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Coffee consumption and its impact on diabetes and cardiovascular disease
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Like most foods in history, coffee has been worshiped and demonized in equal measure in the past decades of the nutritional science boom. In this article, we will reveal what the most recent science tells us regarding the consumption of this grain and its impact on diabetes and cardiovascular disease.
edit time: 14 Dec 23 10:21:53 by sasikarn
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Coffee contains bioactive components that make it enormously attractive in the theoretical framework of our health. In addition to caffeine, which we will talk about later, it contains other micronutrients with antioxidant effects and anti-inflammatory properties.
However, those same compounds that initially seem beneficial have historically been related to an increase in blood pressure and a greater risk of myocardial infarction and hence the beginning of the controversy.
Absorption and metabolism
Caffeine absorption can reach its peak 15 minutes after ingestion and its half-life in adults is 2.5 to 4.5 hours after consumption, although it will depend on many factors. For example, smoking greatly increases the metabolism of its absorption, shortening it by more than 50% while the use of oral contraceptives or even pregnancy can double or triple the half-existence of caffeine in the body.
Coffee or caffeine
Low to moderate doses of caffeine (50 to 300 mg) can cause increased alertness, energy, and ability to concentrate, while higher doses can have negative effects such as anxiety, restlessness, insomnia, and increased sleep, and heart rate.
Still, the science behind coffee points in the direction of a health benefit when consumed between 3-5 cups a day (or an average of 400 mg, thinking that one cup can contain about 95 mg).
But, the question that arises for all of us talking so much about caffeine is Does the benefit come from caffeine, from the plant compounds in the coffee bean or from the whole thing itself?
The truth is that in nutritional sciences it is very complex to want to identify the exact nutrient that produces an effect on health. We are nourished, within a set of global dietary patterns, from whole foods that contain many nutrients in specific amounts and proportions.
It is impossible, and at the same time unrealistic, to dissociate the effect of an isolated nutrient because there may be a synergy with its counterparts.
Coffee and type 2 diabetes
It has been observed that regular coffee consumption is associated with a reduced risk of developing type 2 diabetes. Furthermore, this protective association is dose-dependent, that is, the more coffee, the greater the protection, and even seems to be independent of the caffeine levels.
What exactly happens with caffeine in relation to diabetes?
Well, its consumption initially seems beneficial considering that it is associated with weight loss thanks to two events. On the one hand, it induces greater satiety by reducing appetite and, on the other hand, it increases energy expenditure through an increase in basal metabolism, but also with an increase in food-induced thermogenesis.
It has been specifically observed that the consumption of 6 doses of 100 mg of caffeine daily caused a 5% increase in energy expenditure throughout the day.
The problem with caffeine and type 2 diabetes, regardless of those weight control benefits that we explained, responds to other metabolic aspects. It has been observed that caffeine could reduce insulin sensitivity immediately after consumption.
It is believed that this could be due to an inhibitory effect of this compound on the glucose storage capacity in the muscle. Although, indeed, regular coffee consumption (4-5 cups for 6 months) does not affect insulin resistance.
It is believed that habitual caffeine consumption induces tolerance to it so that the acute negative effects on glucose metabolism are lost. If we add to that the benefits that other coffee compounds can induce, the balance of its consumption remains positive.
Specifically, several animal and human studies find that ingestion of coffee phytochemicals promotes the preservation of functional beta cell mass through improved mitochondrial function, reduced endoplasmic reticulum stress, and prevention or elimination of aggregates of proinsulin or misfolded amylin.
Furthermore, it has been observed that its consumption induces an adaptive cellular response characterized by the de novo synthesis of enzymes involved in cellular defense and repair. An important organ of action for coffee appears to be the liver, which causes better fat oxidation and a lower risk of steatosis.
Coffee and cardiovascular disease
In the same way that there is controversy comparing the acute and chronic effect of caffeine intake on type 2 diabetes, it occurs in cardiovascular diseases. In people who are not regular caffeine consumers, its intake increases systolic and diastolic blood pressure levels in the short term.
The interesting point is that these studies are carried out with isolated intakes of caffeine and that, with similar doses, its negative effect has not been reproduced with coffee consumption, even in people with hypertension.
It is believed that it is possible that other nutrients, such as in this case chlorogenic acid, counteract the effect.
In relation to cholesterol, there is a component found in most coffee selections called cafestol that can produce an increase. The concentration of this harmful element can decrease or increase depending on the type of coffee preparation (increasing LDL and predicting an estimated increase of more than 10% in cardiovascular events).
Thus, the highest concentrations are found in unfiltered coffee; intermediate concentrations in coffee espresso and Italian or Moka coffee makers; and very low in drip-filtered, instant, and percolator coffee.
Coffee and mortality
A recent meta-analysis studied more than eighty thousand cases of patients with type 2 diabetes to compare those who died as heavy coffee consumers compared to those who were not.
It was found that, compared with people who were not consumers, the intake of 4 cups of coffee per day for several years was associated with a hazard ratio of 0.79 and 0.60 for mortality from any cause, mortality from cardiovascular disease or coronary heart disease, and cardiovascular events totals.
Another important aspect is that coffee consumption is associated, among others, with some unhealthy lifestyle habits such as smoking. Therefore, it is important to always control these variables so as not to obtain contradictory and confusing results in the studies.
Specifically, in the evaluation of mortality, the authors found this inverse association between coffee consumption and the risk of death from any cause taking into account the sugar that was added to it.
We must keep in mind that, for example, the addition of two small teaspoons of sugar per coffee with an average consumption of 5 cups per day, corresponds to an intake of 50 grams of added sugar per day, which exceeds all medical-nutritional recommendations. for patients with diabetes and the general population.
Conclusion
Regular consumption of 3 to 5 cups of coffee daily in drip-filtered, instant, or percolator formats without added sugar can provide a beneficial effect to people with type 2 diabetes who are at cardiovascular risk.
Like any dietary decision, other unwanted effects of its consumption must be considered before making its recommendation, among which we can find insomnia, nervousness, gastrointestinal problems, etc.
The decisions that our patients make, for reasons of taste or preference, should also be respected regardless of whether we know the beneficial effect of consuming a food.
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