Coffee and life

November 9, 2012

Gary E Foresman MD


In a recent New England Journal of Medicine (NEJM) article, many questions about coffee consumption and mortality were answered. As you know from my article, the complex “herbal” preparation known as coffee has a potent blend of antioxidants and bioflavonoid anti-inflammatory compounds linked to a wide array of health benefits. Despite hundreds of articles linking coffee consumption with a lower risk of diabetes, Parkinson’s, liver disease, and heart disease (just to name a few), you still find people confused, thinking, “Isn’t coffee bad for you?”

In a Puritanical country where nearly everyone is taught “if it feels good it must be bad for you,” I have refreshing news for you. This study follows the NIH-AARP cohort of 229,119 men and 173,141 women (age 50-71 years old) over a 14 year period looking at coffee consumption and cause- specific mortality.

Although there are so many co-variants to consider, here are some simple conclusions.

Compared to non-coffee drinkers, those who drink 4-5 cups of coffee per day have a 12 percent (men) and 16 percent (women) reduction in all-cause mortality. In some cases drinking greater than 6 cups of coffee per day (no limit) added to the benefits, but this was not consistent. Furthermore decaffeinated coffee, in most cases, provided similar benefits to caffeinated coffee.

Breaking it down a bit further, coffee had no effect on cancer mortality for men or women. However, the cause-specific mortality for women at 4 to 5 cups per day vs. 0 cups per day, showed a reduction in death from heart disease of 22 percent, respiratory disease 35 percent, stroke 18 percent, injuries and accidents 36 percent (seems only to relate to caffeinated coffee), infectious disease 40 percent, diabetes 18 percent and other causes 26 percent.

In men the same numbers, still at 4 to 5 cups per day, include a reduction in death from heart disease of 13 percent, respiratory disease 17 percent, stroke 35 percent, injuries and accidents 28 percent (in guys this took greater than 6 cups per day of caffeinated coffee), infectious disease 30 percent, diabetes 20 percent, and “other causes” 29 percent.

Maybe that’s too many numbers for most of you, but undeniably what you see is an across-the-board reduction in mortality from every cause except cancer, in men and women, in decaffeinated and caffeinated coffee drinkers. As this is an observational study based on one questionnaire at the beginning of the trial, one can’t get to the proof of causality. We have thousands of other studies documenting the causative reasons; just no one has a trial covering 14 years with such profound reductions in mortality. Any and all multibillion dollar drugs do not provide this kind of benefit in treating any one of the conditions which coffee treats.

Never let common sense be over-ruled. If you don’t drink coffee because you feel poorly when you do, don’t drink coffee. But when people stop drinking coffee for “health reasons”, they are dramatically worsening their risk of dying from the condition they think they are helping.

That just doesn’t make sense.

Gary E. Foresman, MD is Board Certified and Fellowship Trained in Internal Medicine, Functional, Anti-Aging and Regenerative Medicine, and a Fellow in Integrative Cancer Therapies. He is President of Middle Path Medicine in Arroyo Grande.

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With all due respect to Dr. Foresman, I find his summaries to be reckless. Coffee is a cardio tonic. It increases heart rate and contributes to anxiety symptoms. It causes tolerance, dependence, and withdrawal, characteristics more alligned with drugs than food substances. The hundreds of studies he cites have not been conclusive. What about the studies linking coffee to tinnitus, GI acid secretion, even domestic aggression?

And by abstaining from coffee he concludes people are “worsening their risk of dying.” Come on, really?

Many people are sensitive or even intolerant to the effects of caffeine, especially in the concentrations seen in modern day coffee houses like starbucks and pete’s. Endorsing coffee as an elixir for our health woes is just plain irresponsible.

I am curious if this may just be keeping well-hydrated with boiled water (more purified) or the actual coffee bean. I know hot tea is supposed to also be very good for you.

Also, what would espresso and Turkish style (heavy/thick from finer grinds) do for us. I often only have a daily double shot espresso and not the standard watery kind.

Dehydration is a good point. I’m surprised it wasn’t mentioned. Since coffee is a diuretic, it makes sense to balance the coffee volume with good water, just as a base line, then add your normal daily water consumption.

Here is the first coffee article written by Dr. Foresman from around 2009, and it addresses the need to drink twice as much water as coffee in order to remain hydrated. He also details the chemicals found in coffee that have specific health benefits. Enjoy!

This is very interesting. My fathers side of the family was/is known for living to be well into their nineties. My dad used to say, “we live old, that is unless cancer gets us”. My great aunt recently died at age 99, her brother died at 97 and her sister died at 92 and the same can be said for my grand father and great grand parents . All my aunts and uncles (8 of them) are still living except for one who died of cancer at 46. Although my dad died at 82 with Alzheimers, he was the first to manifest the disease and was otherwise healthy as no one has lost their wits as they aged/age in his family.

Something that no one in the family has ever considered is that my dads side of the family are/were all heavy coffee drinkers, they all drank/drink at least 5-6+ cups a day. My dad used to talk about how his grandfather smoked a pipe for 60+ years and cooked his eggs in bacon grease every morning etc, and lived to be 102. He also drank over a lb of coffee a week!

I wonder if ………………

I hope so. I usually put down between 1/2 and a whole pot per day…

Only one problem I see with the article. I was just talking to my Dr. recently about this. My Dr. stated the fact that while this does help, how many people continually drink five or six cups a day? My Dr. mentioned that most drink about two or three. I find that is about mine and a lot of people I know’s consumption. I know that someone will reply that they have drank six. Yes I do once in awhile if out to breakfast with a friend BUT this is a continueing consumpsition of five or six EVERY day. Hard to do. And not just sitting at your desk. Weekends too.

I agree, but I can tell you, my Mom was one of those! She drank coffee all day long, kept a pot on the stove over the pilot light to keep it warm in the days before microwave ovens. I never thought anything of it until I grew up and moved away. She is 93 now.

You are right. My grandfather drank a thermos plus a day but again one of few that would keep that up on a daily basis. Died three months short of 95 and in good health. Also ate lots of red meat and potato’s.

I loved reading this article while drinking my morning cup of coffee! Cheers! On with the day ahead of me!!