Living Well in Myanmar

Study shows coffee may be good for you, but careful with 3-in-1

Doctors, public health officials and consumers have long wondered about the health risks of coffee. Because coffee is a stimulant, a natural assumption is that drinking too much of it will speed up the body’s metabolic system to the point of causing damage. Interestingly, research hasn’t really supported this concern and may in fact suggest the opposite.

A recent New England Journal of Medicine article looked at 400,000 people aged 50 to 70 and found that the more coffee people drank, the longer they tended to live. Because of the design of the study we can’t tell if the reduced risk of death is specifically because of the coffee, or whether there are other things about the lifestyle of coffee drinkers that are actually conferring the benefit.

The findings correspond with the general trend of coffee research. Low to moderate consumption (up to 3 cups per day) is associated with decreased risk for heart attack, reduced incidence of Parkinson disease and a small, protective effect against Alzheimer disease, depression and diabetes. Although the data is inconclusive and sometimes conflicting, coffee drinking may also be associated with decreased risk of breast, mouth/throat, liver and prostate cancer. In any case, coffee has never been shown to cause any type of cancer.

It’s unclear why coffee seems to confer a health benefit. We know coffee contains antioxidants. Also blood tests of people who have just had coffee show reduced levels of inflammation and better insulin sensitivity. However, the specifics of where and how the molecules in coffee do good things remain unknown

So is there any reason to believe that the people of Myanmar are benefiting from all the coffee and tea that is consumed at street-side shops? Perhaps, but a large proportion of coffee consumed in Myanmar comes from adding hot water to 3-in-1 powder packets that contain coffee, sugar and nondairy creamer. While I’m unaware of any health studies that have evaluated the long-term prognosis for people that drink heavy amounts of 3-in-1, the product is concerning for several reasons.

The proportionally high sugar content in the combo packets may negate some of the benefit of coffee by causing rapid spikes in blood sugar. At the same time, nondairy creamers often contain trans-fatty acids, which allow them to be stable at high temperatures but are known to be dangerous for heart health. In fact, food regulatory agencies in developed countries are currently forcing companies to remove trans-fats from food products. Finally, sugar and non-dairy creamer may reduce the antioxidant concentrations of a cup of coffee.

Even without added fake milk and sugar, drinking coffee comes with some risks. We all know that, in addition to alertness, caffeine can cause anxiety, nervousness, insomnia and irritability. People who drink coffee are more likely to drink alcohol and smoke cigarettes. Heavy caffeine intake is known to cause palpitations (a rapid heart beat) in susceptible individuals, although as mentioned there is no known increased risk of heart disease.

There is a caffeine withdrawal syndrome that occurs in approximately 50 percent of people who suddenly quit a coffee habit. Typically caffeine withdrawal manifests as headache, fatigue, drowsiness, depressed mood and difficulty concentrating. Also, regular caffeine consumption increases the chance of suffering from migraine headaches (paradoxically, a dose of caffeine delivered in a drink or in a pill can be a moderately effective treatment for a headache).

All of the evidence for the benefit of coffee comes from observational studies, meaning scientists ask people questions about their behavior and then try to correlate that with health status. This differs from ‘gold standard’ randomised control trials, in which half the people would be given coffee and the other half would be given fake coffee. Therefore doctors have not reached the point of actively recommending coffee for patients.

Nevertheless, it does appear that coffee is good for you.  Unfortunately the additional ingredients in 3-in-1 are certainly not beneficial and may be harmful. As with many of the public health challenges we face in Myanmar, a strong regulatory agency and consumer awareness will be important in allowing people to safely realise the benefits of coffee.  © Christoph Gelsdorf 2013