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Coffee contains several compounds which are known to affect human body chemistry. The coffee bean itself contains chemicals which are psychotropic (in a way some find pleasing) for humans as a by-product of their defense mechanism. These chemicals are toxic in large doses, or even in their normal amount when consumed by many creatures which may otherwise have threatened the beans in the wild.
Coffee contains caffeine, which acts as a stimulant. For this reason, it is often consumed in the morning and during working hours. Students preparing for examinations with late-night "cram sessions" use coffee to maintain their concentration. Many office workers take a "coffee break" when their energy is diminished.
Recent research has uncovered additional stimulating effects of coffee which are not related to its caffeine content. Coffee contains an as yet unknown chemical agent which stimulates the production of cortisone and adrenaline, two stimulating hormones.[1]
For occasions when one wants to enjoy the flavor of coffee with almost no stimulation, decaffeinated coffee (also called ''decaf'') is available. This is coffee from which most of the caffeine has been removed, by the Swiss water process (which involves the soaking of raw beans to absorb the caffeine) or the use of a chemical solvent such as trichloroethylene ("''tri''"), or the more popular methylene chloride, in a similar process. Another solvent used is ethyl acetate; the resultant decaffeinated coffee is marketed as "natural decaf" because of ethyl acetate being naturally present in fruit. Extraction with supercritical carbon dioxide has also been employed.
Decaffeinated coffee usually loses some flavor over normal coffees and tends to be more bitter. There are also coffee alternatives that resemble coffee in taste but contain no caffeine (see below). These are available both in ground form for brewing and in instant form.
Caffeine dependency and withdrawal symptoms are well-documented; see Caffeine for more on the pharmacological effects of caffeine.
Several studies comparing moderate coffee drinkers (about 2 cups a day) with light coffee drinkers (less than one cup a day) found that those who drank more coffee were significantly less likely to develop Alzheimer's disease later in life. [2][3]
Drinking caffeinated coffee has been correlated with a lower incidence of gallstones and gallbladder disease in both men[4] and women[5] in two studies performed by the Harvard School of Public Health. A lessened risk was not seen in those who drank decaffeinated coffee.
A study comparing heavy coffee drinkers (3.5 cups a day) with non-drinkers found that the coffee drinkers were significantly less likely to contract Parkinson's Disease later in life. [6]. Likewise, a second study found an inverse relationship between the amount of coffee regularly drunk and the likelihood of developing Parkinson's Disease. [7]
Many people drink coffee for its ability to increase short term recall and increase IQ[8].
Likewise, in tests of simple reaction time, choice reaction time, incidental verbal memory, and visuospatial reasoning, participants who regularly drank coffee were found to perform better on all tests, with a positive relationship between test scores and the amount of coffee regularly drunk. Elderly participants were found to have the largest effect associated with regular coffee drinking. [9] Another study found that women over the age of 80 performed significantly better on cognitive tests if they had regularly drunk coffee over their lifetimes. [10]
Coffee contains caffeine, which increases the effectiveness of pain killers, especially migraine and headache medications.[11] For this reason, many over-the-counter headache drugs include caffeine in their formula.
Coffee intake may reduce one's risk of diabetes mellitus type 2 by up to half. While this was originally noticed in patients who consumed high amounts (7 cups a day), the relationship was later shown to be linear.[12]
Coffee can also reduce the incidence of cirrhosis of the liver[13] and has been linked to a reduced risk of hepatocellular carcinoma, a primary liver cancer.[14]
Coffee reduces the incidence of heart disease, though whether this is simply because it rids the blood of excess lipids or because of its stimulant effect is unknown.
Coffee is also a powerful stimulant for peristalsis and is sometimes considered to prevent constipation; it is also a diuretic. However, coffee can also cause loose bowel movements.
Practitioners in alternative medicine often recommend coffee enemas for "cleansing of the colon" due to its stimulus of peristalsis, although mainstream medicine has not proved any benefits of the practice.
