Depending on what you’re reading, you may think both. And you would be right. Research is all over the map. When I read that International Coffee Day was October 1, 2022, my first thought was, ‘Do I dare? Do I go there and tackle coffee?’. Because, let’s be honest, for some of you, messing with your coffee I know puts me in a dangerous category, I can already feel some questionable glares coming my way. However, you all know me enough to know that I dug into the research on various coffee-related topics and I hope to present in an objective, non-opinionated manner. I highly value your health & your quality of life – I’m on your team.

Coffee is the most frequently consumed stimulant in the world. Often revered for its taste and aroma, coffee is a complex mixture of more than 800 volatile compounds - caffeine and chlorogenic acids being the most common. These compounds, namely antioxidants – phenolic acids, terpenoids, and such are related to the potential health benefits of coffee. Because it’s used in such high amounts, even small effects on human health can have a considerable impact. Let’s unpack coffee and how it influences our health.

Nutrient Content
A cup of black coffee does not contain much at all in the way of nutrients per se – fat, protein, or carbohydrates. A 200ml cup, or 6.8 fluid ounces, of black coffee contains 2-4 calories. What about micronutrients? Coffee contains some potassium, niacin, and even a bit of magnesium, but all in pretty small amounts. That said, a grande white chocolate mocha with whip contains 430 calories (not to mention 53 grams of sugar!!)! Nutrient-wise, it’s not the coffee, it’s what you may add to the coffee.

Not a nutrient, but the most well-known component of coffee is caffeine. Caffeine is rapidly absorbed – primarily from the small intestine, but also partially from the stomach. Caffeine has a half-life that can range from 2-12 hours due to individual differences in metabolism and absorption. Hence, some can have a cup of coffee and fall right to sleep and many others need 8-12 hours before being able to engage in restful sleep following caffeine consumption. How we absorb and metabolize caffeine is largely responsible for the individual differences on one’s health that one may or may not experience.

Cancer
All in all, coffee consumption is not associated with overall cancer risk. For most cancer types, research suggests no association between coffee and cancer – this is true for cancers of the stomach, pancreas, lung, breast, ovary, and prostate. It may be that coffee has a slightly protective effect against liver cancer and endometrial cancer. While the data is limited, there does not appear to be an association of coffee with cancers of the esophagus, small intestine, gallbladder, skin, kidney, brain, thyroid, and soft tissue sarcoma. So, in regards to cancer, coffee doesn’t appear to weigh heavily in the realm of cancer.

Cardiovascular Health
What about coffee and your heart? You’ll find conflicting research. Generally speaking, low/moderate consumption of coffee of 1-2 cups daily is associated with a lower risk of cardiovascular disease. Chlorogenic acid, a polyphenolic compound in coffee (think antioxidant), has been shown to significantly lower total cholesterol, triglyceride, and LDL-cholesterol levels. High coffee consumers of 4 or more cups daily may experience negative health effects as high caffeine raises concentration of total cholesterol, LDL-cholesterol, and lowers our protective HDL-cholesterol as well as leading to increased blood pressure, tachycardia (AKA rapid heart rate), and arrhythmia. Why does coffee increase cholesterol? Coffee contains compounds known as diterpenes, cafestol, and kahweol that have been shown to influence cholesterol levels.

And did you know that how your coffee is brewed can significantly influence lipid values?
When it comes to choosing the healthiest coffee method for cholesterol, reports indicate that filtered coffee is the best choice. Non-filtered coffee, including espresso, contains compounds that raise LDL cholesterol and have been shown to be associated with an up to 25 percent increased risk of cardiovascular disease mortality when consuming nine or more cups a day (yes, 9 – that’s a lot!). Espresso consumption was associated with increased total cholesterol; this association was stronger in men than in women. Both men and women experienced increased total cholesterol with French press coffee (boiled/plunger coffee). Consumption of filtered coffee, however, was associated with lower mortality.

