by KJ Fallon
Dr. Cornelis pointed out that there is a lot of interest in how coffee can affect our health and there is quite a bit of research around the specifics: “It probably varies by the type of health outcomes you’re looking at,” she said. Most of this is based on either experimental data or epidemiological data—studies of large populations over time.
There are certain diseases or conditions that coffee does seem to affect in a favorable way. “For certain health outcomes that impact the brain such as Alzheimer’s disease or other neurological disorders like Parkinson’s,” stated Dr. Cornelis, “there’s some evidence and a general strong hypothesis suggesting that it’s the caffeine component of coffee, but for other outcomes—diabetes is probably one of the better examples—it could be other things in coffee. For example, the polyphenols, more specifically the chlorogenic acid.” Chlorogenic acid occurs naturally in plants, and is an important part of their metabolic functions.11
Chlorogenic acid can be isolated in leaves and fruit for pharmaceutical use. In addition to its antioxidant uses, chlorogenic acid is also known to slow glucose release into the blood, making it a possible preventative measure for both cardiovascular disease and type 2 diabetes. Chlorogenic acid is also showing promise in cancer treatment, inhibiting chemicals that contribute to tumor growth.12 According to Dr. Cornelis, “Coffee is a primary source of chlorogenic acid for populations that consume a lot of coffee. That might have a beneficial impact on glucose levels which is a key kind of risk factor for type 2 diabetes.
Sanjiv Chopra, MD, is a professor of medicine at Beth Israel Deaconess Medical Center, and has published several books on healthy living, the latest being The Big Five: Five Simple Things You Can Do to Live a Longer, Healthier Life.13 One of the five things is drinking coffee. Quite a bit of coffee, if you can manage it.
Is it caffeine that plays the major part in the health benefits of coffee? We really do not know. As Dr. Chopra explained in an interview, “Coffee has thousands of constituents, amongst them are kahweol and cafestol.” Dr. Chopra said that experimental laboratory studies have shown that pretreatment with kahweol or cafestol abrogates injuries, especially to the liver.14
“Coffee also is very rich in chlorogenic acid, which is one of the richest antioxidants. Coffee is insulin sensitizing, so it helps in type 2 diabetes,” explained Dr. Chopra. “If somebody already has type 2 diabetes and they drink two cups [of coffee] there’s a 30 percent reduction in cardiovascular mortality. But we don’t think it’s the caffeine because I’m not aware of any good studies saying Coca-Cola, caffeine pills, tea, are healthy.” There’s a lot of hullabaloo about tea and green tea being rich in antioxidants, but Dr. Chopra said that he had yet to see a good study.
Coffee can be advantageous to health in other ways. “Coffee drinkers also have lower levels of something called TNF-alpha, tumor necrosis factor alpha; and CRP, C-reactive protein,” Dr. Chopra said. “C-reactive protein is a risk factor for coronary artery disease. We don’t really know the mechanism, but when there are dozens and dozens of studies, and when there’s a dose-dependent effect, then it’s a wake-up call, then we have to say, hmm, intriguing, believable.” Dr. Chopra was impressed by a study published in the New England Journal of Medicine that found “coffee drinkers, men and women, have lower total and cause specific mortality.”15
As for what coffee might have to do with heart attacks and stroke, and what component of the coffee is responsible for any effect, Dr. Cornelis said that while we really don’t know, recent research suggests that coffee might be beneficial for preventing those outcomes. “In terms of my research,” she explained, “I actually take a different approach. I think that the health effects of coffee or caffeine itself might actually vary by our ability to metabolize caffeine.” The amount of coffee that one person needs to drink in order to ward off a certain disease might be very different from the amount another person might need to consume in order for the coffee to offer any kind of protection against the illness or condition.16
There is no firm conclusion as to whether chlorogenic acids affect the flavor of coffee in any way. As mentioned before, chlorogenic acid is a phenolic compound that has antioxidant and other benefits and seems to help with regulating blood sugar.
