COFFEE:
SURPRISING BENEFITS, SURPRISING RISKS

It’s a hot summer afternoon, and the benches outside my local Starbucks are packed with people who share the craving that brought me here--iced coffee. I love hot coffee, but in July, adding ice transforms it from my favorite pick-me-up into the perfect summer refreshment.

During iced coffee season, my consumption increases, and the extra caffeine gets my mind racing. Does coffee counts toward the eight glasses of fluids we’re supposed to drink each day? And what about the headlines I’ve seen about coffee raising risk of heart disease and cancer? I know what my iced coffee is doing for me. But what’s it doing to me?

Quite a bit, it turns out--most of it surprisingly beneficial. The caffeine in coffee (and tea, colas, and to a lesser extent, cocoa and chocolate) is, quite possibly, the world’s most frequently used drug. Like any drug, it should be used consciously and carefully. Fortunately, for those of us who drink no more than a cup or two of coffee a day, the good news outweighs the bad.

COFFEE BENEFITS, COFFEE RISKS

First, about those eight glasses of fluids: Coffee has some diuretic action, raising a red flag that it might contribute to dehydration. But in a recent report, the National Institutes of Health’s Institute of Medicine, concluded that caffeine’s diuretic effect is fleeting and does not contribute to significant fluid loss. Beyond that, the scientific pendulum is swinging away from the notion that it’s best for health to “stay ahead of thirst,” that is, to load up on fluids so we never actually get thirsty. According to recent reports by the British Medical Journal, the and USA Track and Field, the governing body for American track and field sports, forcing fluids causes more harm than minor dehydration, and thirst is the best way to gauge when and how much to drink. So if coffee quenches your thirst, enjoy it. You don’t have to obsess over the fact that it’s a mild diuretic.

The main benefit of coffee--no surprise--is the buzz that gets us up in the morning, keeps us alert while driving, and prevents nodding off in boring meetings. But the latest research shows that in addition to boosting alertness, coffee also improves brain power. British researchers gave people either roughly the amount of caffeine in a 16 oz cola (60 mg), or the amount in an 8-ounce Starbucks coffee (250 mg). Both doses improved performance on intellectual tests. Coffee also elevates mood. So if you want to appear perky and smart, a little java couldn’t hurt.

Here’s more reassuring news: Despite periodic scare headlines that it increases risk of cancer and heart disease, the weight of the evidence shows that coffee has been falsely accused. As part of the ongoing Nurses Health Study, Harvard researchers followed 85,700 female nurses for 10 years. Their conclusion: Coffee “is not an important cause of coronary heart disease.” Meanwhile, after tracking large numbers of people for many years, Italian, Spanish, and Swedish researchers have concluded that coffee plays no significant role in cancers of the breast, colon, rectum, bladder, or pancreas. Nor does coffee contribute to osteoporosis, or mental health problems.

Coffee also has some positive health benefits. It reduces risk of gallstones. If you’re not concerned about gallstones, you should be. Gallstones afflict more than 20 million Americans. A million new cases are diagnosed annually. And the treatment, gallbladder removal, is the leading reason for gastrointestinal surgery, costing the health care system $2 billion a year. Harvard researchers tracked coffee consumption in 127,000 men and women for many years. Two to three daily cups of coffee reduced the men’s gallstone risk 40 percent and the women’s 22 percent. “Gallstones form when cholesterol crystallizes in the gallbladder,” says Michael Leitzmann, M.D. an investigator with the nutritional epidemiology branch of the National Cancer Institute. “Coffee prevents this crystallization.”

Evidence is also mounting that moderate coffee drinking--one to three daily cups--helps protect against Parkinson’s disease.

Finally, coffee reduces risk of Type 2 diabetes--but only if you’re a java junkie. Some 18 million Americans have diabetes, and 90 percent of them have type 2, meaning that they make enough insulin, but their cells have trouble using it. Diabetes can be deadly. It’s a major risk factor for heart disease. But several recent studies show that coffee helps prevent it. In a recent Harvard study that followed 126,000 men and women for 12 years, increasing coffee consumption decreased diabetes risk--a little for one to three cups a day, but up to 54 percent in those drinking six daily cups or more. Caffeine stimulates release of insulin, and coffee is high in magnesium, which protects against diabetes. Of course, if I drank enough coffee to see my diabetes risk plummet, I’d be so wired that I’d never fall asleep. There are better ways to prevent diabetes than overdosing on coffee--more exercise and weight control. But even a daily cup or two helps a little, and that’s beneficial.

With so much upside, you might be tempted to call coffee a health drink. Not so fast. Everyone knows that drinking more than your personal tolerance causes jitters, insomnia, and shortness of temper. Beyond that, some evidence suggests that coffee raises fluid pressure in the eye and contributes to glaucoma.

