Is coffee bad for you

Is coffee bad for you?

Pawel Malczewski
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Short summary

The way that coffee affects you is closely related to the way you react to caffeine. Caffeine can have either a positive or negative effect on your body depending on a few factors, with your genetic make-up the most significant. The combination of a few genes affect how quickly you can metabolize caffeine and get rid of it from your body.

In general, if you are not caffeine sensitive, there are many health benefits of drinking coffee. On the other hand, if you are highly sensitivity to caffeine, the negative effects outweigh the health benefits of coffee.

This article describes evidence based health benefits as well as the negative effects of various daily amounts of coffee. The conclusion summarizes in which scenarios coffee can be bad or good for you, since the answer varies greatly between each individual. Therefore, you should consider in detail which of the situations applies to your case. For a quick answer click here.

What you will find in this article:

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Explanation

You probably have heard some people saying that drinking six cups of coffee per day has no effect on them and others complaining that it takes only one coffee to make them jittery, aggressive, unable to sleep or to have other symptoms such as chest pains.

The opinions on the health effects of coffee are divided. The information available either promotes the health benefits of coffee or warns about its negative side effects.

The truth, however, is that part of the population can benefit from coffee’s health properties and the other part will only experience negative and detrimental health consequences.

What is in coffee?

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In addition to caffeine, the most investigated component, coffee contains more than a thousand compounds, many of which exert important effects on the body, either on their own or in synergy with each other.

Coffee is one of the most important sources of antioxidants (reduces oxidative damage) and a rich source of anti-inflammatory substances. (1)Carlsen MH, Halvorsen BL, Holte K, Bøhn SK, Dragland S, Sampson L, et al. The total antioxidant content of more than 3100 foods, beverages, spices, herbs and supplements used worldwide. Nutrition Journal20109:3. Available here. (2)Liu Y, Kitts DD. Confirmation that the Maillard reaction is the principle contributor to the antioxidant capacity of coffee brews. Food Research International. Volume 44, Issue 8, October 2011, Pages 2418–2424. Available here. (3)Stella Maris da Silveira Duarte, Celeste Maria Patto de Abreu, Hilary Castle de Menezes, Marcelo Henrique dos Santos, Cibele Marli Cação Paiva Gouvêa. Effect of processing and roasting on the antioxidant activity of coffee brews. Ciênc. Tecnol. Aliment. vol.25 no.2 Campinas Apr./June 2005. Available here.
One cup of coffee contains a small quantity of minerals and vitamins, but since moderate users drink about 4-5 coffees per day (400mg of caffeine), these amounts contribute significantly to the overall daily nutrient intake.

The image below shows the total amounts of micronutrients for four servings of two of the most popular coffees: espresso and brewed coffee in a plunger. Please note that the amounts vary depending on factors such as the type of coffee or the method of preparation as shown in this example. The last two columns display the recommended daily allowance of these nutrients for comparison. Data taken from USDA food database.

Nutrients in coffee

Caffeine in coffee

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Coffee contains caffeine which is a stimulant drug that affects the nervous system and has an impact on hormones. Caffeine contents in coffee depend on the type of coffee, the amount in a serving and the method of preparation. A standard coffee serving contains about 100mg of caffeine. However “standards” may vary depending on where you usually get your coffee from. See the article “Caffeine levels in drinks” for more information on coffee and other caffeinated products.

How you react to coffee depends mostly on how you handle caffeine

Caffeine is the most potent ingredient in coffee and has the biggest influence on how our body reacts to coffee.

Although caffeine has many health benefits, it may also produce a wide range of negative symptoms, depending on the individual’s sensitivity and tolerance to caffeine, and in some rare cases caffeine allergy. Before answering the question if coffee is good or bad for you, it is essential to consider the following points on caffeine (for more detailed information related to caffeine, see the article “Is caffeine bad for you?”).

