I'm doing it to increase my healthspan, lower my chances of dementia and Parkinsons.
If you provide research that tells me 3-4 cups a day reduces dementia and Parkinson's risk, then I'll change my habit, but until then this is occurring:
Research suggests caffeine is not the main reason for these other benefits, go ask your incompetent doctor for clarification.
Like Your Coffee Black? Congratulations, You Could Be a Psychopath I need to add milk
How coffee protects against Parkinson’s Aug. 2014
Coffee May Lower Your Risk of Dementia Feb. 2013
Coffee drinkers rejoice! Drinking coffee could lower the risk of Alzheimer’s disease
And this: Coffee's Phenylindanes Fight Alzheimer's Plaque December 2018
New research suggests drinking coffee may reduce the risk of frailty May 2025
I think I'm in this category: I never get
the jitters or flushed skin.
Genetics determine how much coffee you can drink before it goes wrong
I'm doing a 12 cup pot of coffee a day with full fat milk to lessen my chances of dementia and Parkinsons. Tell me EXACTLY how much coffee to drink for that and I'll change. Yep, that is a lot more than the 400mg. suggested limit, I don't care! Preventing dementia and Parkinsons is vastly more important than whatever problems it can cause!
The latest here:
Q&A: Coffee may provide many heart-healthy benefits independent of caffeine
Key takeaways:
- Coffee may help prevent various adverse CV events as a result of potential anti-inflammatory properties.
- Researchers compiled a state-of-the-art review of data on the relationship between coffee and CVD.
Drinking coffee may provide anti-inflammatory benefits leading to potential reductions in future risk for heart disease, according to a state-of-the-art review published in the European Heart Journal.
More than 20 years of mostly observational data showed that coffee may have an impact on the prevention of hypertension, diabetes, heart attack, atrial fibrillation, heart failure and mortality, Gregory M. Marcus, MD, MAS, cardiologist and Endowed Professor of Atrial Fibrillation Research in the division of cardiology at the University of California, San Fransico, and colleagues reported.
Conversely, the researchers highlighted coffee’s potential adverse effects on certain arrhythmias as well as LDL cholesterol.
Healio spoke with Marcus about the observed CV benefits and harms of coffee in addition to the underlying mechanisms behind coffee’s cardioprotective effect and recommendations for healthy consumption.
Additionally, Marcus discussed the results of the CRAVE trial, for which researchers evaluated the real-time physiologic consequences of coffee consumption in healthy adults using multiple wearable devices.
As Healio previously reported, healthy adults experienced no increase in atrial arrythmias and less supraventricular tachycardia on days they consumed coffee vs. abstaining.
Healio: What motivated you to issue this state-of-the-art review?
Marcus: There’s been a growing number of high-quality original research papers on the subject of coffee and various forms of CVD. It was time to try to consolidate all of this recent evidence to inform clinicians and the lay public about what is currently known on the CV effects of coffee.
Healio: The review states that coffee may have a beneficial impact on outcomes such as hypertension, diabetes, MI, arrhythmia, HF and mortality. By what mechanism does coffee achieve these benefits?
Marcus: It’s important to emphasize that the great majority of these studies are observational in nature rather than randomized controlled clinical trials. Although there are a few select randomized clinical trials, almost all these conclusions derive from observational studies.
With that caveat, there are several potential mechanisms that could explain apparent benefits of coffee. My suspicion is that those benefits are multifactorial.
We tend to think of caffeine as potentially raising BP because we think of it as being like adrenaline. It’s important to recognize that caffeine is a diuretic and may lower BP in the long term.
When I see patients in my arrhythmia clinic, I often ask about caffeine, not because I’m concerned it’s exacerbating tachyarrhythmia, but out of concern it’s exacerbating dehydration or volume depletion. I remind people that, especially if they’re prone to feeling faint or having low BP, to somewhat minimize caffeine. If they’re having a cup of coffee, for example, that doesn’t count toward hydration, and they should have at least an equivalent volume of water.
There a consistent finding regarding diabetes, which may be related to salutatory effects on the liver that could be anti-inflammatory, perhaps reducing fatty liver disease, even independent of reducing the risk for diabetes. This also suggests that coffee may simply help with insulin sensitivity, which could contribute to positive health effects.
