
Long-Term Coffee Consumption and Risk of Cardiovascular Disease (2013) - cscurmudgeon
http://circ.ahajournals.org/content/early/2013/11/07/CIRCULATIONAHA.113.005925
======
nirv
"Conclusions: [...] Moderate coffee consumption was inversely significantly
associated with CVD risk, with the lowest CVD risk at 3 to 5 cups/d, and heavy
coffee consumption was not associated with elevated CVD risk."

I am confused here (with the word "inversely"). Do I understand correctly
that: a) moderate consumption of coffee leads to a _reduction_ in the risk of
CVD compared to when a person does not drink coffee at all, and b) strong
consumption does not affect CVD risk comparing to the moderate coffee
consumption?

~~~
nabla9
The relative risk vs coffee consumption curve fist goes below 1.0 (no coffee =
1.0) and reaches minimum around 3-5 cups then starts to increase slowly again.
cardiovascular disease and stroke risk go above 1.0 after 9-10 cups per day.

The study mentions that results may not apply to unfiltered coffee (eg, French
press, Scandinavian boiled, or Turkish/Greek coffee). Other studies have shown
that cholesterol-raising factor in coffee does not pass a paper filter.

~~~
semi-extrinsic
> Other studies have shown that cholesterol-raising factor in coffee does not
> pass a paper filter.

And yet other studies are increasingly pointing towards dietary cholesterol
intake _not being such an important causal factor for CVD_ after all [1], and
that _important evidence going against the cholesterol-is-bad theory was never
published properly_ [2] since the people doing the studies thought the data
was flawed since it went against the prevailing theory.

[1]
[http://annals.org/article.aspx?articleid=1846638&atab=7](http://annals.org/article.aspx?articleid=1846638&atab=7)

[2]
[http://blogs.sciencemag.org/pipeline/archives/2016/04/15/fro...](http://blogs.sciencemag.org/pipeline/archives/2016/04/15/from-
the-far-corner-of-the-basement)

~~~
jcims
I was born in the early 70's. It seems like a good many of the dietary
recommendations I was raised on were BS. It's strange.

~~~
mirimir
It's worse than strange. Consider margarine vs butter. I mean, margarine was
promoted during WWII to conserve dairy for the military. And it was later
promoted as healthy. Gotta cut down on those _bad_ saturated fats! Except ...
Except that hydrogenation (to make vegetable oil solid) creates trans
partially saturated fats. Which raise LDL more than saturated fats!

~~~
keithpeter
I've recently taken to just not having any spread on my bread other than the
main ingredient.

Example: toasted slice of yeast bread (my recipe is 50% white, 20% rye, 30%
wholemeal) with jam or with a slice of cheese or hummus or fool maddamas or an
apple. Just no butter/marge/whatever.

I do now have butter and toast a couple of times a week.

~~~
PKop
Giving up the bread and keeping the butter would be the more healthy choice.

~~~
keithpeter
I take the point, and I do cut the carbs quite often when actively losing
weight (actually specifically reducing my waist measurement)

------
js2
No mention of CYP1A2 genotype which affects caffeine metabolism rate. From a
different study (2006):

 _Intake of coffee was associated with an increased risk of nonfatal MI only
among individuals with slow caffeine metabolism, suggesting that caffeine
plays a role in this association. ... The purpose of this study was to
determine whether CYP1A2 genotype modifies the association between intake of
caffeinated coffee and risk of nonfatal MI._

[https://jamanetwork.com/journals/jama/fullarticle/202502](https://jamanetwork.com/journals/jama/fullarticle/202502)

A more recent (2015) report has this conclusion w/r/t CVD:

 _Consistent observational evidence indicates that moderate coffee consumption
is associated with reduced risk of type 2 diabetes and cardiovascular disease
in healthy adults. In addition, consistent observational evidence indicates
that regular consumption of coffee is associated with reduced risk of cancer
of the liver and endometrium, and slightly inverse or null associations are
observed for other cancer sites._

[https://health.gov/dietaryguidelines/2015-scientific-
report/...](https://health.gov/dietaryguidelines/2015-scientific-
report/14-appendix-e2/e2-39a.asp)

This NYT article summarizes and links to a bunch of studies:

[https://well.blogs.nytimes.com/2016/07/12/for-coffee-
drinker...](https://well.blogs.nytimes.com/2016/07/12/for-coffee-drinkers-the-
buzz-may-be-in-your-genes/)

BTW, if you've used 23andme, it should have your CYP1A2 genotype.

