Coffee Caveats
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The jury is out on whether there’s an association between coffee consumption and elevated blood cholesterol. But there’s less doubt, say experts, that caffeine can affect your nerves-and your bones. “I consider caffeine to be a mind-altering drug, in the same category as nicotine and alcohol,” says Dr. Nicolosi. “Some people are super-sensitive to caffeine and become hyperactive when drinking coffee.” These individuals should consider limiting their consumption of caffeine, he says. Caffeine may also encourage the development of osteoporosis, the bone-thinning disease that affects many women (and men) later in life, says Isadore Rosenfeld, M.D., author of Doctor, What Should 1 Eat? “Caffeine steals calcium from the body by causing more of it to be excreted in the urine,” says Dr. Rosenfeld. He notes, though, that “there’s some research to show that drinking a glass of skim milk a day can offset the losses caused by coffee. So make sure you’re getting plenty of calcium from milk and other sources.” Two health conditions in which some experts advise reducing or completely eliminating caffeine are heart disease and pregnancy. They recommend that people at high risk for heart attack consider drinking less coffee-under four cups a day, according to some research. And while it’s not certain whether caffeine can harm a developing fetus, cautious mothers-to-be may choose to avoid caffeine during their entire pregnancies, recommends Evelyn Tribole, R.D., a dietitian in Beverly Hills, California, and author of Healthy Homestyle Cooking.
Watch the Lattes
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Most people don’t have to be overly anxious about their caffeine intakes, says Robert ]. Nicolosi, Ph.D., director of the Cardiovascular Research Center at the University of Lowell in Massachusetts. “In my view, avoiding caffeine is not one of the lifestyle interventions you need to be most concerned about,” says Dr. Nicolosi. While it’s possible that caffeine may contribute to elevated cholesterol, he says, “the evidence is very weak at this point.” Diekman concurs. “If you enjoy coffee in moderation and it’s not affecting your body-such as accelerating your heart rate-continue to drink it,” she says. “But keep in mind that coffee provides no nutritional value. So make sure it’s not crowding nourishing beverages (such as juice or skim milk) out of your diet.” Also, pay attention to flavored and specialty coffees, including those served at the local coffee bar, says Barbie Casselman, a nutrition consultant in Toronto. Some coffee beverages contain large amounts of high-fat milk and syrup, so you may be sipping more fat and calories than you realize. “Most people think that a cappuccino is 6 ounces of coffee and 2 ounces of whipped milk,” says Casselman. “But a regular-size cap;mccino is actually 2 ounces of espresso plus a cup of milk; in a large cappuccino, there are 12 ounces of milk. If whole milk is used, you might be consuming about 200 calories and eight grams of fat in that 12 ounces of milk. You could eat a dessert for that!”
WHAT ABOUT DECAF?
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You drink decaffeinated coffee, so it can’t possibly affect your cholesterol. Right? Not so fast. In one study, decaffeinated coffee raised levels of “bad” LDL cholesterol, while regular, caffeinated coffee did not.
Scientists at the Lipid Research Clinic at Stanford University had 181 healthy middle-age men drink several cups of regular, drip-filtered coffee a day. After two months, some of the men switched to decaf; others continued to drink regular coffee. After another two months, the decaf drinkers saw their LDL cholesterol increase significantly. The regular-coffee drinkers experienced no such changes in LDL. Further, the LDL cholesterol levels of the decaf drinkers were 6 percent higher than that of the regular-coffee drinkers. The researchers’ conclusion: It is not the caffeine in coffee but some other factor in the decaf that’s responsible for the increase in LDL cholesterol. But William P. Castelli, M.D., medical director of the Framingham Cardiovascular Institute, a wellness program at Metro West Medical Center in Framingham, Massachusetts, remains skeptical. “This is just one study,” he says.
The Caffeine/Cholesterol Connection
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Investigators have conducted numerous studies on the relationship between coffee, elevated cholesterol and heart disease. Results have been inconclusive, however. Some of these studies show that when it comes to coffee and cholesterol, much depends on how the coffee is prepared, according to Dr. Castelli. “Boiled coffee, like the kind drunk in Scandinavia and Turkey, tends to raise cholesterol and the risk of heart disease,” says Dr. Castelli. “But filtered coffee does not raise cholesterol or increase the risk of heart disease.”
