Coffee: The Good, The Bad & The Ugly. What's In Your Cup?


I know I’m not alone in my love for this warming morning ritual. It starts days, brings people together, and crosses cultures. I have cherished memories of sipping café con leche at the corner coffee shop in my mom’s hometown in Spain. Even before that, as a small child, she would let us have a splash of coffee in warmed milk for a special treat, so I early on developed an appreciation for the taste, the smell, and the feel of that warm cup in my hands. I smile at the thought of my dad’s refusal to use a travel mug, a rebel like myself, and always taking his hot coffee in a regular mug on the road. Once out on my own in college, I experimented with different ways to prepare it (hazelnut creamer anyone?), and had more than my fair share of all sorts of coffee in med school and residency. I have leveled off to one cup each morning that I drink black and with gratitude. Do you have coffee memories? Do you remember if you liked it at first try? It’s interesting to look back and see how it has weaved into the various seasons of our lives. THE GOOD: Okay, so it seems there is an opportunity for mindfulness, ritual, and gratitude with the daily habit, but is it truly healthy? For years, the medical recommendation has been to avoid coffee. However, there have been studies in the last several years that have shed new light on the topic. The consumption of coffee has been found to lower risk of heart disease, type 2 diabetes, depression, Multiple Sclerosis, Alzheimer’s disease, and Parkinson’s disease. It may also have anti-cancer properties, including decreasing rates of melanoma, and reducing the chance of developing colorectal cancer by 26%. And, on a less serious note, there was a study in the Journal of Psychopharmacology stating that those who consume coffee have a more positive view of self and others, and essentially that coffee helps people get along better in the workplace. I don’t think I can argue with that! But, why all of these benefits? Coffee is loaded with antioxidants, including phenols, Chlorogenic acid (CGA), cafestol (which can help gallbladder/bile function), and trigonelline (which may prevent dental cavities among other things). Even caffeine itself can be considered an antioxidant. One way antioxidants work is by lowering inflammation. Most every disease has some basis in inflammation, so we are doing ourselves a favor by doing all we can to keep that level low. For many individuals, consuming a low to moderate amount of coffee can be part of a healthy lifestyle. THE BAD: Who should avoid coffee? Or, at least limit it greatly. Some of us have genetics that allows the fast metabolism of caffeine (like my husband, and it drives me crazy that he can have double the caffeine that I can, with no adverse effects), and others (like myself) carry the genetics that cause slow metabolism of caffeine, so even one cup of coffee can feel like a lot. Many sources report that most adults can consume up to 400 mg of caffeine per day without a problem. An 8-ounce cup of coffee contains an average of 100 mg of caffeine, so that would be around 4 cups per day. That seems high to me, but hey, I’m a slow caffeine metabolizer! Some other situations where you may want to reduce or avoid coffee and other source of caffeine are as follows: Headaches/Migraines: The issue with caffeine here is that it is a potent cerebral vasoconstrictor. People who suffer from headaches and migraines are very sensitive to the dilating and constricting of blood vessels in the head. If you can try to keep caffeine levels very close to the same amount every day, it is less likely to cause these symptoms. Even going up or down by one cup can be a trigger. So none at all or a low steady daily amount is the trick here. Anxiety: Coffee can give you a boost of energy, but in many people is a cause of uncomfortable anxiety or jitteriness. If you suffer from these sensations, have you considered tapering off caffeine, or cutting back? It might really help. Insomnia: Most people are aware that caffeine can disrupt sleep, but did you know that it stays in your system in a pretty decent amount for 12+ hours? If you are having sleeping problems, make sure you are not consuming caffeine past noon, or maybe taper off of it all together. Sleep is one of the most important aspects to health. Reflux/Indigestion: Coffee can cause flare-ups of indigestion or GERD. There are a variety of things at play here, but try to notice if coffee is a trigger. Eating a meal along with your cup of joe may help. Palpitations/Racing Heart: First of all, like with all symptoms we talk about on here, make sure you get checked out by your doctor. If diagnosed with a benign form of palpitations, one way to help would be to minimize or avoid caffeine. It is a known trigger. Severe Fatigue: If you are using caffeine to treat your severe fatigue, it is a downward spiral. Work with a doctor to get to the bottom of your symptoms, and try not to just keep upping the caffeine. The more you consume, the more you need, to feel the boost. Coffee should be an enjoyable ritual, and maybe a little boost, but should not be your sole source of energy. Pregnancy: The recommendation from ACOG is to keep caffeine intake under 200 mg per day, which is typically around 12-16 ounces of coffee. There are some mixed studies and the outcomes are unclear, so in my opinion, if you can cut back or avoid, that is optimal. I drank around 6 ounces of regular coffee daily in the first few of months of pregnancy and then switched over to decaf for the remainder. Make sure your beans are decaffeinated using the Swiss water method or another chemical-free and solvent-free decaffeination process. THE UGLY: Two topics under this category: Withdrawal and Mold. To anyone who has quit coffee/caffeine cold turkey, you know that the withdrawal is no joke. If you have any of the above symptoms or just feel like you need a break from caffeine, I advise you taper down gradually to avoid the headaches and that crummy feeling that usually accompanies the cold turkey method. I advise decreasing your caffeinated coffee amount by 25% of your starting amount every 3-5 days, until you reach your goal. You can replace each 25% decrease with decaf, if you are transferring over. A typical cup of decaf coffee still has about 3 to 18 mg of caffeine. If you still have symptoms on decaf, you may be super sensitive to caffeine and might need to stop all sources. Could there be MOLD in your coffee?! Mold commonly grows on crops that have long storage times, including corn, grains, and coffee beans. The worry here is that mycotoxins are released by the molds, and we may be consuming them. It is known that mold can cause health problems, but is exposure from our food a concern? There are mixed reviews in the literature. My takeaway is that if you are a person dealing with chronic health issues or a difficult to treat condition, you may want to take extra measures to avoid mold and mycotoxins in food. It is overall toxic load that commonly seems to tip the bucket over and into chronic illness. If you are feeling great, but want to reduce your toxic load for overall preventative health, you may also want to use mold free and mycotoxin free coffee. There are two brands that I found come highly recommended. They are Bulletproof and Purity. This is not sponsored at all and to be honest, I am not using mycotoxin tested coffee yet (it’s expensive), but I’m thinking about giving it a try.

Hope this info has been useful. Don’t forget, this is all intended as information and not personal medical advice. Come see me or your own doc to discuss further!

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