nosh magazine (issue 1) | Page 5

Without doubt caffeine can affect sleep – both the time it takes you to fall asleep and the duration of sleep. But we are not all affected to the same degree. While some can drink a cup coffee at bedtime without adverse effect, others can have a coffee at breakfast and find themselves tossing and turning that night. This can partly be explained by habituation – the more coffee you drink, the less it affects you – but undoubtedly we all have an individual sensitivity to caffeine. In fact there is a gene we can test for which tells you if you are a good caffeine metaboliser or not. For the majority I simply recommend avoiding caffeine from mid-afternoon to prevent any unwanted effect on sleep. Coffee has been shown to be of benefit in the treatment of asthma, probably by acting as a bronchodilator. As far back as the late 1800s there are reports of caffeine being used to assist breathing in asthmatics. More recently two large scale population studies – one in Italy and the other the USA – have found the risk of asthma to be almost 30% lower in coffee-drinkers compared to non-coffee drinkers. Much is made of the antioxidant content of tea, but coffee has in fact been shown to have a greater total antioxidant power than other beverages including green or black tea, herbal tea or cocoa. The types of antioxidants present, and how well they are absorbed, are of course different in each beverage, and it remains to be seen whether those characteristic of coffee really do prove to be protective against chronic diseases such as cardiovascular disease and cancer. Epidemiological studies have failed to come to definitive conclusions about associations between coffee consumption and cardiovascular disease. In part this has been due to confounding where coffee drinking acts as a marker for some other lifestyle factor that is known to increase risk (e.g., smoking). Several studies have found that coffee does increase blood levels of homocysteine. But while homocysteine levels were originally thought to be a risk factor, this has more recently been questioned and opinion is divided. Either way since the effect of coffee is relatively minor it seems unlikely that there is any real effect on risk of cardiovascular disease. As far as coffee consumption and cancer goes, there have been numerous casecontrol and cohort studies to look for an association. A 2,000 review concluded that there was no evidence to suggest a link between moderate coffee consumption and cancer of any site. It seems clear that for both CVD and cancer prevention there are far more important dietary changes to make than trying to cut down your coffee intake. explain how coffee lowers diabetes risk. However not all studies agree and much more research is needed to draw firm conclusions. You might think that the effects of coffee on the gut are unquestionable. But even here there is conflicting evidence. There is certainly evidence that coffee can exacerbate heartburn in some people, although not all. If you suffer regularly you could try switching to decaf as that seems to help some – but again the published research gives conflicting results. Since decaf affects some just as much as regular coffee it seems likely that some other constituent of coffee is the cause. There is no evidence that coffee increases the risk of stomach ulcers or causes indigestion. nosh magazine conclusions cannot be drawn from only two studies but these results have prompted further research. There is better evidence for a link with Parkinson’s disease. A recent meta-analysis of 13 studies to meet the inclusion criteria, demonstrated a 31 per cent reduction in risk of developing Parkinson’s in those who drank coffee compared to those who did not. This reduction in risk was even greater among men and the relationship was linear meaning that the more coffee they drank the lower their risk became. In women the picture was found to be complicated by whether or not hormone replacement therapy was used post-menopause. Consumption of coffee lowered the risk of Parkinson’s in women who did not use HRT, but raised risk in those who did. This suggests there may be some interaction between a component of coffee and exogenous oestrogen use, but we need more research before firm conclusions can be made. Nevertheless taken together these results tell a promising story for the benefits of coffee on the short and long term functioning of the brain. To me the biggest issues with coffee are how you take it and the portion size. What was once a regular size is now a small, and the large size in some coffee chains are bucket-sized. Add to this a shot of syrup (usually equivalent to seven teaspoons of sugar!) and full fat milk or cream, and you have a significant number of extra kilojoules in your day. And that’s before you add the slice of banana bread on the counter. So, my conclusion is, if like me you love your coffee, enjoy one or two in the morning. Take it black or with milk (skim if you’re cutting kilojoules for weight control), and skip the fancy extras and the extra large sized cups. Then, in the afternoon switch to tea. N The other big chronic disease affecting Australians is type 2 diabetes and there may be good news for coffee lovers here. The famous Nurses Health Study in the US reported early in 2006 that moderate consumption of both coffee and decaffeinated coffee may lower the risk of type 2 diabetes in younger and middleaged women. Caffeine could clearly not explain the effect and so researchers are now looking at other constituents of coffee for possible answers. A second study published last year showed positive effects of coffee on several markers of glucose metabolism. Coffee consumption was linked to lower blood glucose levels, both in the fasting and postprandial state, and lower insulin levels. Over time this could www.n4foodandhealth.com 5