Use the labels in the right column to find what you want. Or you can go thru them one by one, there are only 33,809 posts. Searching is done in the search box in upper left corner. I blog on anything to do with stroke. DO NOT DO ANYTHING SUGGESTED HERE AS I AM NOT MEDICALLY TRAINED, YOUR DOCTOR IS, LISTEN TO THEM. BUT I BET THEY DON'T KNOW HOW TO GET YOU 100% RECOVERED. I DON'T EITHER BUT HAVE PLENTY OF QUESTIONS FOR YOUR DOCTOR TO ANSWER.
Changing stroke rehab and research worldwide now.Time is Brain!trillions and trillions of neuronsthatDIEeach day because there areNOeffective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.
What this blog is for:
My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.
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!
Of course, your fuckingly incompetent? doctor did
nothing with this from 3+ years ago! And still hasn't created a 24 hour
coffee station
This line is great: The findings indicate that even the Espresso Martini cocktail contains the espresso's beneficial compounds - and can contribute to staving off dementia.
Coffee has been associated with key cardiovascular benefits over the years. But how much is too much? It has remained unclear just how many cups of coffee a person can drink on a daily basis without overdoing it.
According to a scientific statement published in Circulation, adults can safely consume up to five cups of caffeinated coffee—good for approximately 400 mg of caffeine—each day. In fact, drinking that much coffee is linked to multiple benefits, including a lower risk of heart failure, heart disease and even stroke.
Higher daily doses of caffeine, however, may increase a person’s risk of high blood pressure or lead to heart rhythm issues. Researchers specifically pointed to energy drinks and their high caffeine levels as a potential health hazard.
The new scientific statement was prepared by a volunteer writing group with support from the American Heart Association (AHA). Co-authors included specialists from the fields of cardiology, nutrition, epidemiology and public health. The scientific statement does not include specific treatment recommendations, but it will help guide future recommendations developed by the AHA and other medical societies.
“Although research suggests that caffeine consumption may be associated with certain cardiovascular benefits for some people, it’s important to remember that there is no ‘one-size-fits-all’ strategy for safe caffeine consumption,” wrote electrophysiologist Gregory M. Marcus, MD, chair of the statement’s writing group and a professor of medicine at the University of California, San Francisco School of Medicine. “People can respond very differently to caffeine based on various factors, such as age, medications, underlying health conditions, genetics and how quickly their bodies metabolize it. What may be a reasonable amount for one person could cause unwanted effects in another, such as heart palpitations, anxiety or sleep disruption. That's why it’s important to pay attention to how your body responds to caffeine and talk with your healthcare team about what is right for you.”
Click here to read the full scientific statement in Circulation. Read about another recent analysis on this topic here.
Picture this: You’re rushing off to work and thinking about the never-ending list of to-do’s you’re hoping to work your way through today. On the way, you pop into your local coffee shop for some much-needed caffeine. But instead of grabbing your large drip coffee or latte to go, you sit down at a table or stand at a coffee bar and drink from a ceramic mug. Does this sound absurd? Well, this is actually how coffee is consumed in many places throughout the world.
In the U.S., we constantly carry around take-away cups of drip coffee, but throughout many parts of the world — like some parts of Europe and New Zealand, for example — that just isn’t the norm.
Sure, some people grab a coffee to-go every now and then, but many people drink their coffee from a mug right there in the cafe — whether seated solo, with a group of friends or standing up at the bar. Sometimes it’s a communal thing to sit down and drink coffee with friends. Other times it’s more about just throwing back an espresso on the way to work — either way it happens right there at the cafe.
“Takeaway coffee culture is often dictated by an environmental lifestyle — for instance in Italy, where it is customary to stand at the bar and enjoy an espresso quickly. This quick, sociable and affordable ritual is deeply rooted in Italian culture,” said Jack Foster, co-owner and operations director at Crosby Coffee in England. “Other European countries such as Austria or France see their customers sit down and savor their coffee leisurely, often accompanied by a pastry. Again, a way of life in some cities and choices made by their communities’ lifestyle.”
