2008 Woodie Awards
Pocket Doc
Issue date: 10/6/08 Section: Pulse
Dr. George
Q: There's research supporting coffee every day and research that discourages it. What is the truth behind the daily caffeine fix?
A: You're right about the contradictory reports. Caffeine has been a lightning rod for research into alleged health risks and benefits for a long time. Since caffeine is the world's most widely consumed psychoactive substance, you can understand the attention. It is now estimated that 90 percent of adults in the US consume at least moderate caffeine daily.
This love affair with caffeine is hardly a new fad, either. We have been using caffeine to temporarily ward off fatigue, heighten awareness and elevate our mood for as long as we have been around. First chewing leaves and berries of particular plants, later steeping those plants in hot water to increase the effect; coffee, tea, kola and cocoa have long been our primary sources of caffeine.
On average, your typical 8 oz. cup of Joe contains around 100 mg. of caffeine. The same volume of tea has about half that much caffeine. Soft drinks have a little bit less than tea. Having said that, because there is so much variability in the products and method of preparation, it's hard to say anything is "average." There are even differences between coffee beans from the same group of coffee bushes. As far as differences by method of preparation, Espresso drinkers can testify that 8 oz. (~500 mg caffeine) of it should require three forms of ID and a note from your mother. Nevertheless, for sake of uniformity, the value of 250-300 mg. of caffeine a day is used by most investigators as the amount of caffeine ingested by a "moderate" coffee drinker.
The principal effects of caffeine are due to its central nervous system stimulation. With that stimulation, we can usually increase our capacity for physical and mental labor, at least for a while. There are studies showing much better performance by runners and bikers. In some of them, the bikers and runners were able to increase speed and endurance quite a bit. Other studies show mental pursuits like memory tasks being performed better after caffeine. There does seem to be something to those gut feelings many of us have that we perform better when "caffeinated." In no way does caffeine eliminate or even decrease our need for sleep; it just temporarily puts it on hold. There is the perception, again temporarily, that we are not tired for at least a few hours.
Less prominent effects of caffeine are appetite suppression and a mild respiratory stimulation that has been used in premature infants who experience spells of apnea (not breathing). As an additive, caffeine is found in many pain and over-the-counter cold medicines, both of which speeds their onset and combats some adverse side effects. It's often effective in relieving migraine headaches. I've also used it successfully with patients who have severe headaches after a lumbar puncture (AKA spinal tap), to help seal the persistent leak of cerebrospinal fluid.
Although widely reported to be a diuretic, the mild diuretic effect of caffeine is actually more than compensated for by the fluid in the caffeine containing beverage for a net positive in hydration. The questions about caffeine and heart disease also are many. Doesn't coffee make people jittery, prone to irregular heart beats and make their blood pressure go up? Doesn't it cause atherosclerosis to accelerate and raise cholesterol?
I know I had always assumed, as do many of my colleagues, that caffeine causes an increase in heart rate, blood pressure, and arrhythmias. I was surprised to learn that with over 100 studies addressing these concerns, it appears that any heart effects are mild and are generally found in persons who are consuming caffeinated beverages for the first times. These mild elevations of blood pressure and pulse rapidly disappear with the tolerance that develops to caffeine within a few days. There appear to be no increased incidence of coronary artery disease in coffee drinkers at all.
Some of the other findings that research has shown are: caffeine causes no change in cholesterol levels, is safe in pregnancy and while breast feeding, has no effect on fibrocystic breast disease or osteoporosis, has no increased risks of cancer of any kind, and it leads to no change in reproductive success. In fact, the American Cancer Society, the American Medical Society and the Food and Drug Administration have all issued formal statements that moderate coffee consumption produces no known health risks. That's a pretty tough trio to satisfy, and that is after many years and many studies.
In summary, moderate daily coffee consumption seems to be quite safe. As long as one has realistic expectations, that is. It won't sober a drunk any faster, contrary to popular opinion. It doesn't help erectile dysfunction, won't give you "six-pack abs," or clear that nasty acne. Like anything else, too much caffeine can be a problem.
Caffeinism is the name given to overdoing a good thing. Insomnia, anxiety, irritability, tremors, headaches, muscle twitching, upset stomach, and palpitations can be yours if you spend too much time at Starbucks.
Like most things, moderation is the key. "If a little bit is good, a lot is better" doesn't work for caffeine. Although there is no true addiction from caffeine, there is a tolerance that develops and withdrawal when one stops.
I started drinking coffee when I worked the night shift at a 24-hour convenience store while going to college in the daytime. Been drinking it ever since, really enjoy it, and I pretty much start every morning with a big cup or two. And I mean every day. On the rare occasions when I have not, I've gotten the headache that many people get when they withdraw from the drug too abruptly. Somehow, starting a morning with coffee and reading the newspaper seems like the way all civilized people should do it. At least that's what feels right to me.