  • Caffeine allergy
    Caffeine allergy is extremely rare. However, if you show common allergic reactions, such as hives or anaphylaxis, you should avoid caffeinated drinks. (read more..)
  • Caffeine sensitivity
    Caffeine sensitivity is determined by each individual’s genetic make-up and dictates how well we can handle caffeine.Being caffeine-sensitive or a slow caffeine metabolizer restricts how much coffee you can handle. Negative rather than positive health effects occur as a result of caffeine intake. (read more..) On the other hand, fast caffeine metabolizers, those that can quickly break down and excrete caffeine, experience a wide range of health benefits from caffeine intake.
  • Caffeine tolerance
    If you are not highly sensitive to caffeine, it is possible to build up tolerance to caffeine. This means that after a few days of consuming the same daily amount of caffeine, its symptoms, such as increased energy, euphoric feeling, increased focus and disturbance in sleep, tend diminish and even disappear. In some extreme cases, you can build your tolerance to the point of overconsumption and high dependency (caffeinism), which has detrimental results on your health.
  • Caffeine overdose
    Caffeine overdose may occur whether you are sensitive to caffeine or not. It depends on the combination of the dose and your level of sensitivity. To avoid caffeine overdose, learn your safe limit.

Is coffee addictive?

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Coffee is often described as an addictive beverage, since it contains caffeine and it seems to be hard to quit. Caffeine, although a drug, is not addictive. Individuals who drink caffeinated drinks on a daily basis become physically dependent on caffeine, so they choose to avoid experiencing the unpleasant withdrawal symptoms. (4)Nehlig A, Daval JL, Debry G. Caffeine and the central nervous system: mechanisms of action, biochemical, metabolic and psychostimulant effects. Brain Res Brain Res Rev. 1992 May-Aug;17(2):139-70. Available here. (5)The Science of Drug Abuse and Addiction: The Basics. NIH. National Institute on Drug Abuse. Available here. (6)American society of addiction medicine. Definition of Addiction Available here. (7)The National Alliance of Advvocates for Physical Dependence and Addiction. Available here. (read more..)

When is coffee bad for you?

