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Most but not all problems associated with coffee drinking result from the effects of caffeine. Caffeine is also found in black and green tea, most cola drinks, chocolate, cocoa, the herb guaraná, and some over-the-counter drugs. Although caffeine content varies considerably, fresh brewed coffee typically contains more caffeine than instant coffee and vaguely twice as much as black tea, which in turn contains more caffeine than does green tea. Amounts of caffeine in chocolate and cocoa are significantly lower, and caffeine content of other groups of products varies greatly.
In addition to problems caused by coffee drinking, there may be a few benefits. Some,1 but not all2 studies suggest that coffee drinkers have a lower risk of colon cancer. Caffeine is known to dilate breathing passages3 and has been used as an acute treatment for asthmatic attack when other remedies are unavailable.4 In addition, athletic performance during enduranceexercise appears to be enhanced by caffeine in many athletes,5,6 and caffeine may reduce constipation.7 Coffee drinking has also been linked to reduced risk of suicide in women.8
Warning to pregnant women: Caffeine ingestion during pregnancy has been linked to growth-retardation or low birth weight in infants.9 The risk of spontaneous abortion is also higher in women who consume caffeine.10 Many nutritionally oriented doctors recommend that pregnant women limit their caffeine intake to a maximum of 300 mg (or approximately three cups of coffee) per day.
(The following list is comprehensive, although not necessarily exhaustive. Contact your health care professional for more information.)
Long-term and complete avoidance of caffeine reduces symptoms of fibrocystic breast disease.22,23 Caffeine is found in coffee, black and green tea, some soft drinks, chocolate, cocoa, and a number of over-the-counter drugs. The decrease in breast tenderness can take six months or more to occur after caffeine is eliminated. Breast lumpiness may not go away; however, the pain often decreases.
Many doctors are confused about the effects of caffeine on breast tissue, because at first glance, the research appears contradictory. When researchers tell women to cut back or to eliminate caffeine for less than six months, results are unimpressive.24,25 Moreover, for every study that says fibrocystic disease patients do not drink more coffee than other women,26,27 another study says otherwise.28,29 More important, the original research did not claim that fibrocystic patients drink much coffee—only that they are especially sensitive to the coffee they do drink.
Twins with similar or identical genes should be affected similarly by caffeine. Research has been done studying the effects of caffeine on breast symptoms in twins. In that report, the twin with symptoms was more likely be the coffee drinker.30 This evidence clearly supports the idea that coffee drinking can affect breast symptoms in some women.
Two studies have reported that coffee consumption is associated with increased homocysteine levels.37,38 These findings are consistent with studies that have found both smoking and caffeine consumption to be associated with an increased risk of both cardiovascular disease and osteoporosis.
Caffeine is found in regular coffee, black and green tea, some soft drinks, chocolate, cocoa, and many over-the-counter pharmaceuticals. While not every study has found that caffeine reduces female fertility,48 most doctors of natural medicine recommend that women trying to get pregnant avoid caffeine. Decaffeinated coffee has been linked to spontaneous abortion.49 Some researchers suspect that the tannic acid found in any kind of coffee and black tea may contribute to infertility.50
Coffee interferes with the absorption of iron.53 However, moderate intake of coffee (four cups per day) may not adversely affect the risk of iron-deficiency anemia when the diet contains adequate amounts of iron and vitamin C.54 Black tea contains tannins that strongly inhibit the absorption of the most common form of dietary and supplemental iron (non-heme iron). In fact, this iron-blocking effect is so effective that drinking black tea can help treat hemochromatosis, a disease of iron overload.55 Consequently, individuals who are iron deficient should avoid drinking tea.
In a group of 980 postmenopausal women, lifetime caffeine intake equal to two cups of coffee per day was associated with decreased bone density in those who did not drink at least one glass of milk daily during most of their life.60 However, in 138 healthy postmenopausal women, long-term dietary caffeine (coffee) intake did not associate with bone density.61 Until more is known, postmenopausal women should limit caffeine consumption and consume a total of approximately 1,500 mg of calcium per day (from diet and supplements).
