The B n Co

Eri H l, Pen t i ic I r

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Objectives
● Educate audience about coffee consumption and the
related health implications.

● Obtain evidence to support clinical recommendations

regarding coffee consumption.

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Outline
● Introduction
● Components of coffee
● Today’s Dietitian article findings
● Research Analysis
○ Diabetes
○ Cardiovascular Disease
○ Cognitive Function

● Clinical Recommendations

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Why or why don’t you drink coffee?
Reasons for drinking coffee: Reasons for not drinking coffee:
● More energy/ focus ● Bad taste/smell
● Tastes good ● Addictive
● Habit ● Can’t sleep at night
● Socialize ● Side effects
● Caffeine withdrawal ● Expensive
● Suppress appetite ● Pregnant/health issues
● Health benefits ● Adverse health outcomes

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Coffee: Fact or Fiction
● Coffee dehydrates you
○ Fiction

● 1.5 oz espresso has less caffeine than an 8 oz drip coffee

○ Fact

● Coffee is an appetite suppressant

○ Fiction

● Dark roasts contain more caffeine than light roasts

○ Fact/ Fiction

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Introduction
● Second most consumed beverage in the world
○ 62% of Americans

● Second most traded commodity in the world

● Over 100 coffee bean species
○ Coffee Arabica- Brazil
○ Coffee Robusta- Vietnam

● Grown in 70 countries
● At least 38 different types of coffee drinks

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Black coffee naturally
contains 0-5 kcal

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Food for thought Common
additives
Serving
Size
Calories
(kcal)
Fat (g)

Flavored 1 Tbsp 40 4
creamer

Half and 1 Tbsp 20 2

half

Cream 1 Tbsp 50 2

Whipped 8 Tbsp 80 7
Cream

Flavored 2 Tbsp 105 0

Syrup

Caramel 1 Tbsp 25 0
Drizzle

Sugar 1 tsp 15 0

Values obtained from Supertracker.usa.gov 8

Evolution of coffee
● 850 AD: First discovered in Ethiopia
○ Goats

● 1000: Persian philosopher documents medical benefits

● 1400’s-1500’s: Spreads to Asia and Europe
○ Coffee prohibition

● 1773: Boston tea party makes it patriotic to drink coffee

● 1971: First Starbucks opened in Seattle
● 2018: Over 400 billion cups consumed by Americans each year

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How It’s Made

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What’s in the cup?
Caf e
Pol h s
Mic ti t
Pot um
Mag um
Pho h

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Caffeine in Café
● Most widely consumed psychoactive drug
○ Legal and unregulated

● Mild CNS stimulant

● Typical cup of coffee: 75 -175 mg caffeine

● Benefits: Improved attention, alertness, and physical performance

● Drawbacks: Hyperactivity, disturbed sleep patterns

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Caffeine Metabolism/ Function
● Metabolized in the liver cytochrome P450 oxidase into three dimethyl
xanthines
○ Paraxanthine- CNS stimulant and increases lipolysis
○ Theobromine- vasodilator and diuretic
○ Theophylline- relaxes smooth muscles

● Speeds you up by not slowing you down

● Half life varies among individuals

○ 4-6 hours

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Protecting Polyphenols
● Natural compounds characterized by the
presence of several phenol groups
● Variations in absorption, metabolism
and bioavailability of different
polyphenols
● Opens up aromatic ring and neutralizes
reactive oxygen species
● Prominent polyphenols: chlorogenic, and
caffeic 14
Mocha Micronutrients
● Present in lower amounts unless Micronutrient Amount per 8 oz cup of
regular black coffee
consumed in large quantities
Potassium 116 mg
● Potassium: blood pressure, muscle
Magnesium 7 mg
contraction, nerve transmission
Phosphorus 7 mg
● Magnesium: component of bone, muscle
contraction, blood clotting Values obtained from Supertracker.usa.gov

