Post #32: “Spilling the Tea” On Coffee (A Gen-Z Compliant Title)

I have never been a coffee drinker myself but “is there any downside to drinking coffee?” is probably one of the most frequent questions I am asked, given that I seem to be surrounded by both casual coffee drinkers as well as coffee aficionados. Unlike most of my other posts, I don’t have personal data to share on this topic (post #32), but I have to say that, as I dug into the published scientific literature, I was surprised at how much this beverage has been researched and yet the mechanisms behind why it works aren’t completely understood.

Let me start by providing some background on what makes research on coffee complicated.?

The Many Faces Of Coffee Beans: While there are two major “parent” coffee bean types - Arabica and Robusta - there are more than 120 different types of coffee beans in the market. Their characteristics vary based on their chemical composition, the region where the beans are grown, their storage conditions, as well as their processing methods. This means that any observational study, or even prospective study, where the user is asked how many cups of coffee they drink, but not which specific variety of coffee bean, has a high probability of convolving the impact of the different coffee bean types.

The Art Of Coffee Making: Even if the beans are the same, the art form of how the coffee is brewed, the coffee-to-water ratio, water temperature, filtration method, and brewing time all affect the ratio of the different chemicals in the finished beverage. As per a study done by Socala et. al., certain coffee-specific compounds, which some evidence suggests may have antioxidant and anti-inflammatory effects, are present exclusively in unfiltered varieties of coffee such as French press coffee and espresso. So different preparation methods can dramatically impact the benefits that coffee can provide.

There Is Caffeine And Then There Is Coffee: While caffeine is the most well known ingredient in coffee, there are hundreds of other bioactive compounds, including oils, tannins and other polyphenols, non-caffeine alkaloids, and even trace amounts of minerals and vitamins. It is therefore close to impossible to deconvolve the effects of each compound present within it, as well as its interactions with each other. While some believe it is the caffeine that gives coffee its healthy properties, there are others that argue that it is these additional ingredients that make the difference.

Keeping the above variables in mind, let’s look at some of the results highlighted by various journals on the health impact of this popular drink (the first 4 points below have been very well documented on the Harvard School of Public Health’s website). I have summarized some of the key findings here but you can read the full blown version of the various studies done by clicking on the attached links:

Cancer: In 2016, the World Health Organization’s International Agency for Research on Cancer (AICR) found “no conclusive evidence for a carcinogenic effect of drinking coffee” (where the only limited evidence for concern was related to drinking beverages at very hot temperatures). Moreover, evidence from AICR suggests that drinking coffee may reduce risk for endometrial and liver cancer.?

Type 2 Diabetes: Long-term studies have shown that habitual coffee drinkers have a lower risk of developing type 2 diabetes compared with non-drinkers. The polyphenols and minerals, such as magnesium in coffee, may improve the effectiveness of insulin and glucose metabolism in the body. In a meta-analysis of 45,335 people with type 2 diabetes followed for up to 20 years, an association was found with increasing cups of coffee and a lower risk of developing diabetes. Compared with no coffee, the decreased risk ranged from 8% with 1 cup a day to 33% for 6 cups a day. Caffeinated coffee showed a slightly greater benefit than decaffeinated coffee.

Cardiovascular Risk: Evidence suggests that drinking coffee regularly may lower the risk of heart disease and stroke. Among 83,076 women in the Nurses’ Health Study, drinking 4 or more cups of coffee each day was associated with a 20% lower risk of stroke compared with non-drinkers. Decaffeinated coffee also showed an association, with 2 or more cups daily and a 11% lower stroke risk. The authors found no such association with other caffeinated drinks such as tea and soda. These coffee-specific results suggest that components in coffee other than caffeine may be protective. Other studies have shown that heavier coffee intake of 6 or more cups daily was neither associated with a higher nor a lower risk of cardiovascular disease.?