In a study of Chinese women, increasing tea consumption was associated with increasing prevalence of PMS.64 Among a group of college students in the United States, consumption of caffeine-containing beverages was associated with increases in both the prevalence and severity of PMS.65 Moreover, the more caffeine women consumed, the more likely they were to suffer from PMS.66 Therefore, many nutritionally oriented doctors recommend that women with PMS avoid sources of caffeine.
1. Ekbom A. Substantial coffee consumption was associated with a lower risk of colorectal cancer in the general population. Gut 1999;44:597.
2. Hartman TJ, Tangrea JA, Pietinen P, et al. Tea and coffee consumption and risk of colon and rectal cancer in middle-aged Finnish men. Nutr Cancer 1998;31:41–8.
3. Gong H, Simmons MS, Tashkin DP, et al. Bronchodilator effects of caffeine in coffee. Chest 1986;89:335–42.
4. Werbach MR. Nutritional influences on illness. Bronchial asthma part 2: caffeine. Int J Alt Complementary Med 1992;Sept:24 [review].
5. Van Soeren MH, Graham TE. Effect of caffeine on metabolism, exercise endurance, and catecholamine responses after withdrawal. J Appl Physiol 1998;85:1493–501.
6. Kovacs EMR, Stegen JHCH, Brouns F. Effect of caffeinated drinks on substrate metabolism, caffeine excretion, and performance. J Appl Physiol 1998;85:709–15.
7. Brown SR, Cann PA, Read NW. Effect of coffee on distal colon function. Gut 1990;31:450–3.
8. Kawachi I, Willett WC, Colditz GA, Stampfer MJ, Speizer FE. A prospective study of coffee drinking and suicide in women. Arch Intern Med 1996;156:521–5.
9. Fenster I, et al. Caffeine consumption during pregnancy and fetal growth. Am J Public Health 1991;81:458–61.
10. Fernandes O, Sabharwal M, Smiley T, et al. Moderate to heavy caffeine consumption during pregnancy and relationship to spontaneous abortion and abnormal fetal growth: a meta-analysis. Reprod Toxicol 1998;12:435–44.
11. Bruce M, et al. Anxiogenic effects of caffeine in patients with anxiety disorders. Arch Gen Psychiatry 1992;49:867–9.
12. Urgert R, Schulz AGM, Katan MB. Effects of cafestol and kahweol from coffee grounds on serum lipids and serum liver enzymes in humans. Am J Clin Nutr 1995;61:149–54.
13. Superko HR, Bortz WM, Albers JJ, Wood PJ. Lipoprotein and apolipoprotein changes during a controlled trial of caffeinated and decaffeinated coffee drinking in men. Circulation 1989;80:II–86.
14. Nygärd O, Refsum H, Velanb PM, et al. Coffee consumption and plasma total homocysteine: The Hordaland Homocysteine Study. Am J Clin Nutr 1997;65:136–43.
15. Regular or decaf? Coffee consumption and serum lipoproteins. Nutr Rev 1992;50:175–8 [review].
16. Christensen L. Psychological distress and diet-effects of sucrose and caffeine. J Applied Nutr 1988;40:44–50.
17. Greden JF, Fontaine P, Lubetsky M, Chamberlin K. Anxiety and depression associated with caffeinism among psychiatric inpatients. Am J Psychiatry 1978;135:963–6.
18. Kawachi I, Willett WC, Colditz GA, Stampfer MJ, Speizer FE. A prospective study of coffee drinking and suicide in women. Arch Intern Med 1996;156:521–5.
19. Tuomilehto J, Tuomilehto-Wolf E, Virtala E, LaPorte R. Coffee consumption as trigger for insulin dependent diabetes mellitus in childhood. BMJ 1990;300:642–3.