Coffee contains the anticancer compound methylpyridinium. This compound is not present in significant amounts in other food materials. Methylpyridinium is not present in raw coffee beans but is formed during the roasting process from trigonelline, which is common in raw coffee beans. It is present in both caffeinated and decaffeinated coffee, and even in instant coffee.[15]
The tannins in coffee may reduce the cariogenic potential of foods. In vitro experiments have shown that these polyphenolic compounds may interfere with glucosyltransferase activity of mutans streptococci, which may reduce plaque formation. In rat experiments, tea polyphenols reduced caries. [16]
Coffee consumption decreased risk of gout in men over age 40. In a large study of over 45,000 men over a 12-year period, the risk for developing gout in men over 40 was inversely proportional with the amount of coffee consumed.[17]
Many notable effects of coffee are related to its caffeine content. Amongst other known negative health associations it is not clear whether these are due to the caffeine or other unidentified compounds (suggesting that these may be modified by switching to decaffeinated coffee).
Many coffee drinkers are familiar with "coffee jitters", a nervous condition that occurs when one has had too much caffeine. It can also cause anxiety and irritability, in some with excessive coffee consumption, and some as a withdrawal symptom. Coffee can also cause insomnia in some, while paradoxically it helps a few sleep more soundly.
Due to its diuretic effect, coffee use can lead to dehydration in some individuals, and as a result, contribute to constipation. [18]
Like tea, coffee causes staining of the teeth.[19]
A recent study by Harvard Med that set out to prove that the caffeine in coffee would put people at risk for high blood pressure ended up rejecting the theory. 155,000 nurses were followed for 12 years and the results showed that large amounts of coffee did not induce a "risky rise in blood pressure"[20]. As a note, this study did not include men.
A February 2003 Danish study of 18,478 women linked heavy coffee consumption during pregnancy to significantly increased risk of stillbirths (but no significantly increased risk of infant death in the first year). "The results seem to indicate a threshold effect around four to seven cups per day," the study reported. Those who drank eight or more cups a day (64 U.S. fl oz or 1.89 L) were at 220% increased risk compared with nondrinkers. This study has not yet been repeated, but has caused some doctors to caution against excessive coffee consumption during pregnancy.[21]
There are also gender-specific effects: in some PMS sufferers it increases the symptoms; it can reduce fertility in women; it may increase the risk of osteoporosis in postmenopausal women; and there may be risks to a fetus if a pregnant woman drinks 8 or more cups a day (48 U.S. fl oz or 1.4 L or more).
Decaffeinated coffee is occasionally regarded as a potential health risk to pregnant women, due to the high incidence of chemical solvents used to extract the caffeine. These concerns have almost no basis, however, as the solvents in question evaporate at 80–90 °C, and coffee beans are decaffeinated before roasting, which occurs at approximately 200 °C. As such, these chemicals, namely trichloroethane and methylene chloride, are present in trace amounts at most, and neither pose a significant threat to unborn children. Women still worried about chemical solvents in decaffeinated coffee should opt for beans which use the Swiss water process, where no chemicals other than water are used.
A 2004 study tried to discover why the beneficial and detrimental effects of coffee conflict. The study concluded that consumption of coffee is associated with significant elevations in biochemical markers of inflammation. This is a detrimental effect of coffee on the cardiovascular system, which may explain why coffee has so far only been shown to help the heart at levels of four cups (20 fl oz or 600 mL) or fewer per day.[22]
The health risks of decaffeinated coffee have been studied, with varying results. One variable is the type of decaffeination process used; while some involve the use of organic solvents which may leave residual traces, others rely on steam.
A study has shown that cafestol, a substance which is present in boiled coffee drinks, dramatically increases cholesterol levels, especially in women. Filtered coffee contains only trace amounts of cafestol.
Polymorphisms in the ''CYP1A2'' gene may lead to a slower metabolism of caffeine. In patients with a slow version of the enzyme the risk for myocardial infarction is increased by a third (2-3 cups) to two thirds (>4 cups). The risk was more marked in people under the age of 59.[23]
A Harvard study over 20 years of 128,000 people published in 2006 concluded that there was no evidence to support the claim that coffee consumption itself increases the risk of coronary heart disease. The study did, however, show a correlation between heavy consumption of coffee and higher degrees of exposure to other coronary heart disease risk factors such as smoking, greater alcohol consumption, and lack of physical exercise.[24] The results apply only to coffee filtered through paper filters, which excludes boiled coffee and espresso, for example. Additionally, the lead researcher on this study acknowledged that subsets of the larger group may be at risk for heart attack when drinking multiple cups of coffee a day due to genetic differences in metabolizing caffeine.
