, Griffin J. Caffeine ingestion and fluid balance: a review. J Hum Nutr Diet. 2003 16(6):411–420.
Eskelinen MH, et al. Midlife Coffee and Tea Drinking and the Risk of Late-Life Dementia: A Population-Based CAIDE Study. J Alzheimers Dis. January 2009. 16(1);85-91
Cao C, et al. Caffeine suppresses amyloid-beta levels in plasma and
brain of Alzheimer’s disease transgenic mice. J Alzheimers
Dis. 2009;17(3):681-97.
No comments:
Post a Comment