20. Babb RR. Coffee, sugars and chronic diarrhea. Postgrad Med 1984;75:82,86–7.
21. Veien NK, Hattel T, Justesen O, et al. Dermatoses in coffee drinkers. Cutis 1987;40:421–2.
22. Minton JP, Foecking MK, Webster DJT, Matthew RH. Caffeine, cyclic nucleotides, and breast disease. Surgery 1979;86:105–8.
23. Minton JP, Abou-Issa H, Reiches N, et al. Clinical and biochemical studies on methylxanthine-related fibrocystic breast disease. Surgery 1981;90:299–304.
24. Ernster VL, Mason L, Goodson WH, et al. Effects of a caffeine-free diet on benign breast disease: a randomized trial. Surgery 1982;91:263.
25. Allen S, Froberg DG. The effect of decreased caffeine consumption on benign proliferative breast disease: a randomized clinical trial. Surgery 1987;101:720–30.
26. Marshall JM, Graham S, Swanson M. Caffeine consumption and benign breast disease: a case-control comparison. Am J Publ Health 1982;72(6):610–2.
27. Lubin F, Ron E, Wax Y, et al. A case-control study of caffeine and methylxanthines in benign breast disease. JAMA 1985;253(16):2388–92.
28. Boyle CA, Berkowitz GS, LiVoisi VA, et al. Caffeine consumption and fibrocystic breast disease: a case-control epidemiologic study. J Natl Cancer Inst 1984;72:1015–9.
29. Vecchia C, Franceschi S, Parazzini F, et al. Benign breast disease and consumption of beverages containing methylxanthines. J Natl Cancer Inst 1985;74:995–1000.
30. Odenheimer DJ, Zunzunegui MV, King MC, et al. Risk factors for benign breast disease: A case-control study of discordant twins. Am J Epidemiol 1984;120:565–71.
31. Chou T. Wake up and smell the coffee. Caffeine, coffee, and the medical consequences. West J Med 1992;157(5):544–53 [review].
32. Elta GH, Behler EM, Colturi TJ. Comparison of coffee intake and coffee-induced symptoms in patients with duodenal ulcer, nonulcer dyspepsia, and normal controls. Am J Gastroenterol 1990;85(10):1339–42.
33. Pehl C, Pfeiffer A, Wendl B, Kaess H. The effect of decaffeination of coffee on gastro-oesophageal reflux in patients with reflux disease. Aliment Pharmacol Ther 1997;11:483–6.
34. Stampfer MJ, Malinow R, Willett WC, et al. A prospective study of plasma homocysteine and risk of myocardial infarction in US physicians. JAMA 1992;268:877–81.
35. Bostom AG, Silbershatz H, Rosenberg IH, et al. Nonfasting plasma total homocysteine levels and all-cause and cardiovascular disease mortality in elderly Framingham men and women. Arch Intern Med 1999;159:1077-80.
36. Folsom AR, Nieto J, McGovern PG, et al. Prospective study of coronary heart disease incidence in relation to fasting total homocysteine, related genetic polymorphisms, and B vitamins. Circulation 1998;98:204–10.
37. Nygärd O, Refsum H, Ueland PM, Vollset SE. Major lifestyle determinants of plasma total homocysteine distribution: the Hordaland Homocysteine Study. Am J Clin Nutr 1998;67:263–70.
38. Stolzenberg-Solomon RZ, Miller ER 3rd, Maguire MG, et al. Association of dietary protein intake and coffee consumption with serum homocysteine concentrations in an older population. Am J Clin Nutr 1999;69:467–75.
39. Rachima-Maoz C, Peleg E, Rosenthal T. The effect of caffeine on ambulatory blood pressure in hypertensive patients. Am J Hypertens 1998;11:1426–32.