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  • Summary of negative effects of caffeine
    Coffee may be not recommended for some people due to its caffeine contents. Individuals with caffeine allergy, slow caffeine metabolizers, children, women who are pregnant or at risk of developing breast cancer should avoid or limit coffee intake to the minimum. Drinking more coffee than your level of sensitivity allows may induce unpleasant overdose symptoms. Overconsuming when you are not sensitive to caffeine may lead to caffeinism and the risk of developing serious medical conditions such as GERD.
  • Coffee contributes to acid reflux in people who suffer from (or are prone to) GERD
    Gastroesophageal reflux (GERD)* is often caused by the transient relaxation of the lower esophageal sphincter (LES). LES is a muscle between the stomach and the esophagus that ideally only opens when you swallow food. If this muscle is relaxed, stomach acid may be pushed up to the esophagus burning its delicate lining.In people who suffer from GERD, this sphincter relaxation occurs more frequently and is easily triggered by some foods, especially coffee. (8)Nwokediuko SC. Current Trends in the Management of Gastroesophageal Reflux Disease: A Review. ISRN Gastroenterology. Volume 2012 (2012), Article ID 391631, 11 pages. Available here. Decaffeinated coffee, however, has significantly less impact in individuals with reflux disease. (9)Wendl B, Pfeiffer A, Pehl C, Schmidt T, Kaess H. Effect of decaffeination of coffee or tea on gastro-oesophageal reflux. Aliment Pharmacol Ther. 1994 Jun;8(3):283-7. Available here.*Different spelling of (e/oe)sophagus
    GERD – gastro – esophageal reflux (U.S, Canada)
    GORD – gastro – oesophageal reflux (U.K, Australia)
  • Coffee is bad for your heart if you are a slow caffeine metabolizer
    Slow metabolizers have an increased risk of a non-fatal heart attack when they drink 2-3 cups of coffee per day (200-300mg caffeine). Those who drink 4 cups of coffee have 4 times more risk of heart attack comparing with those that drink 1 cup per day. (read more..)
  • Coffee may increase the risk of ovarian cancer
    Postmenopausal women who drink five or more caffeinated coffees per day have a higher risk of developing ovarian cancer. (10)Lueth NA, Anderson KE, Harnack LJ, Fulkerson JA, Robien K. Coffee and caffeine intake and the risk of ovarian cancer. Cancer Causes Control. 2008 Dec;19(10):1365-72. Available here.
  • Breast cancer
    No correlation was found between breast cancer and caffeine in one study (11)Phelps HM, Phelps CE. Caffeine ingestion and breast cancer. A negative correlation. Volume 61, Issue 5, pages 1051–1054, 1 March 1988. Available here.. However, other studies show the association with a higher risk of fibrocystic breast disease in women who are at the higher risk of developing breast cancer. (12)Boyle CA, Berkowitz GS, LiVolsi VA, Ort S, Merino MJ, White C, Kelsey JL. Caffeine Consumption and Fibrocystic Breast Disease: A Case-Control Epidemiologic Study. JNCI J Natl Cancer Inst (1984) 72 (5): 1015-1019. Available here.
  • Coffee can contain diterpenes: cafestol and kahweol which increase blood lipids
    Cafestol and kahweol (called diterpenes) are potent cholesterol-raising agents contained in coffee.Filtered and instant coffees contain the least amount of these compounds, since the filtering process traps the diterpenes. The highest levels of diterpenes per cup are found in Turkish coffee, French press, espresso and boiled coffee consumed in Scandinavia. It is important to note, however, that espresso coffee is consumed in smaller amounts (1oz) than brewed coffee (240ml cup), so it may have very little effect on the cholesterol levels.  (13)Corrêa TA, Rogero MM, Mioto BM, Tarasoutchi D, Tuda VL, César LA. Paper-filtered coffee increases cholesterol and inflammation biomarkers independent of roasting degree: A clinical trial. Volume 29, Issues 7–8, July–August 2013, Pages 977–981. Available here. (14)Silva JA, Borges N, Santos A, Alves A. Method Validation for Cafestol and Kahweol Quantification in Coffee Brews by HPLC-DAD. Food Analytical Methods. December 2012, Volume 5, Issue 6, pp 1404-1410. Available here. (15)Batta A, Kaur H. Coffee is a medical advice. Dept of Medica Biochemistry, Baba Farid University of Health Sciences/GGS Medical College Faridkot, Punjab, India. Feb 2016. Available here.
    .Please note that there is evidence that cafestol and kahweol have anti-cancer properties and are good for the livers’ health. (16)Batta A, Kaur H. Coffee is a medical advice. Dept of Medica Biochemistry, Baba Farid University of Health Sciences/GGS Medical College Faridkot, Punjab, India. Feb 2016. Available here.
  • Health effects of additives taken with coffee
    When coffee is consumed with any other additives besides water, it may have an additional impact on health, especially with the average daily amounts of coffee (4-5 cups).
    Adding sugar to coffee increases greatly the calorie intake and adds high amount of fructose, augmenting the risk of metabolic syndrome.
    Drinking coffee with milk may cause lactose intolerance symptoms in some individuals and add to the calorie intake. Non-dairy creamers contain all sorts of unhealthy ingredients, such as hydrogenated soybean oil, high-fructose corn syrup and monosodium glutamate.
    When is coffee bad for you?

When is coffee good for you?

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Health benefits of coffee drinking
Most health benefits are achieved by the majority of the population with an intake of 3-5 coffees per day. Individuals who are allergic to caffeine should avoid coffee and those that are caffeine sensitive should reduce the caffeine intake to the point where symptoms are not detectable (e.g. select decaf over standard coffee).

