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Is coffee bad or good?

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Is coffee good or bad?

According to a recent huge study published in the New England Journal of Medicine, a highly regarded medical journal, coffee is good for you.

 

Details of the study:

 

  • Over 400,000 men and women were analyzed were followed from baseline (1995–1996) until the date of death or December 31, 2008, whichever came first,
  • Among participants who completed the 24-hour dietary-recall questionnaire, 79% drank ground coffee, 19% drank instant coffee, 1% drank espresso coffee, and 1% did not specify the type of coffee they consumed.
  • With questionnaire’s assessing diet and lifestyle, a total of 33,731 men and 18,784 women died.
  • Participants resided in six states (California, Florida, Louisiana, New Jersey, North Carolina, and Pennsylvania) and two metropolitan areas (Atlanta and Detroit)
  • As compared with men who did not drink coffee, men who drank 6 or more cups of coffee per day had a 10% lower risk of death, whereas women in this category of consumption had a 15% lower risk. Similar associations were observed whether participants drank predominantly caffeinated or decaffeinated coffee.
  • Inverse associations were observed for deaths due to heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections, but NOT for deaths due to cancer.
  • Note: Coffee drinking men had a slightly, non- statistically significant increase risk of cancer (Freedman et al, 2012)

 

My take on this:

Freedman’s study suggest’ that a dose-dependent amount of coffee of 6 cups a day, decaf or regular can protect against a variety of disease associated death’s except cancer. It is unclear why coffee drinking men had a slight increase in mortality. Does this mean men should stop drinking coffee? Or should men “gulp the java” for its decrease in mortality from other non-cancer related conditions?

Interestingly, another large prospective study in 2011 showed that men who drank three or more cups of coffee a day, decaf or regular, had a decrease chance of developing high risk, lethal prostate cancer (Wilson et al. 2011).

 

I think the take home message is the following:

Coffee seems to have protective qualities and one should not give up coffee for unproven health reasons. The typical mugs of coffee often used is the equivalent of 2 cups. 2 mugs a day or 4 cups a day should be more than enough.

The non-coffee drinker does not need to start drinking coffee if he or she choose’s not to. All studies cited are epidemiological and as valuable as they are, especially when studying a large population, they are not conclusive.

Mix green tea into the picture. Variety is key for disease protection with food as it is with beverages. Green tea has shown to have protective qualities in numerous studies including is one large prospective Japanese study that looked at over 49,000 men (Kurahashi et al. 2008).

It does not matter if it’s decaf or regular – so unless caffeinated coffee bothers you, drink the “high octane” kind. Caffeine may not be harmful, even possibly protective and it may keep you alert and your metabolism high.

Those who should probably abstain:

  • Men suffering from prostatitis or prostate enlargment – caffeinated beverages aggravates urinary symptoms. Decaf may be OK.
  • Women (and men) suffering from interstitial cystitis. A recent study suggest’ that caffeine consumption may aggravate symptoms (Friedlander et al. 2012). This includes caffeinated tea as well. Again, decaf may be OK.
  • Those with high blood pressure should probably abstain as well. While coffee drinkers with normal blood pressure will probably not become hypertensive from drinking caffeinated or decaffeinated coffee, hypertensive men and women should skip.

Finally, none of the studies cited mention whether or not adding milk or sugar makes a difference. I would guess it does. It would be only a guess. However, a drop of milk and a dab of sugar is likely harmless. Straight black is probably best.

 

 

References:

Freedman ND, Park Y, Abnet CC, Hollenbeck AR, Sinha R. Association of coffee drinking with total and cause-specific mortality. N Engl J Med. 2012 May 17;366(20):1891-904.

Wilson KM, Kasperzyk JL, Rider JR, Kenfield S, van Dam RM, Stampfer MJ, Giovannucci E, Mucci LA. Coffee consumption and prostate cancer risk and progression in the Health Professionals Follow-up Study. J Natl Cancer Inst. 2011 Jun 8;103(11):876-84.

Shafique K, McLoone P, Qureshi K, Leung H, Hart C, Morrison D. Coffee consumption and prostate cancer risk: further evidence for inverse relationship. Nutr J. 2012 Jun 13;11(1):42.

Friedlander JI, Shorter B, Moldwin RM.Diet and its role in interstitial cystitis/bladder pain syndrome (IC/BPS) and comorbid conditions. BJU Int. 2012 Jun;109(11):1584-91.

Kurahashi N, Sasazuki S, Iwasaki M, Inoue M, Tsugane S. Green tea consumption and prostate cancer risk in Japanese men: a prospective study. Am J Epidemiol 2008; 167: 717

 

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by Dr. Geo

5 comments… add one

  • WIlliam Hyer ,

    I drink coffee for its invigorating effects as well as its peristaltic stimuli. We all know that studies have been done that a bowel that is voiding on a regular basis is less likely to store carcinogens in the digested matter. I believe this and I practice it regularly with brief stints of absence of coffee consumption.

    Reply
    • Yes, thanks William. Brief stints of abstinence makes sense. Caffeine is a stimulant and excess of all stimulants have a negative, stressful effect on the adrenal glands. A good rule of thumb is anything in excess is not good. But it is good to know that coffee consumption is not such a bad thing.

      Reply
  • larry drake ,

    i don’t drink coffee hardly anyway. it messes with my ibs and it makes me hungrier than i already was. plus, next to the Coke, sweetened tea, it’s really more caffeine than i really need to have in me anyway. so i just pass and settle for sweetened tea or water, thank you.

    Reply
  • seth p ,

    Hi Dr Geo,

    Thanks for this update. I don’t drink coffee more than once a month. But when I see a study like this in the headlines I always wonder “should I start?” But then (in this case) I wonder, would I need to drink 6 or more cups a day for it to be effective? So, your comments to clarify the findings are most helpful.

    Reply
    • I think the message from this large study is that: 1. people do not need to give up coffee for health reason’s. 2. There is protective effects from coffee consumption. 3. men had a slightly higher risk of developing cancer (unspecific) 4. It is unclear if milk and sugar was added and if this made a difference in mortality. As a non-coffee drinker I will not begin drinking coffee. There is ample evidence of the benefits of green tea which is my preference and has half the amount of caffeine as coffee, cup for cup. Lastly, a person with type A personality type who is naturally an “adrenaline junky” would not do well with 6 cups of coffee a day – we do not need a randomized clinical trial to prove that. To your question: If you like coffee continue drinking it unless you are a “bad type A person” – hard time sleeping, anxious, nervouse, etc. Six cups a day may be too much. Incorporate green tea into the mix. Thanks for the comment Seth.

      Reply

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