Want to dig deeper? Your genetics significantly influence your ability to metabolize caffeine. The enzyme, CYP1A2, accounts for ~95% of caffeine metabolism. There are those who are fast caffeine metabolizers (CYP1A2*1A) where caffeine does not appear to pose a risk. For others, however, that are slow caffeine metabolizers (CYP1A2*1F), research suggests an increased risk of nonfatal myocardial infarction AKA heart attack. Risk increased by 36% for those drinking 2-3 cups coffee daily and increased by 64% for those drinking 4 or more cups coffee daily. This risk was more pronounced for those younger than the median age of 59 years who also carried the slow caffeine metabolizing CYP1A2*1F gene variant. Among the slow metabolizers, the risk associated with drinking 4 cups or more coffee daily compared with less than 1 cup daily increased from 2-fold for individuals younger than 59 years to more than 4-fold for those younger than 50 years. While more research is needed, it would be wise to limit coffee, and caffeine consumption in general, if you are a slow caffeine metabolizer.

Blood sugar
Again, research is mixed. Research studies do not report a consistent impact of drinking coffee on acute metabolic control, except for the effects of caffeine. That said, I’ve definitely seen individuals where coffee increases their blood sugar acutely. Epidemiological, or population-based, studies suggest an inverse association of habitual coffee consumption with the risk of type 2 diabetes. Why? Habitual coffee consumption may lower the risk of type 2 diabetes by preventing the deterioration of liver and beta cell function during chronic metabolic stress, hence, preventing the onset of diabetes. A 24-week trial with 126 overweight Asian participants reported no significant change of insulin sensitivity after daily consumption of 4 cups of caffeinated coffee compared to a coffee-like placebo drink. There was also no difference in fasting glucose. Similarly, a trial in 45 overweight North American participants reported no change in insulin sensitivity after consumption of caffeinated or decaffeinated coffee for 8 weeks, compared with water.

Neuroprotection
While research is mixed, epidemiological studies suggest that regular coffee consumption may be associated with a reduced risk of various neurodegenerative disorders, including Parkinson’s disease, Alzheimer’s disease, and neurocognitive decline. How? It’s still unclear, but it’s likely that inhibiting adenosine receptors is involved. Results from this clinical study indicate that regular consumption of coffee/caffeine seems to be protective for Alzheimer’s disease and dementia. However, in a large prospective study, caffeine intake showed no association on dementia incidence in women and men and no association with cognitive decline in men. Overall, chlorogenic acid-rich coffee produced positive effects on mood, alertness, decreased mental fatigue, and alleviated headaches yet it did not produce substantial pro-cognitive effects.

Hormones
As is well known, caffeine boosts adrenaline, hence the ‘perk up’. Ironically, it’s possible that this adrenaline boost may lead to fatigue and lower mood later in the day. Caffeine can inhibit adenosine, which helps to calm the body. This is helpful to increase alertness, but may lead to sleep disturbances later. While caffeine doesn’t influence the stages of our sleep (like other stimulants do), by keeping you awake longer, that may result in less time for restorative sleep.

What about cortisol, a primary ‘stress hormone’? Stress increases cortisol and caffeine can increase cortisol. The combination of caffeine and mental stress further increases cortisol levels. While caffeine did not acutely increase cortisol levels in the absence of stress in this trial, the repeated combination of caffeine with stress and food intake led to a significant spike in cortisol levels. Caffeine's effect on cortisol may be greater in persons with higher levels of central nervous system activation, such as those at high risk for high blood pressure.

It’s important to have adequate cortisol levels yet high levels of cortisol can lead to increased blood sugar, mood changes, negative effects on the cardiovascular system, and weight gain. Essentially, excessive caffeine takes a toll on your ever important hypothalamic pituitary adrenal (HPA) axis – your stress response system. All in all, high amounts of caffeine, 4 cups or more of coffee daily, as well as chronic stress undoubtedly increase cortisol levels that lead to negative health effects. Small to moderate amounts of caffeine, however, may help to lift mood and provide a kick in your step. Generally speaking, it’s wise to avoid caffeine after 2pm to help ensure proper sleep.