One factor that might affect how much the body benefits from drinking coffee is the roast of the coffee. But there are no firm conclusions about this and it is still under investigation. Some studies suggest that there might be more chlorogenic acid in light roasted coffee, so therefore light roast coffees might be more beneficial with respect to helping the body ward off some diseases and conditions.17 On the other hand, there are more melanoids in darker roasts. Melanoids might help fight off some cancers, inflammation, and maybe even hypertension to some degree.18
Some studies have found that darker roasts are more effective than lighter roasts when it comes to bestowing added health benefits. The title of a study in Molecular Nutrition and Food Research, “Dark roast coffee is more effective than light roast coffee in reducing body weight, and in restoring red blood cell vitamin E and glutathione concentrations in healthy volunteers,” speaks for itself.19
No one can really say for sure, however, which roast—light or dark—offers the most overall health benefits. There has to be more research, asserted Dr. Chopra. The studies out there are, he said, what are called epidemiological. A researcher asks questions, such as, “Do you drink coffee, yes or no? Do you drink regular or decaf? How many cups of coffee do you drink in a day?” Dr. Chopra continued, “Whether putting [in] cream or milk or sugar, whether it’s organic coffee or pure coffee with more pure constituents, no one’s done that study and I don’t think it’ll ever get done.”
But what about the melanoids in darker roasts? Dr. Chopra said they don’t translate into health benefits unless you conduct a study: “You can have something that says this is helpful and then the way we study it in medicine is you do a placebo control, randomized trial, [and] blind, where the investigator doesn’t know which subjects are getting the active and which are getting the placebo, and the patients don’t know. Then a study monitor assesses it and at the end you look at the results.” But, he said, this will never happen with coffee. Can you have ten thousand subjects and tell five thousand of them that they can’t drink coffee and the other five thousand that they should drink coffee, and then out of those, half of them must drink this kind of coffee and the other half must drink that kind of coffee, and drink the coffee a certain way and at a certain time? It is just not feasible.20
But we are discovering more about coffee’s health benefits, and how caffeine affects coffee drinkers. Dr. Cornelis has always been interested in the genetics and, she said, we know that there is a genetic component to coffee consumption. “The genetic components are really pointing to our ability to metabolize caffeine. In general,” she added, “what I mean by caffeine metabolism is that if individuals who are genetically predisposed to, who genetically kind of have this genetic signature in that they metabolize caffeine quickly, those same individuals are consuming more coffee or caffeine in general.”
Dr. Cornelis’s literature shows that these genetics that alter our metabolism ultimately impact our behavior, so people are naturally titrating their levels accordingly. There is no easy way to test to see if you are getting the right amount of caffeine for your metabolism. Dr. Cornelis said, “We tend to consume as much as we need. I think you can probably relate that if you are a coffee consumer you know when you might need a coffee because you’re either feeling tired or sleepy. You have a cup of coffee and then you know generally how much you need to consume. That’s kind of a learned experience . . . it’s just interesting that there is a genetic component to that but we generally just go by feel.”
Harvard researchers are also looking into what else is behind the benefits of coffee. It seems that decaffeinated coffee might have some of the same benefits as caffeinated coffee so the magic elements have to be something besides caffeine.
Dr. Co
rnelis added that these studies suggest that it’s the non-caffeine components of coffee that affects type 2 diabetes...“partly because you kind of see the same protective effect of coffee on type 2 diabetes with decaf coffee and also with other studies that looked at the impact of caffeine on glucose levels, interestingly and paradoxically the caffeine has adverse effects on glucose.”
Dr. Chopra’s book The Big 5 discusses many of the health benefits of coffee. Elizabeth Blackburn, PhD, who, with two colleagues, was awarded the Nobel Prize in medicine of physiology for discovering telomeres and telomerase.21 As Dr. Chopra wrote in his book, “Just like we have a plastic tip on the end of shoelaces, there is a cap on the end of chromosomes called a telomere. Shortened telomeres and decreased telomerase activity is associated with cell aging.”22 Dr. Chopra added, “Now there’s a study, I think in the last six months, [that shows] coffee drinkers have longer telomeres.”23
Is it possible to drink decaffeinated coffee and still get the health benefits? “Decaffeinated coffee seems to have similar health benefits, except for cirrhosis of the liver,” Dr. Chopra said. “There, for some reason, protection is seen with regular coffee and not decaf coffee.” He specializes in hepatology, the field of liver disease.