~~~
steadicat
I have 23andme, but their results are not very clear. All they say is “You
have two variants associated with consuming more caffeine.” I’m unsure how to
square that with the studies above. Do I have fast or slow metabolism? Do I
have higher or lower risk of MI?

~~~
kyberias
Figure out what is the name of the SNP of the CYP1A2 variant, download your
SNP data from 23andme and look for it yourself.

~~~
kyberias
Actually I can help you out some more. The SNP in question is rs762551.

Go to Tools -> Browse RAW data -> search for rs762551.

It should show something like this:

    
    
      Gene    SNP	    genomic loc  Variants   Your result
      CYP1A2  rs762551  75041917     A or C     ? / ?
    

If you have A/A you're "fast metabolizer". (good) If you have A/C or C/C,
you're "slow metabolizer". (not so good)

From SNPedia:

"In terms of genotypes, only rs762551(A;A) individuals are considered fast
metabolizers. Individuals who are rs762551(A;C) heterozygotes or rs762551(C;C)
homozygotes are both considered slow metabolizers."

------
eloff
I find this result surprising. Caffeine restricts blood vessels, so you'd
expect blood pressure to go up the more you consume, and likewise you'd expect
long-term elevated blood-pressure to increase your risk of cardiovascular
disease.

Likewise in a correlational study, you'd expect people who drink more coffee
to have more hectic lives and get less sleep, which surely shouldn't reduce
your risk of cardiovascular disease.

I'm at a loss for a possible mechanism behind this result. Protective effect
of antioxidants in coffee? Hard to believe.

Nonetheless it seems a great excuse to reach for that second cup when I start
flagging in the early afternoon.

~~~
aportnoy
It very well may be that income is a confounding variable. Being able to
afford 3-5 cups/day means you’re more likely to have a relatively high income,
and thus a better health situation.

~~~
gruturo
First time I was out of Italy I literally could not believe the price of
coffee. And people could not believe me, when I told them how much cheaper it
was in Italy. We’re talking 40 cents vs $2 (recent example I remember both
prices for the same year, circa 2011). So yeah - depends on the country, or
whether you make it yourself, coffee can be extremely cheap. No correlation
between consumption and wealth (esp. in countries like Italy where literallly
everyone drinks it)

~~~
lancebeet
In Italy, the cost of the coffee as a service is much lower than in the rest
of Europe and the USA. Espressos are made much faster and more frequently, the
volume is lower which means they can be drunk quicker, and Italians generally
spend less time in the cafe. Not to mention that in most of Europe, Italian
coffee is served, which is more expensive there than in Italy. Even so, the
cost of the actual coffee is only around 10 cents for quality beans.

~~~
lostlogin
You probably noticed that you pay more if you sit down. Drink at the bar and
it’s usually cheaper.

------
notrlyimportant
I drink tea now, but I used to drink coffee. I'm a T1D (Type 1 Diabetic), so I
get blood-work done quite regularly, BP measurements, etc. I was surprised to
see my BP drop significantly with my switch to mostly black tea (118/78 ->
100/60). I also notice less fluctuations in fasting blood sugars; my A1C is
always between 4.8 and 5.2 FWIW. I feel more hydrated, I'm significantly less
tired and I'm calmer. I have a cup of coffee every now and then, and I'm
amazed at its impact, it's a very intense drink. I believe tea is the
healthier beverage, but that's just me. I drink a lot of tea to compensate for
the caffeine loss (4-6) cups (8oz) a day.

