Black Coffee Can Reduce Risk Of Heart Diseases, Diabetes And Many More, But Only With Low Sugar And Fat: Experts

You may not think about the health benefits of coffee every time you drink it in the morning, but a new study suggests that regular and moderate consumption of coffee can reduce the risk of various life-threatening diseases. Researchers at the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University in the United States have found that the amount of sugar and saturated fat added to coffee can affect this benefit.

First Study

This research, published in The Journal of Nutrition, indicates that those who drink 1 to 2 cups of caffeinated coffee daily have a lower risk of death from heart disease. Particularly, drinking black coffee or coffee with low sugar and low fat reduces the risk of all-cause mortality by up to 14 per cent. However, if a large amount of sugar or cream is added to the coffee, this benefit is not observed.

The senior author of the study, Fang Fang Zhang, who is a professor of nutrition at the Friedman School, says that coffee is one of the most consumed beverages in the world. In America, about half of adults drink at least one cup of coffee daily. In such a scenario, it is important to know its effect on health. Our results show that even though the bioactive compounds in coffee may be beneficial, these benefits can be diminished if large amounts of sugar and saturated fat are added to it.

This study is based on an analysis of data from nine cycles of the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018 and mortality data linked from the National Death Index. It used the 24-hour dietary recall records of 46,000 adults in the US (aged 20 years and older). Consumption was classified based on the type of coffee (caffeinated or decaf) and the amount of sugar and saturated fat added to it.

In the study, low sugar is defined as less than 2.5 grams (or half a teaspoon) in an 8-ounce cup and low saturated fat is considered as 1 gram per cup or the equivalent of 5 tablespoons of 2 per cent milk.

We spoke with Dr Piyush Ranjan, Vice Chairperson, Institute of Liver Gastroenterology. Additionally, discussions were also held with Dr Sandeep Mishra, former Director, Department of Cardiology, AIIMS and Dr Amrinder Singh Malahi, specialist, Cardiovascular Radiology & Endovascular Interventions, AIIMS.

We also took the opinion of Dr Pawan Kumar Goyal, Senior Director, Internal Medicine, Fortis Hospital. A conversation on this subject was also held with Dr Bhumesh Tyagi, Consultant - General Medicine and Physician, Sharda Care - Health City.

Second Study

A new report from the American Society for Nutrition highlights the potential health benefits of moderate coffee consumption for the elderly. Studies suggest that drinking coffee may reduce the risk of heart disease, memory decline, Parkinson's disease and type-2 diabetes. The antioxidants and anti-inflammatory compounds present in coffee contribute to these benefits.

Doctors say that drinking too much coffee can increase problems like anxiety, insomnia, or high blood pressure in the elderly. It has also been observed that the effects of coffee can vary depending on the type (black, decaf with milk) and the individual's health condition. Experts suggest that people who are taking regular medications should consume coffee only after consulting their doctor.

Piyush Ranjan, Vice Chairperson, Institute of Liver Gastroenterology and Pancreatico-Biliary Sciences

Coffee is no longer just a beverage; it has become a bioactive dietary complex that has a profound effect on our health. It contains more than 1,000 chemical compounds, the prominent ones being caffeine, chlorogenic acid, trigonelline, kahweol and cafestol. If consumed in limited quantities (up to 3-4 cups daily), it provides several health benefits.

Most of us turn to coffee to overcome tiredness or lethargy during the day. Its main active ingredient, caffeine, stimulates the central nervous system. By blocking adenosine receptors, it increases the secretion of chemicals like dopamine and norepinephrine, which energise the body and mind. The risk of neurodegenerative diseases like Alzheimer's and Parkinson's has been found to be significantly lower among regular coffee drinkers.

Recent research indicates that coffee is also beneficial for the liver. In the liver, caffeine is metabolised by the CYP1A2 enzyme, which produces paraxanthine, theobromine and theophylline. These are all inflammation-reducing compounds.

Drinking coffee slows the progression of non-alcoholic fatty liver disease (NAFLD), reduces the risk of cirrhosis and may lower the probability of liver cancer (hepatocellular carcinoma) by up to 40 per cent. It also reduces liver enzymes (ALT, AST, GGT), which are indicators of liver inflammation and damage.