The apparent protective effects on AF is especially counterintuitive. It turns out, AF is very commonly triggered during times of enhanced vagal tone. It’s so very common for patients, for example, to develop AF while they’re sleeping or after a heavy meal. By providing a sort of antivagal effect by increasing a catecholamine-like state with caffeine, perhaps that could reduce risk for AF.
Caffeine famously blocks the effect of adenosine, and that’s one of the mechanisms by which it’s thought to inhibit sleepiness. We know from the EP lab that giving adenosine, at least in high doses, can trigger AF. By blocking adenosine, perhaps that’s protecting against AF.
There may just be some anti-inflammatory effects of coffee. It can be difficult, if not impossible, to disentangle effects that are related to coffee itself as opposed to caffeine. There are some data suggesting some of these benefits that we described in the paper are observed with decaffeinated coffee.
One of the randomized controlled trials we conducted in this area was called CRAVE. In that study, we randomly assigned people day-to-day to either consume all the caffeinated coffee they wanted or avoid it while wearing a bunch of sensors, one being a Fitbit.
We found that on days when people were randomly assigned a caffeinated coffee, they exercised substantially more. We know that exercise can reduce the risks of all the things that were observed.
Healio: One study referenced in the state-of-the-art review investigated the negative impact of unfiltered coffee on LDL. Can you tell me a little bit more about that?
Marcus: There do seem to be compounds in coffee that raise LDL that are large enough that they can be filtered out with typical filtered coffee. With coffee that does not involve the filtering process, those slip through and therefore may worsen high cholesterol, which is one of the things that would appear to be contradictory to the protective observations regarding CAD. How one rectifies that disparity is unclear, and it suggests that the benefits of coffee on CAD, if they are real and not all explained by confounding, presumably are independent of effects on cholesterol.
Healio: Another adverse effect of coffee mentioned is its ability to induce premature ventricular contractions. Can you explain why coffee might have that effect?
Marcus: The most compelling evidence here is from our CRAVE trial. Participants served as their own controls, and on days randomly assigned to consume caffeinated coffee, they had about twice the number of premature ventricular contractions.
The evidence is fairly strong that compounds such as caffeine can theoretically trigger these early beats from the lower chamber. It’s important to mention though that the true effects of coffee are complex and it’s not as simple as saying, “because it may lead to one arrhythmia, it therefore leads to most arrhythmias.”
This demonstrates how different heart rhythm disturbances are themselves. They are distinct in their origins and their mechanisms.
This adverse effect on increasing the number of premature ventricular contractions is fairly unique and seems to be the one heart rhythm disturbance that may be exacerbated by coffee.
There are groups of patients who are plagued by very frequent premature ventricular contractions, and those are the people in whom premature ventricular contractions are clinically relevant. We don’t know how or whether coffee would influence the frequency of those premature ventricular contractions. That’s an important area of future study.
Healio: Can you explain more why many of these beneficial observations appear to occur independent of actual caffeine intake?
Marcus: We don’t know. But it suggests there may be beneficial effects of coffee itself. Coffee does have compounds in it that appear to reduce inflammation, and that also may come back to beneficial effects on the liver, which then may have beneficial effects on insulin sensitivity. But we still don’t completely understand those mechanisms.
Healio: What would you say is the correct or healthy level of daily coffee consumption?
Marcus: Different people metabolize caffeine differently. Almost certainly, there is not a one-size-fits-all in terms of the optimal amount of coffee or caffeine to be consumed.
I would say there is insufficient evidence to recommend anyone initiate coffee consumption if it is not something they enjoy or not something they’re already doing. These data demonstrate that those who enjoy coffee should continue to do so without fear of increasing their risk for heart disease.
In terms of the exact amount, I would say that people should simply listen to their bodies. All things in moderation is probably a wise rule of thumb. Generally speaking, one to two cups of coffee per day is probably optimal.
Healio: Is there anything else you would like to mention?
Marcus: It is interesting to consider the possibility that with future research, especially with randomized controlled clinical trials, we may learn how to apply some of these findings to more specific recommendations and even potentially initiation of either coffee itself or some compound in it that’s found to be helpful.
But for now, I wouldn’t recommend initiation for those who aren’t otherwise regularly drinking coffee.
For more information:
Gregory M. Marcus, MD, MAS, can be reached at greg.marcus@ucsf.edu or @gregorymmarcus on X.
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