The Iowa Women's Health Study showed that women who consumed coffee actually had fewer cardiovascular disease incidents and lower cancer rates than the general population. For women who drank 6 or more cups, the benefit was even greater. However, this study excluded 35% of its original participants who already had cardiovascular disease and other chronic diseases when the study began. Since participants were all over the age of 55, no good conclusion can be drawn about the long term effect of coffee drinking on heart disease from this study.[25]
1. Klag MJ, Wang NY, Meoni LA, Brancati FL, Cooper LA, Liang KY, Young JH, Ford DE. Coffee intake and risk of hypertension: the Johns Hopkins precursors study. ''Arch Intern Med'' 2002;162:657-62. PMID 11911719.
2. Maia, L., & de Mendonça, A., Does caffeine intake protect from Alzheimer's disease?, ''European Journal of Neurology'', July 2002, 9:4, 377 ([1] accessed Nov 30, 2006)
3. Lindsay, J., ''et al.'', Risk Factors for Alzheimer’s Disease: A Prospective Analysis from the Canadian Study of Health and Aging, Am J Epidemiol 2002; 156:445-453, ([2] accessed Nov 30, 2006)
4. Leitzmann, W.F., ''et al.'', A prospective study of coffee consumption and the risk of symptomatic gallstone disease in men, ''JAMA'' (1999), 281:2106-12
5.
Leitzmann MF, Stampfer MJ, Willett WC, Spiegelman D, Colditz GA, Giovannucci EL., Coffee intake is associated with lower risk of symptomatic gallstone disease in women, ''Gastroenterology'', 2002 Dec;123(6):1823-30
6. Webster Ross, G. ''et al.'', Association of Coffee and Caffeine Intake With the Risk of Parkinson Disease, ''JAMA'', May 24, 2000, 283:20, ([3] accessed Nov 30, 2006)
7. Benedetti M.D. ''et al.'', Smoking, alcohol, and coffee consumption preceding Parkinson’s disease, ''Neurology'', 2000:55, 1350-1358. ([4] accessed Nov 30, 2006)
8. Koppelstaeter F, Siedentopf C, Poeppel T, Haala I, Ischebeck A, Mottaghy F. Influence of caffeine =excess on activation patterns in verbal working memory. Radiological Society of North America, 2005, abstract no LPR06-05 link.
9. Jarvis, M.J., Does caffeine intake enhance absolute levels of cognitive performance?, ''Psychopharmacology'', 2 December, 2005, 110:1-2, 45-52. ([5] accessed Nov 30, 2005).
10. Johnson-Kozlow, M., ''et al.'', Coffee Consumption and Cognitive Function among Older Adults, ''Am J Epidemiol'' 2002; 156:842-850 ([6] accessed Nov 30, 2006)
11. Headache Triggers: Caffeine
12. Salazar-Martinez E, Willet WC, Ascherio A, Manson JE, Leitzmann MF, Stampfer MJ, Hu FB. Coffee consumption and risk for type 2 diabetes mellitus. ''Ann Intern Med'' 2004;140:1-8. PMID 14706966.
13. Klatsky AL, Morton C, Udaltsova N, Friedman GD. Coffee, cirrhosis, and transaminase enzymes. ''Arch Intern Med'' 2006;166:1190-5. PMID 16772246.
14. Inoue M, Yoshimi I, Sobue T, Tsugane S; JPHC Study Group. Influence of coffee drinking on subsequent risk of hepatocellular carcinoma: a prospective study in Japan. ''J Natl Cancer Inst'' 2005;97:293-300. PMID 15713964.
15. COFFEE CAN PREVENT COLON CANCER
16. Touger-Decker, R. & van Loveren, C., Sugars and dental caries, ''American Journal of Clinical Nutrition'', October 2003, 78:4, 881S-892S.