  • Summary of health benefits of caffeine
    Many health benefits of coffee can be attributed to caffeine. The positive effects are associated with fast caffeine metabolizers. If you are sensitive to caffeine, however, these benefits may not apply. Caffeine:
    • improves learning capacity, alertness and mood;
    • helps to burn fat during exercise;
    • decreases the risk of gout;
    • improves heart health, if you are a fast caffeine metabolizer;
    • reduces the risk of depression and suicide;
    • reduces the risk of developing dementia, Alzheimer’s and Parkinson’s disease;
    • reduces the risk of type 2 Diabetes Mellitus;
    • has protective properties in liver diseases;
    • increases physical performance in athletes.For more detailed information, read the article “Is caffeine bad for you?”
  • Coffee reduces gout incidence and flare-ups in some people
    The consumption of coffee is associated with a lower incidence of gout and may reduce gout flare-ups in some people. This positive effect is due to coffee’s (not necessarily caffeine’s) ability to decrease uric acid in the blood. (Note: the consumption of tea is not associated with decreased uric acid). (17)Singh JA, Reddy SG, Kundukulam J. Risk Factors for Gout and Prevention: A Systematic Review of the Literature. Curr Opin Rheumatol. 2011 Mar; 23(2): 192–202. Available here. (18)Choi HK, Curhan G. Coffee consumption and risk of incident gout in women: the Nurses’ Health Study. Am J Clin Nutr October 2010 vol. 92 no. 4 922-927 . Available here. (19)Choi HK, Willett W. Curhan G. Coffee consumption and risk of incident gout in men: A prospective study. http://onlinelibrary.wiley.com/doi/10.1002/art.22712/full Available here. A large observational study showed that intakes of 4-5 coffees per day, have a 40% lower risk of gout and of at least 6 cups per day a 59% lower risk, when compared with zero intake. (20)Choi HK, Willett W. Curhan G. Coffee consumption and risk of incident gout in men: A prospective study. http://onlinelibrary.wiley.com/doi/10.1002/art.22712/full Available here.
    However, there are some claims stating that consuming large amounts of coffee can cause an increased risk of recurrent gout attacks and flare-ups, but they are not confirmed by studies.
  • Coffee consumption doesn’t increase the risk of cancer, and possibly lowers the risk of some cancers
    Coffee consumption is not linked to the risk of cancer mortality. (21)Crippa A, Discacciati A, Larsson SC, Wolk A, Orsini N. Coffee Consumption and Mortality From All Causes, Cardiovascular Disease, and Cancer: A Dose-Response Meta-Analysis. Am J Epidemiol. 2014 Oct 15;180(8):763-75. Available here.

    Colorectal cancer
    Studies on coffee and colorectal cancer are somewhat conflicting although more studies show positive effects. One large systematic study review has found no association between caffeinated coffee and colorectal cancer in men and women. This means that it neither increases nor decreases the risk of cancer in the colon or rectum. (22)Je Y,Liu W, Giovannucci E. Coffee consumption and risk of colorectal cancer: A systematic review and meta-analysis of prospective cohort studies. Article first published online: 30 OCT 2008. Available here. Another more recent large study, however, found that individuals who drink caffeinated coffee have a lower risk of developing colon cancer, specifically proximal tumors, while decaffeinated coffee drinkers show lower risk in both colon and rectal cancers. (Tea has shown no association with colorectal cancer risk). (23)Caffeinated and decaffeinated coffee and tea intakes and risk of colorectal cancer in a large prospective study Am J Clin Nutr July 2012 ajcn.031328. Available here.
    Individuals who had two cups of decaffeinated coffee daily showed a 52% lower incidence of rectal cancer compared to those who never consumed decaffeinated coffee.

    Liver cancer
    Coffee consumption is significantly related to a decreased risk of liver cancer, although it is not known which compound or synergy of compounds have these protective properties. Increasing the consumption of coffee per day by two cups reduces the risk of liver cancer by 43%. (24)Larsson SC, Wolk A. Coffee Consumption and Risk of Liver Cancer: A Meta-Analysis. Volume 132, Issue 5, May 2007, Pages 1740–1745. Available here. (25)Shimazu T, Tsubono Y, Kuriyama S, Ohmori K, Koizumi Y, Nishino Y, et al. Coffee consumption and the risk of primary liver cancer: Pooled analysis of two prospective studies in Japan. International Journal of Cancer. Volume 116, Issue 1, pages 150–154, 10 August 2005. Available here.
    (26)Shimazu T, Tsubono Y, Kuriyama S, Ohmori K, Koizumi Y, Nishino Y, et al. Coffee consumption and the risk of primary liver cancer: Pooled analysis of two prospective studies in Japan. International Journal of Cancer. Volume 116, Issue 1, pages 150–154, 10 August 2005. Available here.

