
Coffee plays a prominent role in the culinary and cultural landscape of the United States and many other nations. Whether imbibed in the form of endless watery refills at greasy-spoon breakfast joints, or as a custom latte grabbed on the way to work, or as a concentrated espresso to cap a four-star dining experience, coffee has retained or even enhanced its status as âthe most popular beverage after water.â1
In its most unprocessed form, coffee is a red (when ripe) cherry-like fruit, with the coffee bean found at the center. Precursors to modern coffee included a beverage made around 1000 AD with the whole fruitâboth beans and hullâand a âwine-like concoctionâ made with the fermented pulp.2 Roasting of coffee beans began in the thirteenth century, setting the stage for todayâs ubiquitous caffeinated beverage.
Coffee is an economic mover and shaker, second only to crude oil in its dominance of the global commodities market.3 Coffee exports, currently valued at over twenty billion dollars annually, are at record levels, although the surplus production has contributed to a two-year downward trend in prices that has squeezed the incomes of smaller producers.4 In the U.S., coffee shops are the fastest growing ânicheâ in the restaurant business, and Starbucks is the countryâs third largest restaurant chain3 (without even counting the more than twenty-four thousand coffee shops operated by Starbucks International).5 As a leading purveyor of value-added coffee products, Starbucksâ net earnings (estimated at almost twenty-five billion dollars in 2018)6 have surpassed the monetary value of global coffee bean exports.
Per capita consumption of coffee is highest in countries such as Finland and Brazil, but Americans lead the world in total consumption, downing one hundred and forty-six billion cups of coffee per year.7 Roughly two-thirds of Americans (64 percent) drink at least one cup of coffee per day.8 Interestingly, employed adults consume more caffeinated beverages (including coffee) than unemployed adults.9 National studies looking broadly at dietary caffeine intake have showed that two-thirds of daily caffeine comes from coffee (with tea in second place), andâperhaps explaining Starbucksâ astronomical revenuesâover half comes from âstore-bought coffee.â9
A FALSE FRIEND
Coffee contains more than eight hundred volatile compounds, including caffeine and chlorogenic acid (coffeeâs primary polyphenolic compound).10 Caffeine is toxic to some insects and animals, notably herbivores.1 In humans, caffeine is a psychoactive substance and a central nervous system stimulant.11 In an upbeat video about coffee on the Smithsonian website,12 Sir Hans Kornberg (biochemistry professor at Boston University) explains the caffeine moleculeâs stimulant effects as follows: ordinarily, something called âcyclic AMPâ (a derivative of ATP, the primary molecule required for cellular energy) tells a cellâs machinery to âget moving;â when enough cyclic AMP has been made, ânatural mechanismsâ come along and call a halt to cyclic AMP production. Caffeine, however, overrides these natural mechanisms, removing the brake and allowing uninterrupted production of cyclic AMP.12 This âamped-upâ production of cyclic AMP has been a known biological action of caffeine for decades.13 In lay terms, it means that coffee and caffeine âwill cause the body to âforgetâ that it is tired.â14
Many coffee drinkers celebrate the âalertness, elevated mood, wakefulness, increased speech and motor activity and decrease[d] appetiteâ that are the temporary hallmarks of their beverage of choice (and indeed, of all stimulants, whether natural or synthetic).15 The French author, HonorĂŠ de Balzac, is reputed to have been a major coffee habituĂŠ, consuming up to fifty cups a day when in the throes of writing his literary masterpieces.1 As Balzacâs coffee habit implies, caffeineâs ability to stimulate âpleasure and rewardâ centers in the brain makes it highly addictive; over time, an individual will need to take in ever more caffeine to achieve the same effects.16
Despite Balzac’s example, the founder of a modern company that trains Fortune 500 companies on emotional intelligence claimed in Forbes in 2012 that coffee is actually a âsilent killer of success.â17 To explain this assertion, the Forbes author described a variety of undesirable caffeine-induced effects, including hyper-arousal; irritability, anxiety and other forms of emotional hijacking of behavior; rapid shallow breathing that âdeprives the brain of the oxygen needed to keep your thinking calm and rationalâ; and decreased quality of sleep. With regard to the latter, he also noted that âcaffeine has a six-hour half-life, which means it takes a full twenty-four hours to work its way out of your system.â A blogger writing for coffee fans concurs, admitting that coffeeâs ability to keep drowsiness at bay âprovides a short-term solution that creates a long-term problem.â14