17. Coffee consumption and risk of incident gout in men: A prospective study, , HK, Choi, Arthritis Rheum, 2007
18. Basson, Marc D. , "Constipation" emedicine [7]
19. Watts A. & Addy M., Tooth discolouration and staining: a review of the literature, ''British Dental Journal'', March 24 2001, 190:6 309-316 [8] Accessed Nov 30, 2006
20. William Cromie, "Coffee Gets Cleared of Blood Pressure Risk", ''Harvard Gazette''. November 10 2005 (accessed August 1 2006 at http://www.news.harvard.edu/gazette/2005/11.10/06-coffee.html)
21. Wisborg K, Kesmodel U, Bech BH, Hedegaard M, Henriksen TB. Maternal consumption of coffee during pregnancy and stillbirth and infant death in first year of life: prospective study. ''BMJ'' 2003;326:420. PMID 12595379.
22. Zampelas A, Panagiotakos DB, Pitsavos C, Chrysohoou C, Stefanadis C. Associations between coffee consumption and inflammatory markers in healthy persons: the ATTICA study. ''Am J Clin Nutr'' 2004;80:862-7. PMID 15447891.
23. Cornelis MC, El-Sohemy A, Kabagambe EK, Campos H. Coffee, CYP1A2 genotype, and risk of myocardial infarction.
JAMA. 2006 Mar 8;295(10):1135-41. PMID 16522833.
24. Lopez-Garcia E, van Dam RM, Willett WC, Rimm EB, Manson JE, Stampfer MJ, Rexrode KM, Hu FB. Coffee consumption and coronary heart disease in men and women: a prospective cohort study. ''Circulation'' 2006;113:2045-53. PMID 16636169.
25. Andersen LF, Jacobs DR Jr, Carlsen MH, Blomhoff R. Consumption of coffee is associated with reduced risk of death attributed to inflammatory and cardiovascular diseases in the Iowa Women's Health Study. ''Am J Clin Nutr'' 2006;83:1039-46. PMID 16685044.
Coffee as a stimulant
Coffee contains caffeine, which acts as a stimulant. For this reason, it is often consumed in the morning and during working hours. Students preparing for examinations with late-night "cram sessions" use coffee to maintain their concentration. Many office workers take a "coffee break" when their energy is diminished.
Recent research has uncovered additional stimulating effects of coffee which are not related to its caffeine content. Coffee contains an as yet unknown chemical agent which stimulates the production of cortisone and adrenaline, two stimulating hormones.[1]
For occasions when one wants to enjoy the flavor of coffee with almost no stimulation, decaffeinated coffee (also called ''decaf'') is available. This is coffee from which most of the caffeine has been removed, by the Swiss water process (which involves the soaking of raw beans to absorb the caffeine) or the use of a chemical solvent such as trichloroethylene ("''tri''"), or the more popular methylene chloride, in a similar process. Another solvent used is ethyl acetate; the resultant decaffeinated coffee is marketed as "natural decaf" because of ethyl acetate being naturally present in fruit. Extraction with supercritical carbon dioxide has also been employed.
Decaffeinated coffee usually loses some flavor over normal coffees and tends to be more bitter. There are also coffee alternatives that resemble coffee in taste but contain no caffeine (see below). These are available both in ground form for brewing and in instant form.
Caffeine dependency and withdrawal symptoms are well-documented; see Caffeine for more on the pharmacological effects of caffeine.
Benefits
Reduced risk of Alzheimer's disease
Several studies comparing moderate coffee drinkers (about 2 cups a day) with light coffee drinkers (less than one cup a day) found that those who drank more coffee were significantly less likely to develop Alzheimer's disease later in life. [2][3]
Reduced risk of gallstone disease
Drinking caffeinated coffee has been correlated with a lower incidence of gallstones and gallbladder disease in both men[4] and women[5] in two studies performed by the Harvard School of Public Health. A lessened risk was not seen in those who drank decaffeinated coffee.
Reduced risk of Parkinson's disease
A study comparing heavy coffee drinkers (3.5 cups a day) with non-drinkers found that the coffee drinkers were significantly less likely to contract Parkinson's Disease later in life. [6]. Likewise, a second study found an inverse relationship between the amount of coffee regularly drunk and the likelihood of developing Parkinson's Disease. [7]
Cognitive performance
Many people drink coffee for its ability to increase short term recall and increase IQ[8].