If you’re obsessed with the hustle and can’t imagine doing anything else but run off from the cafe with your coffee and cart it around everywhere you go for the next hour, you’re going to want to keep reading to see how things are done differently.
For insight, we reached out to coffee experts for their take on takeaway coffee culture in the United States and how this is different from other parts of the world where takeaway culture hasn’t fully taken over.
“In Brazil, people enjoy their coffee in cafes over long conversations. It’s a very social thing. It’s certainly not about taking your coffee on the run in a paper cup.” — Paulo Peres, who was born and raised in Brazil and is managing principal at specialty coffee importer Agrisapien Traders LLC in the United States
“As someone with Brazilian and Italian nationality, I can say that the coffee culture in both countries is much more social. In Brazil, you’ll be offered coffee at almost every house or office you visit, and after lunch, many people stop at a local bakery for a coffee and a chat with the locals. Similarly, in Italy, people visit espresso bars, where even if they spend just two minutes, they prefer to enjoy their coffee in a proper cup and have a brief conversation with the barista.
“In Italy and Brazil, people generally prefer to stop for their coffee in a proper cup, regardless of the coffee’s quality.” —Bruna Costa, who is a licensed coffee Q grader and director and co-founder of Bossa Coffee Company in London. She was born and raised in a coffee-producing and exporting family in Brazil.
“When my dad took me out to coffee after I moved from Guatemala to Chicago in 1995, I was surprised with the rushed cafe culture in the U.S. Coming from a country where coffee is commonly enjoyed in a ceramic mug without milk at any time of day, it was a surprise to see iced and hot lattes as the norm, all served in a to-go cup to keep up with the fast pace of American life. In the U.S., people rarely have time to sit down and enjoy a cup of coffee with family and friends the way we do in Guatemala.” — Glendy Alejandro, a Guatemala native who works as lead barista at Venteux Brasserie, Cafe & Oyster Bar in Chicago.
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India
“The take away coffee culture in the U.S. is considerably different from what I’ve seen in India. In India coffee and tea breaks are common especially during the work day, which makes it something that people want to have away from their desks. So you will see a lot of small coffee and tea shops right outside large office buildings with people standing near the establishment drinking their coffee and engaging in conversation with their co-workers, away from their desks.
“As part of Indian culture, food and drink are very social concepts. So most occasions where Indians eat or drink are not alone in their car or on their way to work but rather something they would do with their family at home or with their colleagues at work or with their friends after work. It’s very much an experience rather than just a product.” — Shonali Paul, founder of Paul John Indian Caffeine Company, which is based in the United States and sources coffee beans from South India
“In the Philippines, where I have been living for the past 12 years, the coffee culture is more of a leisurely quality. Cafés are more like social hubs, places to escape the heat and humidity, and the baristas take pride in crafting each beverage with care.
“Unlike in the U.S., where many people drink coffee primarily for its caffeine boost when rushing from one place to another, it’s a ritual in Southeast Asia. Honestly, it’s not uncommon here in the Philippines to see families or groups of friends spending an entire afternoon at a café, enjoying the AC and free Wi-Fi.
“While the convenience of takeaway coffee is undeniable, there’s something to be said for the slower, more intentional approach to coffee culture that I experience here in the Philippines. It’s more of a feeling of community, which can be harder to find in the fast-paced, grab-and-go world of American coffee shops.” — Mark Morphew, who is originally from the United Kingdom and is founder of the online educational coffee resource BeanGround
Europe
“Size of drinks and commuting play a huge role in how Americans drink their coffee. In Italy people drink a cappuccino, generally around 6-8 ounces, or an espresso, 2-4 ounces. These small drinks are easy to enjoy at the cafe in a porcelain cup in a couple minutes. In the U.S., the large chains, Starbucks being the obvious one, you see 16, 20, 24-plus ounce sized drinks. Those are not meant to be drank in one sitting. Additionally unless you live in a big city you drive to work, so the convenience of a drive-thru, which obviously equals a takeaway, is where commuters flock so they can drink their coffee in the car on the way into work.