    Skin cancer – Melanoma
    Two recent large studies have shown a reduction of risk of cutaneous melanoma. It was found that four or more cups of caffeinated coffee per day decreased the risk of melanoma by up to 25%, but decaffeinated coffee hasn’t shown a significant reduction of this risk. Because of this difference, more studies are under way to show the association with caffeine or possibly a synergetic effect of caffeine with other compounds in coffee. (27)Loftfield E, Freedman ND, Graubard BI, Hollenbeck AR, Shebl FM, Mayne ST, Sinha R. Coffee drinking and cutaneous melanoma risk in the NIH-AARP diet and health study. J Natl Cancer Inst. 2015 Jan 20;107(2). pii: dju421. Available here. (28)Liu J, Shen B, Shi M, Cai J. Higher Caffeinated Coffee Intake Is Associated with Reduced Malignant Melanoma Risk: A Meta-Analysis Study. Available here.

    Gastric cancer
    No association between coffee and gastric cancer was found in a large systematic review and meta-analysis. (29)Botelho F, Lunet N, Barros H. Coffee and gastric cancer: systematic review and meta-analysis. Cad. Saúde Pública vol.22 n.5 Rio de Janeiro May. 2006. Available here.

  • Caffeine and multiple sclerosis (MS)
    Studies on the association between coffee and MS are inconclusive. However, the most recent study (2016) showed that a high intake of caffeinated coffee is related to around 30% lower risk of multiple sclerosis. It is thought to be due to caffeine’s neuroprotective properties, and its ability to suppress pro-inflammatory cytokine production. More studies are needed, however, to confirm the findings of the caffeine involvement. (30)Hedström AK, Mowry EM, Gianfrancesco MA, Shao X, Schaefer CA, Shen L, et al. High consumption of coffee is associated with decreased multiple sclerosis risk; results from two independent studies. J Neurol Neurosurg Psychiatry Available here.
  • Coffee hydrates rather than dehydrates
    Drinking coffee was previously thought to have diuretic effects due to its caffeine content. However, many studies have disproved this belief and showed that coffee has rather hydrating effects due to its liquid content. (read more..)
  • Coffee and heart disease
    For fast metabolizers (medium to high caffeine users), long term intake of between 3-5 cups daily of coffee shows the biggest reduction of risk of cardiovascular disease (CVD). Consumption of large amounts of coffee was not associated with increased risk of CVD. (31)Ding M, Bhupathiraju SN, Satija A, van Dam RM, Hu FB. Long-Term Coffee Consumption and Risk of Cardiovascular Disease: A Systematic Review and a Dose-Response Meta-Analysis of Prospective Cohort Studies. CIRCULATIONAHA.113.005925. November 7, 2013. Available here. (32)Crippa A, Discacciati A, Larsson SC, Wolk A, Orsini N. Coffee Consumption and Mortality From All Causes, Cardiovascular Disease, and Cancer: A Dose-Response Meta-Analysis. Am J Epidemiol. 2014 Oct 15;180(8):763-75. Available here.Fast metabolizers also show a 22% lower risk of heart attack by having 2-3 cups of coffee per day (200-300mg caffeine).
  • Coffee reduces risk of Alzheimer’s
    Caffeine contents in coffee has been shown to reduce the risk of Alzheimer’s disease. (33)Rosso A. Review: Caffeine: Neuroprotective Functions in Cognition and Alzheimer’s Disease. AM J ALZHEIMERS DIS OTHER DEMEN October/November 2008 23: 417-422. Available here. (34)Flaten V, Laurent C, Coelho JE, Sandau U, Batalha VL, Burnouf S. From epidemiology to pathophysiology: what about caffeine in Alzheimer’s disease? Biochemical Society Transactions Apr 01, 2014, 42 (2) 587-592. Available here. However, there is not enough evidence that decaffeinated coffee reduces such risk.
  • Coffee reduced risk of dementia