Likewise, in tests of simple reaction time, choice reaction time, incidental verbal memory, and visuospatial reasoning, participants who regularly drank coffee were found to perform better on all tests, with a positive relationship between test scores and the amount of coffee regularly drunk. Elderly participants were found to have the largest effect associated with regular coffee drinking. [9] Another study found that women over the age of 80 performed significantly better on cognitive tests if they had regularly drunk coffee over their lifetimes. [10]
Analgesic enhancement
Coffee contains caffeine, which increases the effectiveness of pain killers, especially migraine and headache medications.[11] For this reason, many over-the-counter headache drugs include caffeine in their formula.
Antidiabetic
Coffee intake may reduce one's risk of diabetes mellitus type 2 by up to half. While this was originally noticed in patients who consumed high amounts (7 cups a day), the relationship was later shown to be linear.[12]
Antineoplastic
Coffee can also reduce the incidence of cirrhosis of the liver[13] and has been linked to a reduced risk of hepatocellular carcinoma, a primary liver cancer.[14]
Cardioprotective
Coffee reduces the incidence of heart disease, though whether this is simply because it rids the blood of excess lipids or because of its stimulant effect is unknown.
Laxative/diuretic
Coffee is also a powerful stimulant for peristalsis and is sometimes considered to prevent constipation; it is also a diuretic. However, coffee can also cause loose bowel movements.
Practitioners in alternative medicine often recommend coffee enemas for "cleansing of the colon" due to its stimulus of peristalsis, although mainstream medicine has not proved any benefits of the practice.
Antioxidant
Coffee contains the anticancer compound methylpyridinium. This compound is not present in significant amounts in other food materials. Methylpyridinium is not present in raw coffee beans but is formed during the roasting process from trigonelline, which is common in raw coffee beans. It is present in both caffeinated and decaffeinated coffee, and even in instant coffee.[15]
Prevention of dental caries
The tannins in coffee may reduce the cariogenic potential of foods. In vitro experiments have shown that these polyphenolic compounds may interfere with glucosyltransferase activity of mutans streptococci, which may reduce plaque formation. In rat experiments, tea polyphenols reduced caries. [16]
Gout
Coffee consumption decreased risk of gout in men over age 40. In a large study of over 45,000 men over a 12-year period, the risk for developing gout in men over 40 was inversely proportional with the amount of coffee consumed.[17]
Risks
Many notable effects of coffee are related to its caffeine content. Amongst other known negative health associations it is not clear whether these are due to the caffeine or other unidentified compounds (suggesting that these may be modified by switching to decaffeinated coffee).
Anxiety and sleep changes
Many coffee drinkers are familiar with "coffee jitters", a nervous condition that occurs when one has had too much caffeine. It can also cause anxiety and irritability, in some with excessive coffee consumption, and some as a withdrawal symptom. Coffee can also cause insomnia in some, while paradoxically it helps a few sleep more soundly.
Constipation
Due to its diuretic effect, coffee use can lead to dehydration in some individuals, and as a result, contribute to constipation. [18]
Cosmetic
Like tea, coffee causes staining of the teeth.[19]
Blood pressure
A recent study by Harvard Med that set out to prove that the caffeine in coffee would put people at risk for high blood pressure ended up rejecting the theory. 155,000 nurses were followed for 12 years and the results showed that large amounts of coffee did not induce a "risky rise in blood pressure"[20]. As a note, this study did not include men.
Effects on pregnancy and menopause
A February 2003 Danish study of 18,478 women linked heavy coffee consumption during pregnancy to significantly increased risk of stillbirths (but no significantly increased risk of infant death in the first year). "The results seem to indicate a threshold effect around four to seven cups per day," the study reported. Those who drank eight or more cups a day (64 U.S. fl oz or 1.89 L) were at 220% increased risk compared with nondrinkers. This study has not yet been repeated, but has caused some doctors to caution against excessive coffee consumption during pregnancy.[21]
There are also gender-specific effects: in some PMS sufferers it increases the symptoms; it can reduce fertility in women; it may increase the risk of osteoporosis in postmenopausal women; and there may be risks to a fetus if a pregnant woman drinks 8 or more cups a day (48 U.S. fl oz or 1.4 L or more).