40. Jee SH, He J, Whelton PK, et al. The effect of chronic coffee drinking on blood pressure. A meta-analysis of controlled clinical trials. Hypertension 1999;33:647–52.
41. Wakabayashi K, Kono S, Shinchi K, et al. Habitual coffee consumption and blood pressure: a study of self-defense officials in Japan. Eur J Epidemiol 1998;14:669–73.
42. Hofeldt FD. Reactive hypoglycemia. Metabol 1975;24(10):1193–208.
43. Grodstein F, Goldman MB, Ryan L, Cramer DW. Relation of female infertility to consumption of caffeinated beverages. Am J Epidemiol 1993;137:1353–60.
44. Hatch EE, Bracken MB. Association of delayed conception with caffeine consumption. Am J Epidemiol 1993;138:1082–92.
45. Wilcox A, Weinberg C, Baird D. Caffeinated beverages and decreased fertility. Lancet 1988;ii:1453–6.
46. Williams MA, Monson RR, Goldman MG, et al. Coffee and delayed conception. Lancet 1990;335:1603 [letter].
47. Stanton CK, Gray RH. Effects of caffeine consumption on delayed conception. Am J Epidemiol 1995;142:1322–9.
48. Joesoef MR, Beral V, Rolfs RT, et al. Are caffeinated beverages risk factors for delayed conception? Lancet 1990;335:136–7.
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52. Hollingworth HL. The influence of caffeine on mental and motor efficiency. Arch Psychol 1912;20:1–66.
53. Morck TA, Lynch SR, Cook JD. Inhibition of food iron absorption by coffee. Am J Clin Nutr 1983;37:416–20.
54. Mehta SW, Pritchard ME, Stegman C. Contribution of coffee and tea to anemia among NHANES II participants. Nutr Res 1992;12:209–22.
55. Kaltwasser JP, Werner E, Schalk K, et al. Clinical trial on the effect of regular tea drinking on iron accumulation in genetic haemochromatosis. Gut 1998;43:699–704.
56. Rogers PJ, Richardson NJ, Elliman NA. Overnight caffeine abstinence and negative reinforcement of preference for caffeine-containing drinks. Psychopharmacology 1995;120:457–62.
57. Hernandez-Avila M, Colditz GA, Stampfer MJ, et al. Caffeine, moderate alcohol intake, and risk of fractures of the hip and forearm in middle-aged women. Am J Clin Nutr 1991;54:157–63.
58. Kynast-Gales SA, Massey LK. Effect of caffeine on circadian excretion of urinary calcium and magnesium. J Am Coll Nutr 1994;13:467–72.
59. Harris SS, Dawson-Hughes B. Caffeine and bone loss in healthy postmenopausal women. Am J Clin Nutr 1994;60:573–8.
60. Barrett-Connor E, Chang JC, Edelstein SL. Coffee-associated osteoporosis offset by daily milk consumption. The Rancho Bernardo Study. JAMA 1994;271:280–3.
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63. Feldman EJ, Isenberg JI, Grossman MI. Gastric acid and gastrin response to decaffeinated coffee and a peptone meal. JAMA 1981;246:248–50.
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65. Rossignol AM. Caffeine-containing beverages and premenstrual syndrome in young women. Am J Public Health 1985;75(11):1335–7.
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| Supplement Facts |
Serving Size: 1 Tablet
|Amount Per Serving||%DV|
|Calcium (from Dibasic Calcium Phosphate)||75 mg||8.000%|
**Daily Value (DV) not established.
Ingredients: Stearic Acid, Cellulose Gum, Silica, Magnesium Stearate, Methylcellulose, Glycerin.
Consult your healthcare professional prior to use if you have or suspect a medical condition, are taking prescription drugs, or are pregnant or lactating. Each serving contains as much caffeine as about 2 cups of coffee. Too much caffeine may cause nervousness, irritability, sleeplessness, and occasionally, rapid heartbeat. Do not exceed the recommended intake. Keep out of reach of children.