Health Effects Of Coffee: Is It Thumbs Up or Thumbs Down?

Today, the verdict is thumbs up, with study after study extolling the merits of three to five cups of black coffee a day in reducing risk for everything from melanoma to heart disease, multiple sclerosis, type 2 diabetes, Parkinson's disease, liver disease, prostate cancer, Alzheimer's, computer-related back pain and more.

To stay completely healthy with your coffee consumption, you'll want to avoid packing it with calorie laden creams, sugars and flavors. And be aware that a cup of coffee in these studies is only 8 ounces; the standard “grande” cup at the coffee shop is double that at 16 ounces.

And how you brew it has health consequences. Unlike filter coffee makers, the French press, Turkish coffee or the boiled coffee popular in Scandinavian countries fail to catch a compound called cafestol in the oily part of coffee that can increase your bad cholesterol or LDL.

Finally, people with sleep issues or uncontrolled diabetes should check with a doctor before adding caffeine to their diets, as should pregnant women, as there is some concern about caffeine's effect on fetal growth and miscarriage. And some of the latest research seems to say that our genes may be responsible for how we react to coffee, explaining why some of us need several cups to get a boost while others get the jitters on only one.

Patrons of coffeehouses were said to be more likely to gamble and engage in “criminally unorthodox sexual situations,” according to author Ralph Hattox. By 1511 the mayor of Mecca shut them down. He cited medical and religious reasons, saying coffee was an intoxicant and thus prohibited by Islamic law, even though scholars like Mark Pendergrast believe it was more likely a reaction to the unpopular comments about his leadership. The ban didn't last long, says Pendergrast, adding that coffee became so important in Turkey that “a lack of sufficient coffee provided grounds for a woman to seek a divorce.”

As the popularity of coffee grew and spread across the continent, the medical community began to extol its benefits. It was especially popular in England as a cure for alcoholism, one of the biggest medical problems of the time; after all, water wasn't always safe to drink, so most men, women and even children drank the hard stuff.

Local ads such as this one in 1652 by coffee shop owner Pasqua Rose popularized coffee's healthy status, claiming coffee could aid digestion, prevent and cure gout and scurvy, help coughs, headaches and stomachaches, even prevent miscarriages.

But in London, women were concerned that their men were becoming impotent, and in 1674 The Women's Petition Against Coffee asked for the closing of all coffeehouses, saying in part: “We find of late a very sensible Decay of that true Old English Vigour. … Never did Men wear greater Breeches, or carry less in them…”

By 1730, tea had replaced coffee in London as the daily drink of choice. That preference continued in the colonies until 1773, when the famous Boston Tea Party made it unpatriotic to drink tea. Coffeehouses popped up everywhere, and the marvelous stimulant qualities of the brew were said to contribute to the ability of the colonists to work longer hours.

In the mid-1800s America was at war with itself and one side effect is that coffee supplies ran short. Enter toasted grain-based beverage substitutes such as Kellogg's “Caramel Coffee” and C.W. Post's “Postum” (still manufactured). They advertised with anti-coffee tirades to boost sales. C.W. Post's ads were especially vicious, says Pendergrast, claiming coffee was as bad as morphine, cocaine, nicotine or strychnine and could cause blindness.

While inventions and improvements in coffee pots, filters and processing advanced at a quick pace throughout the 1900s, so did medical concerns and negative public beliefs about the benefits of coffee.

Good Housekeeping magazine wrote about how coffee stunts growth. And concerns continued to grow about coffee's impact on common aliments of the era, such as nervousness, heart palpitations, indigestion and insomnia.

In Science Magazine, on September 2, 1927, 80,000 elementary and junior high kids were asked about their coffee drinking habits. Researchers found the “startling” fact that most of them drank more than a cup of coffee a day, which was then compared to scholarship with mostly negative results.

A 1973 study in the New England Journal of Medicine of more than 12,000 patients found drinking one to five cups of coffee a day increased risk of heart attacks by 60% while drinking six or more cups a day doubled that risk to 120%.

Another New England Journal of Medicine study, in 1978, found a short-term rise in blood pressure after three cups of coffee. Authors called for further research into caffeine and hypertension.

A 38-year study by the Johns Hopkins Medical School of more than a 1,000 medical students found in 1985 that those who drank five or more cups of coffee a day were 2.8 times as likely to develop heart problems compared to those who don't consume coffee. But the study only asked questions every five years, and didn't isolate smoking behavior or many other negative behaviors that tend to go along with coffee, such as doughnuts. Or “Doooonuts,” if you're Homer Simpson.

Now begins the era of the meta-analysis, where researchers look at hundreds of studies and apply scientific principles to find those that do the best job of randomizing and controlling for compounding factors, such as smoking, obesity, lack of exercise and many other lifestyles issues. That means that a specific study, which may or may not meet certain standards, can't “tip the balance” one way or another. We take a look at some of the years. The results for coffee? Mostly good.

But first, a negative: A 2001 study found a 20% increase in the risk of urinary tract cancer risk for coffee drinkers, but not tea drinkers. That finding was repeated in a 2015 meta-analysis. So, if this is a risk factor in your family history, you might want to switch to tea.

Some of these data analyses found preventive benefits for cancer from drinking coffee, such as this one, which showed drinking two cups of black coffee a day could reduce the risk of liver cancer by 43%. Those findings were replicated in 2013 in two other studies.

A meta-analysis found a correlation between coffee consumption and lung disease, but the study found it impossible to completely eliminate the confounding effects of smoking.

A meta-analysis of 11 studies on the link between stroke risk and coffee consumption between 1966 and 2011, with nearly a half a million participants, found no negative connection. In fact, there was a small benefit in moderate consumption, which is considered to be three to five cups of black coffee a day. Another meta-analysis of studies between 2001 and 2011 found four or more cups a day had a preventive effect on the risk of stroke.

As for prostate cancer, this 2011 study followed nearly 59,000 men from 1986 to 2006 and found drinking coffee to be highly associated with lower risk for the lethal form of the disease.

More meta-analysis of studies on heart failure found four cups a day provided the lowest risk for heart failure, and you had to drink a whopping 10 cups a day to get a bad association.

For general heart disease a meta-analysis of 36 studies with more than 1.2 million participants found moderate coffee drinking seemed to be associated with a low risk for heart disease; plus, there wasn't a higher risk among those who drank more than five cups a day.

How about coffee's effects on your overall risk of death? One analysis of 20 studies, and another that included 17 studies, both of which included more than a million people, found drinking coffee reduced your total mortality risk slightly.

As a sign of the times, the U.S. Department of Agriculture now agrees that “coffee can be incorporated into a healthy lifestyle,” especially if you stay within three to five cups a day (a maximum of 400 mg of caffeine), and avoid fattening cream and sugar. You can read their analysis of the latest data on everything from diabetes to chronic disease here.

The largest study to date on coffee and mortality surveyed 520,000 people in 10 European countries and found that regularly drinking coffee could significantly lower the risk of death.

Another study with a focus on non-white populations had similar findings. That study surveyed 185,000 African-Americans, Native Americans, Hawaiians, Japanese-Americans, Latinos and whites. The varying lifestyles and dietary habits of the people observed in both studies led the authors to believe that coffee's impact on longevity doesn't have to do with how its prepared or how people drink it — it has to do with the beverage's biological effect on the body.

But stay tuned. There's sure to be another meta-study, and another opinion. We'll keep you updated.