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"To Drink or Not to Drink"
.... your cup of coffee.

by Dr. C. K. Wong, M.D.

August, 2000
Dr. Wong's advice won't make you live longer, but you'll enjoy a lot more of it less. In the 19th Century R.L. Stevenson wrote The Strange Case of Dr. Jeckyll and Mr. Hyde. Here for the 21st Century is the Strange Case of Dr. Wong vs. Mr. Coffee.

Raise your cup!

A study recently published in the Journal of the American Medical Association suggested that a daily indulgence in coffee may reduce the risk of Parkinson's disease. Parkinson's disease is a disease of the nervous system that causes a slow and gradual loss of motor function. It is estimated (i.e. medical parlance for "we guess") that the prevalence of this disease is between 60 to 187 per 100,000 population. We don't really know what causes this disease, but genetic/hereditary factors probably aren't too important, as only 5% of patients have a family history of the disease. This observation of possible (please notice I say "possible") beneficial, or salutary, effects of coffee comes from a study involving more than 8,000 men of Japanese ethnicity living in Hawaii. There are 102 cases of PD identified. Here is the good news for Java addicts: those men who drink one or two four-ounce cups of coffee a day are half as likely to have PD as the non-coffee drinkers. Those REAL coffee drinkers, who drink 7 or more 4-ounce cups a day are 5 times less likely to have PD than those with tight lips. But, Java addicts, don't get excited too fast, (if you're not already hyped-up by the coffee), in medicine, as in Life, there are always different ways of looking at one thing.

First, if you have already pulled out your calculator and have done a little math, the prevalence of PD in this group of men is greater than 1,200 per 100,000. Something is odd here, though I don't know what. Secondly, caffeine, the stuff you Java addicts are craving, or, have developed a deep appreciation for, is a chemical that, among many other things, affects the so-called dopamine system of the brain. Well, guess what also affects this system? You're right. There is no escaping the truth: amphetamines and cocaine. Got you! In PD, this "dopamine system" suffers from deterioration. Therefore, caffeine may be enhancing the function of the dopamine system, and is treating (as a medicine), or masking the symptoms of the disease. Of course, it is also possible that daily consumption of coffee does somehow preserve and protect the dopamine system against development of PD. Thirdly, this study involves only Japanese men, no women, or other ethnicities of coffee appreciators. On the other hand, since we still have no known way of preventing Parkinson's disease... drink up! a votre sante.

But not so fast!

Watch your blood pressure! Four to five cups of coffee a day may raise your blood pressure by 5 points, an increase that could increase your risk of stroke. Whether coffee would increase the risk of heart attack is not that clear. One would expect so. But the information from a study of more than 121,000 female nurses does not show any relationship between coffee consumption and heart attack (and who is going to argue with 121,000 female nurses high on caffeine? Have you ever tried to argue with one nurse high on caffeine?). But female nurses are, (how should I put this?) special (I want to be able to leave the hospital or my office tomorrow in one piece with my skin intact). Would this observation apply to male nurses? To Japanese-Hawaiian American men? To Caucasian males who's German ancestry traces from Germany to Connecticut to Florida to Texas?

And watch your cholesterol! Coffee consumption has been shown to increase LDL cholesterol, the "bad" cholesterol (think of "lousy" for the "L" in LDL, and "healthy" for the "H" in HDL). It turns out that probably it is the bad stuff in unfiltered coffee that is the main culprit. So, this is not good news for those who appreciate boiled, plunged, or percolated coffee; really bad news for Middle Eastern, Egyptian, and Turkish coffee aficionados. Preparing coffee with good paper or a gold filter would remove most of the offending chemicals that are thought to be the culprit.

So, drink up.... your cup of filtered coffee...

But not so fast!

If you are pregnant, which those Hawaiian Japanese men didn't have to worry about, you may want to limit your coffee appreciation as much as possible. There are some studies that suggest that 6 or more cups of coffee daily increases the risk of miscarriage and low-birth-weight babies. We don't know if lesser coffee consumption would have the same risks or not. Some researchers have criticized that these findings or conclusions are flawed. At any rate, before there is more data, I would say it is prudent to limit your coffee appreciation during pregnancy.

Over the years, there has been much talk about coffee and cancer. The bottom line is, there is no convincing data so far to support a relationship between coffee, caffeine, and cancer. You could relax your grip on that cup a little bit now, but you may not be able to do so due to all that Java in your bloodstream. For women who are concerned about fibrocystic breast disease (some doctors advocate not using the term "disease" for this condition as, although it may be quite annoying, it is a benign condition), there is no evidence that coffee consumption increases the risk of developing a fibrocystic breast condition.

For those who appreciate coffee a lot, or many times a day, it may be a good idea to take calcium supplements, as coffee causes you to eliminate calcium in your urine. Yes, you urinate more calcium if you drink coffee, no kidding.

Now, let us appreciate our one 4-ounce cup of filtered coffee a day. Let us perform this one daily ritual that defies differences in ethnic origins, nationalities, religious believes (at least for most religions), and political bends. Let us appreciate this one thing that we can all do in peace and contentment.

Dr. C. K. Wong, M.D.
August, 2000

Easy to swallow and time-released so you'll think about it later.
From the doctor who is not afraid to tell you what you don't want to hear

More by Dr. C. K. Wong, M.D.

  • "To Drink or Not to Drink"....your cup of coffee
    Dr. Wong's advice won't make you live longer, but you'll enjoy a lot more of it less. In the 19th Century R.L. Stevenson wrote The Strange Case of Dr. Jeckyll and Mr. Hyde. Here for the 21st Century is the Strange Case of Dr. Wong vs. Mr. Coffee.

  • Want to know how much a caffeine addict you are?
    Coffee, tea, CocaCola, chocolate .....
    Instant, brewed, iced ....

  • "Natural" Medicine and the Wild, Wild West

  • Coffee Forum

    .... I want you to know that the Strange Case of Dr. Wong and Mr. Coffee is good. What a concept: a medical doctor who presents, in living black and white, information worth knowing, in terms that make sense; a doctor doesn't come across as somebody auditioning for the part of Henny Penny or somebody with "Starbuck" in their last name. As I am a devout and practicing hypochondriac (and have been so long enough to have picked up a thing or two, and I'm not talking 'things' you take care of with a shooter of penicillin, know what I mean, Bubba, get where I'm comin' from?), I have been exposed to a generous share of the medical "mumbo unless it's jumbo, or perhaps it's gumbo" rap. I can hardly wait until tomorrow morning so I can really kick back and enjoy my one medically-allowed mug of coffee in the a.m. with a clear conscience. (Note: I've used a "gold" filter for years and recommend it without reservation.) - M Jarvis, September 11, 2000

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