    Drinking 3-5 cups of coffee per day is associated with a decreased risk of developing dementia by 65%. Caffeine, antioxidant capacity and increase of insulin sensitivity is believed to cause these effects. However, more studies are needed. (35)Eskelinen MH, Kivipelto Miia. Caffeine as a Protective Factor in Dementia and Alzheimer’s Disease. Journal of Alzheimer’s Disease, vol. 20, no. S1, pp. 167-174, 2010. Available here. (36)Beydoun MA, Beydoun HA, Gamaldo AA, Teel A, Zonderman AB, Wang Y. Epidemiologic studies of modifiable factors associated with cognition and dementia: systematic review and meta-analysis. BMC Public Health 2014. Available here.
  • Coffee reduces risk of Parkinson’s diseaseThe risk of developing Parkinson’s disease is 31% lower for caffeinated coffee drinkers in comparison to non-drinkers. Decaf coffee seems to have no effect. (37)Rodrigues F, Caldeira D, Ferreira J, Costa J. Caffeine exposure and the risk of Parkinson’s disease: an update of a systematic review and meta-analysis of observational studies. Instituto de Medicina Molecular, Clinical Pharmacology Unit, Lisbon, Portugal. Available here. (38)Santos C, Costa J, Santos J, Vaz-Carneiro A, Lunet N. Caffeine Exposure and the Risk of Parkinson’s Disease: A Systematic Review and Meta-Analysis of Observational Studiess. Journal of Alzheimer’s Disease, vol. 20, no. S1, pp. 221-238, 2010. Available here. (39)Ascherio A, Weisskopf MG, O’Reilly EJ, McCullough ML, Calle EE, Rodriguez C, Thun MJ. Disease Mortality in the Cancer Prevention Study II Cohort: The Modifying Effects of Estrogen. Am. J. Epidemiol. (2004) 160 (10): 977-984. Available here. (40)Hernán MA, Takkouche B, Caamaño-Isorna F, Gestal-Otero JJ. A meta-analysis of coffee drinking, cigarette smoking, and the risk of Parkinson’s disease. Ann Neurol. 2002 Sep;52(3):276-84. Available here.
  • Coffee and Diabetes 2
    Regular consumption of both caffeinated and decaffeinated coffee is associated with decreased risk of diabetes type 2. (41)Jiang X, Zhang D, Jiang W. Coffee and caffeine intake and incidence of type 2 diabetes mellitus: a meta-analysis of prospective studies. European Journal of Nutrition. February 2014, Volume 53, Issue 1, pp 25-38. Available here. (42)van Dam RM, Hu FB. Coffee Consumption and Risk of Type 2 DiabetesA Systematic Review. JAMA. 2005;294(1):97-104. Available here. (43)Ding M, Bhupathiraju SN, Chen M, van Dam RM, Hu FB. Caffeinated and Decaffeinated Coffee Consumption and Risk of Type 2 Diabetes: A Systematic Review and a Dose-Response Meta-analysis. Diabetes Care, Volume 37, February 2014. Available here. (44)van Dijk AE, Olthof MR, Meeuse JC, Seebus E, Heine RJ, van Dam RM. Acute effects of decaffeinated coffee and the major coffee components chlorogenic acid and trigonelline on glucose tolerance. Diabetes Care. 2009 Jun;32(6):1023-5. Available here.Individuals with type 2 diabetes have a reduced risk in overall mortality, and mortality associated with cardiovascular disease (CVD) and coronary heart disease (CHD). (45)Bidel S, Hu G, Qiao Q, Jousilahti P, Antikainen R, Tuomilehto J. Coffee consumption and risk of total and cardiovascular mortality among patients with type 2 diabetes. Diabetologia. 2006 Nov;49(11):2618-26. Epub 2006 Sep 21. Available here. A large study found that the risk of developing type 2 diabetes mellitus was 35% lower for those who drink at least 6 cups of coffee per day and 28% lower for those who drink 4-6 cups, comparing to those who consumed less than 2 cups per day. (46)van Dam RM, Hu FB. Coffee consumption and risk of type 2 diabetes: a systematic review. JAMA. 2005 Jul 6;294(1):97-104. Available here.
    Another study, only considering the male population, found that those that consumed 6 or more cups of coffee per day had a 54% lower risk in developing type 2 diabetes mellitus compared to those who didn’t drink coffee at all.  (47)Salazar-Martinez E, Willett WC, Ascherio A, Manson JE, Leitzmann MF, Stampfer MJ, Hu FB. Coffee consumption and risk for type 2 diabetes mellitus. Ann Intern Med. 2004 Jan 6;140(1):1-8. Available here.
  • Coffee reduces risk of Liver diseases
    Individuals with chronic liver diseases are encouraged to drink at least 3 cups of coffee per day, since it has positive effects on liver health. It is believed that the synergy of multiple compounds in coffee provides the liver some protective properties.

