Most people think they should stop drinking coffee. In my clinic, it belongs to the holy triad of things people think they should cut down or quit when they aren’t feeling optimal.
It’s either red meat, alcohol or coffee that gets the chop if things are going well.
Contrary to my article on alcohol (spoiler alert: it’s not good for you), I’m here to offer a somewhat contrarian opinion on the holy triad again, this time with everyone’s favourite black energy bean.
I say contrarian because, in the case of alcohol, I went in with the opinion that a small amount was healthy.
You know everything in moderation, depending on the moderator.
In the case of coffee, it was the opposite. Most people feel that too much is bad, and some feel they must quit altogether to be healthy.
Well, this article will shed some reassuring light on the positive effects of coffee consumption on various elements of your health.
We’ll also look for some areas to be careful of, especially regarding your digestive and mental health.
Around one hundred and twenty coffee shops opened in Hong Kong between January and August 2021.[1]
That’s saying something for a region where milk tea and yuen yueng (a local Cantonese drink mixing tea and coffee) reign supreme.
In the US, the average consumption is around four hundred million cups a day, even though only two states in the US produce their own coffee. That’s nothing, though, to the largest coffee consumer in the world, Finland.
Finnish people, on average, consume around four cups of coffee daily. This daily amount can increase markedly, with some having up to eight or nine cups daily![2]
The last time I had that much coffee, I thought the earth was shaking.
I realised it was just my body.
Once again, though, I immediately think of the adverse effects of that level of coffee consumed daily.
Epidemiological studies conducted over the last five to ten years disagree.
Let’s look at the positive, unexpected for most, effects of coffee.
Now epidemiological studies aren’t considered gold standard methodologies for the research nerds out there. Still, for getting a potentially balanced view of the effects of something on a large population of people over time, they can at least provide a starting point to improve our understanding.
The first of these studies is one that genuinely surprises people. The study, published in the New England Journal of Medicine, concluded that light to moderate coffee consumption (up to three cups daily) was inversely associated with total and cause-specific mortality.
In English, non-drinkers had a higher death rate.[3]
A similar study published in June 2022, with one hundred and ninety thousand people in South Korea, got a little more specific. It confirmed the earlier study above, finding that daily up to three cups of coffee benefits cardiovascular disease, respiratory disease and diabetes, but not cancer mortality.[4]
Caffeine and coffee can be opposed when it comes to cardiovascular disease.
One constant argument in the coffee/caffeine debate is called the “coffee paradox.”
Caffeine increases blood pressure, but coffee seems to reduce it. When you look into the studies and get a little more granular, it appears that the increase in blood pressure caused by coffee and the caffeine within it lasts up to or less than three hours.[5]
After two weeks, there did not seem to be any evidence suggesting that longer-term consumption caused issues with blood pressure. Not only that, it may benefit high blood pressure by positively affecting the blood vessels that contribute to it.[6]
It doesn’t stop with the cardiovascular system. Coffee also has a hepatoprotective effect.
Or, in simpler terms, it can play a role in protecting your liver.
To contextualise this, non-alcoholic fatty liver disease (NAFLD), the leading liver disease in the world, affects around one-third or just above thirty per cent of the world’s population.[7]
Not only this, but NAFLD is bidirectional when it comes to metabolic syndrome, a combination of blood pressure, blood sugar and cholesterol issues and type 2 diabetes.[8]
Bidirectional means that as fatty liver worsens, so do its associated conditions. In contrast, as the fatty liver improves, so do the related conditions. I’ve seen it in practice too.
Back to coffee and its effects on the liver.
A meta-analysis brought together epidemiological studies to look at coffee consumption, the risk of NAFLD, and the progression of NAFLD into more severe, irreversible liver conditions.
In both separate analyses, the results were quite staggering. Coffee drinkers were significantly less likely to get NAFLD if they didn’t have it as a pre-existing condition. Drinking coffee was also found to dramatically reduce the progression of fatty liver into more severe diseases such as fibrosis.[9]
To contextualise this following study a little more, let’s briefly chat about blood tests and liver enzymes.
Natural medicine practitioners tend to look at blood tests slightly differently than modern medicine. The main reason for this is two-fold. The first is one of our principles is “prevention is the best form of cure.” The second is that most of us, at best, only get our blood checked annually, if that, considering the limitations the pandemic placed on visiting your local doctor.
Based on this, when a natural medicine practitioner sees your liver enzymes trending upwards, this can often prompt the need to follow up with further investigations to check on the presence of fatty liver.
