Vol. 13 Issue 2

Washington University Review of Health Spring 2020
Don’t Lose Heart on Coffee
Writer: Ben Lieberman | Editor: Akshay Govindan | Illustrator: Eugenia Yoh
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Many studies over the
years have tried to
answer that question.
One of the first large-scale studies
was the Honolulu Longitudinal
Heart Study. It examined many
factors in over 8000 Japanese men
residing in Hawaii from 1965 to
1968. Specifically, the study investigated
the association between cardiac
event outcomes and lifestyle
factors like smoking and drinking,
including an item for coffee. A 1986
study following up with the data
found that--although the effect size
was small-- there was a statistically
significant impact of higher coffee
consumption on total serum
cholesterol, both of which are
well-established risk factors of
coronary heart disease risk, especially
in men. These studies had to
use a model that took into account
the correlation between smoking
and coffee consumption. This effect
was not present for caffeinated tea
and cola, control sources of caffeine.
In 1991, a prospective cohort study
confirmed this finding, showing
that coffee can be a risk factor in
raising total cholesterol.The researchers
randomly split sixty-four
healthy volunteers into three
groups. One group drank six cups of
non-filtered coffee daily, one group
drank six cups of filtered coffee, and
one group did not drink any coffee.
Non-filtered coffee drinking was
positively correlated with higher
low-density lipoprotein (LDL)
levels. They concluded some
LDL-raising factor is responsible. In
1995, scientists identified a component
in coffee called diterpenes that
are a causative agent of higher
serum cholesterol. These can easily
be filtered out. So does
boiled-and-unfiltered coffee consumption
lead to high cholesterol?
Not necessarily. Many of these
studies were admittedly small
case-control studies and looked at
cholesterol without considering
other effects that also influence
coronary heart disease (CHD) risk
at the population level. A recent
2015 population study found lower
incidence of CHD events in those
who drank coffee than those who
didn’t. Specifically, the graph was a
U-shape, with a declining risk until
the greater than five cups per day
segment had a higher risk than
three to five cups per day segment.
Scientists today know there are
positive effects of moderate coffee
consumption on long-term CHD
risk, perhaps due to antioxidants or
other components or associated
lifestyle factors that go along with
moderate coffee consumption. This
means three to five cups a day is
ideal, with more or less consumption
leading to higher risk within
the population. A 2014 meta-analysis
confirmed a whopping 16
percent reduction in total mortality
in the population associated with
four cups per day, where four was
the ideal number.
Drinking coffee probably won’t
make up for other unhealthy habits.
But there is little reason to stop
moderate consumption as long as it
is filtered. Working from home can
be tough. Whether you’re a morning
person or all hours, hopefully
coffee can be a source of cardiovascular
health in a time of stress.
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