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Coffee and health

DOI:10.1016/j.imr.2014.08.002
Authors:
Jae-Hoon Bae at Keimyung University
Jae-Hoon Bae
Jae-Hyung Park at Keimyung University
Jae-Hyung Park
Seung-Soon Im at Keimyung University
Seung-Soon Im
Dae-Kyu Song at Keimyung University
Dae-Kyu Song
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Abstract and Figures

Most modern people start daily life with drinking a cup of coffee. Many people would also finish their daily work with coffee. As such, coffee drinking is an important part of daily life these days. It has been told that coffee is a driving force for human to develop science, because it has an alerting effect on human brain. However, some people with experience of feeling irregular heartbeat or headache are reluctant to drink coffee, which suggests individual variation to coffee intolerance. This review is to briefly summarize the effect of coffee on human health.
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integr med res 3 (2014) 189–191
Available online at www.sciencedirect.com
Integrative Medicine Research
journal homepage: www.imr-journal.com
Mini Review
Coffee and health
Jae-Hoon Bae∗, Jae-Hyung Park, Seung-Soon Im, Dae-Kyu Song
Department of Physiology, Keimyung University School of Medicine, Daegu, Korea
article info
Article history:
Received 31 July 2014
Received in revised form
21 August 2014
Accepted 22 August 2014
Available online 30 August 2014
Keywords:
caffeine
chlorogenic acid
coffee drinking
type 2 diabetes
hypertension
abstract
Most people start their day with a cup of coffee. Many people would also finish their daily
work with coffee. As such, coffee drinking is an important part of modern daily life. It has
been told that coffee is a driving force for humans to develop science, because it has an
alerting effect on the human brain. However, some people report experiencing irregular
heartbeat or headaches and are thus reluctant to drink coffee, which suggests individual
variation to coffee intolerance. The aim of this review is to briefly summarize the effects of
coffee on human health.
© 2014 Korea Institute of Oriental Medicine. Published by Elsevier. This is an open access
article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
Coffee has taken an important place in human society for at
least 1200 years. Its consumption, which probably originated
in northeast Africa, spread out to the Middle East in the 15th
century and thence to Europe. After oil, coffee has become the
second most valuable commodity around the world. Today,
coffee is among the most widely consumed pharmacologically
active beverages, and its consumption has become a regular
part of daily life worldwide. It is estimated that more than half
of Americans drink coffee every day. The average consumption
for a person in the European Community is 5.1 kg/year, which
is similar to that in the United States.1
In fact, coffee is a complex mixture of chemicals, and is the
main source of caffeine in many populations. However, it also
contains thousands of different chemicals, including carbo-
hydrates, lipids, nitrogenous compounds, vitamins, minerals,
alkaloids, and phenolic compounds (Fig. 1).2
∗Corresponding author. Department of Physiology, Keimyung University School of Medicine, 1095 Dalgubeol-daero, Dalseo-gu, Daegu
704-701, Korea.
E-mail address: jhbae@kmu.ac.kr (J.-H. Bae).
Although caffeine is a major component of coffee, the con-
tent is highly variable—ranging between 30mg and 175 mg in
a cup (150 mL) of home-prepared coffee. Caffeine is the most
widely consumed psychoactive drug worldwide and appears
to exert most of its biological effects through the antago-
nism of the adenosine receptor. Adenosine is an endogenous
inhibitory neuromodulator that prompts feelings of drowsi-
ness, and thus caffeine induces generally stimulatory effects
in the central nervous system. In addition, the physiologi-
cal effects of caffeine intake include acute elevation of blood
pressure, increasing metabolic rate, and diuresis.3Based on
the data reviewed, it can be concluded that moderate caf-
feine intake (2–3 cups or 300 mg/day) is not associated with
adverse effects, such as cardiovascular stimulatory effects and
behavioral changes, at least in healthy adults.4However, caf-
feine is not completely harmless. In fact, caffeine crosses
http://dx.doi.org/10.1016/j.imr.2014.08.002
2213-4220/© 2014 Korea Institute of Oriental Medicine. Published by Elsevier. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
190 Integr Med Res (2014) 189–191
Fig. 1 – Chemical structures of major biologically active compounds in coffee.
the human placenta, rapidly reaching a similar concentra-
tion in the fetus and mother. The excessive intake of caffeine
has been implicated as a cause of spontaneous abortion or
impaired fetal growth.3Caffeine intake for women who plan to
become pregnant and for women during gestation should not
exceed 300 mg/day. In a variety of studies for caffeine inges-
tion, children can be defined as another risk group because
altered behavior including nervousness or anxiety is found.3
It is judged that an intake of 2.5 mg/kg body weight/day is
an upper limit of caffeine consumption in children (Federal
Department of Health, Ottawa, Ontario, Canada).
