Tag Archive for: coffee

Bottoms Up!

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As we approach the holiday season, do we have to skip the fruit juice punch or the pumpkin spice lattes? How about eggnog? Let’s take a look at the study on the risks of various drinks, and determine the relevance and the practical risk of what you drink.

Does What You Drink Really Matter?

Here are some of the issues I found with the study.

The data used a food frequency questionnaire as well as additional surveys to collect all the data. I’ve talked enough about the problems with the food frequency questionnaire, and the INTERSTROKE Study didn’t use any better techniques.

In prior papers from the INTERSTROKE study, the researchers identified 10 risk factors that accounted for 90.7% of the Population Attributable Risk (PAR) worldwide for a first-time stroke. The PAR together with the percentage contribution of each factor is as follows:

  • Prior history of hypertension or blood pressure of 140/90 or higher: 47.9%
  • Lack of regular physical activity: 35.8%
  • Apolipoprotein (ApoB) to ApoA1 ratio: 26.8%
  • Diet assessed by the modified Alternative Healthy Eating Index: 23.2%
  • Waist-to-hip ratio: 18.6%
  • Psychosocial factors: 17.4%
  • Current smoking: 12.4%
  • Cardiac causes: 9.1%
  • Alcohol consumption: 5.8%
  • Diabetes mellitus: 3.9%

What a person drinks would be a small contributor to the diet assessment. It’s legitimate, but there are bigger issues in my opinion.

Finally, looking at the actual risk of stroke in the U.S. and Canada, it’s 0.9% if you’re 18–44 years old, it’s 3.8% at 45–64 yrs, and it’s 7.8% if you’re over 65. That’s the risk without modifying any risk factors in the PAR. What a person drinks would be a very small contributor to that risk. I think working on BP and exercise first makes a lot more sense.

The Bottom Line

Does what you drink matter? Unless you overconsume alcohol, probably not. Could you help yourself out? Yes. Drink seven or more cups of water per day—that’s just 60 ounces—and enjoy a cup or two of any type of tea per day; if you like iced tea, try Paula’s recipe on our website. And if all you’ve ever had is black tea, you need to branch out and try some more exotic varieties. Both water and tea lowered the odds ratio of a first stroke.

Other than that, try to strike a balance with what you drink. Spend more time getting your BP under control, and one of the ways to do that is to exercise. This is as good a time as any to begin. I know you can do it.

What are you prepared to do today?

        Dr. Chet

References:
1. International Journal of Stroke 2024, Vol. 19(9) 1053–1063.
2. Journal of Stroke 2024;26(3):391-402.
3. Lancet 2016 Aug 20;388(10046):761-75.
4. MMWR. May 23, 2024. 73(20);449–455.

What Am I Supposed to Drink?

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Why would someone ask that question? It was in response to a health news report on a couple of studies that suggested that if you drink too much fruit juice, any soda at all, or five or more cups of coffee, you’ll have an increased risk of a first stroke. Let’s take a look at the studies to see if we should change any of our drinking habits.

Based on the methodology, cases of first stroke were recruited from 142 centers in 32 countries between March 2007 and July 2015; at the same time, they recruited matched controls who did not have a stroke. They ended up with 13,462 subjects with stroke and 13,488 controls that did not have strokes. The mean age was close to 62 +/- 13 years. Besides biometric data including neural imaging, the researchers used a variety of surveys including food frequency questionnaires to determine all fluid intake.

After accounting for 15 potential factors that might skew the data, researchers calculated the odds ratios for water, soda, fruit juice, coffee, and tea intake. Teas of all types reduced the odds ratio for stroke, as did drinking seven or more cups of water per day. Any soda, fruit juice, or five or more cups of coffee per day raised the odds ratio, almost doubling the risk of a first stroke.

Should we be concerned? Let’s take a closer look at what this study really means on Saturday.

What are you prepared to do today?

        Dr. Chet

References:
1. International Journal of Stroke 2024, Vol. 19(9) 1053–1063.
2. Journal of Stroke 2024;26(3):391-402.