Coffee’s biggest downside is its effect on women’s fertility. Coffee delays conception and increases risk of miscarriage. Several studies show that drinking more than one cup a day makes it harder for women to get pregnant. For three months, Danish researchers followed 423 couples who were trying to conceive. Compared with those who drank less than one cup a day, conception rates were 12 percent lower in women who drank one to two cups, and 37 percent lower in women who drank more than two cups a day. “We’re not sure why coffee is associated with delayed conception,” says Michael Bracken, Ph.D., a professor of epidemiology at Yale, “but we know that coffee decreases levels of estrogen and prolactin, two hormones involved in fertility.” (However men hoping to become fathers might have an extra cup. Some studies suggest that caffeine boosts the stamina of sperm.)

As if delayed conception isn’t bad enough, several studies show that pregnant women who drink more than a cup a day have an unusually high rate of spontaneous abortion. In one involving 1500 pregnant women, Danish researchers discovered that daily intake of more than 375 mg of caffeine, the amount in a 12-ounce Starbucks coffee, more than doubled risk of miscarriage.

Robert Barbieri, M.D. chief of obstetrics and gynecology at Brigham and Women’s Hospital in Boston, advises pregnant women and those trying to conceive to limit their caffeine intake to no more than 250 mg a day, approximately the amount in an 8-ounce Starbucks coffee.

DRINK WITH A CLEAR CONSCIENCE

While a cup or two a day won’t hurt most Americans, coffee can hurt Mother Earth and the people who grow the beans, mostly impoverished small farmers in tropical nations. This realization has given birth to coffee activism, a small, but growing movement of coffee enthusiasts who reject “corporate coffee” in favor of “fair trade” coffee that’s usually “shade-grown,” “bird-friendly,” and “organic.”

Coffee grows in sun or shade. Corporate coffee plantations prefer sun because it allows mechanized farming that increases yields. But sun-grown coffee involves clearing tropical forests and destroying the vast number of plants and animals, notably birds, they support. Shade-grown, bird-friendly coffee preserves tropical forests, flora, and fauna.

Organic means grown without pesticides. Non-organic coffee contains pesticide residues, usually a few parts per billion. There is no compelling evidence that these residues harm coffee drinkers, but farmers who work with pesticides have unusually high cancer rates. If you buy organic produce, chances are you’ll gravitate toward organic coffee. Because organic coffee costs more, sellers might be tempted to label their product organic when it isn’t. You can be reasonably confident that coffee is really organic if it’s “certified organic” by the Organic Crop Improvement Association.

Fair trade means that the coffee comes from a company, often a nonprofit, that buys beans direct from small growers, bypassing the corporate coffee system. Currently, according to coffee activist Robert Rice, Ph.D., a geographer and policy researcher at the Smithsonian Institution in Washington, D.C., the major coffee corporations pay growers a starvation wage of 50 cents a pound. Fair trade companies such as TransFair USA (www.transfairusa.org) or Global Exchange (www.globalexchange.org), pay at least $1.26 per pound, which improves growers’ standard of living and helps them produce organic, shade-grown, bird-friendly coffee. Fair Trade coffee currently accounts for only about 1 percent of the U.S. coffee market, but it’s it one of the fastest growing segments of the coffee market.

“As a coffee consumer,” Rice explains, “you have a choice. You can buy corporate coffee that destroys tropical forests, erodes tropical land, pays growers a pittance, and subjects them to pesticides and you to pesticide residues. Or you can buy fair trade coffee that’s usually organic, often shade-grown, protects tropical land, forests, and wildlife, and pays growers at a living wage.”

Coffee is the world’s best-tasting drug--especially over ice on a hot summer day. The good news is that unless you can’t cope with coffee jitters, or you have glaucoma or a family history of it, or you’re a woman who’s pregnant or trying to conceive, a daily cup or two won’t harm you, and it just might do you some good. In fact, the main hazards of coffee don’t concern drinkers’ health, but the health of the growers and the land where it’s grown. “Fair Trade coffee costs more,” Rice explains, “but it allows you to drink locally while thinking globally.”

Sidebar:
Deciphering Decaf
Decaffeinated coffee is a misnomer. It’s not entirely caffeine-free. Decaffeination removes more than 99 percent of caffeine, but what remains translates to about 3 mg per cup--very little, but still enough to upset some people who are super-sensitive. Coffee can be decaffeinated using just water (“Swiss water process”), or carbon dioxide, or industrial chemicals, notably methylene chloride. The Food and Drug Administration considers chemical decaffeination safe, but if you gravitate toward organic coffee and produce, you might opt for water or CO2 process.

Sidebar:
Banishing Bitterness
Coffee’s rich, complex flavor includes some bitterness--too much for some palates. If you prefer less bitterness: Buy a medium roast (as opposed to dark). Use a coarse grind. And use drip brewing (instead of boiling or French press).

Sidebar:
Coffee Boosts Pain Relief
Anacin and Excedrin claim that their “extra ingredient” provides greater pain relief than plain aspirin. The extra ingredient is caffeine, and the claim is true. Many studies show that adding around 65 mg of caffeine to pain relievers--aspirin, ibuprofen, acetaminophen, and others--increases pain relief by about 40 percent. Caffeine blocks pain perception, has pain-relieving action, and elevates mood, which also helps relieve pain. Next time you have a headache, instead of washing down your favorite pain reliever with water, try a cup of coffee, tea, or cola. You’ll get more pain relief.