No one can understand the truth until he drinks of coffee’s frothy goodness. ~Sheik Abd-al-Kadir
But what exactly is the truth about coffee? For years the recommendations have vacillated from detrimental and abstinence to miracle health tonic at doses only fit for the waking dead, eternal insomniacs among us. 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 evidence suggests that your second cup of Joe is not only safe but makes a great part of a healthful approach to food and diet.
Just how important a part that cup of java may play 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 is associated with a 10% reduction in all-cause mortality. This was further correlated in a more recent large, meta-analysis that found the 3 to 4 cups of coffee each day was associated with significant reductions in all-cause mortality as well as 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) 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; 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. 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, a signature pathologic finding in those with the condition. 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.
These powerful plan antioxidant components in our morning brew 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.
So go ahead, wake up, smell the coffee and have that second cup….
1.The Office of Disease Prevention and Health Promotion. Scientific Report of the 2015 Dietary Guidelines Advisory Committee. http://health.gov/dietaryguidelines/2015-scientific-report/10-chapter-5/d5-5.asp Accessed August 6, 2015.
2.Freedman ND, Park Y, Abnet CC, et al. Association of coffee drinking with total and cause-specific mortality. N Engl J Med. 2012;366:1891-1904.
3.Crippa A, Discacciati A, Larsson SC, Wolk A, Orsini N. Coffee consumption and mortality from all causes, cardiovascular disease, and cancer: a dose-response meta-analysis. Am J Epidemiol. 2014;180:763-775.
4.Larsson SC, Orsini N. Coffee consumption and risk of stroke: a dose-response meta-analysis of prospective studies. Am J Epidemiol. 2011;174:993-1001.
5.Wu JN, Ho SC, Zhou C, et al. Coffee consumption and risk of coronary heart diseases: a meta-analysis of 21 prospective cohort studies. Int J Cardiol. 2009;137:216-225.
6.Natella F, Nardini M, Belelli F, et al. Coffee drinking induces incorporation of phenolic acids into LDL and increases the resistance of LDL to ex vivo oxidation in humans. Am J Clin Nutr. 2007;86:604-609.
7.Gómez-Ruiz JA, Leake DS, Ames JM. In vitro antioxidant activity of coffee compounds and their metabolites. J Agric Food Chem. 2007;55:6962-6969.
8.Nardini M, D’Aquino M, Tomassi G, et al. Inhibition of human low-density lipoprotein oxidation by caffeic acid and other hydroxycinnamic acid derivatives. Free Radic Biol Med. 1995;19:541-552.
9.Montagnana M, Favaloro EJ, Lippi G. Coffee intake and cardiovascular disease: virtue does not take center stage. Semin Thromb Hemost. 2012;38:164-177.
10.Mostofsky E, Rice MS, Levitan EB, Mittleman MA. Habitual coffee consumption and risk of heart failure: a dose response meta-analysis. Circ Heart Fail. 2012;DOI:10.1161/CIRCHEARTFAILURE.112.967299. http://circheartfailure.ahajournals.org Accessed August 6, 2015.
11.Dixit S, Stein PK, Dewland TA. Consumption of “healthy” caffeinated products and cardiac ectopy. Program and abstracts of the Heart Rhythm Society 2015 Scientific Sessions; May 13, 2015; Boston, Massachusetts. Abstract PO01-113.
12.Larsson SC, Orsini N. Coffee consumption and risk of stroke: a dose-response meta-analysis of prospective studies. Am J Epidemiol. 2011;174:993-1001.
13.Larsson SC, Virtamo J, Wolk A. Coffee consumption and risk of stroke in women. Stroke. 2011;42:908-912.
14.D’Elia L, Cairella G, Garbagnati F, et al. Moderate coffee consumption is associated with lower risk of stroke: meta-analysis of prospective studies. J Hypertension. 2012;30 (e-Supplement A):e107.
15.Kokubo Y, Iso H, Saito I, et al. The impact of green tea and coffee consumption on the reduced risk of stroke incidence in Japanese population: The Japan public health center-based study cohort. Stroke. 2013;44:1369-1374.
16.Huxley R, Lee CM, Barzi F, et al. Coffee, decaffeinated coffee, and tea consumption in relation to incident type 2 diabetes mellitus: a systematic review with meta-analysis. Arch Intern Med. 2009;169:2053-2063.