Coffee to Go

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The health benefits of tea are substantial, and in some ways, coffee is even better. They both have substantial amounts of  phytonutrients, but this isn’t about the benefits to your heart, your liver, or your brain. This is about the comparative benefits to your digestive system of coffee and tea. While the fiber approach wasn’t really significant, one of the nutrients in both drinks was.

While I’ve never given it much thought, some people feel the urge to defecate shortly after drinking a cup of coffee, and to a lesser extent, tea as well. With all those phytonutrients, researchers selected a nutrient common to both to test: caffeine. That appeared to be the only study done to directly test the impact of caffeine on bowel movements.

The subjects were required to insert an anorectal manometer into their rectum to test the pressure of the anal sphincter muscles. (Let’s pause here to say a thank you to all the people who volunteer as subjects in these health studies.) There was no response to drinking plain water, but after caffeine ingestion there was a significant increase in pressure at 10 minutes and even greater pressure at 15 minutes. In short, the increase in pressure indicated the ability to “go” once the muscles relaxed.

The only issue I see is the amount of caffeine: the researchers tested at 3.5 mg/kg body weight. For a 180-pound person, that would be almost 300 mg caffeine in one dose, or almost four cups of coffee at one sitting. It would have been nice to see the lowest dose that worked, because not many people would tolerate that much caffeine in one dose. Then there is the issue of genetics, comparing fast metabolizers versus slow caffeine metabolizers.

The Bottom Line

That’s the scoop on poop from a coffee versus tea perspective. You probably never thought about it, but that morning cup of Joe just might help you go. Enjoy the Super Bowl—or not. But if you only watch it for the half-time show, you might want to consider your timing on what you drink, when you drink it, and how much caffeine you get.

Remember, the Aging with a Vengeance: Managing Pain webinar is in two weeks on February 25. Information will be coming soon.

What are you prepared to do today?

        Dr. Chet

Reference: Dis Colon Rectum. 2008 Jun;51(6):928-31.

Fiber, Coffee, and Tea

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Paula’s recovery from her knee replacement is going well. While she’s been rehabbing, she does a lot of reading and recently passed on an article that compared the health benefits of coffee vs. tea. One of the comparisons was about fiber: did either have any? The article suggested that there was 1 to 1.5 grams of fiber per cup of coffee. If true, that would help fiber-lacking Americans reach their RDA of 25 to 35 grams of fiber per day.

I checked it out. In a single study, researchers found that there was about 0.5 g fiber in 3.3 ounces of brewed coffee or just over a gram per 8-ounce cup. If you drink coffee like I do, that could add up. But what about tea? Nothing really, whether brewed black or green tea. Matcha (green tea) does have fiber, but it’s not clear whether it’s just in the residue after brewing or in the liquid itself.

What coffee and tea both have are phytonutrients and plenty of them. While fiber might not be readily available, could there be something else that could help with digestion and especially, elimination? Yes, and I’ll tell you about it on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: J Agric Food Chem. 2007 Mar 7;55(5):1999-2003.

How Coffee Relates to CVD

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Researchers in Germany used a unique approach in the Hamburg City Health Study: they selected the first 10,000 volunteers. Volunteers who didn’t drink coffee were eliminated from the study, so they ended up with 9,009 subjects.

The researchers collected dietary data along with a variety of other demographic and physiological variables, integrating lifestyle-related behavior, comorbidities, biomarkers, electrocardiographic and echocardiographic data, and finally major cardiovascular diseases (CVDs). They divided up the subjects by coffee intake: low = less than three cups a day, medium = three or four cups per day, and high = more than four cups of coffee per day.

Results

This epidemiological cross-sectional study resulted in the following:

  • High coffee consumption correlated with slightly higher LDL cholesterol
  • Moderate and high coffee consumption correlated with lower systolic blood pressure and lower diastolic blood pressure
  • Different levels of coffee intake didn’t impact heart rhythms or function
  • Most important, coffee intake did not impact the presence of CVD nor prior cardiac events such as heart attacks and heart failure

Were the results of coffee and LDL cholesterol concerning? No—the difference was just five mg/dl, well within measurement error.

