Caffeine Blues_ Wake Up to the Hidden Dangers of America's #1 Drug ( PDFDrive )
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thought to the consequences.
My .goal in is to provide you with the facts you need to make informed choices about your own caffeine consumption. Until now, reliable information about caffeine has been unavailable, and there are some intriguing reasons for that. First of all, most people are generally unaware of the amount of caffeine they are ingesting. Manufacturers can add caffeine to any food or beverage they want without disclosing the amount. (More about that in Chapter 7.) Few people know how much caffeine is in a cup of coffee or a can of soda, so they have no way of evaluating the danger. Instead, they rely on what they hear and read in the media, and that information is rarely accurate.
In his landmark review of caffeine and human health, R. M. Gilbert concludes: “If more were known about caffeine’s effects, and if what is known were known more widely, the damage done by caffeine might very well appear to be intolerable”.3
Industry Feathers in the Academic Nest
The caffeine industry has generated a tremendous amount of propaganda and disseminated it successfully throughout the scientific, medical, and public arenas. But you won’t see SPONSORED BY THE CAFFEINE INDUSTRY
stamped across the top. This material is invariably published by foundations and institutes with very academic-sounding names. But the fact is that many of these august bodies are heavily influenced by the caffeine industry, and so are the reports you read and hear.
The International Life Sciences Institute, for example, has been churning out studies and information to government, academic, and public institutions for decades. Few know that it is supported by the caffeine industry. In 1985, the ILSI merged with the prestigious Nutrition Foundation, an organization whose mission statement includes the acknowledgment that it is “created and supported by leading companies in the food and allied industries.” Prominent among the trustees of the combined ILSI/Nutrition Foundation are executives from the Coca-Cola Company, PepsiCo, Hershey Foods, NutraSweet, and Procter &
Gamble.
A Case in Point
If you were curious about the dangers of caffeine, you would undoubtedly come across a brochure entitled What You Should Know about Caffeine. You would find this ubiquitous brochure on information racks in hospitals, pharmacies, public health offices, or in your doctor’s office. It’s available through the mail and on the Internet. What You Should Know about Caffeine is published by the very official-sounding International Food Information Council in Washington, D.C. The brochure does not list sponsors or disclose an industry affiliation.
When I requested specific details of industry sponsorship, I received another glossy color brochure that mentioned nothing about which organizations supply the funds to disseminate all this information.
After pressing the issue through several phone calls, I finally received a list of IFIC “supporters,” including Pepsi-Cola, Coca-Cola, M&M/Mars Candy, NutraSweet, Nestle, Hershey Foods, Frito-Lay, Procter & Gamble, and the Arco Chemical Company. Oddly enough, the IFIC “partners” also included the Association of Women’s Health, Obstetric and Neonatal Nurses; the National Association of Pediatric Nurses Associates and Practitioners; and the Children’s Advertising Review Unit of the Council of Better Business Bureaus, Inc.
This strategy perfectly illustrates the approach of the caffeine industry: aligning itself with professional health organizations and scientific foundations.
What better way to head off criticism that its products are harming the American public?
Is the Information Accurate?
What You Should Know about Caffeine states: “Caffeine does not accumulate in the bloodstream or body and is normally excreted within several hours following consumption.” In fact, only about 1 percent of caffeine is excreted. The remaining 99 percent must be detoxified by the liver, and the removal of the resulting metabolites is a slow and difficult process. In Chapter 3, you will learn that it can take up to twelve hours to detoxify a single cup of coffee.
In fact, the matter of accumulation has never been resolved. Evidence suggests that it may take up to seven days to decaffeinate the blood of habitual coffee drinkers.4 Plus, it can take three weeks or more for the body’s levels of
stress hormones to return to normal. If that’s not accumulation, what is?
All the News That Fits, We Print
Prominent on the first page of What You Should Know about Caffeine is a colored box that states:
Research in relation to cardiovascular disease, reproduction, behavior, birth defects, breast disease and cancer has identified no significant health hazard from normal caffeine consumption.
When I inquired as to exactly what “normal” consumption was, I was told 200 to 300 milligrams per day. As you will soon find out, most American adults ingest that amount before noon.
What about ingestion of more than 300 milligrams of caffeine? The IFIC
doesn’t say a word about that, but in the following chapters you will learn exactly how that much caffeine can damage and even destroy your health. This information has been withheld from you because until now, the loudest voices in the caffeine debate have been connected directly or indirectly to the caffeine industry.
Digging Deeper
When I asked the IFIC for scientific support for their assertion that 300
milligrams of caffeine was perfectly safe, they sent me a report published in Food and Chemical Toxicology. The authors of this report are both employees of the Coca-Cola Company and members of the National Soft Drink Association.5
As you might expect, the report downplays the effects of caffeine in the American diet, using some interesting techniques.
When Is a Cup Not a Cup?