Dr. Chopra explained, using the example of alcoholic cirrhosis, “Now for decades, we’ve been mystified, how come some people drink a pint of whiskey a day for twenty years and at the end of twenty years, 20 percent get cirrhosis? Is it their genes? Is it the way they metabolize alcohol through an enzyme called alcoholic dehydrogenase? The answer is coffee. If you drink that much [alcohol] and drink one cup of coffee a day, [there’s a] 20 percent reduction in the chance of getting alcoholic cirrhosis, two cups, 40 percent, four cups, 80 percent.”
“We have a very busy liver service at the Beth Israel Deaconess Medical Center, with very sick patients, pre- and post-transplants, and have taught all the residents and fellows, students, to ask every patient about coffee,” Dr. Chopra said. “Week after week, during the last many years, I’ve sat down for rounds and they tell me about the five admissions and so on, and they say, ‘Dr. Chopra, nobody drinks coffee.’ One day I sat down, and the intern had a grin on his face, and he said, ‘We finally have a patient who drinks coffee. And we asked him whether it’s regular or decaf because you taught us it has to be regular, and it’s regular coffee.’”
Then the intern asked the patient who said he drank coffee how many cups he drank a day and he answered four cups, four good-sized cups. “So,” Dr. Chopra said, “you know, these epidemiological studies, they make excellent explanations, but I’ll take my own history. And we go for rounds, they introduce me, I sit down, I take a detailed history, at the end I said, tell me about tea and coffee. He said, ‘Doc, I don’t drink tea, I love coffee.’ I said, what do you drink? He said, ‘Well, I go to drink coffee, I got to drink the real stuff.’ I said, how many cups? He says, ‘Four cups.’ I said, what size, and he pointed to a paper cup, about eight ounces. And I asked one more question, how long have you been drinking coffee? He said, ‘Since my liver transplant.’ And the house staff fell down. That’s the art of history taking.”
Dr. Chopra continued, “He said, ‘I never liked coffee. I got my liver transplant. I don’t know what happened, I have a craving for coffee. Should I stop it?’ I said, no, no, keep drinking it. So he was in, not for recurrent liver disease, he was in for bad cellulitis and because they’re immunosuppressed we take it seriously and admit them and treat them. I have yet to come across a patient who drank four, five cups of coffee a day, regular coffee a day, and wound up with bad liver disease, if he or she had been doing it for many years. I’m a liver specialist so I got intrigued about this twenty-five years ago.”
Migraines
When it comes to pain in the head, caffeine is both a culprit and a cure, according to WebMD and Cleveland Clinic.24, 25 Quite a few pain relievers have caffeine as an ingredient (i.e., Excedrin Migraine, Anacin). Caffeine can improve the success of an analgesic by 40 percent. And there are also occasions when a headache might be vanquished with just caffeine alone.
Parkinson’s Disease
According to a study headed by Alberto Ascherio, professor of Epidemiology and Nutrition at Harvard T. H. Chan School of Public Health, having four to five cups of java a day can nearly halve the possibility of getting Parkinson’s Disease, as opposed to those who drink little or no caffeine.26
Cardiovascular Disease
In his book The Big Five, Dr. Chopra refers to a Harvard study done with researchers from Universidad Autónoma de Madrid that examined the possible link between coffee and strokes in women. Researchers found that: “women who drank two or more cups day reduced the risk of stroke by 19 percent—and the more coffee they drank the greater the reduction in risk.”27
Nonsmoking women who drank four-plus cups of coffee were even better off, and had a 43 percent reduction in stroke incidence. And it doesn’t seem to be the caffeine in the coffee that is the reason, since those who drank tea or other beverages with caffeine did not see the benefits, while those who drank two-plus cups of decaffeinated coffee did.28, 29
Depression
A 2011 Harvard School of Public Health’s Department of Nutrition study showed that women who drank caffeinated coffee had a 20 percent lower risk of getting depression than women who did not drink coffee.30, 31, 32
Dementia
Researchers at Indiana University at Bloomington led by Hui-Chen Lu identified twenty-four compounds that might potentially boost the brain enzyme, NMNAT2, which has been shown to defend against dementia. One of the compounds is caffeine and that is what the team focused on for the study. According to Hui-Chen Lu, more research on the other twenty-three compounds needs to be done and how they affect the brain.33
Single Serve for Portion Control?
