Wednesday, June 06, 2007


My day, like that of many millions of other people, starts with a cup of hot, sweet coffee. The caffeine in it lifts the mood as it sweeps away early-morning inertia. The sugar taken with the coffee is an admirable way of correcting any hypo-glycaemia. I repeat the dose when I reach my office. Is the small luxury of drinking coffee evidence of an addiction to caffeine, popularly supposed to be a noxious chemical and regularly attacked in the health and beauty columns of magazines? Or is it, as I prefer to believe, regularly but falsely maligned, and not only harmless but, when taken in moderate amounts, beneficial to someone's health?

Most doctors have been brought up to believe, as the health and beauty correspondents do, that the world would be a better place without coffee drinking. Doctors mutter darkly that coffee could be responsible for an increased risk of a fast heart rate, other cardiac arrhythmias, high blood pressure and heart attacks. They even hint that it could cause cancers, including cancer of the pancreas.

Few of those who preach against coffee have studied the evidence. If they did, they might realise that many of the stories that have circulated about coffee since it was discovered 1,300 years ago in the Middle East are myths. Recent research has suggested that for most people it is clinically harmless, and for many medically helpful. The latest benefit attributed to coffee is its ability to reduce the levels of uric acids in the blood, cutting the number of attacks of gout that periodically afflict some people. This conclusion resulted from work at the Harvard School of Public Health, the Women's Hospital, Harvard Medical School and the Canadian Arthritis Research Centre at the University of British Columbia.

The evidence that research teams have collected and analysed on the benefits of coffee for gout sufferers has been published in the latest issue of Arthritis and Rheumatism. The conclusion was that drinking four or more cups of coffee a day dramatically reduces the risk of gout in men.

[Drama is in the eye of the beholder. Only 1.6% of the sample got gout so for most people drinking coffee or not is irrelevant. It should also be noted that decaffeinated coffee was recorded as having similar effects. What it means that most gout sufferers did not drink much coffee is however entirely speculative. Perhaps it just means that they preferred drinking port!]

The study was based on the analysis of people drawn from the 50,000 health professionals whose medical condition has been carefully followed for the past 12 years.

Other university work includes a smaller study of 757 patients who had been found to be suffering from gout. Researchers assessed the risk of having attacks of acute gout and related this to the amount of coffee drunk. The likelihood of an attack of gout was 40 per cent lower in those patients who drank four to five cups of coffee, but reduced by a dramatic 59 per cent for those who drank six or more cups daily.

Nearly all the myths surrounding coffee that have terrified its drinkers over the years have been exploded. For example, a former patient of mine told me this week that his father had forbidden him to have coffee as it caused liver cirrhosis. An old belief, but absolute nonsense. Six years ago Dr Arthur Klatsky, a well-known American research physician, and other investigators showed that coffee, but no other caffeine-based drink, tended to delay the onset of alcoholic and nonalcoholic cirrhosis.

Eight years ago research published in the Journal of the American Medical Association indicated that coffee drinking reduced the incidence of gallstones and gall bladder disease. More recently, it has also been shown to lessen the likelihood of developing type 2 diabetes.

Harvard studies have cleared coffee of the frequent charge that it increases the chances of strokes and heart attacks. Now there is convincing evidence that it certainly has no adverse effect on the heart attack or stroke rate, but shows a slight benefit. However, the advantage of taking it as a cardio-protective drug is so small that it is safer to describe its influence as neutral.

Nor has there ever been any evidence that coffee causes cancer. Its influence on rectal cancer has been debated for many years but the current opinion is if it has one, it is likely to be beneficial.

Is there such a thing as too much coffee? It is probably safer to take coffee and all other pharmacologically active substances in moderation, but three or four cups are unlikely to hurt anyone. As it increases alertness and sensitivity, it would be as well to avoid it altogether if you have insomnia, or a heart rate that behaves erratically when stimulated in other ways. Pregnant women should also take it in strict moderation. Everyone else should enjoy their early-morning coffee. It's not a vice but a pleasure. As they drink it, they should remember that it even reduces the suicide rate in women.


The flavonol crusade continues

The wonders of flavonols seem to be most promoted in connection with chocolate but double-blind studies have not borne out the epidemiological enthusiasms -- e.g. Farouque HM et al. "Acute and chronic effects of flavanol-rich cocoa on vascular function in subjects with coronary artery disease: a randomized, double-blind, placebo-controlled study." Clinical Science, 2006 . Pesky, isn't it?

Researchers may have the answer: a dietary supplement containing a compound found in common foods like grapes, tea, cocoa, and blueberries, coupled with a little exercise. In a study conducted in mice, animals fed a diet enriched with the compound, known as epicatechin, showed signs of better brain functioning than mice that ate a typical diet. When the supplement was combined with regular exercise, the advantages went up significantly.

The investigators believe epicatechin, which is a type of chemical known as flavonols, helps the brain work better by promoting blood vessel growth in a part of the brain responsible for learning and memory. It may also play a role in developing mature nerve cells. When epicatechin is combined with exercise, it also appears to favorably impact genes important in protecting learning and memory, and dampen down the effect of genes responsible for inflammatory and neurodegeneration.

The researchers plan more studies to confirm the beneficial effects of epicatechin. "A logical next step will be to study the effects of epicatechin on memory and brain blood flow in aged animals," study author Henriette van Praag, Ph.D., of the Salk Institute, was quoted as saying, "and then humans, combined with mild exercise." She and her fellow investigators write in the paper, "An active lifestyle combined with a flavonol-rich diet may prevent aging-related cognitive disorders and/or neurodegenerative disease."



Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

Trans fats:

For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.


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