by Неизвестный
Clinical Depression, Anxiety, and Panic Attacks
While depression is certainly not a female disorder, women account for 76
percent of all doctor visits for this malady. Depression is the single most common psychiatric diagnosis, and it is estimated that nearly 20 percent of American adults will seek medical or psychiatric help for this problem at some point in their lives.
One study demonstrated that chronic, heavy caffeine ingestion can be associated with depression and may also cause anxiety and panic in panic disorder patients—not to mention aggravating the symptoms of PMS. This same study showed that caffeine-sensitive users can have symptoms of caffeinism at relatively low doses, and individuals who consume moderate to heavy amounts of caffeine can have their woes compounded by withdrawal symptoms if they try to quit.50
In a study of agoraphobia and panic attacks, caffeine consumption exacerbated anxiety in 54 percent of the patients and triggered panic attacks in 17 percent. Fifty-one percent of female agoraphobics experienced worsening anxiety symptoms in the premenstrual phased51 When you remember that women with PMS tend to self-medicate by ingesting more caffeine and that the leading pain reliever for menstrual cramps contains caffeine, you can see why this is such a devastating scenario.
Fibrocystic Breast Disease
Millions of women suffer from monthly or chronic pain associated with benign breast lumps. The cause of this condition, known as fibrocystic (or cystic) breast disease, is not known, but research has identified contributing factors, among them caffeine.
The association between caffeine and fibrocystic breast disease was postulated as early as 1945, and since then it has been confirmed by numerous investigators.52–53, 54, 55 In 1979, Dr. John Minton of Ohio State University College of Medicine discovered that women with this condition have abnormally high levels of a chemical messenger known as cyclic adenosine monophosphate (cAMP) in their breast tissue. Since caffeine is known to increase cAMP, Minton conducted an experiment to see if avoidance of caffeine would help.
It did. In fact, 82 percent of the women who strictly avoided caffeine experienced complete disappearance of breast lumps.56 Similar results have been obtained by other researchers,57–58 and in 1997, the American College of Obstetricians and Gynecologists in Washington, D.C., observed that women who eliminate coffee and other caffeinated products tend to see improvement in this painful condition within four to six weeks.59
Breast Cancer
It is well known that fibrocystic breast disease is a risk factor for breast cancer,60
so you would imagine that caffeine would be a risk factor too. But here the research is inconclusive. While animal research has identified a number of worrisome caffeine-related changes in breast tissue and growth61, most human studies have found no correlation between breast cancer and caffeine intake.
Even in studies where there is an apparent connection, researchers question whether there is a true cause-effect relationship.62 At this point, I believe the connection between caffeine and breast cancer is similar to that for other cancers —which, as we have discussed in Chapter 5, is unclear.
Fecundity and Delayed Conception
Fecundity is the likelihood that a sexually active woman using no birth control will conceive. Studies show that consumption of 300 milligrams or more (the equivalent of two mugs of coffee, or one mug and a few cola beverages) has a negative effect on fecundity. In fact, women consuming this common level of caffeine were more than twice as likely to suffer delayed conception of more than a year compared to women who consumed no caffeine.63
In a study reported in Lancet, 104 healthy women who had been attempting to become pregnant for three months were interviewed about their use of caffeinated beverages, alcohol, and cigarettes. In their subsequent cycles, women who consumed more than the equivalent of one cup of coffee per day were half as likely to become pregnant, per cycle, as women who drank less. What’s more, researchers are confident that caffeine was the problem because there was a clear dose-response effect. In other words, the more caffeine the woman consumed, the less likely it was that she would conceive in a given month.64
To explore the issue further, researchers recently pooled data from five European nations over a two-year period and came up with similar results: Caffeine reduces fecundity.65 The intriguing question is, How and why?
Consider the perspective that I’ve used throughout this book: the big picture of evolutionary biology. If Mother Nature’s game plan is survival of the species, why would caffeine reduce fecundity? Could it be that elevated stress hormones send a message to the woman’s body that it might not be the best time to conceive a child? More .research is required to confirm this theory, as well as the multitude of additional issues that have come up regarding caffeine and childbirth. Perhaps the most serious is what happens after conception.
Complications and “Adverse Outcomes” of Pregnancy and
Childbirth
My entire perspective on “adverse outcomes” changed radically the moment my wife became pregnant. Until that moment, I was able to look very scientifically at risk ratios and all the assorted statistics surrounding childbirth. But suddenly, when it was a real child (”my” child) inside the womb of the woman I love, these numbers became meaningless. It didn’t matter how small the risk was. I didn’t care if it was one miscarriage out of 10,000 pregnancies. If that one
didn’t care if it was one miscarriage out of 10,000 pregnancies. If that one miscarriage or stillbirth or birth defect or any other “adverse outcome” could be prevented, I wanted to know about it. I became incensed when reading scientific reports that downplayed the risk associated with caffeine simply because the number of affected babies was small. I wondered how these researchers would explain that statistical concept to the distraught parents.
