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Coffee: The Original Wonder Drug?
July
24, 2012
Mental
and Medical Benefits of Coffee: Introduction
The
best part of waking up...is reducing your risk of neurodegeneration. And
depression, and cancer, and cardiovascular disease... It's becoming increasingly
clear that coffee is more than just a morning routine. The body of data
suggesting that the world's most widely used stimulant is beneficial in a
variety of mental and medical conditions is growing at a staggering rate. A
recent study published in the New England Journal of Medicine found that
coffee consumption lowered all-cause mortality by over 10% at 13-year
follow-up.[1] Based primarily on recent Medscape Medical News
coverage, the following slideshow reviews the potential medical and psychiatric
benefits of coffee consumption
Cardiovascular Disease
It may seem counterintuitive: A substance
known to increase blood pressure might actually be good for your cardiovascular
system. Caffeine consumption can cause a short-lived increase in blood pressure
– a major risk factor for cardiovascular disease (CVD) – and regular use has
been linked to a longer-term increase. However, when caffeine is ingested via
coffee, enduring blood pressure elevations are small and CVD risks may be
balanced by protective properties. Coffee beans contain antioxidant compounds
that reduce oxidation of low-density lipoprotein (LDL) cholesterol and coffee
consumption has been associated with reduced concentrations of inflammatory
markers.[2-7] Moderate coffee intake was associated with a lower
risk for coronary heart disease as far out as 10 years,[3] and new data
suggest that an average of 2 cups a day protects against heart failure.[8]
Photo courtesy of Thinkstock
Cerebrovascular Disease and Stroke
The vascular benefits of coffee are not lost
on the brain. According to a 2011
meta-analysis, consuming between 1 and 6 cups a day reportedly cut stroke
risk by 17%.[9] A 22% to 25% risk reduction was seen in a large sample
of Swedish women followed for an average of 10 years.[10] And while
coffee's impact on stroke risk in those with CVD is still in question, a meta-analysis
presented at the European Meeting on Hypertension 2012 found that 1 to 3 cups a
day may protect against ischemic stroke in the general population.[11]
Diabetes
and Weight Loss
Despite
coffee's association with increased blood pressure, the steamy brew appears to
benefit other aspects of so-called “metabolic syndrome,” the dangerous cluster
of hypertension, hyperglycemia, abnormal lipid levels, and increased body fat.
Numerous studies have linked regular coffee drinking with improved glucose
metabolism, insulin secretion, and a significantly reduced risk for type 2 diabetes.[12-14]
Preliminary data from an ongoing study also suggest that coffee consumption can
promote weight loss. Overweight patients treated with unroasted coffee beans in
supplement form lost an average of 17 pounds over 22 weeks. The study authors
suspect that this effect may be due in part to coffee containing chlorogenic
acid, a plant compound with antioxidant properties thought to reduce glucose
absorption.[15]
Cancer
With so many ingestibles thought to increase
cancer risk – soda, grilled meat, all things pickled – at least we can rest
easy when it comes to coffee (according to recent data, anyway). Evidence
suggests that moderate to heavy coffee consumption can reduce the risk for
numerous cancers, including endometrial (> 4 cups/day),[16] prostate
(6 cups/day),[17] head and neck
(4 cups/day),[18,19] basal cell
carcinoma (> 3 cups/day),[20] and estrogen receptor-negative breast cancer
(> 5 cups/day).[21] The benefits are thought to be at least
partially due to coffee's antioxidant and antimutagenic properties.[16,18]
Neurodegeneration
It's clear that coffee temporarily affects
cognition – try getting through morning rounds without a cup. But new research
also links coffee with more enduring effects on cognitive well-being. A study
published in the Journal of Alzheimer's Disease showed that patients
with mild cognitive impairment and plasma caffeine levels of > 1200 ng/mL –
courtesy of ~3 to 5 cups of coffee a day – avoided progression to dementia over
the following 2 to 4 years. [22] Corresponding studies in mice suggest
that caffeine suppresses enzymes involved in amyloid-beta production, while
coffee consumption boosts G-CSF, interleukin-10, and interleukin-6 levels,
cytokines thought to contribute to the reported benefits. Caffeinated coffee
has long been thought to be neuroprotective in Parkinson disease (PD), and recent work
found that variants in the glutamate-receptor gene GRIN2A affect PD risk in
coffee drinkers.[23] Furthermore, data
presented at this year's American Academy of Neurology Annual Meeting showed
that 3 cups of coffee a day may prevent the formation of Lewy bodies, a
signature preclinical pathologic finding in PD.[24] Despite the
encouraging associations in neurodegenerative disease, caffeine intake has also
been associated with accelerating age of onset of Huntington
disease.[25]
Depression
A 2011 study
suggests that a boost in coffee consumption might also benefit our mental
health[26]: Women who drank 2 to 3 cups of coffee per day had a 15%
decreased risk for depression compared with those who drank less than 1 cup per
week. A 20% decreased risk was seen in those who drank 4 cups or more per day.