Decaffeinated coffee is occasionally regarded as a potential health risk to pregnant women, due to the high incidence of chemical solvents used to extract the caffeine. These concerns have almost no basis, however, as the solvents in question evaporate at 80–90 °C, and coffee beans are decaffeinated before roasting, which occurs at approximately 200 °C. As such, these chemicals, namely trichloroethane and methylene chloride, are present in trace amounts at most, and neither pose a significant threat to unborn children. Women still worried about chemical solvents in decaffeinated coffee should opt for beans which use the Swiss water process, where no chemicals other than water are used.
Coronary artery disease
A 2004 study tried to discover why the beneficial and detrimental effects of coffee conflict. The study concluded that consumption of coffee is associated with significant elevations in biochemical markers of inflammation. This is a detrimental effect of coffee on the cardiovascular system, which may explain why coffee has so far only been shown to help the heart at levels of four cups (20 fl oz or 600 mL) or fewer per day.[22]
The health risks of decaffeinated coffee have been studied, with varying results. One variable is the type of decaffeination process used; while some involve the use of organic solvents which may leave residual traces, others rely on steam.
A study has shown that cafestol, a substance which is present in boiled coffee drinks, dramatically increases cholesterol levels, especially in women. Filtered coffee contains only trace amounts of cafestol.
Polymorphisms in the ''CYP1A2'' gene may lead to a slower metabolism of caffeine. In patients with a slow version of the enzyme the risk for myocardial infarction is increased by a third (2-3 cups) to two thirds (>4 cups). The risk was more marked in people under the age of 59.[23]
A Harvard study over 20 years of 128,000 people published in 2006 concluded that there was no evidence to support the claim that coffee consumption itself increases the risk of coronary heart disease. The study did, however, show a correlation between heavy consumption of coffee and higher degrees of exposure to other coronary heart disease risk factors such as smoking, greater alcohol consumption, and lack of physical exercise.[24] The results apply only to coffee filtered through paper filters, which excludes boiled coffee and espresso, for example. Additionally, the lead researcher on this study acknowledged that subsets of the larger group may be at risk for heart attack when drinking multiple cups of coffee a day due to genetic differences in metabolizing caffeine.
The Iowa Women's Health Study showed that women who consumed coffee actually had fewer cardiovascular disease incidents and lower cancer rates than the general population. For women who drank 6 or more cups, the benefit was even greater. However, this study excluded 35% of its original participants who already had cardiovascular disease and other chronic diseases when the study began. Since participants were all over the age of 55, no good conclusion can be drawn about the long term effect of coffee drinking on heart disease from this study.[25]
References
1. Klag MJ, Wang NY, Meoni LA, Brancati FL, Cooper LA, Liang KY, Young JH, Ford DE. Coffee intake and risk of hypertension: the Johns Hopkins precursors study. ''Arch Intern Med'' 2002;162:657-62. PMID 11911719.
2. Maia, L., & de Mendonça, A., Does caffeine intake protect from Alzheimer's disease?, ''European Journal of Neurology'', July 2002, 9:4, 377 ([1] accessed Nov 30, 2006)
3. Lindsay, J., ''et al.'', Risk Factors for Alzheimer’s Disease: A Prospective Analysis from the Canadian Study of Health and Aging, Am J Epidemiol 2002; 156:445-453, ([2] accessed Nov 30, 2006)
4. Leitzmann, W.F., ''et al.'', A prospective study of coffee consumption and the risk of symptomatic gallstone disease in men, ''JAMA'' (1999), 281:2106-12
5.