Coffee also strengthens the gut microbiome, which is the good bacteria in the intestines. The polyphenols and soluble fibre found in it act as prebiotics, which nourish beneficial bacteria like Bifidobacterium and Akkermansia muciniphila.

Coffee improves insulin sensitivity and blood sugar control, especially due to its chlorogenic acid, which slows down glucose absorption in the body and inhibits glucose production in the liver. Research has found that regular coffee consumption can reduce the risk of type 2 diabetes by 20-30 per cent.

Coffee is the biggest source of antioxidants, especially for those whose diet is not varied. Its polyphenols, particularly chlorogenic acid, eliminate free radicals and reduce chronic inflammation, which is the root of many diseases.

Caffeine increases thermogenesis in the body, which expends energy and utilises fat breakdown. Its metabolite, paraxanthine, further enhances fat oxidation, improving body composition and helping with weight control when combined with exercise.

Long-term studies indicate that coffee drinkers have a lower risk of liver, colorectal, prostate and endometrial cancers. The only condition is that excessive sugar or cream should not be added to the coffee. Coffee without much fat or sweetness not only provides freshness in daily life but is also beneficial for everything from the brain to the heart and from the liver to the digestive system.

Drinking 3-4 cups of coffee daily isn't just a pleasant habit; it can also be a powerful tool for maintaining lifelong health. Although coffee has many benefits, young people should be cautious about its excessive consumption. Drinking too much coffee can become an addiction, leading to problems like acidity, rapid heartbeat (palpitations) and anxiety. Therefore, it is better to consume it in moderation.

Dr Sandeep Mishra, former director of AIIMS Cardiology Department

Black coffee is very beneficial for many parts of the body, including the heart. It contains a large amount of antioxidants that slow down the aging process of the body's organs. They also prevent inflammation in the organs. It is important to note that coffee is beneficial only if it is consumed without sugar and milk and in limited quantities.

Dr Amarinder Singh Malahi, Department of Cardiovascular Radiology and Endovascular Intervention, AIIMS, New Delhi

As a doctor and researcher, I believe that the new research emerging about coffee for the elderly is quite interesting and promising. Several large studies indicate that if coffee is consumed daily in moderation, the risk of cognitive decline, heart disease, Parkinson's and even type 2 diabetes can be reduced. The antioxidants and anti-inflammatory compounds present in coffee are likely the reason for these benefits.

Its effect is not the same for everyone. The elderly often have issues like high blood pressure, bone weakness, or sleep problems, so how much and what type of coffee to drink depends on their health. Black coffee, meaning without sugar and cream, is considered the best. And if someone has a problem with caffeine, decaf coffee is a good alternative.

I tell my patients that if they are taking regular medications, they must consult a doctor about how much coffee they should drink. For most people, 2 to 3 cups of coffee a day is safe, but those who complain of restlessness, insomnia, or high blood pressure should reduce the amount.

Overall, if you want to get the benefits of coffee then the most important thing is to maintain balance, take the advice of a doctor and listen to your body. Only then you will enjoy coffee and remain healthy.

Dr Pawan Kumar Goel, Senior Director of Internal Medicine at Fortis Hospital

Does drinking coffee reduce the risk of memory loss and heart disease in the elderly? How reliable is the research done on this?

The claims being made that drinking coffee reduces the risk of memory loss and heart disease in the elderly are supported by several long-term and observational studies.These also have some limitations.

Many cohort studies and meta-analyses indicate that drinking 3-5 cups of coffee daily can lower the risk of memory decline, Alzheimer's and other dementia-related diseases in older adults. This protection is observed in a U-shaped pattern, meaning neither too little nor too much, but moderate consumption provides the most benefit.

The caffeine, antioxidants and anti-inflammatory compounds in coffee may reduce oxidative stress, inflammation and amyloid buildup in the brain. This is considered a potential reason for this benefit. Several long-term studies, like AIBL, show that people who drink more coffee experience less cognitive decline and have lower amyloid accumulation in the brain even after many years.

However, this research is mostly observational, which makes it unclear whether coffee is the direct cause or if other factors (like a healthy lifestyle) could also be responsible.

In the context of heart diseases:

Several studies and meta-analyses have shown that those who drink a moderate amount of coffee have a lower risk of heart disease and death, especially in women. Among those who drink 3-5 cups per day, the risk of death from heart disease has been observed to be about 21 per cent lower. This effect also depends on the individual's physical response (such as genetics, chronic illnesses and interactions with medications). Excessive amounts of coffee can also be harmful.