17.Sartorelli DS, Fagherazzi G, Balkau B, et al. Differential effects of coffee on the risk of type 2 diabetes according to meal consumption in a French cohort of women: the E3N/EPIC cohort study. Am J Clin Nutr. 2010;91:1002-1012.
18.Floegel A, Pischon T, Bermann MM, et al. Coffee consumption and risk of chronic disease in the European Prospective Investigation into Cancer and Nutrition (EPIC) Germany study. Am J Clin Nutr. 2012;95:901-908.
19.Bhupathiraju SN, Pan A, Manson JE, et al. Changes in coffee intake and subsequent risk of type 2 diabetes: three large cohorts of US men and women. Diabetologia. 2014;57:1346-1354.
20.Koloverou E, Panagiotako DB, Pitsavos C, et al. The evaluation of inflammatory and oxidative stress biomarkers on coffee–diabetes association: results from the 10-year follow-up of the ATTICA Study (2002–2012). Eur J Clin Nutr. 2015 Jul 1. [Epub ahead of print]
21.Vinson JA, Burnham B, Nagendran MV, et al. Randomized double-blind placebo-controlled crossover study to evaluate the efficacy and safety of a green coffee bean extract in overweight subjects. Program and abstracts of the 243rd American Chemical Society National Meeting and Exposition; March 25-29, 2012; San Diego, California. Abstract 92.
22.Je Y, Hankison SE, Tworoger SS, et al. A prospective cohort study of coffee consumption and risk of endometrial cancer over a 26-year follow-up. Cancer Epidemiol Biomarkers Prev. 2011;20:1-9.
23.Wilson KM, Kasperzyk JL, Rider JR, et al. Coffee consumption and prostate cancer risk and progression in the Health Professionals Follow-up Study. J Natl Cancer Inst. 2011;8;103:876-884.
24.Turati F, Galeone C, La Vecchia C, et al. Coffee and cancers of the upper digestive and respiratory tracts: meta-analyses of observational studies. Ann Oncol. 2011;22:536-544.
25.Galeone C, Tavani A, Pelucchi C, et al. Coffee and tea intake and risk of head and neck cancer: pooled analysis in the international head and neck cancer epidemiology consortium. Cancer Epidemiol Biomarkers Prev. 2010;19:1723-1736.
26.Song F, Qureshi AA, Han J. Increased caffeine intake is associated with reduced risk of Basal cell carcinoma of the skin. Cancer Res. 2012;72:3282-3289.
27.Loftfield E, Freedman ND, Graubard BI, et al. Coffee Drinking and Cutaneous Melanoma Risk in the NIH-AARP Diet and Health Study. J Natl Cancer Inst. 2015;107(2). pii: dju421. doi: 10.1093/jnci/dju421. Print 2015 Feb.
28.Li J, Seibold P, Chang-Claude J, et al. Coffee consumption modifies risk of estrogen-receptor negative breast cancer. Breast Cancer Res. 2011;13:R49.
29.Bhoo-Pathy N, Peeters PHM, Uiterwaal C, et al. Coffee and tea consumption and risk of pre- and postmenopausal breast cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC) cohort study. Breast Cancer Res. 2015;17:15. doi: 10.1186/s13058-015-0521-3.
30.Cao C, Loewenstein DA, Lin X, et al. High blood caffeine levels in MCI linked to lack of progression to dementia. J Alzheimer Dis. 2012;30:559-572.
31.Borota D, Murray E, Keceli G, et al. Post-study caffeine administration enhances memory consolidation in humans. Nature Neuroscience. 2014;17:201-203.
32.Hamza TH, Chen H, Hill-Burns EM, 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;7: e1002237.
33.Mowry E, Hedstrom A, Gianfrancesco M, et al. Greater Consumption of Coffee is Associated with Reduced Odds of Multiple Sclerosis. Neurology. April 6, 2015;84(14).Supplement S45.004.
34.Ross W, Duda J, Abbott R, et al. Association of coffee caffeine consumption with brain Lewy pathology in the Honolulu-Asia Aging Study. Program and abstracts of the 64th Annual Meeting of the American Academy of Neurology; April 21-28, 2012; New Orleans, Louisiana. Abstract S42.005.
35.Lucas M, Mirzaei F, Pan A, et al. Coffee, caffeine, and risk of depression among women. Arch Intern Med. 2011;171:1571-1578.