Leitzmann MF, Stampfer MJ, Willett WC, Spiegelman D, Colditz GA, Giovannucci EL., Coffee intake is associated with lower risk of symptomatic gallstone disease in women, ''Gastroenterology'', 2002 Dec;123(6):1823-30
6. Webster Ross, G. ''et al.'', Association of Coffee and Caffeine Intake With the Risk of Parkinson Disease, ''JAMA'', May 24, 2000, 283:20, ([3] accessed Nov 30, 2006)
7. Benedetti M.D. ''et al.'', Smoking, alcohol, and coffee consumption preceding Parkinson’s disease, ''Neurology'', 2000:55, 1350-1358. ([4] accessed Nov 30, 2006)
8. Koppelstaeter F, Siedentopf C, Poeppel T, Haala I, Ischebeck A, Mottaghy F. Influence of caffeine =excess on activation patterns in verbal working memory. Radiological Society of North America, 2005, abstract no LPR06-05 link.
9. Jarvis, M.J., Does caffeine intake enhance absolute levels of cognitive performance?, ''Psychopharmacology'', 2 December, 2005, 110:1-2, 45-52. ([5] accessed Nov 30, 2005).
10. Johnson-Kozlow, M., ''et al.'', Coffee Consumption and Cognitive Function among Older Adults, ''Am J Epidemiol'' 2002; 156:842-850 ([6] accessed Nov 30, 2006)
11. Headache Triggers: Caffeine
12. Salazar-Martinez E, Willet WC, Ascherio A, Manson JE, Leitzmann MF, Stampfer MJ, Hu FB. Coffee consumption and risk for type 2 diabetes mellitus. ''Ann Intern Med'' 2004;140:1-8. PMID 14706966.
13. Klatsky AL, Morton C, Udaltsova N, Friedman GD. Coffee, cirrhosis, and transaminase enzymes. ''Arch Intern Med'' 2006;166:1190-5. PMID 16772246.
14. Inoue M, Yoshimi I, Sobue T, Tsugane S; JPHC Study Group. Influence of coffee drinking on subsequent risk of hepatocellular carcinoma: a prospective study in Japan. ''J Natl Cancer Inst'' 2005;97:293-300. PMID 15713964.
15. COFFEE CAN PREVENT COLON CANCER
16. Touger-Decker, R. & van Loveren, C., Sugars and dental caries, ''American Journal of Clinical Nutrition'', October 2003, 78:4, 881S-892S.
17. Coffee consumption and risk of incident gout in men: A prospective study, , HK, Choi, Arthritis Rheum, 2007
18. Basson, Marc D. , "Constipation" emedicine [7]
19. Watts A. & Addy M., Tooth discolouration and staining: a review of the literature, ''British Dental Journal'', March 24 2001, 190:6 309-316 [8] Accessed Nov 30, 2006
20. William Cromie, "Coffee Gets Cleared of Blood Pressure Risk", ''Harvard Gazette''. November 10 2005 (accessed August 1 2006 at http://www.news.harvard.edu/gazette/2005/11.10/06-coffee.html)
21. Wisborg K, Kesmodel U, Bech BH, Hedegaard M, Henriksen TB. Maternal consumption of coffee during pregnancy and stillbirth and infant death in first year of life: prospective study. ''BMJ'' 2003;326:420. PMID 12595379.
22. Zampelas A, Panagiotakos DB, Pitsavos C, Chrysohoou C, Stefanadis C. Associations between coffee consumption and inflammatory markers in healthy persons: the ATTICA study. ''Am J Clin Nutr'' 2004;80:862-7. PMID 15447891.
23. Cornelis MC, El-Sohemy A, Kabagambe EK, Campos H. Coffee, CYP1A2 genotype, and risk of myocardial infarction.
JAMA. 2006 Mar 8;295(10):1135-41. PMID 16522833.
24. Lopez-Garcia E, van Dam RM, Willett WC, Rimm EB, Manson JE, Stampfer MJ, Rexrode KM, Hu FB. Coffee consumption and coronary heart disease in men and women: a prospective cohort study. ''Circulation'' 2006;113:2045-53. PMID 16636169.
25. Andersen LF, Jacobs DR Jr, Carlsen MH, Blomhoff R. Consumption of coffee is associated with reduced risk of death attributed to inflammatory and cardiovascular diseases in the Iowa Women's Health Study. ''Am J Clin Nutr'' 2006;83:1039-46. PMID 16685044.
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