Coffee: could it be good for you after all?

You love your coffee. You’ve never wanted to believe that it’s bad for your bladder, bad for your arteries, and a crutch allowing you to work too hard.

So it’s been great to hear the good news stories about coffee being good for you after all…but can we trust them?

I owe the blog post idea to a friend who reported with delight that he’d heard from an expert on the radio that due to its health benefits, coffee should be drunk at a rate of six cups a day. As someone who quit coffee at age 16, and counsels women regularly to give it up for the sake of their overactive bladder, I agreed with him that this was worth some investigation.

A 2008 study of 30 000 people showed that 6 cups of coffee per day is not linked with increased deaths. Still, knowing that statistically, death is no more likely if I indulge in coffee is not quite enough to convince me to take up the habit. You could say the same about nose-picking.

Unexpectedly, some studies have found a link between coffee consumption and reduced stroke risk (but not if you are not already a regular coffee drinker). Others showed a less risk of developing Alzheimer’s and Parkinson’s disease with coffee drinking. And even more startling, drinking more than 6 or 7 cups a day reduced diabetes risk.

So, there’s no denying there seem to be some positive links between coffee and your health. However, the important thing to remember is that these are associations only – and an association is not the same as a cause-effect relationship.

It’s important not to oversimplify these findings. One theory about the effect on diabetes risk was that coffee contains magnesium, which is important for insulin regulation. This is an oversimplification. In reality, coffee is a diuretic, and by producing more urine, it results in increased loss of magnesium from the body. So if coffee does actually cause positive change (and remember, we can’t prove cause, only association), it isn’t because of this.(And by the way, magnesium has positive effects on your bladder).

Over-focusing on these findings also tends to make us ignore the big picture. It makes scenarios like these possible:

• Despite the fact I have an enormous amount of visceral (abdominal) fat, I believe that drinking coffee will prevent me getting diabetes

• I reach for that seventh cup of coffee because the scientists are telling me it’ll reduce my diabetes risk, but meanwhile, I increase my risk of bladder cancer and possibly osteoporosis

• I deny any harm of my coffee habit – despite the fact I never have a coffee without a cigarette

It also focuses on serious diseases at the expense of general well-being and quality-of-life issues. For example, drinking coffee:

• Increases the excretion or blocks the uptake of numerous essential minerals, such as iron, calcium, zinc and magnesium

• Can reduce the quality of your sleep

• Makes you pee more often, and for some, can make it harder to get to the toilet without leaking

• Stimulates the bowel in some (but not all) people, which could be a good or a bad thing, depending on whether you tend towards diarrhoea or constipation (but is definitely not good if you experience any level of accidental bowel leakage)

Still, a scan of the research literature about coffee proves surprising. There seems to be no link with gout, and no link with bladder pain syndrome/interstitial cystitis. Even when it comes to your bladder control – incontinence and overactive bladder – there is not very convincing research evidence to convict coffee.

What’s the take-home message?

It seems that coffee is not necessarily the demon it is made out to be. It definitely improves your short-term mental performance, and is related in some way to a reduce risk of certain diseases (though we can’t say it directly causes this).

Having said that, research evidence looks at trends in a large population group. It is not the same as discerning an effect for yourself. That’s why I do suggest to all my overactive bladder patients that they have a caffeine-free trial. Many of them notice no difference whatsoever when they cut out coffee. Others notice a startling improvement, which drastically improves their quality of life, and makes it all worthwhile.

This just shows that reporting of research, while essential, does not account for individual variations. Where there’s no risk involved, it’s always smart to test out the hypothesis on yourself. Feel better after a week off coffee? Bladder problems disappear when you lose the coffee? Great. Cut it out. The proof is in the pudding.

If you don’t see the benefits from losing the coffee, then don’t feel guilty about your coffee drinking. But be realistic. You’ll know if you’re using it as a crutch or if it’s linked with other poor health habits like reaching for a cigarette, eating too many biscuits, working too hard or being a couch potato. And please, if you do love your coffee, think about taking magnesium and zinc supplements to make up for your losses.

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