Chapter 22: What's Coffee(Caffeine) Got to do With My Health?
One of the Worlds most popular drink has health benefits when taken in moderation!
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Coffee! It's the name most of us are automatically attracted to early in the morning. It's a workplace meeting or social gathering to reminisce about chai or coffee. The essence of coffee, just the smell of it; makes our senses go crazy. There are billion-dollar business empires just to keep everyone depended on to caffeine. There is a reason behind this fantastic potion, which started around the last millennium.
The history of coffee is a global tale, with its roots dating back to the 9th -10th century in Ethiopia. The legend goes that a goat herder discovered the energizing effects of coffee after his goats became more active upon consuming the coffee cherries. This discovery led to the cultivation of coffee beans and a flourishing trade in the 15th century in the Arabian peninsula, particularly in Yemen. The 17th century saw the birth of coffee houses, known as Yahweh Khana in the Middle East, and the spread of cafés, or coffeehouses, to Europe. Coffee's journey continued through the East India Company to the rest of Europe, where it quickly gained popularity, leading to the establishment of European-controlled coffee plantations in colonies like Indonesia and the Caribbean. Today, coffee is a global commodity, with Brazil, Vietnam, and Colombia among the top producers. The beans are exported worldwide to be processed and sold in retail like Starbucks, Dunkin, and many other coffee houses, making coffee one of the most widely consumed nonalcoholic beverages, connecting coffee lovers across the globe.
If you are one of the 80% of coffee consumers in this country, keep reading. Study after study, and data after data, consistently show that coffee consumption in moderation is beneficial for health. From boosting mental alertness to reducing the risk of certain diseases, coffee has a range of health benefits. Let's explore this unique coffee consumption, its health benefits, and its dependency. We are so addicted that if by any chance coffee/caffeine is unavailable tomorrow, half of the world economy will collapse! (LoL).
Caffeine is the main ingredient in coffee and tea. It's the caffeine that makes it a psychoactive substance that makes us dependent on the stimulant. Caffeine is present in various fruits, seeds, leaves, etc.; some plants include cocoa beans(active chocolate ingredient), Yerba matte leaves, and Guayana berries. Some of these are included in the various drinks in the supplement market. Teenage segment populations primarily consume caffeine in energy drinks, whereas adults use caffeine in coffee or chai beverages. In a fast-paced world, we need supplements to initiate sleep (at least 7 hours recommended), and to keep us alert and attentive, we need caffeine(the irony of today's times). Coffee and tea have been consumed for centuries and have become integral part of cultural traditions and social life.
Coffee comprises of hundreds of biologically active phytochemicals, including polyphenols such as chlorogenic acid and lignans, the alkaloid trigonelline, melanoidins formed during roasting, and modest amounts of magnesium, potassium, and vitamin B3 (niacin).
Coffee mainly comprises of hundreds of biologically active phytochemicals, including polyphenols such as chlorogenic acid and lignans, the alkaloid trigonelline, melanoidins formed during roasting, and modest amounts of magnesium, potassium, and vitamin B3 (niacin). These protect the body from oxidative damage caused by free radicals(reduce inflammation), reducing the risk of chronic diseases. When the coffee is consumed, the absorption completes within 45 minutes after ingestion, with caffeine levels peaking 15 minutes to 2 hours. It is metabolized in the liver to form smaller metabolites to uric acid, eventually excreted in the urine. It can take upto 10 hours to completely clear the caffeine(watch out if you have sleep issues, do not consume later part of the day).
So what makes us alert and improve fatigue and decrease drowsiness, caffeine binds to the molecule called adenosine receptors and block adenosine. Accumulation of adenosine in the brain inhibits arousal and increases drowsiness. In moderate doses (40mg to 300mg) caffeine can stop the effects adenosine and reduce fatigue and reduce reaction time and increase alertness.
If it’s too scientific and boring, now is the time to get some coffee…(Ha Ha!)
Now that we understand this age old addictive potion(I hope you are with me so far), let’s review the literature about what it does to the health. We do consume lot of coffee some us do 2, 3, 4 or 5 cups or more of coffee everyday and look at the Starbucks caffeine content Tall (12 oz): 260 mg. Grande (16 oz): 330 mg. Venti (20 oz): 415 mg(wow).