“Taking breaks to enjoy food and beverage isn’t celebrated as much in the U.S. In Spain, business shuts down for a long lunch, [and] in Sweden you Fika, taking a break to enjoy coffee and a snack. How often we work through lunch, eating at the computer, or skip it all together here in the United States. In all my years in coffee, a general coffee shop that has seating may have 20-30% have their orders be for here — oftentimes less than that. My greatest encouragement to U.S. coffee drinkers to enjoy coffee for here, beyond just taking time to stop and enjoy the moment, is the waste impact. Coffee shops produce a significant amount of waste due to-go culture. There are businesses like Stumptown who actually offer a .25 discount when you order your drink for here to encourage this sustainable practice.” — Laila Ghambari, a coffee industry consultant and former U.S. Barista Champion
“Coffee culture in Europe versus the U.S. is quite different, but each has a purpose and a place. In Europe, the coffee scene is characterized by a slower pace, one that fosters conversation and engagement, whereas in the U.S., the coffee environment is characterized by speed and efficiency. Both coffee cultures share one key element: routine.” —Alexa Lindsay, brand manager of Segafredo Zanetti USA
The original version of this story was published on HuffPost at an earlier date.
I do coffee all day, takes that long to
get in a 12 cup pot of coffee. This won't change my habit, it's mainly
to reduce my dementia and Parkinsons risk and no one knows the amounts
for that.
I'm still doing a 12 cup pot of coffee daily to prevent Parkinsons
and frailty! Much more important than any problems it can cause.
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!
Of course, your fuckingly incompetent? doctor did
nothing with this from 3+ years ago! And still hasn't created a 24 hour
coffee station
This line is great: The findings indicate that even the Espresso Martini cocktail contains the espresso's beneficial compounds - and can contribute to staving off dementia.
If you’re a coffee lover, this news will surely perk you up. According to the American Heart Association’s recent scientific statement in Circulation, most adults can safely consume up to five, 8-ounce cups of caffeinated coffee (equal to about 400 mg of caffeine) a day without harming your heart or increasing your risk of cardiovascular disease.
The scientists also say for some people, that third, fourth, or fifth cup may decrease the risk of some cardiovascular conditions, including stroke, heart failure, heart disease, hypertension (high blood pressure) and atrial fibrillation, along with Type 2 diabetes.
These findings are reassuring because they finally dispel the long-standing myth that coffee is detrimental to cardiovascular health, says Craig Basman, M.D., a structural and interventional cardiologist and associate director of Structural and Congenital Heart Disease at Hackensack University Medical Center (HUMC) in Hackensack, NJ.
“The conventional guidance, based on earlier studies and the existing literature, was to limit caffeine intake to one to two cups a day,” he explains. “But now we’re seeing that moderate coffee consumption may actually provide cardioprotective benefits, and adding an extra cup or two daily doesn’t appear to increase cardiovascular risk, including arrhythmia (an abnormal or irregular heart rhythm) risk, in healthy adults,” says Dr. Basman.
Related video: How much coffee per day is safe? Here's the answer. (WATN Memphis)Bibhu Mohanty, M.D., a structural cardiologist and an associate professor at the University of South Florida Morsani College of Medicine in Tampa, agrees. He believes the AHA statement acknowledges and gives a broad recommendation that’s good for most people based on existing data, all without pushing any extremes. statement acknowledges and gives a broad recommendation that’s good for most people based on existing data, all without pushing any extremes.
“This is the most definitive statement coming from a body as authoritative as the American Heart Association,” says Dr. Mohanty. “What they’ve distilled is in the 3 to 5 cup range, you’re not going to hurt yourself or add to your cardiovascular risk.”
Here’s more of the research findings and how those drinking a little extra Joe every day may keep some cardiovascular issues, and more, at bay.