Is there an antioxidant in coffee? Yes, indeed. Coffee is the
number one diet source of antioxidants in many countries
including the United States, Italy, Spain, and Norway. Coffee
beans contain phenolic antioxidant compounds. The major
polyphenol in coffee is chlorogenic acid. Chlorogenic acid is
one of the major strong antioxidant compounds in coffee.5The
antioxidant activity of coffee depends on the chemical compo-
sition. In addition, it was observed that the antioxidant activity
of coffee varies according to the degree of roasting. Maximum
antioxidant activity was measured for the medium-roasted
coffee.6
Coffee consumption has been associated with higher
concentrations of serum total cholesterol and low den-
sity lipoprotein cholesterol. Cafestol and kahwoel are two
diterpenes found in coffee oil. Diterpenes are the main
cholesterol-raising compounds in coffee, but they are mostly
removed by paper filters. Therefore, unfiltered coffee is a
significant source of diterpenes, whereas the consumption
of filtered coffee results in very little increase in serum
cholesterol.7
The relationship of coffee with health has been featured in
more than 8000 professional medical studies during the past
40 years. However, in many cases, conflicting findings and con-
cerns have arisen, making it difficult for health professionals
and the public to interpret the data. Coffee consumption tends
to attract tobacco smoking, but many studies did not account
for this potential confounding the data analysis.8Some mea-
surement errors seem to be inevitable in the assessment of
coffee consumption, because people consume a wide variety
of coffee from day to day. Coffee intake is determined by the
size of the coffee cup and the strength of the brew as well
as frequency of consumption. Despite 20 years of reassuring
research, many people still avoid caffeinated coffee because
they worry about the biological effects of caffeine. What is the
conclusion of so much attention? We have thought that cof-
fee is good for your health when consumed in moderation.
Harvard Women’s Health Watch (2004) reported that current
research reveals that in moderation coffee is a safe bever-
age that may even offer some health benefits.9However, it is
also emphasized that difficulties and challenges in designing
a solid experiment or clinical trials to elucidate the effects of
coffee on human health are present.
Many studies show that coffee consumption may help pre-
vent several chronic diseases. In particular, long-term coffee
consumption is associated with significant dose-dependent
reductions in the risk of developing type 2 diabetes.4Fur-
thermore, coffee intake reduces the risk of liver damage in
people at high risk for liver disease including hepatic injury,
cirrhosis, and hepatocellular carcinoma.10 Its consumption is
also inversely associated with the risk of Parkinson’s disease
in men and women who have never used postmenopausal
estrogen.11 The risk of Alzheimer’s disease is lower in those
who regularly consume caffeine-containing coffee than in
those who do not drink it.12 Coffee has also been shown to
improve endurance performance in long-duration physical
J.-H. Bae et al/Coffee and health 191
activities. It is very interesting that the relative risk of suicide
was decreased by 13% for every cup of coffee consumed daily.13
In general, coffee consumption has been inversely associated
with the risk of cancer at various sites including liver and
colorectum, but there is no clear explanation of how coffee
protects against cancer.14
It should be considered that coffee does have modest car-
diovascular effects such as tachycardia, high blood pressure,
and occasional arrhythmia.1The acute effects of coffee on
the cardiovascular system might arise in the time immedi-
ate to coffee intake or in more susceptible individuals. Recent
analyses have concluded that a weak inverse association may
exist between coffee consumption and the risk of stroke, but
further research is needed to clarify this.14 Although there
is no definite clinical relationship between coffee intake and
the risk of cardiac arrhythmia, many doctors would not rec-
ommend coffee for the patients. Any contribution of coffee
ingestion to the development of hypertension is likely to be
small, but it is considerable particularly in infrequent coffee
drinkers.4Caffeine leads to a slight decrease in the efficiency
of calcium absorption in gastrointestinal tract. Thus, an ade-
quate intake of calcium and vitamin D and a limitation of
coffee intake to 2–3 cups/day may help reduce the risk of
osteoporosis and its related fracture particularly in elderly
adults.3
Coffee consumption is used for social activity, leisure,
improvement of work performance, and well-being. Coffee
is not only a medicinal alternative but also a beverage con-
taining numerous potential health benefits. The results from
many types of research suggest the positive effects of cof-
fee consumption on various aspects of health, as mentioned
above briefly. Despite the general good outcomes, it should
be emphasized that individual sensitivity to coffee and the
biological effects of coffee among humans may vary because
of personal single nucleotide polymorphic variants, as shown
in an investigation on genetic polymorphisms in apolipopro-
tein E (APOE).15 And some negative effects of coffee tend to
emerge in excessive drinking, so it is the best to avoid heavy
coffee intake. This minireview covers just a few of the health
benefits and adverse effects associated with drinking coffee.
Further studies on the functionally significant polymorphisms
are needed for a better understanding of the effects of coffee
on personal health.
Conflicts of interest
All contributing authors declare no conflicts of interest.
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A prospective study of coffee drinking and suicide in women
Article
Among the many reported central nervous system effects of long-term caffeine use is improvement in mood. To examine prospectively the relationship of coffee and caffeine intake to risk of death from suicide. We conducted a 10-year follow-up study (1980 to 1990) in an ongoing cohort of 86 626 US female registered nurses aged 34 to 59 years in 1980, who were free of diagnosed coronary heart disease, stroke, or cancer. Information on coffee and caffeine intake was collected by a semiquantitative food frequency questionnaire in 1980. Deaths from suicide were determined by physician review of death certificates. Fifty-six cases of suicide occurred during 832 704 person-years of observation. Compared with non-drinkers of coffee, the age-adjusted relative risk of suicide in women who consumed two to three cups per day was 0.34 (95% confidence interval [CI, 0.17 to 0.68) and 0.42 (95% CI, 0.21 to 0.86) in women who consumed four or more cups per day (P for linear trend=.002). These findings remained essentially unchanged after adjusting for a broad range of potential confounding factors, including smoking habit, alcohol intake, medication use (diazepam and phenothiazine), history of comorbid disease (hypertension, hypercholesterolemia, or diabetes), marital status, and self-reported stress. A strong inverse relationship was similarly found for caffeine intake from all sources and risk of suicide. The data suggest a strong inverse association between coffee intake and risk of suicide. Whether regular intake of coffee or caffeine has clinically significant effects on the maintenance of affect or the prevention of depression merits further investigation in clinical trials and population-based prospective studies.
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