If you want to check for yourself, these enzymes, ALT, AST and GGT, are abbreviated on your blood report.
What do the liver enzymes involved in fatty liver have to do with the coffee I drink to wake me up in the morning?
Well, several studies have found coffee consumption has been associated with lower levels of ALT, AST and GGT. Not only that, multiple studies around different regions of the world, such as Italy, Mexico, Japan and the US, have found a similar connection, further validating coffee’s benefits for the liver.[10]
To give some real-world context, the coffee intake for these studies was an average of two to three cups a day.
How does coffee affect the gut and the brain?
As always on this site, we are looking at ways to help you feel better with your digestive or mental health situations and coffee, well after all the positivity so far, has mixed results.
To keep on the positive side, for now, if you’ve drunk a coffee recently, you probably already know how it can affect the brain.
The caffeine increases your degree of alertness and reduces the sensation of fatigue, leading to better performance in tasks requiring fast reactions.
Would you believe that caffeine in one study had better results on cognition than the popular recreational stimulant modafinil?[11]
Initial studies have shown promise in helping to reduce the risk of Alzheimer’s disease and dementia. However, contrary to the article you may read in the news media, most of the positive coverage for this has been via animal studies. The fact that we are yet to see some well-designed human studies suggest there is a way to go, but the future is bright.
Coffee does seem to have benefits for another debilitating brain condition, Parkinson’s disease.
In one meta-analysis of thirteen studies, people who consumed caffeine (through coffee) presented a significantly lower rate of Parkinson’s disease progression and risk in general.[12]
Another exciting study found that people who started drinking coffee in mid-life developed five-fold fewer cases of Parkinson’s disease at the age of sixty-five years old when compared to non-drinkers.[13]
By now, you might consider that coffee isn’t all that bad for you, but if you have gut problems, the situation might be slightly different.
Indeed, coffee may make things worse.
An Iranian study assessing just under three and a half thousand people found a significant association between coffee intake and the severity of IBS. A further note from this study found that coffee drinkers had greater odds of developing IBS than non-drinkers.[14]
The reasons behind this come from coffee’s effect on the digestive system. Coffee increases motility and reduces transit time in the gut.[15] [16]
In simpler terms, this means that coffee is bad news for people experiencing IBS-D (diarrhoea dominant IBS). People living with IBS-D generally have enhanced motility and faster transit time already.[17]
Often then, coffee can make the loose bowel patterns of IBS-D worse. Studies have also shown that the intestinal permeability or leaky gut picture is also worse in coffee drinkers.[18]
It’s not all bad, though; coffee and its plethora of bioactive ingredients can do important probiotic species some good.
These studies are purely associative or in animals at this point. Still, they’re certainly an interesting example of the type of diversity changes we can see in the microbiome with dietary intervention.
For example, one study investigating moderate coffee intake, three cups daily for three weeks, found significant increases in the beneficial Bifidobacterium species. Some participants even saw a higher metabolic activity from the Bifidobacterium group, suggesting that it amplified their benefits simultaneously.
How good is coffee?!
There are some things to be aware of, though.
The first, from my point of view, is the one that often differentiates people’s experience of coffee. The genetic component of breaking down and eliminating coffee and caffeine in your body varies from two to eight hours. Generally, for caffeine to reach its half-life, the time it takes for the amount to halve in your bloodstream, the amount of time is two to four hours for an average person.
We would call this person a normal metaboliser.
For fast metabolisers, this would be two hours, but for slow metabolisers, this could be around eight hours.
The message here for those who don’t know their personalised genes on this is that have most of your coffee in the morning to avoid it interfering with your deep and restorative sleep patterns.[19]
So what do you think?
We touched on people’s desire to give up coffee as part of the holy trinity of “things that aren’t good for me.”
Hopefully, this article has gone some way to both reassure you that coffee consumption may not be as bad as you think. At the same time, like most things, there are some situations where taking some time off coffee can be beneficial to get you better if you have IBS-D or anxiety and depression.
On the whole, why not have that extra cup at 10 am and watch your world’s colours get brighter, knowing that you are most likely extending your life simultaneously.