The short-term effect of coffee on mood may be due to altered serotonin and
dopamine activity, whereas the mechanisms behind its potential long-term
effects on mood may relate to its antioxidant and anti-inflammatory properties,
factors that are thought to play a role in depressive illnesses.[26-29]
Liver Disease
The liver might help break down coffee, but
coffee might protect the liver (in some cases). Evidence suggests that coffee
consumption slows disease progression in patients with alcoholic cirrhosis and
hepatitis C and reduces the risk of developing hepatocellular carcinoma.[30-33]
A 2012
study reported that coffee intake is associated with a lower risk for
nonalcoholic fatty liver disease (NAFLD),[34] while other recent
work found that coffee protects against liver fibrosis in those with
already established NAFLD.[32]
But That's Not All...
A grab-bag of other research suggests that
coffee intake may relieve dry-eye syndrome by increasing tear production,[35]
reduce the risk for gout,[36] and potentially fight infection.[37]
Coffee and hot tea consumption were found
to be protective against one of the medical community's most concerning bugs,
methicillin-resistant Staphylococcus aureus (MRSA).[37]
While it remains unclear whether the beverages have systemic antimicrobial activity,
study participants who reported any consumption of either were approximately
half as likely to have MRSA in their nasal passages.
And Finally, the Risks
As is often the case, with the benefits come
the risks, and coffee consumption certainly has negative medical and
psychiatric effects to consider. Besides the aforementioned potential increase
in blood pressure, coffee can incite or worsen anxiety, insomnia, and tremor
and potentially elevate glaucoma risk.[38] Also, given the potential
severity of symptoms, caffeine withdrawal syndrome is under
consideration for inclusion in the forthcoming DSM-5.[39]
Additional research is necessary to better
assess and balance the potential benefits and drawbacks of coffee consumption.
But mounting evidence suggests that going back for a second cup might not
necessarily be a bad decision.
Author
Bret Stetka, MD, Editorial Director, Medscape from WebMD
Disclosure:
Bret Stetka, MD, has disclosed no relevant financial
relationships.
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Reviewers
Henry R. Black, MD, Clinical Professor of Internal Medicine;
Director, Hypertension Research, Center for the Prevention of Cardiovascular
Disease, New York University School of Medicine, New York, New York
Disclosure:
Henry R. Black, MD, has disclosed the following relevant
financial relationships: Served as a director, officer, partner, employee,
advisor, consultant, or trustee for: Novartis Pharmaceuticals Corporation; XOMA
US LLC; Daiichi Sankyo, Inc.; MSD; Mitsubishi Pharma America, Inc.; Ligand
Pharmaceuticals Incorporated; SERVIER; BioSante Pharmaceuticals Served as a
speaker or member of a speakers bureau for: Boehringer Ingelheim
Pharmaceuticals, Inc. Received income in an amount equal to or greater than
$250 from: Novartis Pharmaceuticals Corporation
Felice
N. Jacka, PhD, Associate Professor, Barwon Psychiatric Research Unit, Deakin
University, Geelong, Australia
Disclosure:
Felice N. Jacka, PhD, has disclosed no relevant financial
relationships.
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