EFFECTS ON BODY AND BRAIN
Dr. Louisa Williams (author of Radical Medicine) characterizes caffeinated coffee as a âpotent pharmacological agentâ that can cause numerous harms (see Table 1).18 Williams encourages coffee drinkers to âgradually detoxify this drug from their bodies and lifestyle,â transitioning first to organic decaffeinated coffee, then switching to organic black or green tea and, finally, drinking herbal teas, beverages made from roasted chicory or simply warm water and lemon juice. (Note that decaffeinated coffee is not a desirable endpoint; it is neither entirely caffeine-free nor free of the other phytochemicals in coffee that can produce strong physiological effects.19)
After ingestion, caffeine is widely distributed throughout the body, âpromptlyâ getting into all the body tissues and crossing the blood-brain, blood-placenta and blood-testis barriers.1 Williams observes that caffeine is a methyl-xanthineâa type of molecular compound that functions simultaneously as a stimulant âthat can increase heart rate and blood flowâ and as a relaxant âthat can open blood vessels and loosen muscular tissues.â20 The stimulant property of methylxanthines is âone of the main reasons people often feel their hearts racing after consuming a lot of caffeinated foods or drinks.â20
Depletion of the adrenal glands and compromised nutrition and digestion are some of the many harmful effects of caffeine outlined by Williams.18 The adrenal glands govern the production of key hormonesâincluding sex hormones, stress hormones such as cortisol and the neurotransmitters epinephrine, norepinephrine and dopamine. Williams and other holistically oriented medical practitioners note that coffee has extremely negative effects on this intricately balanced system. Coffeeâs artificial stimulation of the adrenal glands and especially cortisol âmeans that every time you drink coffee, youâre activating the bodyâs fight-or-flight response,â21 putting your nervous system âon constant red alertâ whether or not there is any actual stress.22 Normally, cortisol levels are high in the morning to help an individual ârise and shine for the day,â but when routine coffee consumption drives up cortisol artificially, it changes the pattern.21 Cortisol ends up being low in the morning instead of highâprompting the person to reach for a morning cup of coffee and perpetuating the topsy-turvy cycle until, finally, more severe adrenal fatigue sets in.23
Research has shown that coffee and caffeine affect utilization and absorption of key nutrients, for example, depleting magnesium and reducing absorption of iron.24 As a diuretic, caffeinated coffee also contributes to calcium excretion to such an extent that it âcan add up to significant bone thinning.â25 Although some researchers rate this bone loss effect as âcontroversial,â one study found that elderly postmenopausal women who consumed about eighteen ounces of brewed coffee a day experienced âsignificantly higher rates of bone loss at the spineâ compared to women with a lower daily intake.26 These effects on bone density prompted Colorado researchers in 2009 to recommend that premenopausal women limit their caffeine consumption to avoid osteoporosis.27
A couple of years ago, reflecting the current trendiness of anything to do with the microbiome, coffee lovers greeted a study published in Science28 with considerable fanfare. Although the study covered an extremely wide range of âintrinsic, environmental, dietary and medication parameters,â coffee enthusiasts pounced on the one sentence linking coffee, tea and wine to âa healthier and more diverse community of microbes living in the gut.â29 The researchers attributed this association to the three beveragesâ high polyphenol content.28 Others, however, have suggested that coffeeâs impact on the gut may not actually be beneficial. Dr. Edward Group of the Global Healing Center describes numerous undesirable effects on gut health, including a reduction in the stomach acid needed for digestion when morning coffee is consumed on an empty stomach (true for both caffeinated and decaffeinated coffee); a weakening of the stomachâs protective mucosal layer; acid reflux and esophageal changes resulting from coffeeâs relaxation of the esophageal sphincter; aggravation of bowel disorders or an overactive bowel; and premature release of partially digested food into the small intestine, which can damage the intestinal wall and facilitate dysbiosis.24
