Studies Debunk Coffee As Health Risk

PHOENIX - It may be the most coveted herb in the world. And the most controversial.

For millions, coffee is a godsend. It's the slammin', eye-poppin' slap-in-the-face beverage that launches us on our day.

Detractors claim that coffee's caffeine is a stimulant no one really needs and may be responsible for everything from infertility and heart attacks to stomach ulcers and fibrocystic breast disease.

The truth is that coffee is a complex liquid, and how it affects our health is still being looked into. However, based on the most recent round of studies, it appears that drinking moderate amounts of coffee -- two to three cups a day -- does little harm and may actually provide health benefits.

``I think most of the evidence now shows that coffee isn't going to cause you serious health problems unless you're into excessive consumption (eight to 10 cups a day),'' said Shirley Strembel, registered dietitian and public-health nutritionist for Maricopa County.

Sharon Hoelscher Day, University of Arizona extension agent in family consumer sciences, agrees.

``Recent research has not found too many problems,'' Hoelscher Day said. ``At Harvard, for instance, they found that women who drink six or more cups of coffee a day weren't any more likely to have heart attacks than women who didn't drink six cups.''

That's good news for 64-year-old Meg Paige of Phoenix who said she's been drinking 15 cups of coffee a day since she was introduced to the stuff as a teenager.

``I drink even more in the winter,'' Paige said, adding that she has had absolutely no health problems from coffee, which she drinks black. She claims that it doesn't even keep her up at night.

``It's about the only thing I drink except for a little water,'' Paige said.

Dr. Anita Murcko of Phoenix is a specialist in internal medicine. Murcko said she ``really enjoys'' coffee but consumes only a modest two to three cups a day. Murcko said another Harvard study published in the ``Journal of the American Medical Association'' shows that coffee helps prevent gallstones and symptomatic gallbladder disease in men.

The study, released this year, took place over a 10-year period and involved 46,000 men ages 40 to 75 with no prior history of gallstone disease.

``I don't think anyone really knows what it is in the coffee vs. caffeine in general that makes the difference,'' Murcko said, ``but this appears to be a very good study.''

She said there's also growing evidence that coffee may reduce the risk of cirrhosis of the liver among heavy drinkers of alcohol, improve short-term memory, postpone muscle fatigue and protect against free-radical damage to tissues.

A study conducted at the University of California at Davis found that coffee has more antioxidant activity than red wine, green or black tea, or orange juice. Researchers there led by Takayuki Shibamoto announced in February that just smelling freshly brewed coffee can make you healthier. They concluded that the aroma of coffee contains about 300 antioxidants and that the smell of regular or decaffeinated gives you the same benefit as eating three oranges.

There's also something to the long-prescribed home remedy that coffee can sometimes alleviate the symptoms of asthma. That's because coffee contains caffeine-related compounds, called theophyllines, that help with asthma relief. But Murcko said, ``You have to drink a lot of coffee to benefit from this, and it's a very mild effect.''

Claims that coffee promotes the effectiveness of certain migraine drugs may or may not be valid.

``No one knows if that is because caffeine withdrawal is contributing to the migraine,'' Murcko said.

But what's of particular interest to scientists is why coffee does what we all know it does: increase alertness and prolong waking hours.

``That's why it's a stimulant,'' Murcko said. ``It probably enhances release of excitatory transmitters in your brain that allows you to be more alert.''

Now the bad news Of course, not all the news is good. Coffee does pose health risks. It most definitely can promote insomnia, anxiety, irritability, heartburn and indigestion. But one of the risks that concerns Murcko most is the link between coffee and osteoporosis in menopausal women. Murcko said menopausal women require at least 600 milligrams of calcium per day. If they don't get that much and are heavy coffee drinkers, caffeine they ingest can impair the absorption of calcium and contribute to osteoporosis.

In the past, coffee has also been linked to heart disease, fibrocystic breast disease, stomach ulcers, and pancreatic and colorectal cancer. However, more recent studies seem to exonerate coffee in connection with these issues. Physicians such as Murcko are still cautious.