What about decaf?
Decaffeinated coffee is, of course, much lower in caffeine and also a tad lower in phytochemicals. That said, research hasn’t shown a significant health difference with regular or decaf coffee. If you’re a slow caffeine metabolizer or have found that caffeine increases your blood pressure, blood sugar, cholesterol, or other, opting for a decaf (or alternative) would be a wise choice. And, if you’re going to opt for decaf, coffee or tea, for that matter, seek one that uses a water decaffeination process, not one that uses chemicals. One option is Mommee Coffee made from 100% organic Arabica beans; it’s also a great low-acid option.

Low acid coffee
Coffee can lead to digestive issues for some. Why is that? Likely culprits - acids and caffeine. The high acid content accelerates digestion, hence, one may experience loose stools. The caffeine in coffee increases gastrointestinal contractions and stomach acid, which can lead to acid reflux and heartburn. You may find it surprising that dark roasts tend to be lower in acidity than light or medium roasts; the longer roasting process results in fewer compounds that stimulate the release of stomach acid. Because espresso brews relatively quickly, less acid filters into the finished espresso. What about cold brew? Cold brew coffee has a long steeping process, which results in a lower acid product. A few low-acid coffee brands that appear to be well-liked include Purity Organic Coffee, Trucup Born to be Mild, Puroast Coffee, Lifeboost Coffee Embolden, and Golden Ratio Original Gold Coffee. For what it's worth, Golden Ratio is also certified FODMAP-friendly, so it may be a safe option for those suffering with irritable bowel syndrome (IBS).

Coffee Alternatives
Well, the obvious one in this category is green tea – which is rich in polyphenols, contains some caffeine, but much less than coffee. Green tea and matcha can be a future newsletter. What about other alternatives? Recently, there have been new products hitting the market, such as mushroom and adaptogen based products. A few that come to mind include MUD\WTR, Om, Four Sigmatic, and Ryze. How do they differ?

MUD\WTR is a coffee-free, organic combination of masala chai (black tea), mushrooms (chaga, cordyceps, reishi, Lion’s mane), and spices (cacao, turmeric, cinnamon, ginger, cardamom, black pepper, nutmeg, cloves, Himalayan pink sea salt); it contains 1/7 the caffeine of coffee and over 2000mg mushrooms per serving; that’s a solid medicinal mushroom dosage. Four Sigmatic is a coffee/mushroom blend – organic & fair trade certified coffee with organic chaga and organic Lion’s mane mushrooms (500 mg total/serving). It does contain caffeine though less than typical coffee and also lower in acid. For more potent mushroom options, Om and Ryze would be preferred. Om mushroom coffee combines organic, non-GMO coffee with 2000+ mg mushroom blend per serving. Om contains cordyceps, Lion’s mane, turkey tail, reishi, and ginkgo biloba. Similarly, Ryze is a 100% organic mushroom coffee with 2000mg mushroom per serving – cordyceps, Lion’s mane, reishi, shiitake, turkey tail, king trumpet). Not only does mushroom coffee provide a great source of antioxidants and immune boosting properties, they’re also lower in acid and caffeine. More on the therapeutic effects of mushrooms HERE.

Bottom Line
Coffee does offer some antioxidant and anti-inflammatory properties, both regular and decaffeinated. A standard cup of coffee is 6 fluid ounces – that’s not a typo; six ounces. Needless to say, that’s a fraction of what most consume. The smallest cup of coffee at most coffeehouses is typically 12 ounces and most opt for a larger size. Low to moderate coffee consumption, 1-2 cups daily, appears safe and may confer health benefits on cardiovascular risk, blood sugar, and offer neuroprotection. Operative word: may. High consumption appears to have negative health effects.

If you drink coffee regularly, it may well be worth determining if you are a slow, moderate, or fast metabolizer of caffeine. If you’ve run 23andme or ancestry.com and want to know where you stand with the CYP1A2 enzyme, message me. If blood sugar or glycemic regulation is a challenge for you, it may be wise to monitor how your body specifically reacts to coffee, caffeinated and decaffeinated. This could be accomplished with a continuous glucose monitor or finger prick glucose monitoring. And, if you’re looking for other options to lower your coffee and/or caffeine intake and/or simply trying to boost your immune function, try a mushroom coffee or non-coffee containing mushroom beverage!

Hope you all are transitioning into the Fall season with ease!

In Health,
Natalie