Research and Perspectives

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Caffeine—The Subtle Addiction

Every second, Americans drink approximately 4,848 cups of coffee. New Yorkers alone drink a million cups of coffee every ten minutes. (Health Letter, 1982.) It is little wonder that coffee and the caffeine it contains play a major role in dozens of diseases in the United States, from the number one killer, heart disease, to the number one physical complaint, chronic fatigue. (Goulart, 1984.)

Of course, the United States is not the only nation that consumes large quantities of drinks containing caffeine. The following results of U.S. studies are representative of a worldwide problem.

Medical researchers have long suspected that coffee consumption contributes to diseases affecting the heart or the blood vessels attached to the heart. Obtaining conclusive data, though, has been difficult. Many studies measured coffee drinking at a time remote from reported heart problems. Other studies did not adequately consider important variables such as cigarette smoking, age, and cholesterol level in the blood. They could not establish whether the heart disease primarily resulted from drinking coffee.

Since 1980, however, several research teams have published significant medical reports demonstrating that the chronic abuse of caffeine is very risky. Researchers at the National Center for Health Statistics and Johns Hopkins Medical School, for example, recently published their findings from a thirty-year study that confirmed a close relationship between coffee intake and coronary heart disease. (LaCroix et al., 1986.)

Caroline Bedell Thomas, M.D., designed the study in 1946. She and other doctors tracked a group of 1,040 physicians for thirty years, following changes in coffee intake, blood pressure, cholesterol level, and cigarette smoking. At the thirty-year follow-up, 10.7 percent of the participants who drank five or more cups of coffee per day reported incidence of coronary heart disease, compared with 1.6 percent among the group who drank no coffee. When the data were adjusted to account for changes in coffee intake and for other variables, the risk of heart disease among heavy coffee drinkers was still two or three times as great as the risk among abstainers. It was found, though, that those who quit drinking coffee heavily faced no greater risk of heart disease ten years later than those who never drank it at all.

At the Tenth World Congress of Cardiology in Washington, D.C., another group of investigators also presented their findings from a twenty-year study of the effects of coffee consumption on coronary heart disease. (Dyer et al., 1986.) They studied 1,910 middle-aged patients, taking into account such factors as the number of cigarettes smoked daily, age, cholesterol level, and diastolic blood pressure.

They found a remarkable connection between heavy coffee drinking and death due to heart disease. They wrote, “These results support the hypothesis that those who drink more than five cups of coffee per day are at an increased risk of coronary heart disease death, particularly acute [short but severe], non-sudden, myocardial infarction.” (Dyer et al., 1986, p. 22.) The term myocardial infarction is the name for the death of small areas of heart muscle tissue, resulting from interruption of the blood supply.

Some people avoid caffeine by switching to decaffeinated coffee. However, several medical investigations over the last decade have shown that between 40 and 50 percent of decaffeinated coffee drinkers have gastrointestinal difficulties, such as ulcers, colitis, or diarrhea. (Goulart, 1984.) Decaffeinated coffee stimulates the production of stomach acid because the roasting of coffee beans releases harsh acids and oils that irritate stomach linings. One study of 13,000 patients in Boston area hospitals also showed that the risk of developing myocardial infarction was the same for decaffeinated coffee drinkers as it was for regular coffee drinkers. (Health Letter, 1982.)

Several studies have proposed reasons why drinking coffee might be related to coronary heart disease. First, because coffee contains a moderate amount of caffeine, a stimulant, it may promote arrhythmias—variations in the normal heartbeat—leading to acute heart problems. (Prineas et al., 1980.) Second, coffee intake and elevation of the cholesterol level in the blood may be linked. (Mathias et al., 1985.)

Apparently, the potency of caffeine is related to body weight. To a 150-pound adult, “a cup of instant coffee or a can of cola beverage could give about 1 mg caffeine per kilogram of body weight. In a very young child, a cup of chocolate or a candy bar would give the same proportion of stimulant to body weight. When this child drinks a can of cola, … caffeine intake is comparable to an adult drinking four cups of instant coffee. … Restlessness, irritability, sleeplessness, and nervousness are some of the symptoms.” (Bunker and McWilliams, 1979, p. 30.)

Understanding the effects of caffeine upon children is important for Latter-day Saint parents. As seen in the accompanying table, many commonly used beverages and products contain varying amounts of caffeine. The products are listed only for comparison. The Church has taken no stand against any substances containing caffeine other than coffee and tea. As Elder Bruce R. McConkie wrote about the Word of Wisdom, “Some people become cranks. … There is no prohibition in Section 89 as to the eating of white sugar, cocoa, chocolate, … or anything else except items classified under tea, coffee, tobacco and liquor. If some particular food disagrees with an individual, then that person should act accordingly without reference to the prohibitions in this particular law of health.” (McConkie, 1966, pp. 845–56.)

After twenty years of experience in medicine, I counsel inquiring members that eating or drinking anything that may result in bodily harm is probably a violation of the spirit of wisdom enjoined in Doctrine and Covenants 89. The Word of Wisdom is true to its name—it wisely instructs us against drinks that are harmful to our bodies. These include coffee and tea.

Common Sources of Caffeine

Product

Caffeine (milligrams)

Coffee Drip (6 oz. cup) Percolated (6 oz. cup) Instant regular (6 oz. cup) Decaffeinated (6 oz. cup)

175 132 64 3

Cola drinks Coca-Cola Classic (12 ozs.) Coca-Cola, new (12 ozs.) Coke Free (12 ozs.) Pepsi (12 ozs.) Pepsi Free (12 ozs.) Dr. Pepper (12 ozs.) Mountain Dew (12 ozs.) Tab (12 ozs.) Jolt (12 ozs.) 44 oz. cup of Coke/Pepsi Tea (5 min. brew, 6 ozs.)

46 46 0 43 0–2 38 52 50 71 169/158 24–60

Cocoa and chocolate 1 Cocoa beverage (water mix, 6 ozs.) Milk chocolate candy bar (8 ozs.) Baking chocolate (1 oz.) White chocolate 2 Carob (chocolate substitute)

18 48 35 0 0

Nonprescription drugs Caffedrine capsules (each) NoDoz tablets (each)

100 100

Weight-control aids Dexatrim (daily dose) Dietac (daily dose) Prolamine (daily dose)

200 200 280

[illustration] Illustrated by Rob Magiera

Clifford J. Stratton is Doctor of Human Anatomy at the School of Medicine, University of Nevada at Reno. He serves as stake athletic director of the Sparks Nevada Stake.

    Notes

  1.   1.

    Cocoa and chocolate products also contain the caffeine-related stimulant theobromine. Cocoa has 228–284 mg/6 oz. cup; chocolate has 480 mg/8 oz. bar.

  2.   2.

    White chocolate does not contain caffeine—it is a by-product of chocolate.