    Coffee intake showed protective properties against alcoholic and non-alcoholic cirrhosis and reduced the risk of mortality from cirrhosis. Coffee intake also lowers the rate of developing hepatocellular carcinoma, improves antiviral therapy in hepatitis C patients, and reduces the severity of non-alcoholic fatty liver disease symptoms and the risk of developing liver cancer. (48)Saab S, Mallam D, Cox GA, Tong MJ. Impact of coffee on liver diseases: a systematic review. Liver International. Volume 34, Issue 4, pages 495–504, April 2014. Available here. (49)Larsson SC, Wolk A. Coffee Consumption and Risk of Liver Cancer: A Meta-Analysis. Volume 132, Issue 5, May 2007, Pages 1740–1745. Available here. (50)La Vecchia C. Coffee, liver enzymes, cirrhosis and liver cancer. Hepatology. April 2005Volume 42, Issue 4, Pages 444–446. Available here.
    By contrast, decaffeinated coffee, tea and cola-drinks have not been associated with these protective properties. Therefore, it is believed that these properties are due to the synergy of caffeine with other coffee compounds. (51)Gallus S, Tavani A, Negri E, La Vecchia C. Does coffee protect against liver cirrhosis? Ann Epidemiol. 2002 Apr;12(3):202-5. Available here.

  • Coffee reduces risk of depression and suicide
    Several observational studies show that caffeinated coffee is associated with a decreased risk of depression and that suicide risk associated with depression is lower in individuals with a higher consumption of coffee. An amount of 4-5 coffees per day is the most optimal in risk reduction and is associated with 20% lower risk of developing depression and 53% lower suicide risk. However, the risk is 58% higher with a usage of at least 8 cups of coffee per day compared to moderate coffee drinkers. (52)Lucas M, Mirzaei F, Pan A, Okereke OI, Willett WC, O’Reilly ÉJ, Koenen K, Ascherio A. Coffee, Caffeine, and Risk of Depression Among Women. Arch Intern Med. 2011 Sep 26; 171(17): 1571–1578. Available here. (53)Tanskanen A, Tuomilehto J, Viinamäki H, Vartiainen E, Lehtonen J, Puska P. Heavy coffee drinking and the risk of suicide. Eur J Epidemiol. 2000;16(9):789-91. Available here. (54)Kawachi I, Willett WC, Colditz GA, Stampfer MJ, Speizer FE. A Prospective Study of Coffee Drinking and Suicide in Women. Arch Intern Med. 1996;156(5):521-525. Available here. (55)Lucas M, O’Reilly EJ, Pan A, Mirzaei F, Willett WC, Okereke OI, Ascherio A. Coffee, caffeine, and risk of completed suicide: Results from three prospective cohorts of American adults. The World Journal of Biological Psychiatry. Volume 15, Issue 5, 2014. Available here.
    Please note that these are only observational studies which don’t actually prove that coffee causes the reduction of the risks of depression and suicide.
  • Coffee and Mortality rate
    Large studies show that regular and long term coffee consumption is associated with a lower incidence of deaths from all causes, specifically due to heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections. The exact reasons are unknown but it is thought to be associated with the more than 1000 compounds contained in coffee, including caffeine and antioxidants, such as polyphenols.

    The optimal daily amount of coffee for both men and women is 4-5 coffees per day. This intake guarantees a 12% decrease in death risk in men and 15% in women. (56)Freedman ND, Park Y, Abnet CC, Hollenbeck AR, Sinha R. Association of Coffee Drinking with Total and Cause-Specific Mortality N Engl J Med 2012; 366:1891-1904May 17, 2012. Available here.
    The risk of all-cause mortality and mortality associated with cardiovascular diseases is slightly reduced in decaffeinated coffee drinkers. (57)Lopez-Garcia E, van Dam RM, Li TY, Rodriguez-Artalejo F, Hu FB. The relationship of coffee consumption with mortality. Ann Intern Med. 2008 Jun 17; 148(12): 904–914. Available here.

Is decaf coffee bad for you?

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In summary, decaf coffee is quite healthy and regular intake of decaf coffee has many positive health effects.  It is a great alternative for those who enjoy the taste but cannot drink coffee due to caffeine contents.

What is decaffeinated coffee?