Hope this helps xx
References
[1] https://www.tatlerasia.com/dining/drinks/best-hong-kong-coffee-shops-culture-2021, viewed 29th September 2022
[2] https://www.statista.com/statistics/708603/coffee-consumption-per-capita-in-finland/, viewed 29th September 2022
[3] Freedman ND, Park Y, Abnet CC, Hollenbeck AR, Sinha R. Association of coffee drinking with total and cause-specific mortality [published correction appears in N Engl J Med. 2012 Jul 19;367(3):285]. N Engl J Med. 2012;366(20):1891-1904. doi:10.1056/NEJMoa1112010
[4] Cho HJ, Yoo JY, Kim AN, et al. Association of coffee drinking with all-cause and cause-specific mortality in over 190,000 individuals: data from two prospective studies. Int J Food Sci Nutr. 2022;73(4):513-521. doi:10.1080/09637486.2021.2002829
[5] Mesas AE, Leon-Muñoz LM, Rodriguez-Artalejo F, Lopez-Garcia E. The effect of coffee on blood pressure and cardiovascular disease in hypertensive individuals: a systematic review and meta-analysis. Am J Clin Nutr. 2011;94(4):1113-1126. doi:10.3945/ajcn.111.016667
[6] Yamaji T, Harada T, Hashimoto Y, et al. Relationship of Daily Coffee Intake with Vascular Function in Patients with Hypertension. Nutrients. 2022;14(13):2719. Published 2022 Jun 29. doi:10.3390/nu14132719
[7] Riazi K, Azhari H, Charette JH, et al. The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2022;7(9):851-861. doi:10.1016/S2468-1253(22)00165-0
[8] Powell EE, Wong VW, Rinella M. Non-alcoholic fatty liver disease. Lancet. 2021;397(10290):2212-2224. doi:10.1016/S0140-6736(20)32511-3
[9] Hayat U, Siddiqui AA, Okut H, Afroz S, Tasleem S, Haris A. The effect of coffee consumption on the non-alcoholic fatty liver disease and liver fibrosis: A meta-analysis of 11 epidemiological studies. Ann Hepatol. 2021;20:100254. doi:10.1016/j.aohep.2020.08.071
More References!
[10] Wadhawan M, Anand AC. Coffee and Liver Disease. J Clin Exp Hepatol. 2016;6(1):40-46. doi:10.1016/j.jceh.2016.02.003
[11] Repantis D, Bovy L, Ohla K, Kühn S, Dresler M. Cognitive enhancement effects of stimulants: a randomized controlled trial testing methylphenidate, modafinil, and caffeine. Psychopharmacology (Berl). 2021;238(2):441-451. doi:10.1007/s00213-020-05691-w
[12] Hong CT, Chan L, Bai CH. The Effect of Caffeine on the Risk and Progression of Parkinson’s Disease: A Meta-Analysis. Nutrients. 2020;12(6):1860. Published 2020 Jun 22. doi:10.3390/nu12061860
[13] Ren X, Chen JF. Caffeine and Parkinson’s Disease: Multiple Benefits and Emerging Mechanisms. Front Neurosci. 2020;14:602697. Published 2020 Dec 17. doi:10.3389/fnins.2020.602697
[14] Koochakpoor G, Salari-Moghaddam A, Keshteli AH, Esmaillzadeh A, Adibi P. Association of Coffee and Caffeine Intake With Irritable Bowel Syndrome in Adults. Front Nutr. 2021;8:632469. Published 2021 Jun 15. doi:10.3389/fnut.2021.632469
[15] Poole R, Kennedy OJ, Roderick P, Fallowfield JA, Hayes PC, Parkes J. Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes [published correction appears in BMJ. 2018 Jan 12;360:k194]. BMJ. 2017;359:j5024. Published 2017 Nov 22. doi:10.1136/bmj.j5024
[16] Brown SR, Cann PA, Read NW. Effect of coffee on distal colon function. Gut. 1990;31(4):450-453. doi:10.1136/gut.31.4.450
[17] Posserud I, Ersryd A, Simrén M. Functional findings in irritable bowel syndrome. World J Gastroenterol. 2006;12(18):2830-2838. doi:10.3748/wjg.v12.i18.2830
[18] Cibicková E, Cibicek N, Zd’ánský P, Kohout P. The impairment of gastroduodenal mucosal barrier by coffee. Acta Medica (Hradec Kralove). 2004;47(4):273-275.
[19] Weibel J, Lin YS, Landolt HP, et al. Regular Caffeine Intake Delays REM Sleep Promotion and Attenuates Sleep Quality in Healthy Men. J Biol Rhythms. 2021;36(4):384-394. doi:10.1177/07487304211013995