Depression: Naturally occurring polyphenols in both caffeinated and decaffeinated coffee can act as antioxidants to reduce damaging oxidative stress and inflammation of cells. It may have neurological benefits in some people and act as an antidepressant. Caffeine may affect mental states such as increasing alertness and attention, reducing anxiety, and improving mood. A moderate caffeine intake of less than 6 cups of coffee per day has been associated with a lower risk of depression and suicide. However in a few cases of sensitive individuals, higher amounts of caffeine may increase anxiety, restlessness, and insomnia. Suddenly stopping caffeine intake can cause headache, fatigue, anxiety, and low mood for a few days and may persist for up to a week.?

Neurodegenerative Diseases: The impact of drinking coffee on protecting against neurodegenerative diseases was not as clear. An observational study that was published in the Neurological Research journal in 2013 to study the relationship between coffee consumption and Alzheimer’s Disease (AD), had a headline that suggested that drinking coffee reduced the risk of AD. However, on closer inspection, the conclusion was not compelling because the results were based on interviewing people about their coffee consumption habits and even then, different studies had different conclusions. This is the type of study (similar to the one about Metformin’s effects on longevity that I had written about) that makes for virality but is often misleading, in my opinion, because most of us only have time to read only the headlines. In a prospective study published in the European Journal of Clinical Nutrition, a population comprising 6710 men and women, aged 50–79 years and free from Parkinson's disease at the baseline, was studied. At baseline, enquiries were made about coffee consumption in a self-administered questionnaire on the average number of cups per day. During a 22-year follow-up, the study showed that people who drank 10 or more cups of coffee a day had a slightly lower risk of developing Parkinson’s than those who didn’t drink any coffee at all. However, the FDA recommends consuming no more than 400 mg of caffeine a day, which is equivalent to about 4 cups of coffee, because of the other deleterious effects of caffeine. The risk-reward doesn’t seem to be very compelling to drink 10 cups of coffee a day.?

So what’s the bottom line on the impact of coffee? A large body of evidence suggests that consumption of caffeinated coffee does not increase the risk of cardiovascular diseases and cancers. In fact, consumption of 3 to 5 standard cups of coffee daily has been consistently associated with a reduced risk of several chronic diseases. While caffeine does not appear fully responsible for the “magic” of a daily brew, the effects of each individual component on cognition remain poorly understood. Some individuals may not tolerate higher amounts of caffeine due to symptoms of jitteriness, anxiety, and insomnia. Specifically, those who have difficulty controlling their blood pressure may want to moderate their coffee intake. Because of the potential negative side effects some people experience when drinking caffeinated coffee, it is not necessary to start drinking it if you do not already or to increase the amount you currently drink, as there are many other dietary strategies to improve your health. Decaffeinated coffee is a good option if one is sensitive to caffeine.?

Here are a few things to keep in mind when you enjoy your next cup of coffee (I found the Sleep Foundation’s website to be a very good reference on this topic):

Avoid Add-ons: It’s important to keep in mind that the extra calories, sugar, and saturated fat in a coffee house beverage loaded with whipped cream and flavored syrup might offset any health benefits found in a basic black coffee.

Hydrate Well: Coffee is a diuretic which means it can lead to dehydration and imbalanced electrolytes in the body. So remember drinking coffee isn’t the same as drinking water; in fact it has the opposite effect so always hydrate well after drinking coffee.

Drink It Earlier In The Day: Coffee can increase alertness but it also means it can make it harder to fall asleep. If you are feeling sleepy in the daytime, it may be because you aren’t getting enough sleep. Drinking coffee to stay alert can worsen the problem the following night. The earlier in the day you can consume your coffee, the better. Try to avoid drinking coffee for at least 6 hours before bed time; preferably even sooner.

Pregnancy and Coffee: Pregnant women are advised to aim for less than 200 mg of caffeine daily, the amount in 2 cups of coffee, because caffeine passes through the placenta into the fetus and has been associated with pregnancy loss and low birth weight.?

So, “that’s the tea” on coffee (I have been dying to use a Gen-Z phrase and I found a good time to do it). For those of you hardcore coffee drinkers, I am sure you have some of your own observations that have been insightful; I would love to hear about them in the comments section. Until next time …

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