Paging Dr. Frischer: Coffee
Many of you are aware of my aversion to mushrooms. I happen to have one more intense and inexplicable dislike: coffee! As a scientist, however, I do my best to be unbiased. Let’s look at the pros and cons of being a coffee drinker.
The research shows many reasons to recommend indulging. Many of them are grounded in the fact that coffee is a source of vitamins and minerals, including vitamins B2, B5, B1, B3, folate, manganese, potassium, magnesium and phosphorus.
In addition, coffee contains phytochemicals, which can act as antioxidants, affect cholesterol absorption, and inhibit inflammation. Among other things, phytochemicals can actually improve the gut microbiome (bacteria that aid digestion and boost immunity) and prevent cellular damage.
Studies have shown that coffee drinkers tend to have a lower risk of death from any cause. Of course, these benefits depend on many factors, including how much you drink, your age, gender, underlying health issues, medicines you take…and genetics. Some of these health benefits are attributed to the effects of caffeine, and others are related to coffee’s other components.
Drinking coffee regularly may help those with prediabetes to resist progressing to diabetes. This may be due to antioxidants, anti-inflammatory compounds, and insulin-sensitivity boosters. Even decaffeinated coffee might confer some of these benefits. It may be linked to a lower risk of Parkinson’s disease and Alzheimer’s disease.
A reduced risk of metabolic syndrome and chronic kidney disease has been shown, as well as liver cancer, liver disease in general (including cirrhosis), gallstones and kidney stones. It used to be thought that consuming coffee increased the chance of getting kidney stones, but newer data suggests that consuming moderate amounts (perhaps 1 1/2 cups per day) can actually reduce the risk. This is because caffeine leads to increased urine volume and increased calcium excretion, which may prevent the crystallization of substances that form stones.
What is the data on heart disease? Studies show that drinking one or more cups of plain caffeinated coffee per day may reduce the risk of heart failure, and that the benefits may extend to the overall cardiovascular system. Drinking up to three cups per day was associated with a lower risk of stroke and death from cardiovascular disease.
Caffeine has been linked to improved mood and a lower risk of depression. Does this observation really take a study? Just recall your last conversation with someone who has NOT yet had their morning coffee! Studies actually show that the effects of caffeine are not merely transitory. Drinking coffee may reduce the risk of depression by nearly one-third. Researchers suspect that both coffee and antidepressant medications lower inflammation, which may have an effect on depression. In addition, the positive impact on our gut biome may produce or enhance other compounds that have beneficial effects on mood. Caffeine sharpens mental and physical agility, increases processing speed, attention, alertness, vigor and motivation, and decreases apathy, irritability, and fatigue.
The downsides of drinking coffee? I’ve personally heard reports from my patients of anxiety, new or worsening tremors, headache, rapid heartbeat, increased heartburn from reflux, and urinary frequency due to its diuretic effect.
Excessive consumption can reduce bone density in women. The data indicates that pregnant women should certainly limit consumption. And, note that all of this does not even take into account the undesirable effects of adding cream, sugar, artificial creamer, or artificial sweetener to our daily diet!
My bottom line? For most of us, it is OK to drink coffee daily, and it may offer health and productivity benefits. But, as with practically everything, moderation is key.
Pay attention to how you personally experience coffee’s side effects. Some are more sensitive to the stimulatory effects of caffeine. Dietary guidelines may “allow” up to 400 mg of caffeine per day, but if an 8-ounce cup of coffee contains about 95 mg, that would amount to more than four (small) cups per day. Most of my patients do not tolerate that quantity of caffeine well.
If you suffer from acid reflux, get palpitations, have trouble sleeping, or experience symptoms of anxiety, I recommend that you taper down gradually in order to avoid headaches and other symptoms of withdrawal.
Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 10927 Downey Ave., Suite C, Downey, CA 90241.