Getting a Healthy Kick From Coffee
David A Fein, MD
It seems like every time we find a food that we really enjoy someone comes along with a medical study telling us that it is bad for us. We have become so conditioned to this happening that just about any time I ask a patient how much coffee they drink their response seems about as guilty as if they were admitting to a major drug habit. Even though it is just a routine question, patients expect their doctor to tell them there is something harmful about their morning jolt of caffeine.
The “food police” have tried for years to pin a bad rap on coffee. Of course, caffeine can cause some symptoms such as heartburn, palpitations or insomnia. It also turns out that there are some very beneficial effects in a cup of coffee. For some people it may even offer health benefits. So, here is some of the latest news about the potential health benefits of coffee that may help to take some of the guilt out your coffee pleasure or at least get a nagging spouse to let you drink in peace.
The most recent good news for coffee comes from research presented last week at the European Society of Cardiology annual scientific meeting in Vienna. A study done at the University of Athens found improved elasticity in the aorta (the main artery from the heart) in coffee drinkers. The elasticity of the blood vessels typically decreases as we get older and may contribute to development of high blood pressure. In essence, this finding meant that the coffee drinkers had younger arteries.
Coffee contains numerous substances besides caffeine and the volatile compounds that create its aroma and flavor. The researchers postulate that the vascular effect they saw was related to the presence of a class of chemicals called polyphenols. The effect was seen in moderate coffee drinkers who drank one to two cups of coffee per day. At higher intake levels the effect appeared to diminish, perhaps because the effect of other chemicals in the coffee overwhelmed the effect of the polyphenols.
The study also found that moderate coffee drinkers, compared with those who rarely drink coffee were:
- Less like to get diabetes (22% versus 34%)
- Less likely to have high cholesterol (41% vs 55%)
- Less likely to be overweight
- Less likely to develop cardiovascular disease (19% versus 26%)
That last finding is very interesting. Several prior studies have looked at the risk of heart attacks in coffee drinkers. The results have been controversial. Given that the caffeine in coffee has multiple effects on the circulation some researchers have questioned whether too much caffeine could increase the risk of heart attacks.
A study published in the March 8, 2006, issue of the Journal of the American Medical Association found that genetically determined variations in the way that caffeine is metabolized by different people could identify who has an increased cardiac risk from caffeine. Caffeine is broken down in the body by a particular form of an enzyme named Cytochrome P450 1A2. Some people have a form of the enzyme that breaks down caffeine slowly and some have a form that breaks it down rapidly. This study showed that the intake of coffee was associated with an increased risk of heart attack only in those who had the slow type of the enzymes. A genetic test is available to determine whether you have the fast or slow enzyme.
So, what do these findings mean for you?
If you already know that you have coronary artery disease or are at high risk for cardiovascular disease then it may be helpful to have the gene test done to determine how your body handles caffeine. Those with the slower type of enzyme may want to limit their intake.
If you are a moderate coffee drinker who is not at high cardiovascular risk then take some comfort. You coffee habit is probably healthy. As long as you do not have problems such as palpitations, difficulty sleeping well, tremors, heartburn or other side effects then you can enjoy your coffee guilt free