expert reaction to study looking at coffee, cholesterol, coffee drinker’s sex and coffee brewing method

A study published in Open Heart examines the relationship between self-reported coffee consumption and cholesterol levels.

Senior Cardiac Nurse at the British Heart Foundation, June Davison, stated:

“It is important to remember that this type of study can only demonstrate a correlation and cannot establish a cause-and-effect relationship.

“We must also exercise caution when drawing definitive conclusions, as the researchers did not use a standardised definition of espresso. In addition, they did not account for variables, such as the addition of milk or sugar to coffee, that could have an effect on people’s health. Further research is required to investigate this further.

“If you enjoy a cup of coffee, these findings should not cause you concern; for most people, a moderate amount of coffee is safe. However, you should be cautious if you enjoy adding flavoured syrups or whipped cream, as these can increase your sugar and saturated fat intake. If you are sensitive to caffeine or experience heart palpitations (fluttering or pounding), you should limit your caffeine intake.

Dr. Dipender Gill, NIHR Clinical Lecturer in Clinical Pharmacology and Therapeutics at the University of St. George in London, stated:

“This observational study of over 20,000 participants in the Norwegian city of Troms examines the association between self-reported consumption of various coffee types and cholesterol levels. The variation in the association between coffee consumption and cholesterol levels observed when stratifying the population by gender and method of coffee brewing is intriguing, but caution should be exercised when interpreting causal effects. For instance, the observed differences may be explained by confounding variables that generate spurious associations. Men and individuals with a preference for a particular type of coffee may also have other lifestyle factors that influence their cholesterol levels. In general, it is difficult to infer causation from observational study designs, and randomised clinical trials are typically required for this.”

Dr. Duane Mellor, Registered Dietitian and Senior Teaching Fellow at the Aston University Medical School, stated:

“Although this is an intriguing study, it is important to note that it is cross-sectional, so it does not examine the effect of coffee consumption over time; rather, it merely suggests that consuming more coffee is associated with a higher cholesterol level. It is important to note, as the author does, that the size of a cup of coffee can vary from person to person and from place to place, despite their examination of espresso, plunger, filter, and instant coffee. In Norway, where the study was conducted, espresso cups were found to be larger than in other nations. Also, it’s not just about how the coffee is brewed; heat can also play a role, with higher water temperatures on beans possibly extracting compounds linked to the effects observed with plunger coffee in this and previous studies.

“In other studies examining long-term coffee consumption, perhaps less so with plunger coffee, lower rates of heart disease and type 2 diabetes have been linked to coffee consumption. Importantly, although there was a correlation between total cholesterol and coffee, there was no information on the type of cholesterol or its association with the risk of heart disease.

Coffee may reduce the risk of heart disease and type 2 diabetes, according to some studies. It is also important to remember that what we add to our coffee (such as sugar, syrups, and cream) or eat alongside it in the form of snacks and desserts can have a greater impact on our health.”

Prof. Tom Sanders, Emeritus Professor of Nutrition and Dietetics at King’s College London, stated:

“It is well known that terpinoids (kahweol and cafestol) found in coffee significantly increase blood cholesterol” (more than saturated fat and cholesterol). In the past, residents of Troms consumed large quantities of boiled coffee that was rich in these compounds. The concentrations are lower in expresso coffee, which is frequently prefered by men. Cafetière-prepared coffee has similar concentrations to boiled coffee. The concentrations are low in instant coffee. The Dutch dietary recommendations recommend filtered coffee over other varieties.

“It does not matter what type of coffee you drink if you only consume one or two cups per day, but it does matter if you consume more than that.

“This study reveals associations between coffee consumption and blood cholesterol levels.” It is not a clinical trial, but rather a follow-up to the original Tromso Heart Study, which found that drinking large quantities of boiled coffee in the 1980s was associated with high blood cholesterol. Numerous studies on coffee consumption have demonstrated that coffee terpinoids raise cholesterol levels in both men and women. Rather than a physiological difference, it is more likely that the differences observed between men and women are due to differences in coffee drinking behaviour.”

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