I've noticed an intriguing phenomenon over the last several years that I've fondly nicknamed coffee shame.  What is coffee shame?  Thewell-intentioned, but typically misguided, guilt or remorse over one’s coffee consumption.

As I obtain my patients’ full medical and social history, their alcohol, exercise, and green vegetable "habits" rarely seem to provoke the kinds of explanations their coffee consumption so frequently does. "I know I should be drinking less", "I tried so hard to give it up, but I just couldn't do it", and "I've been doing half-caff, that's better, right?"-just a handful of the disclaimers that patients tend to lead in with.  

All of this coffee shame, combined perhaps with my personal love for the age-old brew, has prompted me to attempt to set the record straight.  In the wise words of Clark Gable, “I never laugh until I’ve had my coffee.”  So here are some facts about coffee to smile about. The proven benefits of low to moderate coffee consumption are plentiful.  I have listed them below for you.  Of note, low to moderate is defined as less than three eight-ounce cups per day.

Benefits:

• Increase in alertness and ability to concentrate

• Decreased risk of Parkinson's disease

• Slightly lower or delayed risk of Alzheimer's disease

• Decreased risk of Type 2 Diabetes

• Improvement in acute headache symptoms

• Modest decrease in constipation symptoms

• Decreased risk of alcoholic cirrhosis

• Slowed progression of liver disease in those with advanced Hepatitis C

• Reduced risk of gout

• Decreased risk of liver cancer

With all of these incredible potential benefits that low to moderate coffee consumption can have, are there downsides?  Well, just like anything that is enjoyable, there are.  The downsides can include:

• Difficulty sleeping

• Increased anxiety and agitation

• Increased risk of cardiac arrhythmias and cardiac events in those that are susceptible

• Physical and/or psychological tolerance or dependence on caffeine

• Caffeine withdrawal symptoms in those that are tolerant or dependent

• Mild elevation in cholesterol when consuming unfiltered coffee (e.g. French press, espresso)

• Slowed growth and even potential risk of miscarriage or preterm birth when consumed in pregnancy (the studies are mixed on this so always ask your OB)

When I explain all of this to my coffee-loving patients, I usually tell them that there are two magic numbers to keep in mind. Those numbers are two and twelve. Try to keep your coffee consumption to two eight-ounce cups per day, and drink those two cups before twelve o'clock noon.  Pushing the limits of what is considered safe intake of anything is never a good idea, and drinking caffeine of any kind in the afternoon often leads to problems sleeping.  I do have several patients that I recommend stop drinking coffee altogether for various health reasons, so it is extremely important to always check in with your doctor before assuming that your cup of joe is a safe habit.  

Allison Fox, M.D.