My wife and I now have two beautiful boys, and as I’m writing this chapter, we’re expecting a third child. I am extremely happy that Deborah never drank a lot of coffee. In fact, she dislikes the taste, doesn’t drink much tea, and rarely touches soft drinks. All this is good news to me, because the more caffeine research I review, the more I am convinced that these beverages should be avoided by anyone who is pregnant.
Actually, that should include women who are even thinking of becoming pregnant, because intake of caffeine prior to conception is also a risk factor.66 It is well established by now that women who consume caffeinecontaining beverages have increased risk for spontaneous abortions (fetal loss), premature deliveries, and delivering infants with low birth weights.67
Miscarriage/Spontaneous Abortion/Fetal Loss
Whatever term you use, this event is a terrible tragedy. And while no one is going to say that caffeine “causes” miscarriage, the drug is a clear and wellunderstood risk factor. One landmark study found that when intake of caffeine from coffee, tea, and soft drinks was combined, the risk of miscarriage related to caffeine was more significant than the risk related to alcohol or smoking.68
An important study published in the Journal of the American Medical Association found that fetal loss (their term for the baby dying in utero) was directly and powerfully related to caffeine consumption before pregnancy.
Women who consumed more than 321 milligrams of caffeine per day before they became pregnant had nearly twice the risk of fetal loss compared to those who consumed less than 48 milligrams per day. Obviously, the risk became worse if the mother continued drinking caffeine during pregnancy. In that case, a 200 percent increase in risk was associated with any caffeine intake over 163
milligrams per day.69
Caffeine is also a major risk factor in late spontaneous abortions, i.e., those occurring at the end of the first trimester or thereafter. The data from the definitive study will surprise you. In all, 80 percent of the women in the study
were consuming caffeine, and nearly 30 percent were consuming more than 150
milligrams daily. Women in this group were far more likely to lose their babies (73 percent inc
reased risk), and in women who had suffered a previous miscarriage, there was over a four-fold (400 percent) risk of spontaneous abortion associated with any intake of caffeine70
Action/Inaction
In 1976, the Center for Science in the Public Interest (CSPI) sent a brief to the Department of Health urging the department to “immediately inform doctors and pregnant women that caffeine may cause birth defects or miscarriages and that women in the first three months of pregnancy should minimize their consumption of … caffeine.” They cited new and compelling data reported in Medical World News that thirteen of fourteen women who drank seven or more cups of coffee per day had experienced “problem pregnancies,” including miscarriages and stillbirths.71
In 1981, the FDA issued an advisory warning that “pregnant women should avoid caffeinecontaining foods and drugs, if possible, or consume them only sparingly.”72 But seventeen years later, this advice is still nearly impossible to follow. Why? Because the caffeine industry refuses to place warnings on their products, and in fact will not even list the caffeine content of foods and beverages.
In fact, the most common advice in print and in person today regarding caffeine and women’s health is still “Caffeine is okay in moderation.” A 1994
medical review of animal and human data actually states that: Maternal coffee or caffeine consumption … does not seem to have measurable consequences on the fetus or the newborn, as long as ingested quantities remain moderate. Therefore, pregnant mothers should be advised to limit their coffee and caffeine intake to 300 mg caffeine/day.73
As you have certainly learned by now, this advice is dangerous, erroneous, and absurd: dangerous because what is moderate for one woman may be clearly excessive for another; erroneous because we know that as little as 100
milligrams of caffeine may increase risk for miscarriage; and absurd because women are consuming foods and beverages with undisclosed amounts of caffeine added to them.
caffeine added to them.
Many members of the medical community refuse to take even a halfhearted stand, as illustrated by this summary published in American Family Physician in 1995:
When women become pregnant, they expect their family physician to answer many questions about potential risks during the pregnancy and possible effects on the developing fetus. … In general, women can be reassured that allergy medications and most common food additives, such as caffeine and aspartame, are safe to use during pregnancy.74
As you have already discovered, nothing could be farther from the truth.
Low Birth Weight
Low birth weight doesn’t just mean you have a small baby. A more accurate term is “fetal growth retardation.” The child has not developed to the extent that he or she should have. Low-birth-weight infants usually have smaller head circumference and are a great deal more at risk for morbidity and mortality (illness and death). This increased risk can extend through infancy, and some say even into adulthood. Babies with fetal growth retardation are often premature, but a baby can be born at term and still have a low birth weight. Caffeine has been shown conclusively to cause fetal growth retardation.75–76, 77, 78
Birth Defects
This is a hotly debated issue. Unlike delayed conception, miscarriage, and low birth weight, there is no clear-cut relationship between caffeine consumption and birth defects. Still, there is evidence on both sides, and the only sensible choice for a pregnant woman is to err on the side of caution and avoid caffeine. After all, data from animal experiments shows a clear relationship between caffeine intake and fetal malformations, especially of the brain and heart. These effects are dose-dependent and detectable at relatively low concentrations.79
There is also the issue of unseen defects that would elude detection but still affect the baby’s health, such as decreased thymic weight (affecting immunity) and degeneration of the lens of the eye. In one animal study, these adverse effects were found in every one of the offspring born to caffeine-fed mothers.80
Equally hidden would be nutritional defects, and the likelihood of this occurrence is very significant. Caffeine fed to female animals causes marked decreases in the iron, copper, and zinc content of their milk.81 This could have serious consequences beyond iron deficiency, in that copper and zinc are critically essential to a newborn’s immune system.
