Thursday, June 14, 2012

Research Update: New Research On Beverages And Health

Coffee consumption and risk of chronic disease in the European Prospective Investigation into Cancer and Nutrition (EPIC)- Germany study.  American Journal of Clinical Nutrition 2012; 95:901-908.

This study of 42,659 men and women from the European Prospective Investigation into Cancer and Nutrition cohort examined the association between coffee consumption and risk of chronic disease, including stroke, cancer, myocardial infarction, and type 2 diabetes.  After approximately 9 years of follow up, subjects consuming 4 or more cups of coffee per day had no increased risk of any disease when compared to those consuming less than 1 cup a day.  In fact, they had a 23% reduced risk of type 2 diabetes.

Take Home Message: Coffee drinking has long been vilified as an unhealthy vice.  However, the research is beginning to mount that at the very least it is not harmful and may even be beneficial to our health.  So if you like a cup of coffee or two in the morning, there is no reason to stop. 

Soda consumption and the risk of stroke in men and women.  American Journal of Clinical Nutrition 2012; 95:1190-1199.

This study takes a look at the association between soda consumption and risk of stroke in a very large group of subjects.  Two cohorts were included in this study: the Nurses’ Health Study (n=84,085) and the Health Professional Follow-up Study (n=43,371).  The women were followed for 28 years and the men were followed for 22 years.  Consuming one of more sodas per day was associated with a 16% higher risk of stroke compared to those who did not drink soda.

Take Home Message: Add stroke to the long list of chronic diseases that are associated with sugar sweetened beverage consumption.  We’ve also seen increases in risk of obesity, type 2 diabetes, hypertension, high cholesterol, and heart disease in heavy soda drinkers.  This is not an ideal beverage choice, to say the least.


Jill Turner said...

Love your blog, thank you for taking the time to put it together! On soda consumption, does the research differentiate between sodas containing sugar and those that are diet/no calorie? As a big diet soda consumer, I always assume the headlines on soda consumption health risks are based on the products that contain sugar and calories. Don’t think it’s likely that I’m ever going to go join a 12-step program for a Diet Coke addiction, but if my stroke risk is genuinely 16 percent higher drinking Diet Coke I’d seriously have to cut back. I suspect my attitude that the studies are talking to me as I’m drinking Diet are pretty prevalent. Thanks!

Dr. Thomas Halton said...

Hey Jill,
Thanks for the kind words and I'm happy you are getting something out of the blog posts. In general, the research does differentiate between regular and diet soda. For example, research from Harvard did not find an association between diet soda and weight gain, type 2 diabetes, or coronary heart disease. Interestingly, they did find an association in this paper between diet soda and stroke. The increased risk was identical to that of sugar sweetened soda; a 16% increased risk of stroke when comparing those who consume 1 or more diet sodas per day to those that don't drink any diet soda. However, in the discussion, the authors advised readers to interpret these results with caution. They mention that there is no clear biologic mechanism for this association and that there was a very small number of cases of hemorrhagic stroke among men consuming one or more diet sodas per day. I generally advise my clients to limit diet soda to one or two servings per week. This level of consumption was not associated with increased risk of stroke in this investigation.

Mike Alves said...

Hi Dr Tom,

How does this study below discussing insulin resistance with coffee consumption relate to the 1st study you commented on regarding coffee consumption up to 4 cups per day?

Am J Clin Nutr. 2008 May;87(5):1254-61.
Caffeinated coffee consumption impairs blood glucose homeostasis in response to high and low glycemic index meals in healthy men.
Moisey LL, Kacker S, Bickerton AC, Robinson LE, Graham TE.

Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada.


p.s. here's the link to the study:

Dr. Thomas Halton said...

Thanks for the comment Mike. I took a look at the article you cited, which shows a reduction in post-prandial glycemic control with coffee consumed before a meal. This was a well designed article that I found an interesting read. Here are my thoughts on how it applies to the latest research on coffee and type 2 diabetes:

1) Caffeine has been shown to increase blood sugar in large doses in previous investigations. This is likely why we perceive a boost in energy after we drink a cup of coffee.

2) The dose is highly relevant here. In the study you cited, the researchers gave subjects a dose of caffeine equivalent to 5 mg of caffeine per kilogram of body weight. I weigh 185 pounds (84.1 kilograms), so if I was in this study, I’d receive 421 mg of caffeine, which is the amount in 6 cups of coffee! This is a huge dose to be drinking at one time. There are many examples of substances that are beneficial in small doses but harmful in large doses. Alcohol comes to mind. A drink a day has proven health benefits, but 6 or more a day and you’ll wreck your health.

3) There are both acute and chronic effects of substances on our bodies. A stimulus may look harmful in the short term, but be beneficial in the long term. For example, physical activity increases blood pressure and heart rate acutely, but lowers them chronically. Coffee may very well do the same thing with our blood sugar.

4) Other substances in coffee may work to counteract the negative effects of caffeine on blood sugar. There are literally hundreds of substances in coffee, including antioxidants and polyphenols. The beneficial effects of these substances on glycemic control may compensate for the negative impact of caffeine.

Therefore, it is more than plausible that caffeinated coffee acutely decreases glycemic control in large doses over the short term, but improves glycemic control in smaller doses over the long term.