Answer: When it’s a “standard” five-ounce serving. For some reason, the above authors state that a standard serving of coffee equals five fluid ounces. That way they can list the caffeine content as eighty-five milligrams per cup. (Most studies claim that a standard cup of coffee equals six fluid ounces, the amount held by a teacup—which is still far less than almost anyone actually drinks at one time.) Likewise the “standard” soft drink serving is listed as six ounces, when all sodas come in twelve-ounce cans—and soft drink manufacturers are now heavily pushing the twenty-ounce bottle. The caffeine content of soft drinks is listed as eighteen milligrams per six-ounce serving. In reality, soft drinks contain anywhere from forty-five to seventy-two milligrams per twelve-ounce can.
“What Caffeine Problem”?
Caffeine consumption is also downplayed in the study cited above by using per capita figures, which is simply the gross amount of caffeine consumed divided by the total population. The problem, of course, is that not everyone consumes caffeine in equal amounts. Per capita figures may be useful for a discussion of economics, but not of health. If you are supposedly reviewing the safety of a substance, it is absolutely critical to consider the individuals most vulnerable to possible adverse effects.
You’ll find, however, that none of the caffeine industry reports take that approach. Instead, they constantly refer to “mean” values, “average” people, and “normal” consumption. Remember the statistician who drowned trying to wade across a lake with an average depth of three feet? You have to look at reality, which is what you’re going to do in Chapter 2 when you calculate the amount of
which is what you’re going to do in Chapter 2 when you calculate the amount of caffeine you consume.
For a scientist, the word average raises a red flag because average figures are often useless. Even worse, the use of averages is the easiest way to manipulate data. In the coffee research reported in newspapers and magazines, you will invariably see “average consumption figures.” But in a group of people with an average consumption of three cups per day, you’ll find some people who drink no coffee at all, some who drink one to three cups, and some who drink six to ten cups a day. Now this might average out to three cups per person, but what good is this information? The effects of caffeine are very much dose related, and, as you have probably alread
y guessed, the effects of one cup of coffee are quite different from the effects of four or six.
It is important to understand that the caffeine industry’s “average” consumer does not exist. This mythical person, upon whom all their conclusions are based, is neither male nor female, weighs approximately 150 pounds, never experiences excessive stress, has perfectly functioning adrenals and liver, does not use birth control pills or any other caffeine-interacting drugs, consumes less than 300
milligrams of caffeine per day, and eats a well-balanced diet including a variety of foods high in B vitamins, calcium, magnesium, and zinc. Anyone who has a disorder that would be aggravated by caffeine is either dropped from caffeine industry studies or buried under the mountain of “mean” values.
The Search for Truth
For the past eight years, I have conducted a systematic review of the world scientific literature on caffeine. This research has taken some real detective work. It’s difficult to tell what’s really going on at first. After all, I drank coffee for over twenty years, simply because I believed like everyone else that coffee, and caffeine, had no adverse health effects.
I was in for the surprise of my life. The first thing I noticed was that much of the research on coffee was imprecise. The majority of researchers refer to the standard coffee cup as a six-ounce serving, but most people drink from mugs, which contain twelve to fourteen ounces or more. That’s not to mention convenience-store coffee cups, which contain anywhere from twenty to thirtytwo ounces. If you’re like most people, you probably consume far more caffeine than you think you do.
Likewise, many reports on coffee failed to specify the brewing method. Six ounces of drip-filtered coffee contain about 100 milligrams of caffeine, but the same amount of percolated coffee gives you 120 milligrams, and European-style boiled coffee packs in 160 milligrams of caffeine per cup.
I began to see that the caffeine issue is rarely taken seriously. Nearly every researcher starts from the assumption that caffeine is okay. Why? Because, consciously or subconsciously, they are influenced by the fact that they themselves depend on coffee. I have visited the offices of hundreds of scientists, professors, and clinicians. The coffee machine is as much a part of their environment as test tubes and computers. Likewise, the journalists who report health news to the public are usually heavy coffee drinkers. I’m not saying that these people are dishonest, only that information can be biased by the habits of those who make and break the news.
The Great Chain of Caffeine
It is also important to look at the chain of biochemical and behavioral events that caffeine creates, not just the immediate effects. Scientists rigorously adhere to this rule when looking at other drugs, but ignore it when studying caffeine. This error is illustrated graphically by one study on the effects of caffeine on schizophrenic patients, where regular coffee was replaced with decaf.6 The researchers postulated that if caffeine produces detrimental psychoactive effects, the patients should improve when decaf is used instead of regular coffee. They made the switch, the patients did not improve, and so the researchers concluded that caffeine has no effect on psychiatric patients.
What’s wrong with this conclusion? The study ignored the chain of events that result from caffeine withdrawal. Here a group of hospitalized schizophrenic patients, who are used to drinking three to eight cups of coffee a day, are switched to decaf without their knowledge. These people are going to have serious withdrawal reactions, including disorientation, irritability, anxiety, and depression. Obviously, they will not show signs of improvement. How could they? Most of them probably had splitting headaches from caffeine withdrawal!