Researchers at Boston University polled 858 women hospitalized with a first heart attack and an equal number of healthy women on their health habits, including coffee consumption. Researchers found that compared with non-coffee drinkers, women who said they drank five to six cups of coffee a day had a 40 percent greater risk of having a heart attack; women who drank seven to nine cups, a 70 percent greater risk. But women who drank less than five cups of coffee a day had no higher risk than women who didn’t drink coffee at all.
Investigators at Kaiser Permanente Medical Center in Oakland, California, evaluated the relationship between coffee and tea intake and mortality rate-including deaths from coronary heart disease-in nearly 129,000 people. After an eight-year follow-up period, neither coffee nor tea was found to have increased the overall death rate in these individuals. Drinking four or more cups of coffee a day was tied to a slightly higher risk of death from heart attack. however. Researchers at Johns Hopkins Medical Institutions in Baltimore had 100 healthy men drink varying amounts of filtered coffee: 24 ounces of regular coffee, 12 ounces of regular coffee, 24 ounces of decaffeinated coffee or no coffee at all. After eight weeks, the men who drank the 24 ounces of regular coffee a day experienced small increases in their total cholesterol, due to slight rises in their “bad” LDL and “good” HDL cholesterol. The researchers concluded that these small increases in LDL and HDL together “should not affect coronary heart disease risk.” That’s because small changes in HDL can protect against much larger changes in LDL, explains Dr. Castelli.
In Israel, researchers analyzed coffee and tea consumption and cholesterol levels in 5,369 people. The investigators’ conclusion: The individuals who drank five or more cups of coffee a day had higher levels of total cholesterol-as much as 18 milligrams/deciliter higher-than the individuals who abstained from coffee. The researchers also noted that the people who drank the most coffee in their study were also the most likely to have negative health habits, especially smoking. “It is conceivable that the increased cholesterol levels in smokers may be confounded by coffee drinking,” wrote the researchers.
Some coffee drinkers may make other lifestyle choices that may be responsible for elevating their cholesterol levels, suggests Connie Diekman, R.D., a dietitian in St. Louis and a spokesperson for the American Dietetic Association. For example, “caffeine tends to stimulate hunger in certain people,” says Diekman. “Some people may respond by eating foods that increase their cholesterol levels. But it’s difficult to isolate the effect of caffeine on cholesterol and to determine whether the increases in cholesterol are caused by caffeine or by something else.”
COFFEE
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Whether you linger over designer lattes at trendy coffee bars or savor fresh, strong joe from your trusty old percolator, one thing’s for sure: When it comes to the relationship between coffee consumption and elevated blood cholesterol, there’s controversy brewing .
Some studies suggest that coffee can raise cholesterol levels; others conclude just the opposite. Most of the studies conducted in the United States have found that people who don’t drink coffee have higher rates of coronary heart disease than coffee drinkers! In fact, the prestigious Framingham Heart Study concluded that drinking up to five cups of coffee a day may actually have lowered the risk of coronary heart disease, says William P. Castelli, M.D., medical director of the Framingham Cardiovascular Institute, a wellness program at Metro West Medical Center in Framingham, Massachusetts.
The good news is, consuming moderate amounts of coffee does not appear to raise the risk of heart disease. What’s more, some experts say that a cup or two of coffee a day shouldn’t significantly affect your cholesterol level. (No large studies have been conducted on the effect of other caffeinated foods or drinks-such as chocolate or cola-on blood cholesterol levels.)
But caffeine can affect the body in other ways. Consumed in large amounts, it can sap bone strength and accelerate the heart rate. Further complicating the coffee/cholesterol issue: the role of nicotine. Some studies note that avid coffee drinkers tend to smoke more than people who drink coffee in moderate amounts, and smoking has definitely been implicated in the development of coronary heart disease.