How might coffee protect your heart?
Coffee beans, harvested from coffee trees, are the seeds that grow inside a fruit called the “coffee cherry.” Like other plant-based foods, coffee offers a multitude of positive properties. For example, according to many studies, consuming plant-based foods can significantly reduce your risk of cardiovascular disease, Type 2 diabetes, some types of cancers and all-cause mortality.
What is it about coffee’s content that might account for a healthier ticker? It may be due to the flavonoids in the beans. “A lot of plant-based products have a variety of flavonoids (bioactive compounds with powerful antioxidant and anti-inflammatory qualities) that impact blood vessel tone and how well they can dilate,” says Dr. Mohanty. “If the lining of blood vessels is allowed to properly dilate, it can allow for more blood flow to the heart, which can be very important if a person has plaque buildup in their arteries.”
Dr. Mohanty also says research has shown that flavonoids contribute to improving your high-density lipoprotein (HDL), known as the “good” type of cholesterol, and decreasing your low-density lipoprotein (LDL), or “bad” cholesterol levels. “Flavonoids can shift the ratio of HDL and LDL cholesterol so it’s going in a good direction,” says Dr. Mohanty.
A higher intake of flavonoids has also been found to lower the risk of hypertension. One study in Frontiers in Cardiovascular Medicine reported those people who had the highest total flavonoid intake were 25% less likely to have high blood pressure compared to the participants with the lowest flavonoid intake.
“Unfiltered coffee can raise unwanted cholesterol whereas filtered coffee cannot,” Dr. Basman says. Why? By using a mesh or paper filter, it prevents certain negative compounds like cafestol, a natural oil that raises LDL levels, from making its way into your coffee.
Adding any extras to your brew can also interfere or cancel out any cardiovascular protection. “The health benefits are quickly lost when you start adding fillers, such as sugar, cream, milk or flavored syrups,” explains Dr. Basman. “You’re adding things containing chemicals and/or fat that’s not necessarily healthy for the heart. For instance, cream or whole milk may raise your cholesterol.”
The paper’s scientists also note adding sugar or dairy products to your coffee can substantially increase calorie intake. This can of course result in extra weight gain, which can potentially increase your risk of developing conditions such as obesity and diabetes, both of which could lead to heart problems.
But Dr. Basman says don’t sweat it too much if you don’t want to drink your coffee straight. “Although the healthiest way to consume coffee is generally black, I’m not overly concerned about a modest amount of milk or sugar having a significant negative metabolic effect,” he says. “As long as it’s not in excessive quantities, it’s unlikely to meaningfully offset the cardiovascular benefits we’re seeing.”
What about other caffeinated drinks?
It's important to note the research looked at caffeinated black coffee and emphasize these possible cardiovascular benefits don’t apply to caffeinated sodas or those keep-you-awake energy drinks, the latter of which can have whopping amounts of caffeine.
“Individually, these drinks have 3 to 10 times more caffeine than a cup of coffee, which if taken in excess, can pose potentially serious problems, such as heart palpitations, arrhythmias and high blood pressure,” warns Dr. Mohanty.
The bottom line
The researchers stress when it comes to caffeine consumption, there’s no “one-size-fits-all” strategy. Individuals can respond differently to caffeine based on an array of factors, including age, medications, underlying health conditions, how quickly their body metabolizes it and even genetics. The scientists also underscore the importance of paying attention to how you respond to caffeine and talking to your doctor if drinking more coffee doesn’t feel right.
However, for many java enthusiasts, there’s no need to feel guilty for indulging in those extra cups. Dr. Mohanty says he’s happy to know people can enjoy their caffeinated coffee and have some guidance on a specific amount of consumption that’s safe. “The paper gives a very fair assessment that consuming within that mid-range of 3 to 5 cups a day is okay and may have positive effects on your heart health.”
After all, coffee is more than just a drink to wake you up; it’s a beverage that brings people together. “Coffee is a big part of our lives both socially and culturally, and no one is trying to take that away from us,” says Dr. Mohanty.