``In practicing, I've had women with fibrocystic breast disease tell me that when they reduce their caffeine intake, they feel better,'' Murcko said. ``So even though the current studies don't show it, I do make the recommendation of less caffeine for these patients.''

Murcko said there's only a slight risk that coffee increases blood pressure and generally only in people who already have hypertension. In fact, Israeli scientists at Tel Hashomer Hospital in Tel Aviv have shown that in people over 50 with mild or moderate hypertension, caffeine raises blood pressure for several hours after a coffee break, according to a brief in this month's issue of ``Health'' magazine.

Some health authorities remain concerned about the potential effects of coffee drinking on heart disease and think that coffee may increase blood levels of homocysteines, an amino acid associated with heart disease and stroke.

Murcko said the idea of caffeine raising homocysteine levels and increasing the risk of cardiovascular disease ``is a stretch.''

There's also some evidence that compounds in coffee increase cholesterol levels. But, according to a 1997 ``Mayo Clinic Health Letter,'' these compounds aren't found in filtered or instant coffee, which most Americans drink. These compounds are found in espresso or boiled coffee, which isn't filtered.

Strembel said that if your cholesterol is a concern, drink filtered coffee and not unfiltered types.

Rehydrate with coffee

Murcko said studies have not conclusively shown that caffeine reduces fertility in women. ``Most of the studies about reproductive health in women and coffee have been made more difficult because women who drink a lot of coffee also seem to smoke,'' Murcko said.

Strembel said that if you're pregnant, you may want to check with your doctor on the risks of caffeine.

``I've seen conflicting reports on whether or not there is any relationship between caffeine and spontaneous abortion,'' Strembel said.

Hoelscher Day said a study published in Tufts University's ``Health & Research Letter'' has lifted a dark cloud from coffee's long reputation as a dehydrating substance. Like most diuretics, it was believed that coffee initiated excessive water loss through increased urination.

``If you're exercising a lot, water or sports drinks are the best way to rehydrate,'' Hoelscher Day said. ``But coffee rehydrates, too. You don't lose all that much water from drinking coffee.''

Nutritionally, Strembel said coffee is a lightweight unless milk is added. Strembel said 6 ounces of brewed coffee contains lots of water, four calories, 0.1 gram of carbohydrate and 0.1 gram of protein.

As for caffeine concentration, the ``Washington Post'' reports that coffee ranks high but is followed closely by other popular drinks. For example, the amount of caffeine in 8 ounces of brewed coffee (65-120 mg) and 8 ounces of instant coffee (60-85 mg) compares with that in: Jolt Cola (12 ounces), 71 mg; Mountain Dew (12 ounces), 55 mg; Coca-Cola (12 ounces), 45 mg; Pepsi-Cola (12 ounces), 37 mg; and Snapple iced tea (16-ounce bottle), 48 mg.

Murcko said you also have to remember that the smaller the volume you put the caffeine in, the bigger the impact.

``That's why, with a caffeine pill, you get a jolt pretty quick,'' she said. ``If you eat a chocolate bar all at once, that concentrated caffeine is also released fast.'' (at)j Dependent on java (at)j Technically, coffee is not addictive. However, that's sometimes hard to believe around hard-core coffee drinkers who refuse to speak before tossing down that first burst of java in the morning. Which raises another health question: How good is it for our mental health to fall into the habit of leaning on caffeine to jump-start our day? Dr. Paula King, a Phoenix psychologist, said there's nothing wrong with leaning a little on coffee in the morning as a coping mechanism.

``We all need ways of managing and feeling like we can function well in life,'' King said. ``It's when that substance or activity becomes more important than anything else in life that it becomes a problem.''

She said she has had patients tell her that they were obsessed with caffeine and couldn't function during the day unless they had a certain amount of it.

``When it gets to that point,'' she said, ``then I would explore with them new coping mechanisms to move toward well-being.''

One thing everyone seems to agree on is that sensitivity to coffee's powers varies significantly from person to person.

``I think that's very important,'' Murcko said. ``Just like alcohol, there are people who are more sensitive to small amounts. That same cup or two that brings alertness to some may cause anxiety and irritability in others.''