Is Coffee Safe to Drink?

Coffee was always safe to drink; the question was how our bodies responded to consuming it. Neither of these studies was perfect, but they show that even high coffee consumers, including myself, may not be at any significant risk for promoting or advancing CVD or cardiovascular events.

I think for most people coffee and caffeine are closely linked. What most of us don’t realize is that coffee is a complex liquid consisting of more than 1,000 bioactive substances, including phytochemicals that have proven beneficial for many organ systems; it’s not only a nervous system stimulant because of the caffeine content.

The Bottom Line

When it comes to coffee, I think it’s person-specific. Taste aside, some people may process caffeine differently, which may impact how much coffee someone could enjoy. These studies add to a body of work which shows that coffee is safe for the heart and other organs; other benefits or issues require further study. For me, time for another mug of Sumatra Roast.

What are you prepared to do today?

        Dr. Chet

Reference: https://www.nature.com/articles/s41598-023-31857-5

Research Update: Coffee and Heart Rhythms

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In one of the first jobs I ever had, the foreman would pour a half-cup of coffee and fill it up with water; he’d had a heart attack and his doctor told him to limit his coffee intake. Fifty years ago, physicians recommended that people avoid coffee if they had high blood pressure or had a cardiac event such as a heart attack. The thought was to lower the stimulating effect of caffeine to keep heart rate and blood pressure lower. In the interim, some studies showed that coffee contributes to cardiovascular disease and more recently, that it may not. So if you love coffee the way I love coffee, you may be encouraged by a couple of recent studies.

The first study examined the effect of coffee on heart rhythms in 100 subjects with a mean age of 39 who served as their own controls. All subjects had a variety of blood tests as well as genetic tests to determine if they were fast or slow processors of caffeine. They also wore a new-age heart rhythm monitor for the 14 days of the study. I’ve worn that monitor, and it gives accurate EKGs to monitor heart rate and heart rhythm abnormalities such as premature atrial contractions and atrial fibrillation.

The subjects were notified the evening before whether they were going to be on a two-day coffee drinking cycle or two-day caffeine avoidance; the idea was to track immediate impacts. The good news: there were no differences in abnormal rhythms on coffee days versus non-caffeine days and no impact of caffeine processing. One interesting observation: on the days subjects drank coffee, they walked more steps. We’ll look at the impact of coffee on cardiovascular disease events on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: N Engl J Med 2023;388:1092-100.

Science Says Coffee Is Good

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Research is based on curiosity; in order to do good research, you have to ask good questions. Researchers in the coffee study asked: Will a little sugar negate the benefits from drinking coffee? We don’t know whether this was the initial question or if researchers wanted to find out whether artificial sweeteners might have negative effects that altered the benefits of plain coffee.

Turns out artificial sweeteners did not have an impact on the mortality of those who used it over the seven years of the observational study. If you drink from one to 4.5 cups of unsweetened or sweetened coffee, there’s a reduction in mortality from CVD and cancer.

If artificial sweeteners did have an impact on mortality, the headlines would have been bigger than they were. Last week’s look at the safety of melatonin for kids led me to ask the author “Why melatonin?” Multiminerals in gummy form generally contain iron, and that can be toxic to toddlers in high quantities. So why not start looking there and then examine other nutrients? To date, I haven’t gotten an answer.

What Do We Mean by “Coffee?”

I explained how I drink my coffee earlier in the week. However for today’s coffee drinkers, there could be high-sugar flavors added as well as whipped cream and other assorted milks. It seems like a science unto itself to know how to order some of the “coffees” available today, let alone fill those orders. Based on what I read in the Methods section, the questionnaire they used didn’t go into that kind of detail. Extra sugar and fat from elaborate coffees may have a negative impact that won’t be determined in this study.