Coffee drinkers who are interested in the microbiome might also want to bear in mind the results of a novel study of âcoffee machine-associated bacteriaâ published in Scientific Reports30 and summarized in Scientific American, which found that nine in ten top-of-the-line espresso machines harbored âa whole menagerie of bacteriaâincluding some pathogenic species more commonly associated with the toilet.â31 (About 30 percent of the worldâs Michelin-starred restaurants feature the brand of espresso machine examined in the study.32) Given the discovery of bacteria with pathogenic properties âand the fast recovery of the [bacterial] communities after rinsing the capsule container,â the studyâs authors advised âfrequent maintenanceâ and preventing contact âof the coffee leach with other parts of the machine to avoid unintended contamination of the beverage.â30
VULNERABLE POPULATIONS
Many researchers acknowledge the association of caffeine intake with âreversible and transient physiological effects broadly and cardiovascular effects specifically,â but surprisingly few are willing to pin any blame for more serious chronic health issues on coffee or caffeine.33 At the same time, some experts have called attention to caffeineâs potentially adverse effects on sleep or cardiovascular and other functions in âspecialâ or âvulnerableâ populationsâbroadly defined as âpregnant and lactating women, children and adolescents, young adults, and people with underlying heart or other health conditions, such as mental
illness.â34
Studies and meta-analyses (studies of studies) in humans have linked coffee consumption during pregnancy (including both caffeinated and decaffeinated brews in some studies) to an increased risk of pregnancy loss,35 preterm delivery36 and other adverse birth outcomes.37 A just-published long-term study of Irish mother-child pairs that looked at the effects of maternal consumption of both coffee and tea found ârobustâ and statistically significant associations of maternal caffeine intake with lower birth weight, shorter birth length, smaller head circumference and shorter gestational age.38 Of note, âsimilar higher risks of adverse birth outcomes were observed for the highest caffeine intake categories from coffee and tea compared with the lowest intake categories.â38
Studies in rodent models suggest that caution about coffee consumption during pregnancy (and lactation) is also warranted due to potential long-term effects on offspring that are irreversible, including adrenal abnormalities.39 A study by investigators in Turkeyâfamous for its ârobust Turkish coffee and strong black teaâ40 and where approximately 60 percent of pregnant women consume caffeineâfound that administration of both low and high doses of caffeine to pregnant rats affected sex steroid levels in the fetus and neonate, leading the authors to speculate about likely effects on âbehavioral and neuroendocrine functions at some point in adult life.â41
Chinese researchers, also using a rat model, found that prenatal caffeine exposure induced âhigh susceptibility to metabolic syndromeâ in the female adult offspring.42 Metabolic syndrome is the name given to a group of risk factors for heart disease, stroke and diabetes. (The risk factors include apple-shaped obesity, high blood pressure, high blood sugar, a high triglyceride level and low HDL-cholesterol.) Somewhat confusingly, some researchers have reported that regular coffee consumption is protective for metabolic syndrome.43 However, a recent study from Finland (the country with the worldâs highest per capita coffee consumption) reported that in individuals who are already type 1 diabetics, both âmoderateâ (three to five cups a day) and âhighâ (greater than five cups a day) coffee consumption was associated with increased odds of metabolic syndrome, and any level of consumption increased the risk of high blood pressure.44
A 2012 rat study out of Iran examined caffeine as a potential risk factor for male infertility, considering both in utero and lactational exposures.45 The researchers identified a number of significant long-term and dose-related effects on the âreproductive efficiency of male offspring rats,â including a decline in sperm density, decreased fetal viability and reductions in testosterone levels. A recent survey of âlifestyle causes of male infertilityâ cites numerous studies linking coffee and caffeine to poor semen quality, sperm DNA damage and prolonged time to pregnancy, although it is unclear whether these effects accrue solely from prior in utero exposure or also from adult caffeine consumption.46
An international childhood cancer consortium also just reported an increased risk of childhood leukemia in the children of regular coffee drinkers.47 The coffee consumption threshold beyond which the researchers detected cancer effects was two-plus cups of coffee a day.