Starbucks caffeine content - Tall (12 oz): 260 mg. Grande (16 oz): 330 mg. Venti (20 oz): 415 mg.
Health Benefits of Caffeine…
Moderate coffee and caffeine consumption is associated with lower risk of developing multiple cardiometabolic diseases, new study finds
A study published in the Journal of Clinical Endocrinology & Metabolism in September 2024 found that regular coffee consumption has a protective effect against multiple cardiometabolic diseases, including Type 2 Diabetes Mellitus, Coronary Artery Disease, and stroke. Using data from the UK Biobank, which included 500,000 participants aged 37-73, researchers discovered that moderate coffee drinkers (about 3 cups per day or 200-300 mg of caffeine) had a significantly reduced risk of new-onset cardiometabolic multimorbidity (CM)—by 48.1% for coffee and 40.7% for caffeine—compared to non-consumers. The study's rigorous methodology, which excluded individuals with ambiguous caffeine intake data, adds credibility to these findings and may reshape our understanding of the health benefits of coffee.
“Consuming three cups of coffee, or 200-300 mg caffeine, per day might help to reduce the risk of developing cardiometabolic multimorbidity in individuals without any cardiometabolic disease,” said the study’s lead author Chaofu Ke, M.D., Ph.D., of the Department of Epidemiology and Biostatistics, School of Public Health at Suzhou Medical College of Soochow University, in Suzhou, China.
A 2023 study published in the New England Journal of Medicine examined the acute effects of caffeine on heart ectopy and arrhythmias, finding no correlation between moderate to high coffee intake and arrhythmias in general. While previous observational studies suggested that high doses of caffeine could lead to atrial and ventricular arrhythmias and even heart failure. This study highlighted coffee consumers averaged over a thousand additional steps per day. This increase in physical activity is associated with improved longevity and reduced mortality, as illustrated by the accompanying graph showing higher activity levels among coffee drinkers.
In the Circulation journal, a systemic review and a dose-response meta-analysis of prospective cohort studies revealed a nonlinear association between coffee consumption and the risk of heart disease. The findings indicated that patients who consumed more than 3 to 5 cups per day had the lowest risk of cardiovascular disease (CVD), including cardiac and stroke risk. Additionally, moderate coffee consumption was associated with a 15% lower risk of heart disease compared to non-drinkers.
A study in hepatology in 2015 examined the connection between coffee consumption and health. The findings suggested that drinking two or more cups of coffee per day significantly reduced the risk of liver disease, especially in individuals with high-risk factors like Metabolic Associated Fatty Liver Disease. This protective effect is attributed to the antioxidant properties of coffee and its complementary effects, which help reduce fat accumulation in the liver. Regular coffee consumption is associated with improved enzyme levels and a lower risk of liver fibrosis and liver cell carcinoma. The study highlights the potential role of coffee in promoting liver health.
Coffee consumption has been linked to reduced mortality rates across various racial and ethnic groups. A study published in the Annals of Internal Medicine in 2017 examined different ethnicities and found that consuming 1 to 3 cups of coffee per day lowered the risk of death from different causes, such as heart disease and cancer.
A 2016 review of several studies examined the relationship between coffee consumption and the risk of different types of cancer, such as liver and colorectal cancer. The findings suggested that regular coffee consumption was linked to a significantly reduced risk of these cancers. The World Health Organization conducted the review and included data from the IARC Monographs, which emphasized the potential protective effects of coffee against specific cancers.
In various studies, the effects of coffee consumption on cognitive function and the risk of neurodegenerative conditions have been explored. A 2012 longitudinal study found that older adults who regularly consumed 3 to 5 cups of coffee per day had a lower risk of cognitive decline and Alzheimer's disease compared to non-coffee drinkers. This suggests that coffee may protect brain health as people age. The study was published in the Journal of Alzheimer's Disease, highlighting coffee's potential role in reducing the risk of neurodegenerative conditions.