Does any particular type or quantity of coffee provide health benefits without risks for the elderly?

The right amount and type of coffee for seniors depends on their individual health.

Quantity: 3-5 cups of coffee per day (up to approximately 400 mg of caffeine) is generally considered safe and may help protect against frailty, memory decline and some age-related diseases in the elderly.

- Caffeinated coffee has been found to be more effective in reducing frailty, especially in people who do not smoke.

- These effects are not seen with decaf coffee, but it can be a better option for elderly people with sleep problems, rapid heartbeat or urinary issues.

- Low-acid and low-caffeine coffee is suitable for elderly individuals who experience heartburn or discomfort from regular coffee. These coffees retain their antioxidants but are gentler on the digestive system and the heart.

Additives: There isn't much direct evidence comparing black coffee to coffee with milk or sugar, but adding too much sugar or cream can increase calories, which can be detrimental for people with diabetes or obesity.

Elderly people face many problems with age like high blood pressure, lack of sleep or bone weakness. In such a situation, should the amount of coffee be reduced?

As one ages, coffee intake should be adjusted keeping health concerns in mind.

High Blood Pressure

In regular coffee drinkers, blood pressure has been found to be higher than normal. The risk of uncontrolled high blood pressure has been observed to be higher in those who drink 3 or more cups a day. Such individuals are advised to reduce the amount of coffee or stop it completely.

Sleep-related problems

Caffeine affects sleep quality and duration, especially in the elderly and people with dementia. Avoiding coffee in the afternoon and evening has been shown to improve sleep. It was found in some elderly women that sleep complaints increased after they stopped drinking coffee. Therefore, it is person-dependent. The general advice is to drink coffee only in the morning and to keep the quantity limited.

Bone weakness

In elderly women, a daily intake of more than 300 mg of caffeine has been linked to a rapid loss of bone density in the spine. This is a particular concern for people with pre-existing weak bones.

For the elderly, it is better to limit caffeine to 50-100 mg per day (approximately one cup of coffee), especially for those with high blood pressure or bone weakness. Coffee should be consumed in the morning so that it does not affect sleep. Determine the quantity according to your own tolerance.

What precautions are necessary for elderly people who drink coffee regularly and are already on medications or suffering from any chronic disease?

Such elderly people should take the following precautions:

Limit caffeine intake

- Limit caffeine intake keeping in mind health conditions like high blood pressure, bone weakness, frequent urination.

- Generally, less than 400 mg of caffeine should be consumed per day, but this amount may be even lower for the elderly.

Beware of drug interactions:

Coffee can reduce the absorption rate of some medications, such as thyroid medicine, tricyclic antidepressants and phenothiazines, by up to 55 per cent. Do not drink coffee for one hour before and two hours after taking these medicines.

Coffee can enhance the effect of some medications, such as asthma drugs or stimulants, which can lead to nervousness or an increased heart rate. Coffee can also affect blood thinners, diabetes medications and drugs that are metabolized in the liver.

Precautions for old diseases:

- People with heart disease are at risk of irregular heartbeat and increased blood pressure.

- Coffee increases the loss of calcium through urine, which can worsen bone weakness. Such patients are advised to take less than 300 mg of caffeine.

- Coffee can aggravate gastric problems (acidity, ulcers, IBS).

- You should avoid coffee if you have frequent urination problems.

Prevention of sleep disturbance:

With age, the metabolism of caffeine slows down, so coffee stays in the body for a longer time. If consumed late in the day, it can disturb sleep. It is better to have coffee in the morning.

Avoid dehydration:

Coffee is a mild diuretic, so it cannot replace water. The elderly should drink plenty of water throughout the day.

Consider decaf coffee:

Decaf coffee can be a better option for the elderly who are highly sensitive, on medication, or suffering from chronic diseases.

Caffeine Addiction and Withdrawal Symptoms:

Reduce coffee intake gradually to avoid withdrawal symptoms like headaches and irritability.

Do not drink coffee with burnt or over-roasted food:

Consuming coffee with such foods increases the risk of absorbing harmful substances. Lightly roasted or boiled foods are better.