COFFEE DRINKERS FOR LIFE?
Market reports indicate that adolescents âare drinking more coffee every year and continually starting at a younger ageââ setting the stage for a life-long coffee-drinking habit.48 Teens and young adults are responding in part to clever marketing that portrays coffee drinking as âclassy and sophisticated.â49 This marketing strategy appears to be paying off, because young workers between the ages of eighteen and thirty-four spend an estimated twenty-four to seventy-four dollars per week on coffee.8 The narrator of the Smithsonianâs fluff video on coffee credits entities such as Starbucks for âtalking about terroir [and] making the geography of coffee available to peopleâ and also waxes poetic about the current wave of coffee âconnoisseurshipâ and ârefinementâ; the short video also features a young college student sniffing and tasting a special brew in the manner of a fine wine.12
According to the advisory committee for the 2015 Dietary Guidelines for Americans, there is a lack of consensus regarding safe levels of coffee and caffeine intake among children and adolescents.9 This may be due to the âdearth of caffeine research among younger consumers.â50 A research team in Iceland is particularly concerned about the implications of teenage caffeine consumption for long-term cardiovascular health, having found that âearly exposure to caffeine may lead to persistent increases in vascular resistance, which in turn is an acknowledged risk factor for the development of hypertension.â50 Headaches are another common vascular symptom associated with coffee drinking. A study that looked at menstruation-related headachesâreported by one in four teenage girlsâfound that daily coffee (and cola) consumption was associated with more frequent headaches.51
Researchers have raised concerns about increased vulnerability to anxiety disorders resulting from caffeine consumption during the developmentally sensitive adolescent years. A study in rats identified âdysregulation of the neuroendocrine stress response systemâ following adolescent caffeine exposure, leading to âenhanced anxiety-related behaviorâ in adulthood.11 Disturbingly, the effects persisted into adulthood âeven after removal of caffeine.â
RISKS OUTWEIGH BENEFITS
A number of studies and meta-analyses have reported inverse (protective) associations of coffee with a variety of diseases.37 (The lead researcher of one of the more influential meta-analyses smilingly poses with a cup of coffee on his university webpage.52) The coffee lobby and even public health and medical professionals have not hesitated to use these studies to shore up their claim that âcoffee is good for you.â53 (Remember when tobacco companies built relationships with academic institutions and funded scientific studies to tout the benefits of another stimulant, called nicotine? Ironically, the companiesâ public relations campaigns âoften [minimized] nicotineâs health risks by comparing it to caffeine or coffeeâ!54)
Much of the coffee-is-beneficial research is actually of a mixed-message nature. For example, one study describes coffee as a risk factor for type 1 diabetes and rheumatoid arthritis but suggests that it is protective for multiple sclerosis and autoimmune liver disease.55 Another study links coffee to an increased risk of breast cancer (among premenopausal and normal-weight women) but a reduced risk of endometrial cancer.56 A study looking at kidney cancer found that decaffeinated coffee consumption was associated with an increased risk of âaggressiveâ kidney cancer, while caffeinated coffee intake apparently reduced the risk57âeven though other work has pointed to caffeine as a kidney toxin.58 And some investigators deny any coffee-associated cardiovascular disease risk at all,10 while others point to likely interactions with genetics, suggesting that some individuals may be genetically âpredisposedâ toward coffee-induced high blood pressure.59 (Does this portend a genetic test for would-be coffee drinkers?)