Yet the research was published and is frequently used to support the erroneous view that caffeine produces no negative psychoactive effects.
It gets worse. These same researchers introduced decaf a second time and did see behavioral improvements. Did they recognize the likelihood of a decreased withdrawal reaction? No way—instead, they stated that these improvements were probably a result of coincidence.
A Matter of Interpretation
I must say right away that I also found investigators who did an excellent job at analyzing the behavioral effects of caffeine ingestion by schizophrenics. One extremely well-designed study documented significant increases in thought disorder and psychosis after caffeine administration. The investigators also found that caffeine increased blood pressure and stress hormone levels in the patient group.7
This is important information for anyone involved in psychiatric care, but how the issue of caffeine and mental health is resolved depends upon which study is read and how the reader wishes to interpret the information. When I brought the latter study to the attention of a leading psychologist, he acknowledged that caffeine can cause significant increases in stress hormone levels but concluded, “A cup of coffee is no more stressful than watching a suspense thriller on TV”.
Can you see the profound error of this response? It looks blindly at the shortterm consequences of caffeine use and ignores the real issue, which is the effects of long-term use. After all, what psychologist would condone the viewing of five suspense thrillers every day, year after year? Yet that analogy accurately describes the body’s hormonal response to regular caffeine consumption.
More Flawed Research: Caffeine and Hypertension
Another common mistake in caffeine research has to do with the relationship of caffeine to hypertension (high blood pressure). I found numerous studies in which hypertensive patients were taken off coffee. After a week or two, when blood pressure did not drop, investigators concluded that caffeine has no significant effect on blood pressure. This is absurd because it may take three weeks or more after withdrawal from caffeine before stress hormones return to normal. Evaluating blood pressure over the first one or two weeks is meaningless.
What’s Real for You?
If you look at the way real people consume coffee and soft drinks, you find, first
of all, that most consume a great deal more than 300 milligrams of caffeine per day. There have been studies that measure the caffeine content of beverages as people actually consume them. One such study, published in Food and Chemical Toxicology, found that the caffeine content of a six-ounce cup of drip, filtered coffee (the type most people drink) ranged from 37 to 148 milligrams.8 A survey conducted by the Addiction Research Foundation found that a “cup” of coffee, as defined by the individual drinker, could contain as much as 333 milligrams of caffeine.9
This conflicting data once again demonstrates that the idea of “normal”
caffeine consumption is meaningless. Some scientific studies suggest that a 170pound man could successfully detoxify 300 milligrams of caffeine over the course of a day without serious damage to his body. Theoretically, this may be possible—but not if he is under any significant degree of stress. Moreover, a 110-pound woman is almost certain to experience significant adverse effects from that amount of caffeine. And for anyone under a great deal of stress, even one cup may be enough to trigger the negative effects of caffeine.
Obviously, caffeine intake needs to be evaluated on an individual basis. In the chapters that follow, you will see that the effects and dangers of caffeine depend upon a host of variables, including gender, weight, age, stress level, general health, and medications. What’s more, caffeine may affect the same person differently at different times. The only way to safeguard your health and the wellbeing of your family is to inform yourself. A great place to start is by taking the “” tests in the next chapter.
CHAPTER 2
Are You Addicited?
How Much Is Too Much?
In the old days, coffee was served in teacups that sit on saucers. That size cup holds six ounces of beverage, which is considered the standard-size cup by researchers and the coffee industry. However, when I ask patients how much coffee they drink and they say, “Oh, no more than three cups a day,” I invariably find that means three mugs a day at fourteen ounces apiece, or the equivalent of
seven cups of coffee. In most coffee shops, a “normal” cup of coffee is fourteen ounces and a large cup is twenty ounces. Thus, one large cup equals 3.3 cups of coffee.
One of my clients told me that he only drank one cup of coffee a day. It turned out to be one of those giant thirtytwo-ounce convenience-store mugs with the vented cover for drinking while you drive. This man (and millions like him) consumed nearly 500 milligrams of caffeine on his way to work on an empty stomach. No wonder there’s so much conflict and tension at the office. By the time they get to work, these coffee-inhaling employees are wired and ready to fly off the handle.
There’s no doubt that the damage done by caffeine is very much dose related.
But it’s impossible to make general, blanket statements about how much caffeine is okay and how much is dangerous, since caffeine’s effects are different for each person. Understanding the effects of your own caffeine ingestion requires self-knowledge and experimentation. As you reflect on the material presented here, most likely you will see yourself in one of the examples or case histories.
As you read, keep an open mind and consider the possibility that how well you live, and even how long you live, depend to a significant degree on the amount of caffeine you consume. This book provides the information you need, but the rest
is up to you.
Obviously, there are many factors affecting longevity and health, but none is easier to modify than caffeine intake. In my clinical practice, I have counseled more than 9,000 patients and kept careful records regarding their compliance and level of success. Of all my recommendations—including weight loss, dietary change, exercise, and stress management—no single factor matched the impact of caffeine reduction.