Decaffeinated (decaf) coffee is coffee with the caffeine removed. The process of decaffeination doesn’t remove all the caffeine from coffee, although the remaining amounts are very small. (See caffeine table) Small amounts of antioxidants are also lost through the decaffeination process, although the overall antioxidant contents still remain very high.

According to the FDA guidelines, decaffeinated coffee must have 97% of the caffeine removed. However, since coffee beans may have varied contents of caffeine, decaf coffees may have different caffeine levels too. The amount of caffeine ranges from none to 13.9mg per 16oz serving in decaffeinated coffees and from 3 to 15.8mg per shot in decaffeinated espresso.

During the process of decaffeination, a small percentage of antioxidants is removed, resulting in about 15% less antioxidant activity compared to standard coffee. (58)McCusker RR, Fuehrlein B, Goldberger BA, Gold MS, Cone EJ. Caffeine Content of Decaffeinated Coffee. J Anal Toxicol. 2006 Oct;30(8):611-3. Available here.

Most studies are done using regular coffee containing caffeine. This most likely because this is what most coffee drinkers have, and because caffeine is its most potent component.

The main difference between the health benefits and negative health effects of caffeinated and decaffeinated coffee are the impact of caffeine and its synergy with other coffee compounds.

Many health benefits of decaffeinated coffee are believed to be due to the high amounts of antioxidants which may have protective properties in cardiovascular diseases, cancers and type 2 diabetes. From the studies mentioned above, the association between decaffeinated coffee was found with:

  • Reduced risk of gout
  • Reduced risk of rectal and colon cancer
  • Reduced risk of type 2 Diabetes
  • Although studies generally show no association with Parkinson’s, Alzheimer disease and dementia (it is thought to be due to the effects of caffeine), some observational studies show that there may be some connection between high amounts of antioxidants. More studies are needed.
  • Lower incidence of death from all causes, heart, respiratory, stroke, injuries, accidents, diabetes and infections. More studies are needed to find out which constituents of coffee are responsible.
  • Reduced risk of liver cancer, although it is not known if it is due to caffeine or other compounds
  • Hydrating properties due to liquid contents.

Negative effects of decaffeinated coffee

  • Reflux, although much lower risk than in regular, caffeinated coffee

Decaffeinated coffee is better than regular coffee for these individuals:

  • With high sensitivity to caffeine;
  • Sufferers of reflux;
  • Pregnant women;
  • When taking medications which interact with caffeine

Conclusion

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When is coffee bad for you?
Coffee may be bad for some people mainly because of its caffeine contents. Figuring out if you are a fast or slow caffeine metabolizer is helpful to determine how coffee can affect your health. Here are some main scenarios where coffee can have negative effects on your health:

  • If you are allergic or highly sensitive to caffeine. In these cases, you should avoid any coffee, since even decaffeinated coffee may contain some caffeine.
  • If you are sensitive to caffeine. Then you should find your daily caffeine limit and never overconsume to avoid overdose symptoms and negative impacts on your health.
  • If you overconsume coffee. Caffeinism has many negative symptoms and leads to serious medical conditions.
  • If you are pregnant or belong to the risk group of developing breast cancer. In these circumstances, you should avoid caffeinated coffee.
  • If you have problems sleeping. In this case, make sure that you don’t drink coffee within 6 hours before going to sleep. If sleep is still affected, increase the period of caffeine abstinence before sleeping and reduce the dosage.
  • If you suffer from indigestion (GERD). Reduce or avoid coffee (both caffeinated and decaffeinated).
  • If you have large daily amounts of unfiltered coffee such as Turkish or French press. These coffees may increase your cholesterol levels.
  • When having large quantities of coffee per day, adding sugar, milk or other additives may add to your daily calories, fructose, or some chemicals that, in large amounts, may have negative health consequences.

When is coffee good for you?
If you are fast caffeine metabolizer, moderate coffee drinker and none of the points above (in the conclusion section) apply to you, 4-5 cups of coffee per day is the most optimal for the maximum health benefits of coffee.

Please note that you should be aware of your level of sensitivity to caffeine. Not everyone can have 4 coffees per day. Two coffees or less may be your optimal amount if you experience overdose symptoms after the third coffee.

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