Is it worth running the risk of losing a pregnancy, damaging oneâs adrenal system or impairing nutrient availability to obtain coffeeâs purported mixed benefits? A Wise Traditions lifestyle that emphasizes a properly prepared nutrient-dense diet, adequate sunlight, time in nature, protection from cell phones and cell towers, and avoidance of toxic pharmaceutical products will go much further toward supporting good health than gambling a ride on the coffee roller coaster.
SIDEBARS
COFFEE AND THE ENVIRONMENT
When considering what coffee does to humans, we should not overlook what coffee production is capable of doing to the environment. Traditionally, coffee was shade-grown under a diverse canopy of native trees that allowed for a ârich web of plant and animal life,â providing corridors for migrating birds, support for pollinators and âecosystem servicesâ that stabilized and replenished soil.60 These practices were especially important given that coffee-growing regions are home to some of the planetâs most delicate ecosystems.61 In the 1970s, industry-favorable agricultural policies and coffeeâs popularity prompted a shift toward sun-grown coffee produced in plantations with no canopyâthis has resulted in massive deforestation, loss of biodiversity, widespread use of toxic chemical fertilizers and soil depletion.60
Intensive agrochemical coffee production relies on an assortment of chemicals with unpronounceable names (such as ametryne, cyproconazole, diuron, epoxiconazole, flutriafol, triadimenol and triazophos), which contaminate both surface water and groundwater62 and create both acute and long-term health risks for farmworkers.63 Residues from these chemicals also pose risks to the end consumer, with âlarge variations in the stability of pesticide residuesâ depending on the processing method used.64
Although organically grown, shade-grown and fairtrade coffees have increased in popularity in the U.S., now accounting for 37 percent of American coffee sales by volume, these âspecialty coffeesâ are still swimming against the tide in the global marketplace.60 In fact, a 2014 study reported a worldwide shift toward more intensive coffee farming over the past two decades.65 Although total global production of shade-grown coffee increased over the time period in question, âthe area of land used for non shade coffeeâŚincreased at a much faster rate, resulting in shade grown coffee falling from 43 percent of total cultivated area to 24 percentââdespite âtwo decades of growth in public awareness of where coffee comes from and the different ways to manage it for biodiversity.â60
WHATâS IN THAT COFFEE DRINK?
Consumers who make a habit of drinking the fancy coffee concoctions on offer in places like Starbucks would do well to become familiar with some of the unhealthy ingredients used by these establishments. Joan Salge Blake of Boston University says, âSo much is added to [coffee]âthe cream, the sugar, the flavoringâthat now what people are drinking is almost like a sweetened, creamy beverage with a coffee flavoring to it.â12
According to the Food Babe (a blogger âhot on the trail to investigate whatâs really in your food!â), Starbucks uses âMonsanto Milkâ (non-organic milk âfrom farms where the cows are almost always fed a diet that consists primarily of GMO feed. . . that is laden with pesticidesâ) or dairy-free âmilksâ that are full of dubious additives such as carrageenan and guar gum.66 The Food Babe also reports that even âtaking the milk out of the equation, most of the drinks at Starbucks are still filled with a ton of sugar [including high fructose corn syrup], natural flavors, preservatives, thickeners, emulsifiers and other artificial additives.â
SUBSTITUTES FOR COFFEE
HOT MOLASSES DRINK: 1 tablespoon molasses, 1 tablespoon coconut oil, 1/4 teaspoon powdered ginger in a mug with enough hot water to fill the mug.
CHICKEN BROTH WITH COCONUT MILK: 1 quart homemade chicken broth, 1 can full-fat coconut milk, juice of 1-2 limes, pinch of red pepper flakes.
>WARM FLAVORED MILK: 2 cups whole raw milk, 1 teaspoon vanilla extract, 1/2 teaspoon chocolate extract, 1 tablespoon carob powder, 2-3 teaspoons maple sugar. Use a whisk to blend all ingredients in a glass pyrex measuring pitcher. Set in simmering water until warm to the touch.
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