Values might change depending on type of water used and origin of bean

● Phosphorus: component of bone, energy

synthesis

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Acrylamide
● Chemical created during roasting
● Added to CA’s carcinogen list in 1990
● National Toxicology Program:
“reasonably anticipated to be a
human carcinogen” (2014)
● Linked to cancer in rodents (2015)

● WHO and International Agency for Research on Cancer currently do

not consider coffee as ‘classifiable as carcinogenic to humans’

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Research Limitations
● Variation in:
○ Type of bean
○ Degree of roasting
○ Type of coffee beverage
○ Additives
○ Definition of one cup

● Comparisons:
○ High vs low consumption
○ Some vs no consumption

● Few randomized control trials

● Foods typically eaten with coffee

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 Today’s Dietitian
● The Power of Coffee

● Assessed “low” vs. “high” intake and “any” vs. “none”

● Health outcomes:

○ All cause mortality ○ Metabolic disease

○ CVD ○ Liver

○ Musculoskeletal system ○ Pregnancy

○ Brain ○ Cancer

Poole R, Kennedy OJ, Roderick P, Fallowfield JA, Hayes PC, Parkes J. Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes. BMJ. 2017;359:j502 18
 Findings
+ All cause mortality
○ 3 cups/day can lower all cause mortality

● Cardiovascular disease
○ 3-4 cups/day can lower risk of development or death from CVD
○ Unfiltered coffee, may increase cholesterol and triglycerides
○ People with uncontrolled high BP, should avoid

● Musculoskeletal system
○ Increased risk of fractures in women compared to men

+ Liver
○ Lower the risk of chronic liver disease, cirrhosis, liver cancer, and gallstones
Poole R, Kennedy OJ, Roderick P, Fallowfield JA, Hayes PC, Parkes J. Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes. BMJ. 2017;359:j502 19
 Findings continued
- Pregnancy
○ Increased risk of low birth weight infants and miscarriages

+ Metabolic disease
○ Decreased risk of developing type 2 diabetes
○ Lower risk of metabolic syndrome

+ Brain
○ Lower risk of Parkinson’s Disease, depression, and Alzheimer's disease

● Cancer
○ Lower prostate, melanoma, oral leukemia, and liver cancer risk
○ May increase lung cancer risk in smokers but reduce risk in non smokers
Poole R, Kennedy OJ, Roderick P, Fallowfield JA, Hayes PC, Parkes J. Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes. BMJ. 2017;359:j502 20
The Power of Coffee Conclusion
● Coffee was more frequently associated with
benefit than harm
● Groups who should avoid coffee:
○ Pregnant women
○ Women with weak bones
○ People with HTN
○ Smokers
● Strong evidence supports:
○ Diabetes
○ Cardiovascular disease
○ Cognitive function
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Res h A ay
- Di b e
- Car as r Di e
- Cog ve F t o
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 Coffee and Diabetes
● Prospective cohort study (14 year follow up)
● n= 75,140 multiethnic adults without diabetes (ages 45-75)

Experimental measures:

● Coffee consumption: Food frequency questionnaire

○ Regular caffeinated coffee, decaffeinated coffee, and espresso/ cappuccino
○ Almost never, <1, 1, 2, and >3 cups/day
● Diabetes:
○ Confirmed via medical records, pharmacy records, and laboratory results

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Doo, T., Morimoto, Y., & Steinbrecher, A. (2013). Coffee intake and risk of type 2 diabetes: The Multiethnic Cohort. Public Health Nutrition,17(06), 1328-1336.
 Diabetes Study Findings
Diabetes risk associated with coffee intake, women and men

Doo, T., Morimoto, Y., & Steinbrecher, A. (2013). Coffee intake and risk of type 2 diabetes: The Multiethnic Cohort. Public Health Nutrition,17(06), 1328-1336. 24
Coffee and Cardiovascular Disease
● Data from cross sectional population based study
● n= 557 adults in Brazil (ages 20-59)

