Smell the Coffee--Just Don’t Drink Too Much
Caffeine.
Hearing the word is enough to make some people jittery, while gulping vast quantities can’t unnerve others.
And the study seesaw doesn’t help. One week, caffeine is OK, even beneficial; the next, it’s not.
In one of the latest thumbs-down studies, researchers at Johns Hopkins University reported last month that women drinking more than three cups of coffee a day were more likely to take at least a year to conceive.
No wonder even die-hards can treat caffeine like an on-again, off-again lover--or that classmate who was often sent to the principal’s office. Fun to hang out with, but potentially dangerous.
Even so, there are good things to say about caffeine consumed in moderation (although defining moderation is something else again). And, if your intake is clearly above the moderate level, there’s reassuring advice about how to cut back. Here, a partial scorecard:
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Caffeine is touted as the thinking person’s drink, a way to boost concentration. “People tell me they can get more done [with caffeine],” says Dr. Denise Sur, a family physician at Santa Monica-UCLA Medical Center and assistant clinical professor of family medicine at UCLA.
It makes sense, since caffeine is a mild central nervous system stimulant--although 56% of respondents surveyed in 1995 by the National Coffee Assn. of the USA also say a cup of coffee is a good way to relax.
In a study published in the journal Appetite in 1994, caffeine improved performance on semantic memory, logical reasoning, recall and recognition memory tasks, according to University of Wales researchers. With some tasks, its effect was even better than the effects of eating breakfast.
But don’t expect too much from that caffeine fix, cautions Tim Kern, a coffee specialist at Starbucks Coffee Co., Seattle. “Coffee helps with repetitive-type tasks and staying alert and awake,” he says, citing studies, but apparently does not boost creativity.
“It probably does improve concentration, but it’s a transient effect,” adds Dr. Mahendr Kochar, chief of hypertension at the Veterans Affairs Medical Center, Milwaukee, who has researched caffeine.
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There are a few--but very few--medical reasons to take caffeine, found not only in coffee but pain relievers, diet pills, sodas and chocolate.
“Caffeine is actually therapeutic for migraine headaches,” Sur says. “If someone is having a classic migraine, caffeine can help. I say that with caution, though, because someone with migraines should not self-dose with caffeine.”
Patients with low blood pressure can also benefit from caffeine, says Kochar. “Coffee helps increase blood pressure and overcome [their] dizziness.”
Certain people, though, should think twice about caffeine intake.
Those with uncontrolled high blood pressure should limit intake to the equivalent of two cups of coffee a day, says Kochar. He allows patients with controlled high blood pressure to consume caffeine “like normal people,” explaining that while caffeine raises blood pressure for a few minutes, “there is not good data on the direct effect of caffeine on blood pressure over a long period of time.”
During pregnancy, caffeine should be minimized or eliminated, as research points to a link between caffeine and miscarriage. In one study, Dr. Claire Infante-Rivard, professor of epidemiology at McGill University, Montreal, followed more than 1,300 pregnant women, comparing the caffeine intake of those who did not miscarry with those who miscarried or whose fetus died. The risk of miscarriage and fetal death increased as more caffeine was consumed.
The best advice, says Infante-Rivard: “not to drink coffee at all during pregnancy.” But one cup a day is probably reasonable, she adds.
Breast-feeding women are wise to stem caffeine intake, too. “Studies show that with two cups or more, you start to see a stimulant effect in the baby,” Sur says.
People suffering from anxiety, panic disorder or sleep problems should cut back or eliminate caffeine, doctors agree. Sur tells patients with ulcers to avoid caffeine and those with coronary artery disease and high cholesterol to minimize consumption.
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So, if you’ve made the cleared-for-caffeine list, how much is OK?
Moderate amounts, doctors agree. But they differ slightly in defining it.
“Anything above four cups is too much,” says Kochar. But he’s talking about 4-ounce cups, not the soup-bowl-size cups served at many coffeehouses or the average 10-ounce coffee mug.
Sur advises stopping at less than three cups of coffee--in 6- or 8-ounce cups--or three types of caffeine, cautioning patients not to overlook the caffeine in teas, sodas (even some clear ones), candies and over-the-counter medicines.
In low doses--20 to 200 milligrams--caffeine can improve feelings of well-being, alertness and energy. (A 5-ounce cup of brewed coffee has 60 to 180 milligrams of caffeine.) At doses of 200 to 800 milligrams, nervousness and anxiety can set in. Doses of 2,000 milligrams and higher can be toxic.
“Everyone metabolizes it differently,” says Kern. Some clear caffeine from their bloodstreams quickly; others take much longer. That helps explain why one person can have a double espresso after dinner and still sleep like a baby but another must cut off the caffeine by noon to get a decent night’s sleep.
Withdrawal symptoms can occur after stopping intakes as low as two cups of coffee a day, according to research by Roland Griffiths, professor of behavioral biology at Johns Hopkins University.
For those unsure whether they’re dependent, Sur asks: “Are you getting headaches at the end of the day if you don’t drink coffee [or other caffeine-containing beverages] in the afternoon?” If so, consider yourself hooked.
Tapering is a better idea than quitting cold turkey, Griffiths says. Caffeine withdrawal is not to be taken lightly. He believes it “should be recognized by the American Psychiatric Assn. as a syndrome severe enough to warrant clinical attention.”
During tapering, headaches, drowsiness, mood changes, muscle pain, flu-like symptoms, anxiety and caffeine craving are common. Simple tasks such as driving a car can be difficult while people are in caffeine withdrawal.
“Probably better than half of people who consume coffee regularly are at risk of withdrawal if they quit,” Griffiths says. “A prudent recommendation is to taper slowly over the course of a week or two,” he says. “Do it empirically; see how you feel.”
But be forewarned: even with the tapering approach, it could be a very miserable 14 days.
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Caffeine, Caffeine Everywhere
Brewed coffee, 1 cup: 50-150 milligrams
Instant coffee, 1 cup: 30-120 mg.
Sweetened coffee mix, 1 cup: 40-80 mg.
Decaffeinated coffee, 1 cup: 2-8 mg.
Brewed tea, 1 cup: 20-100 mg.
Instant tea, 1 cup: 30-70 mg.
Hot cocoa, 5 ounces: 2-20 mg.
Milk chocolate, 1 ounce: 1-15
Dark chocolate, 1 ounce: 5-35 mg.
Mountain Dew, 12-ounce can: 54 mg.
Coca-Cola, regular and diet, 12-ounce can: 46 mg.
Pepsi, regular, 12-ounce can: 38 mg.
Pepsi, diet, 12-ounce can: 36 mg.
Weight control pills, diuretics
and stimulants, per dose: 100-200 mg.
Pain relievers, per dose: 32-100 mg.
Cold/allergy remedies, per dose: 16-30 mg.
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Sources: National Coffee Assn. USA, Specialty Coffee Assn. of America,
PDR Family Guide to Nutrition and Health