The Bottom Line

This was an observational study, so there’s no cause and effect implied. Still it’s good to know that the cup o’ Joe isn’t doing any harm and may actually be good for you. Now, about those tea drinkers…

What are you prepared to do today?

        Dr. Chet

Reference: Ann Internal Med. 2022. https://doi.org/10.7326/M21-2977

Coffee: One Sugar Please

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I have a strong relationship with coffee. I began drinking coffee when my mother put coffee in a bottle with a little sugar for me when I was a toddler. These days, a mother would get reprimanded by somebody if she did such a thing, but in the 1950s there weren’t the variety of drinks for children that are available today; milk, orange juice, and Kool-Aid, that was about it.

When I talk about coffee now, I don’t mean the fancy kind with steamed milk and espresso and other ingredients. I drink strong coffee, eight to ten ounces per mug, with exactly one teaspoon of sugar. I drink only Sumatra roast and use a Turkish grind, which is more like powder than grounds; I get the most flavor out of the beans when I brew it that way. I sit back and drink it, savoring every sip. (And yet somehow I married a woman who thinks the only thing coffee is good for is dipping a biscotti.)

The benefits of coffee have been established in prior studies of coffee drinkers compared to non-coffee drinkers. Coffee seems to reduce mortality from cardiovascular disease and cancer. No one seemed to separate the drinkers who used sweeteners from those who didn’t, and that’s why a recently published study caught my attention.

Researchers examined data from over 170,000 subjects in the U.K. Biobank Study; their purpose was to see if adding sweeteners to coffee, either sugar or artificial sweeteners, impacted the mortality of the subjects. I won’t make you wait until Saturday: the coffee sweetened with sugar had the same reduction in mortality as the unsweetened coffee. What about artificial sweeteners? I’ll talk about those on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: Ann Internal Med. 2022. https://doi.org/10.7326/M21-2977

Research Update on Coffee and Alzheimer’s Disease

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I began drinking coffee when my mother put coffee with sugar and milk into my baby bottle—sounds shocking today, but that’s the way it was. Over 60 years later, I still love coffee, especially strong coffee. That’s why a health headline suggesting coffee may reduce Alzheimer’s and other neurological conditions caught my attention. I had to check it out.

Don’t rush off to the nearest coffee bar just yet, especially if you don’t drink coffee. This was a laboratory experiment to examine a by-product of coffee roasting called phenylindanes. The researchers examined whether these chemicals could prevent the aggregation of amyloid-beta and tau, the building blocks of the plaques and tangles of Alzheimer’s disease. Turns out, they can prevent those clusters and that’s great, but these are test-tube studies.

We’ve seen this many times before. Test-tube studies show beneficial effects of some nutrient and a product is rushed to market with no human trials. While that wasn’t the intent of the researchers, it probably will happen; you can still buy green coffee bean extract for weight loss even though the major clinical trial has been not just discounted but retracted.

I think it shows there’s power in plant nutrients. Eating or drinking a wide variety of all plants will help reduce inflammation, and thus the production of harmful chemicals in our bodies. The benefits are not just limited to raw vegetables or fruits. Cooking can have a beneficial impact on the phytonutrients just as the roasting of coffee beans may have. We don’t have to focus on a single nutrient for benefits.

The keys to health don’t change. Eat better. Eat Less. Move more. And have a cup of coffee or two along the way if you like it.

What are you prepared to do today?

Dr. Chet

 

Reference: Front. Neurosci., 10-2018 https://doi.org/10.3389/fnins.2018.00735

 

Drinking Your Phytonutrients: I Love Coffee

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I’ll say it again: I love coffee. I’ve been drinking it since my mother put coffee with a little sugar in my bottle when I was a baby; I guess she wanted me to stay awake. (Yes, that’s Ma and I in the photo; Paula’s feeling creative this week.)

In my lifetime, the health news has said coffee is both bad and good for you. Today it seems to be mostly on the plus side; there’s good reason for that and it appears the benefits are due to the phytonutrients and—surprise!—the caffeine.

Caffeine . . .

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