Additionally, a 2011 study conducted by Harvard examined the relationship between coffee consumption and the risk of depression in women. The study discovered that women who drank 4 or more cups of coffee per day had a 20% lower risk of developing depression compared to those who drank little or no coffee. This suggests that regular coffee consumption may offer protection against depression. The study was published in the Archives of Internal Medicine, contributing to our understanding of coffee's potential mental health benefits.
Furthermore, in a 2001 study, researchers investigated the impact of coffee consumption on the risk of developing Parkinson's disease. The findings revealed that individuals with higher caffeine intake had a significantly lower risk of developing the disease compared to those with little or no caffeine consumption, suggesting that coffee, due to its caffeine content, may help protect against Parkinson's. The study was published in the Journal of the American Medical Association (JAMA), highlighting coffee's potential neuroprotective effects.
In a 2013 study, researchers looked into the impact of coffee consumption on the endurance performance of athletes. The study found that drinking coffee improved endurance, likely due to the fact that caffeine increases the body's use of fat for energy and helps to preserve glycogen stores during prolonged exercise. This improved use of fat allows athletes to sustain their energy levels for a longer period of time. The study was published in the International Journal of Sports Nutrition and Exercise Metabolism, highlighting the positive effects of coffee on athletic performance.
Caffeine can contribute to pain relief when added to commonly used analgesic agents. Specifically, a review of 19 studies showed that 100 to 130 mg of caffeine added to an analgesic modestly increased the proportion of patients with successful pain relief.
I am not affiliated with Starbucks, Dunkin ', etc (LOL!). The data I am sharing is from various journals over different periods. From what I've seen, caffeine doesn't appear to have any significant adverse effects (so far). Additionally, based on the NEJM study and other research on coffee and its impact on arrhythmias or Afib, no correlation was found with moderate caffeine intake. Interestingly, caffeine seems to benefit all our body systems, with minimal side effects. Some of them include high consumption causing anxiety/jitteriness, increased urination, increased gastric acidity, sleeplessness, increased blood pressure transiently with normalization on regular use, etc. Also, caution is advised during pregnancy to use less than 200mg of caffeine daily. It helps with increased activity and alertness, making us more productive at work and home. Also, more steps mean more activity, which means improvement in longevity.
The researchers conducting these studies must consume a lot of coffee, or I'm just really caffeinated (while writing this blog). After reviewing this data, I feel reassured that moderate caffeine consumption can indeed play a valuable role in preventing chronic diseases. It seems to be another important tool in the arsenal for disease prevention. The more strategies we have to protect ourselves from illness, the better. So far, we've explored the connections between stress and heart disease, Omega-3, Vitamin D, fasting, the flu vaccine, optimal longevity, and now caffeine. Nutrition and exercise are both topics that I am particularly passionate about, and I look forward to addressing them in more detail soon.
What is the Ideal Coffee/caffeine intake?
Studies have shown that 3 cups of coffee, 200 mg - 300mg of caffeine daily, is ideal. Black coffee is better than others due to fewer calories. And if you are like me, be mindful about drinking coffee after 2 p.m. especially with sleep issues, as it can cause sleeplessness, leading to insomnia.
Suman Manchireddy MD FACP FHM, Internal Medicine, Leesburg, VA.
Email : Care@ReliantMD.com
Disclaimer: This is purely informational and educational purposes only, seek medical advise prior to starting any testing or treatment regimen. The data presented here is researched extensively and has been condensed for a broader audience.
References :
https://www.nejm.org/doi/full/10.1056/NEJMra1816604
https://www.nejm.org/doi/full/10.1056/NEJMoa2204737
https://academic.oup.com/jcem/advance-article-abstract/doi/10.1210/clinem/dgae552/7754545?redirectedFrom=fulltext#480766863
https://www.escardio.org/The-ESC/Press-Office/Press-releases/Coffee-drinking-is-associated-with-increased-longevity
https://www.ahajournals.org/doi/10.1161/circulationaha.113.005925
Very informative. Thanks Suman!
This is an amazing compilation of research data about coffee’s effects! Thank you so much. We can glean bits and pieces of the information online but I’ve never seen such a comprehensive overview. My somewhat stable afib is unfortunately negatively affected by more than 1.5 cups of coffee. (12 oz). Just an alert to pay attention to individual body responses LOL.