------
ChuckMcM
And of course the study that its good for you :
[http://www.sciencedirect.com/science/article/pii/S0016508514...](http://www.sciencedirect.com/science/article/pii/S0016508514012001)

I see it is already on the Cure or Kill app [http://kill-or-
cure.herokuapp.com/a-z/c](http://kill-or-cure.herokuapp.com/a-z/c)

~~~
trendoid
OP's post is presenting correlation of moderate consumption with lower
Cardiovascular disease and no correlation with higher consumption. Did you
read the paper?

~~~
ChuckMcM
Hmm, I did read it but I missed the 'inverse' association. This is the second
time in the last 10 days where I've read a paper that presented its conclusion
by asserting a negative. Thanks for the cross check.

------
mrfusion
What about decaf?

~~~
brandon272
I drink almost exclusively decaf these days and wonder if any potential health
benefits shown in these studies are still being imparted. From what I have
been able to tell, the answer is “probably”.

~~~
mrfusion
I mix in a little caff coffee in case I miss the benefits

------
haffi112
What about water consumption? Maybe these coffee drinkers are likely to be
better hydrated than non-coffee drinkers and the effect is not due to coffee
at all?

~~~
ricardobeat
Coffee is known to be diuretic, that’s unlikely to be the case.

~~~
Tharkun
Take that with a grain of salt. Coffee is a diuretic, but unless you're
drinking very strong syrupy stuff, it should contain more water than it makes
you pee.

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jamesdftx
I'm surprised I don't see Guayusa mentioned on HN at all.

~~~
clydethefrog
I am interested! Quick research shows it's related to Mate, does it shares
it's effects? I am interested in buying it, but lots of (local) stores that
sell it don't have it in their inventory any more. To me it raises concerns
over food security for the local populations of Ecuador and Peru. Quinoa comes
to mind.

~~~
jamesdftx
See Runa [0] :)

[0] [http://runa.org/](http://runa.org/)

------
awalias
"Conflict of Interest Disclosures: Dr. van Dam received a research grant from
the Nestec Company. No potential conflicts of interest relevant to this
article were reported."

Guys, Nestec own the world's biggest coffee machine company, Nespresso.

~~~
lostlogin
You surely can’t get a meaningful amount of caffination out of those tiny pods
- even with the Nestles standard manoeuvre of loading them with robusta. Those
steam toys are awful.

------
bradknowles
All good comments here, but I did want to point out that this study was
originally published in 2013, according to that page. The subject line should
be updated to reflect that.

~~~
dang
Changed. Thanks!

------
goptimize
Received August 27, 2013. Revision received October 23, 2013. Accepted October
24, 2013.

Sounds like a trashjournal which would explain pretty much everything.

Correction: not a trash journal, still the review process was super fast

~~~
thijser
Circulation is not a trash journal, but one of the most important publications
in Cardiology. It's surpassed in impact factor only by JACC:
[http://www.scimagojr.com/journalrank.php?category=2705](http://www.scimagojr.com/journalrank.php?category=2705)

~~~
goptimize
this comment included a mistake

~~~
thijser
I think you mixed up Circulation Journal ("Official Journal of the Japanese
Circulation Society",
[http://www.j-circ.or.jp/english/cj/](http://www.j-circ.or.jp/english/cj/))
with Circulation (Journal by the American Heart Association,
[http://circ.ahajournals.org/](http://circ.ahajournals.org/)) The latter is
the source of the coffee article.

~~~
goptimize
thanks for pointing out, I corrected it

------
known
If you're in doubt just take an
[https://en.wikipedia.org/wiki/Enalapril](https://en.wikipedia.org/wiki/Enalapril)
pill once a day

~~~
dominotw
Always a good idea to get your medical advice from internet comments.