I do coffee all day, takes that long to
get in a 12 cup pot of coffee. This won't change my habit, it's mainly
to reduce my dementia and Parkinsons risk and no one knows the amounts
for that.
I'm still doing a 12 cup pot of coffee daily to prevent Parkinsons
and frailty! Much more important than any problems it can cause.
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!
Of course, your fuckingly incompetent? doctor did
nothing with this from 2+ years ago! And still hasn't created a 24 hour
coffee station
This line is great: The findings indicate that even the Espresso Martini cocktail contains the espresso's beneficial compounds - and can contribute to staving off dementia.
Welcome to Impact Factor, your weekly dose of commentary on a new medical study. I’m Dr F. Perry Wilson from the Yale School of Medicine.
If you walk into any hospital breakroom at 3 in the morning, you’re not going to find bowls of kale or treadmills. You’re going to find coffee. It is the raw fuel that keeps the medical system running. Perhaps all of modern civilization. So much of lifestyle medicine involves cutting back on enjoyable things — less carbs, less alcohol. But coffee, along with sex and sleep, is on my very short list of things that are both enjoyable and good for you.
Key Points
Moderate coffee intake (~3-5 cups/day) appears nonharmful; may be cardioprotective.
Habitual coffee intake: BP neutral/↓; caffeine-naive users may have acute BP ↑.
Unfiltered coffee raises LDL via cafestol; paper filtration/instant coffee ≈ no lipid effect.
Coffee intake associated with ↓ type 2 DM, AF recurrence, stroke, HF, CAD risk.
Energy drinks/high-dose caffeine: acute BP ↑; case reports of VF/sudden cardiac arrest.
What mechanisms link coffee to lower AF recurrence?
Which brewing methods alter coffee lipid effects?
How do CYP1A2 variants modify caffeine cardiovascular risk?
Not everyone agrees of course, and cardiologists, for quite some time, were cautious about that most-consumed of all drugs: caffeine. They worried about its potential to promote arrhythmias and its effect on blood pressure with all the attendant downstream risks of stroke and heart attack. But the tide is clearly shifting.
Enter a massive new scientific statement from the American Heart Association (AHA), published in the journal Circulation, that comes out firmly, if not excessively, in favor of coffee. It’s a comprehensive look at Java’s effects on the cardiovascular system, synthesizing decades of occasionally conflicting research and reminding us that coffee is much more than a tasty caffeine-delivery mechanism.
Before we get to the actual clinical outcomes, we have to talk about how incredibly difficult it is to study this stuff. The statement’s authors rightly point out a glaring problem with the caffeine literature: Almost everything we know about caffeine in humans comes from observational studies of people drinking coffee and tea.
In case you haven’t been to a gas station convenience store lately, there are plenty of other ways to get caffeine into your system. The global coffee market is worth something like $200 billion. The global energy drink market is around half that but rising quickly.
Literature trying to examine the effects of caffeine — but using coffee as a proxy — introduces a lot of confounding. First, there is the classic healthy user effect. Moderate coffee drinkers (think 2-3 cups a day) might just have more organized, healthier lives in general compared to those who are slamming energy drinks, or conversely, those who strictly abstain because of underlying illness.
Second, coffee is not just liquid caffeine. It is a wildly complex chemical matrix containing more than 1000 biologically active compounds, including chlorogenic acids, diterpenes, melanoidins, and trigonelline. When an observational study says “coffee does X,” we are often left guessing whether it’s the caffeine acting directly as an adenosine receptor antagonist, or if it’s something else, say the polyphenols exerting an antioxidant effect on the gut microbiome.
And then there is the genetic lottery. Caffeine boasts nearly 100% oral bioavailability and peaks in the bloodstream within an hour, but how long it stays there is completely up to your DNA. Caffeine is almost entirely metabolized in the liver by the CYP1A2 enzyme. Thanks to specific genetic variants, the half-life of caffeine ranges from a rapid 2 hours to a sluggish 12 hours depending on who is drinking it. This means that population-level data on caffeine is always averaging out vastly different biological responses, making broad public health pronouncements incredibly tricky.