Experimental measures:

● Coffee consumption: two 24 hour recalls

○ Coffee consumption classified as <1 cup/day, 1-3 cups/day, or > 3 cups/day
● Polyphenol intake: Phenol-Explore database
○ Coffee polyphenols classified as <101 mg/day, 101-337 mg/day, or >337 mg/day
● Blood pressure
● Lab values

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 Coffee and Cognitive Function
● Meta analysis of 9 prospective cohort studies
● n= >34,000 participants total (follow up 1- 28 years)

Experimental measures:

● Coffee consumption: Food frequency or 1-2 specific questions on a survey

○ Categories ranged from 0 to >6 cups/day

● Cognitive disorder diagnosis from:

○ The Dementia Scale, Cognitive Abilities Screen Instrument, or Mini Mental State
Examination

Wu, L., Sun, D., & He, Y. (2017). Coffee intake and the incident risk of cognitive disorders: A dose–response meta-analysis of nine prospective cohort studies. Clinical Nutrition,36(3), 730-736. 27
 Cognitive Function Study Findings
● Lowest risk of cognitive
disorders was observed with
consumption of 1-2 cups per
day

● Positive or neutral results for

any or no consumption

Wu, L., Sun, D., & He, Y. (2017). Coffee intake and the incident risk of cognitive disorders: A dose–response meta-analysis of nine prospective cohort studies. Clinical Nutrition,36(3), 730-736. 28
Clinical Implications
● Diabetes
○ Lower risk for women consuming >3 cups/day of any
type of coffee
○ Decaf may not have as strong of an effect
● Cardiovascular Disease
○ 1-3 cups/day may reduce risk of cardiovascular disease
● Cognitive Function
○ Consumption of 1-2 cups/day may lower risk associated
with diminished cognitive function

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RD Recommendations
● 2015-2020 Dietary Guidelines: 3-5 8oz cups/day

● Academy of Nutrition and Dietetics: 3-4 cups/day

● 1-3 cups of coffee could be beneficial for DM, CVD, or cognitive health

● Limit added fat and sugar in coffee

● Mindful of food commonly eaten with coffee

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References
1. Poole R, Kennedy OJ, Roderick P, Fallowfield JA, Hayes PC, Parkes J. Coffee consumption and health: umbrella review of meta-analyses
of multiple health outcomes. BMJ. 2017;359:j502
2. Doo, T., Morimoto, Y., & Steinbrecher, A. (2013). Coffee intake and risk of type 2 diabetes: The Multiethnic Cohort. Public Health
Nutrition,17(06), 1328-1336.
3. Wu, L., Sun, D., & He, Y. (2017). Coffee intake and the incident risk of cognitive disorders: A dose–response meta-analysis of nine
prospective cohort studies. Clinical Nutrition,36(3), 730-736.
4. Noguchi, K., Matsuzaki, T., Sakanashi, M., Hamadate, N., Uchida, T., Kina-Tanada, M.,Nakasone, J. (2015). Effect of caffeine contained in a
cup of coffee on microvascular function in healthy subjects. Journal of Pharmacological Sciences,127(2), 217-222.
5. SuperTracker: My Foods. My Fitness. My Health. (n.d.). Retrieved April, 2018, from https://www.supertracker.usda.gov/ foodtracker.aspx
6. 2015-2020 Dietary Guidelines for Americans. (n.d.). Retrieved March, 2018, from https://www.cnpp.usda.gov/2015-2020
-dietary-guidelines-americans
7. T. W. (n.d.). Benefits of Coffee. Retrieved April, 2018, from https://www.eatright.org/health/wellness/preventing-illness/benefits-of-coffee
8. Christensen, J. (2018, March 30). Coffee may come with a cancer warning label in California. Retrieved April, 2018, from
https://www.cnn.com/2018/03/30/health/coffee-cancer-court-decision-warning-label-california/index.html

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