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The public debate surrounding health risks associated with coffee has been ongoing for decades. The most common concern regarding coffee and its relationship to health is its impact on the cardiovascular system. Doctors have historically told individuals with pre-existing heart problems (such as hypertension or arrhythmias) to either limit or stop their coffee consumption.
Recent data reveals a different picture. A 2018 meta-analysis examining data collected from over 250,000 participants indicated an inverse relationship between the amount of coffee consumed regularly and the incidence of developing high blood pressure. Additionally, each additional cup of coffee consumed per day was associated with a 2% decrease in the likelihood of developing hypertension.
Large cohort studies have demonstrated that coffee consumption has been inversely related to rates of heart attacks, strokes and all-cause mortality due to cardiovascular disease. Specifically, a 2009 study evaluating the relationship between coffee consumption and stroke rates among 80,000 women followed for 24 years found that women consuming 2-3 cups of coffee per day were approximately 19% less likely to experience a stroke. Similarly, a 2022 UK-based study found that coffee consumers consuming approximately 3 cups of coffee per day experienced a 17% decreased likelihood of experiencing death from cardiovascular disease. A Swedish study showed that coffee consumers who had previously suffered a heart attack were 40% less likely to die from cardiovascular disease if they continued to consume coffee.
Historically, doctors have blamed caffeine for causing irregular heart rhythms (atrial fibrillation). Current data supports this notion. While there is no increase in the risk of developing atrial fibrillation, current data suggests that moderate amounts of caffeine may actually decrease the risk of developing atrial fibrillation. Furthermore, a study examining patients who had previously developed atrial fibrillation found that coffee consumers had a 23% lower likelihood of experiencing complications compared to non-coffee consumers.
There is one potential caveat to coffee's positive effect on cardiovascular health. Unfiltered coffee (such as French Press or Turkish coffee) increases levels of low-density lipoprotein (LDL) cholesterol. Filtered coffee eliminates these compounds, therefore, filtered coffee brewing methods would be preferable for those concerned with cholesterol levels.
While previous research suggested that caffeine could potentially cause stress to the liver, current research indicates that coffee may help protect the liver. Drinking 2 or more cups of coffee per day has been correlated with improved liver enzyme levels and slowing the progression of liver disease. A large-scale study examining nearly 500,000 participants found that coffee drinkers were 21% less likely to develop chronic liver disease and 49% less likely to experience liver-related death. Researchers have even referred to caffeine as "potentially a medicine" for the liver.
World Health Organization (WHO) previously classified coffee as a possible carcinogen. However, the WHO has since revised their classification based on more current and comprehensive research. Recent data demonstrates that there is no correlation between coffee consumption and an increased risk of cancer. In fact, research suggests that coffee consumption may be inversely related to the development of certain types of cancer (liver and endometrial) and possibly prostate cancer.
Timing and quantity of coffee consumption play a role in maximizing its health benefits while minimizing potential side effects. Many believe that consuming coffee immediately upon waking is counterproductive because it may stimulate the release of cortisol. However, cortisol levels decrease rapidly in habitual coffee consumers. Caffeine remains in the body for several hours (the half-life of caffeine is approximately 5 hours), which is why many experts recommend limiting coffee consumption later in the day to prevent disruption of sleep. For more on how caffeine interacts with sleep, see optimize your sleep for better health. Research has demonstrated that consuming coffee in the morning has a greater mortality benefit compared to coffee consumed later in the day.
The FDA recommends that healthy adults should not consume more than 400 milligrams of caffeine per day. This equates to approximately 2-3 cups of coffee, depending on the brew strength. Coincidentally, this same amount of caffeine has been demonstrated to provide the greatest cardiovascular and longevity benefits.
Coffee is likely to be both safe and potentially beneficial for most individuals. Moderate coffee consumption may contribute to lowering the risk of developing heart disease, improving liver health and reducing the risk of developing certain types of cancer.