36.Brooks M. Sweetened drinks may boost depression, coffee reduces it. Medscape Medical News. January 9, 2013. http://www.medscape.com/viewarticle/777356 Accessed August 17, 2015.
37.Lucas M, Mirzaei F, Pan A, et al. Coffee, caffeine, and risk of depression among women. Arch Intern Med. 2011;171:1571-1578.
38.Pasco JA, Nicholson GC, Williams LJ, et al. Association of high-sensitivity C-reactive protein with de novo major depression. Br J Psychiatry. 2010;197:372-377.
39.Ng F, Berk M, Dean O, Bush AI. Oxidative stress in psychiatric disorders: evidence base and therapeutic implications. Int J Neuropsychopharmacol. 2008;11:851-876.
40.O’Connor A. Coffee drinking linked to less depression in women. New York Times. February 13, 2012. http://well.blogs.nytimes.com/2011/09/26/coffee-drinking-linked-to-less-depression-in-women/ Accessed August 6, 2015.
41.Molloy JW, Calcagno CJ, Williams CD, Jones FJ, Torres DM, Harrison SA. Association of coffee and caffeine consumption with fatty liver disease, nonalcoholic steatohepatitis, and degree of hepatic fibrosis. Hepatology. 2012;55:429-436.
42.Gallus S, Tavani A, Negri E, La Vecchia C. Does coffee protect against liver cirrhosis? Ann Epidemiol. 2002;12:202-205.
43.Bambha K, Wilson LA, Unalp A, et al. Coffee consumption in NAFLD patients with lower insulin resistance is associated with lower risk of severe fibrosis. Liver Int. 2014;34:1250-1258.
44.Modi AA, Feld JJ, Park Y, et al. Increased caffeine consumption is associated with reduced hepatic fibrosis. Hepatology. 2010;51:201-209.
45.Birerdinc A, Stepanova M, Pawloski L, Younossi M. Caffeine is protective in patients with non-alcoholic fatty liver disease. Aliment Pharmacol Ther. 2012;3576-3582.
46.Saab S, Mallam D, Cox II GA, Tong MJ. Impact of coffee on liver diseases. Liver Int. 2014;34:495-504.
47.Arita R, Yanagi Y, Honda N, Maeda S, et al. Caffeine increases tear volume depending on polymorphisms within the adenosine A2a receptor gene and cytochrome P450 1A2. Ophthalmology. 2012;119:972-978.
48.Choi HK, Willett W, Curhan G. Coffee consumption and risk of incident gout in men: A prospective study. Arthritis Rheum. 2007;56:2049-2055.
49.Matheson EM, Mainous AG, Everett CJ, King DE. Tea and coffee consumption and MRSA nasal carriage. Ann Fam Med. 2011;9:299-304.
50.Pasquale L. Program and abstracts of the American Glaucoma Society 22nd Annual Meeting; March 1-4, 2012; New York, New York. Abstracts 83.
51.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Substance-related and addictive disorders. Washington, DC: American Psychiatric Association; 2013.
52.Chawla, J., & Lorenzo, N. (2013, August 12). Neurologic Effects of Caffeine. Retrieved from Medscape: http://emedicine.medscape.com/article/1182710-overview?src=wnl_edit_specol&uac=203629DV&impID=821668&faf=1
53.Doyle, K. (2015, August 6). Coffee Drinking May Lower Inflammation, Reduce Diabetes Risk. Retrieved from Medscape: http://www.medscape.com/viewarticle/848358?src=wnl_edit_specol&uac=203629DV&impID=821668&faf=1
54.Larsson, S. C., Drca, N. J.-U., & Wolk, A. (2015). Coffee consumption is not associated with. BMC Medicine, 13:207 DOI 10.1186/s12916-015-0447-8.
55.Mandrola, J. (2015, May 14). Caffeine Comeback for Patients with Arrhythmia. Retrieved from Medscape: http://www.medscape.com/viewarticle/844670?src=wnl_edit_specol&uac=203629DV&impID=821668&faf=1
56.Stetka, B. S. (2015, August 19). How Healthy Is Coffee? The Latest Evidence. Retrieved from Medscape: http://www.medscape.com/features/slideshow/coffee?src=wnl_edit_specol&impID=821668&faf=1