But perhaps the most important (and nondebatable) point to be made regarding caffeine and birth defects is that caffeine potentiates the known teratogenic (defect-inducing) effect of other substances, such as tobacco and alcohol. In addition, it amplifies the blood-vessel-constricting effect of a number of medications (such as headache remedies) and can seriously reduce oxygen delivery to the fetus.82
Caffeine’s Effects on Infants
Infants of mothers with high caffeine consumption often look like newborns withdrawing from other drugs. One study showed that infants born to mothers who were heavy caffeine users during pregnancy exhibited unusual behavior in the immediate newborn period. Predominant symptoms were irritability, jitteriness, and vomiting. The infants had extensive diagnostic studies, and none of the usual causes for such symptoms could be identified. Blood tests, however, revealed the presence of caffeine, and in half of the cases, caffeine was also found in the urine. The symptoms ultimately resolved without medication,
indicating that the infants were suffering from a caffeine withdrawal syndrome after delivery.83
Newborn babies are extremely sensitive to coffee, from whatever source—breast milk, food, or beverages—because they lack the enzymes that break it down. Case studies show that life-threatening poisoning can result from ingestion of less than one gram of caffeine.84
Caffeine and SIDS
Sudden infant death syndrome (SIDS) is the leading cause of death in children between one month and one year old. Once again, there are numerous factors and, once again, caffeine may top the list. I started researching the issue ten years ago when I learned that caffeine was being used, in massive amounts, to treat neonatal apnea. Here is a condition where the newborn has lapses of breathing; and, lo and behold, caffeine stimulates the breathing mechanism and “cures” the apnea.
By now you ought to be pretty good at detective reasoning. We know that when mothers consume caffeine, children can be born with a chemical dependence on the drug. When they are moved to neonatal observation and don’t get the caffeine, they go into withdrawal, which may include … you guessed it, apnea. Then doctors discover that caffeine effectively treats the apnea and marvel at how wonderful this drug is—when all along it’s the cause of the problem!
This scenario is not far-fetched. In fact, recent research has confirmed that in a significant number of cases, this is precisely what’s going on. A report published in the Archives of Disease in Childhood has found that pregnant women who drink more than twenty-four ounces of coffee per day (or the equivalent in soft drinks, tea, and coffee) are far more likely to give birth to infants who succumb to SIDS. The lead researcher, Dr. Rodney Ford, theorized that maternal caffeine use may stimulate the fetal respiratory system unnaturally.
Then after birth, when this stimulation is withdrawn, the baby’s respiratory drive may be inadequate to withstand infection or other stresses.85
Wake Up and Dump the Caffeine!
There’s no denying that women today are pushed to the limit. It’s a rare family that can “make it” on one paycheck. Unfortunately, to cope with the enormous pressures of juggling work and home life, women are turning to caffeine in everincreasing numbers—and consuming everincreasing amounts of this “legal”
drug.
As this chapter has shown, a mountain of evidence proves that women—and their unborn children—are being seriously harmed by the caffeine habit. Still,
the caffeine industry, and much of the medical community, holds to the contention that “moderate” caffeine intake poses no health risk to women.
Loosely defined, “moderate” intake turns out to be 150 to 250 milligrams of caffeine per day. Su
rveys vary as to how much caffeine American women are actually consuming, but one group of researchers found that the mean intake of their study population was 588 milligrams per day!86
What you need to remember is that the danger thresh old is different for each woman. Caffeine’s effects depend on body weight, body composition, menopausal status, menstrual history, and personality. And caffeine is never a single factor. The effect it has (and the damage it does) depends on your stress level plus your diet, lifestyle, and exercise habits.
The bottom line remains: Reducing or eliminating your intake of caffeine can only benefit your overall health and wellbeing. And there’s only one way to find out: Try it for yourself. My Off the Bean program in Chapter 10 has already worked for hundreds of women, who now find that they enjoy better health and get more done, without the stress and destructive effects of caffeine.
A Word about Stress Management
Remember the equation at the beginning of this chapter? Caffeine = Stress. In this chapter I’ve also presented conclusive evidence of the connection between caffeine and depression. So what can you do about it? Simple. Reduce your intake of caffeine.
Every day of your life, you deserve to feel the best you can possibly feel.
Amazingly, both medical and popular advice regarding stress management and depression seldom address the issue of caffeine. I believe that all the support groups and stress management techniques in the world will have limited effectiveness unless you directly confront one of the root causes of the problem: your caffeine intake.
I challenge you to disabuse yourself of the notion that coffee is a relaxing treat you use to reward yourself. The same goes for caffeinated tea and soft drinks. Far greater rewards are yours to discover when you live your life caffeine free.