That being said, let’s dig into the hard numbers on cardiovascular risk factors, starting with the one that worries primary care docs the most: blood pressure.
Speaking of the source, how you brew your morning cup can literally change your lipid panel. The statement highlights a weird physiological quirk: unfiltered coffee (think French press, Greek, Turkish, or Scandinavian boiled coffee) contains high levels of a cholesterol-raising diterpene called cafestol. In double-blind, placebo-controlled randomized trials, cafestol has been definitively proven to raise LDL cholesterol. But if you simply run that same coffee through a paper filter, the cafestol is trapped. Filtered coffee and instant coffee have essentially zero impact on your cholesterol. A relief, though I do love a nice French press.
Then we have the diabetes paradox. If you look at large prospective cohort studies, habitual coffee consumption is associated with a lower risk for type 2 diabetes. A review of 28 cohort studies found a dose-dependent relationship: People drinking 3.5 cups a day had a 20% lower risk, and those hitting 5 cups a day saw a 30% reduction in risk.
But in lab studies, drinking coffee impairs glucose tolerance, which should not protect against diabetes. The AHA authors suggest the long-term benefit is driven by the noncaffeine components of the bean: magnesium, chromium, chlorogenic acid, which may improve insulin sensitivity. Again, coffee is much more than caffeine.
The heart of the matter, so to speak, may be arrhythmias. For an entire generation, the reflex action for a patient presenting with palpitations or atrial fibrillation (AFib) was to tell them to immediately stop drinking coffee. It made sense. Caffeine is a stimulant, stimulants increase heart rate, ergo, stimulants cause arrhythmias.
But the data tell a completely different story. Observational meta-analyses consistently show that moderate coffee consumption is associated with either a neutral or lower risk for AFib. But we don’t even have to rely on observational data here. The statement highlights a landmark randomized trial in which patients with a history of AFib who were scheduled for elective cardioversion were randomized to either avoid caffeine entirely or consume at least one cup of caffeinated coffee daily. The result? The coffee group had a statistically significant 39% reduction in the risk for recurrent AFib. This is why the latest American College of Cardiology and AHA guidelines explicitly advise clinicians against telling patients to cut out caffeine to reduce AFib risk.
It’s not all lattes and mochaccinos in the arrhythmia world, though. While caffeine might soothe the atria, it seems to irritate the ventricles. Randomized trials confirm that even normal amounts of caffeinated coffee can significantly increase the frequency of premature ventricular contractions. So there you go, there’s no free lunch. Or free coffee.
But before we write a blanket prescription for unlimited caffeine, the AHA panel draws a very hard line at synthetic and high-dose consumption. The salutary effects we see with coffee and tea absolutely do not translate to the massive, concentrated doses found in energy drinks, pre-workout powders, or caffeine pills.
The medical literature has many case reports of young, otherwise healthy people suffering ventricular fibrillation and sudden cardiac arrest shortly after slamming highly concentrated energy drinks. In short, just go for the real stuff.
In the end, this AHA Scientific Statement forces us to embrace a bit of nuance. Moderate caffeine consumption, around three to five 8-ounce cups of brewed coffee, is not clearly harmful. In fact, it might be one of the very few behavioral interventions that is both highly enjoyable and genuinely cardioprotective.
It is rare in medicine that we get to look at our patients, review their daily habits, and tell them to carry on doing exactly what they love. So I think we should take the W here. Enjoy your morning cup of Joe. Maybe run it through a paper filter and, yeah, avoid the Red Bull.
F. Perry Wilson, MD, MSCE, is an associate@fperrywilsonprofessor of medicine and public health and director of Yale’s Clinical and Translational Research Accelerator. His science communication work can be found in the Huffington Post, on NPR, and here on Medscape. His book, How Medicine Works and When It Doesn’t, is available now.