Send your anonymous questions to pulse@chicagoflame.com.
Q: There's research supporting coffee every day and research that discourages it. What is the truth behind the daily caffeine fix?
A: You're right about the contradictory reports. Caffeine has been a lightning rod for research into alleged health risks and benefits for a long time. Since caffeine is the world's most widely consumed psychoactive substance, you can understand the attention. It is now estimated that 90 percent of adults in the US consume at least moderate caffeine daily.
This love affair with caffeine is hardly a new fad, either. We have been using caffeine to temporarily ward off fatigue, heighten awareness and elevate our mood for as long as we have been around. First chewing leaves and berries of particular plants, later steeping those plants in hot water to increase the effect; coffee, tea, kola and cocoa have long been our primary sources of caffeine.
On average, your typical 8 oz. cup of Joe contains around 100 mg. of caffeine. The same volume of tea has about half that much caffeine. Soft drinks have a little bit less than tea. Having said that, because there is so much variability in the products and method of preparation, it's hard to say anything is "average." There are even differences between coffee beans from the same group of coffee bushes. As far as differences by method of preparation, Espresso drinkers can testify that 8 oz. (~500 mg caffeine) of it should require three forms of ID and a note from your mother. Nevertheless, for sake of uniformity, the value of 250-300 mg. of caffeine a day is used by most investigators as the amount of caffeine ingested by a "moderate" coffee drinker.
The principal effects of caffeine are due to its central nervous system stimulation. With that stimulation, we can usually increase our capacity for physical and mental labor, at least for a while. There are studies showing much better performance by runners and bikers. In some of them, the bikers and runners were able to increase speed and endurance quite a bit. Other studies show mental pursuits like memory tasks being performed better after caffeine. There does seem to be something to those gut feelings many of us have that we perform better when "caffeinated." In no way does caffeine eliminate or even decrease our need for sleep; it just temporarily puts it on hold. There is the perception, again temporarily, that we are not tired for at least a few hours.
Less prominent effects of caffeine are appetite suppression and a mild respiratory stimulation that has been used in premature infants who experience spells of apnea (not breathing). As an additive, caffeine is found in many pain and over-the-counter cold medicines, both of which speeds their onset and combats some adverse side effects. It's often effective in relieving migraine headaches. I've also used it successfully with patients who have severe headaches after a lumbar puncture (AKA spinal tap), to help seal the persistent leak of cerebrospinal fluid.
Although widely reported to be a diuretic, the mild diuretic effect of caffeine is actually more than compensated for by the fluid in the caffeine containing beverage for a net positive in hydration. The questions about caffeine and heart disease also are many. Doesn't coffee make people jittery, prone to irregular heart beats and make their blood pressure go up? Doesn't it cause atherosclerosis to accelerate and raise cholesterol?
I know I had always assumed, as do many of my colleagues, that caffeine causes an increase in heart rate, blood pressure, and arrhythmias. I was surprised to learn that with over 100 studies addressing these concerns, it appears that any heart effects are mild and are generally found in persons who are consuming caffeinated beverages for the first times. These mild elevations of blood pressure and pulse rapidly disappear with the tolerance that develops to caffeine within a few days. There appear to be no increased incidence of coronary artery disease in coffee drinkers at all.
Some of the other findings that research has shown are: caffeine causes no change in cholesterol levels, is safe in pregnancy and while breast feeding, has no effect on fibrocystic breast disease or osteoporosis, has no increased risks of cancer of any kind, and it leads to no change in reproductive success. In fact, the American Cancer Society, the American Medical Society and the Food and Drug Administration have all issued formal statements that moderate coffee consumption produces no known health risks. That's a pretty tough trio to satisfy, and that is after many years and many studies.
In summary, moderate daily coffee consumption seems to be quite safe. As long as one has realistic expectations, that is. It won't sober a drunk any faster, contrary to popular opinion. It doesn't help erectile dysfunction, won't give you "six-pack abs," or clear that nasty acne. Like anything else, too much caffeine can be a problem.
Caffeinism is the name given to overdoing a good thing. Insomnia, anxiety, irritability, tremors, headaches, muscle twitching, upset stomach, and palpitations can be yours if you spend too much time at Starbucks.
Like most things, moderation is the key. "If a little bit is good, a lot is better" doesn't work for caffeine. Although there is no true addiction from caffeine, there is a tolerance that develops and withdrawal when one stops.
I started drinking coffee when I worked the night shift at a 24-hour convenience store while going to college in the daytime. Been drinking it ever since, really enjoy it, and I pretty much start every morning with a big cup or two. And I mean every day. On the rare occasions when I have not, I've gotten the headache that many people get when they withdraw from the drug too abruptly. Somehow, starting a morning with coffee and reading the newspaper seems like the way all civilized people should do it. At least that's what feels right to me.
Send your anonymous questions to pulse@chicagoflame.com.
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