Consult a doctor:

When starting any new medication or undergoing treatment for a chronic illness, be sure to consult your doctor about coffee consumption.

Dr Bhumesh Tyagi, Consultant - General Medicine & Physician, Sharda Care - Health City

Does Limited coffee consumption protect the elderly from memory and heart diseases?

Yes, several studies have revealed that drinking a moderate amount of coffee – meaning 3 to 5 cups daily – can reduce the risk of heart disease. A large meta-analysis (which included more than 1.2 million people) found that moderate consumption of coffee is protective against heart disease, but drinking excessive amounts does not provide additional benefits.

Several review reports indicate that consuming 100 to 400 milligrams of caffeine per day may reduce the risk of diseases like Alzheimer's and help preserve memory for a longer time in the elderly. A long-term study named AIBL found that people who drink coffee regularly have less accumulation of the harmful 'amyloid' protein in their brains and their memory declines at a slower rate.

However, all these studies are 'observational,' meaning no medication or intervention was involved. Therefore, it cannot be said that coffee itself is the cause of these benefits. For the elderly, coffee can be part of a supportive lifestyle, but it cannot be a substitute for essential things like exercise, a balanced diet, blood pressure control and quitting smoking.

Do a specific type or amount of coffee provide more benefits, especially in the elderly?

Ideal amount: 2 to 4 cups per day (200–400 mg caffeine) is considered most suitable for the elderly. It can reduce the risk of frailty and mortality.

Type of coffee: Black coffee or coffee with a little milk is the best option as their antioxidants are preserved. For people who have problems with caffeine, decaf (caffeine-free) can also be beneficial.

Avoid sweet coffee: Adding too much sugar or cream reduces the benefits of coffee. If needed, use a small amount of sugar or low-fat milk.

Filtered coffee is better: Drip coffee (filtered) reduces compounds like cafestol, which can raise cholesterol.

Be mindful of the time: Drink coffee only in the morning or by afternoon to avoid affecting sleep and blood pressure. Those who have high blood pressure or irregular heartbeats should choose decaf or light coffee.

The elderly often have high blood pressure, sleep problems, or bone weakness, so is it necessary to change the amount of coffee with age?

High Blood Pressure: Sensitivity to caffeine increases in the elderly. Drinking more than 2-3 cups of coffee can raise BP and cause irregular heartbeats. In such cases, a limited amount or decaf would be appropriate.

Sleep: As one ages, metabolism slows down, due to which a late evening coffee can severely affect sleep. Therefore, avoid coffee after noon.

Bone Health: 4 cups or less of coffee (≤ 400 mg caffeine) does not have a major impact on bones, especially when adequate calcium and vitamin D are consumed. A slight decrease in bone mineral density (BMD) has been observed with higher quantities, especially in men.

Fracture Risk: Drinking a lot of coffee might slightly reduce BMD, but it does not significantly increase the risk of fractures (bone breaks).

Suggestion: For the elderly, it is better to drink 1-3 cups per day (≤ 300–400 mg caffeine) in the morning. Along with this, ensuring an adequate supply of Calcium and Vitamin D is important. If there are any issues related to high blood pressure, sleep, or bones, choose decaf or light coffee.

If an elderly person regularly drinks coffee and also takes medication or suffers from an illness, what precautions should be taken?

Time gap with medicine: Coffee can reduce the effectiveness of many medications, such as those for thyroid, BP, depression, antibiotics,Therefore, maintain a gap of at least 1-2 hours before or after taking these medicines.

Effect on the heart: Caffeine can reduce the effectiveness of beta-blockers or calcium channel blockers, can increase BP and can disrupt heart rhythm, especially in elderly people with high blood pressure.

Diuretic and Dehydration: Caffeine is a mild diuretic, so if someone is taking a diuretic medicine, it can lead to dehydration and electrolyte imbalance. Therefore, drink sufficient water.

Avoid overstimulation: Taking caffeine and other stimulant drugs (like those for asthma or a cold) together can increase anxiety, tremors, lack of sleep and pressure on the heart.

Get personalized advice: Determine the amount and type of coffee according to the individual's condition. Do not drink coffee late in the day, choose decaf or light coffee and be sure to get personalized advice from a doctor.

(This article was translated for The Daily Jagran by Akansha Pandey.)