Here is where the single-serve option found a niche—those who want to drink more coffee but don’t want to drink it all at once, so a single-serve option fulfills a need here. Folks could drink more coffee and every time they had a cup, it would be fresh. And the coffee lover can try different brands, blends, and roasts with each cup of coffee. No committing to a whole pot.
Coffee drinking in studies usually refers to black coffee. You can’t add fatty creamers and load on the sugar and expect to end up with anything remotely resembling a healthy cup of coffee. Something to keep in mind.
About health benefits, if you are trying to decide between getting the health benefits from a glass of wine or a cup of coffee, now you can have both at the same time, in one cup. With all the press about the benefits of resveratrol, a beneficial antioxidant found in red wine that is said to protect the heart and blood flow, it is not surprising that some coffee companies decided to combine resveratrol with coffee. Vera Roasting Company, founded by organic chemist Glen Miller, offers whole bean, ground, and single-serve coffee—CoffVee—consisting of 100 percent arabica beans infused with resveratrol after roasting. Molinari Private Reserve offers wine-infused coffee, a “full-bodied coffee [that] relaxes in a beautiful wine, absorbing the wine’s nose and history . . .” in half-pound bags.
Drink Less—It Might Not Be So Good for You!
Caffeine usually reaches peak level in the blood an hour after drinking a cup of coffee, according to the FDA.34 The caffeine then percolates around in your blood for about four to six hours. Drinking coffee every day causes a tolerance and you may need to drink more to feel the same energizing effects of the caffeine. And, because people metabolize caffeine at different rates, what might be not enough caffeine for one person may be too much for another. And if it is something other than the caffeine in coffee that provides health benefits, maybe decaf would provide the health benefits coffee drinkers are hoping for as an added bonus?
With digestion, coffee can increase acid and can cause heartburn—Dr. Chopra wrote about these not-so-good side effects of coffee in The Big 5. He said that coffee can cause gastroesophageal reflux disease, heartburn, and that is the sam
e whether it’s regular or decaf. And irritable bowel syndrome. Insomnia, tachycardia, tremor[s], it goes on.”35
Coffee can affect sleep patterns, obviously, so that can be a negative in some situations. Drinking too much caffeinated coffee—say around five cups a day—can lead to caffeine withdrawal when the coffee lover suddenly puts the brakes on their daily habit.36 Caffeine is also a diuretic, and too much can cause dehydration and dry, wrinkly skin. So, just drink more water, right? Finally, crashing from too much caffeine can lead to cravings for sweets, as can the idea that having a cup of coffee means having a little something to go along with it, like a doughnut or a piece of cake.
One gourmet method for making coffee has been found to be not so healthy: the French press. Diterpenes (or diterpenoids) are a class of chemical compounds that are found in coffee that help give the bean an oily richness. They are not so good for you. They are normally trapped in a coffee filter, which the French press does not use. Diterpenes could raise LDL (bad) cholesterol levels.
Dr. Cornelis agreed: “Actually that was actually shown several years ago. They found that boiled coffee, which isn’t traditionally consumed now, boiled coffee contained particular lipids. They’re actually called diterpenoids. Those lipids that were not removed from the coffee, those gave rise to increased cholesterol levels. That’s pretty consistent and has been shown in trials. With filtering the coffee, those particular lipids are unfiltered in the coffee so that wouldn’t have any impact on cholesterol.”
Single Serve Might Make Sense When You Want to Drink Less
Need to drink less coffee? The single serve can offer a convenient and quick way to imbibe a specific amount at measured intervals throughout the day and evening and the coffee drinker can still have a cup that is freshly brewed, regular or decaf. Said Dr. Cornelis: “. . . we know from the single serve versus, say, what you get from Starbucks or from a coffee pot more generally is that it’s pretty controlled. You kind of control the amount of coffee that you’re having and possibly the components of coffee. For example, we know that the amount of caffeine in coffee can vary by coffee cups.”
