Tag Archives: Coffee

The Bad Food Bible: A Well-Written, Sensible and Science-Based Approach To Diet

The skeptical cardiologist has been searching for some time for a book on diet that he can recommend to his patients. While I can find books which have a lot of useful content, usually the books mix in some totally unsubstantiated advice with which I disagree.

I recently discovered a food/diet/nutrition book which with I almost completely agree. The author is Aaron Carroll,  a pediatrician, blogger on health care research (The incidental Economist) and a Professor of Pediatrics and Associate Dean for Research Mentoring at Indiana University School of Medicine.

He writes a regular column for the New York Times and covers various topics in health care. His articles are interesting,  very well written and researched and he often challenges accepted dogma.

Like the skeptical cardiologist, he approaches his topics from an unbiased perspective and utilizes a good understanding of the scientific technique along with a research background to bring fresh perspective to health-related topics.

Last last year he wrote a column, within which I found the following:

Studies of diets show that many of them succeed at first. But results slow, and often reverse over time. No one diet substantially outperforms another. The evidence does not favor any one greatly over any other.

That has not slowed experts from declaring otherwise. Doctors, weight-loss gurus, personal trainers and bloggers all push radically different opinions about what we should be eating, and why. We should eat the way cave men did. We should avoid gluten completely. We should eat only organic. No dairy. No fats. No meat. These different waves of advice push us in one direction, then another. More often than not, we end up right where we started, but with thinner wallets and thicker waistlines.

I couldn’t agree more with this assessment and as I surveyed the top diet books on Amazon recently, I saw one gimmicky, pseudoscientific  diet after another. From the Whole30 approach (which illogically  completely eliminates any beans and legumes, dairy products,  alcohol, all grains, and starchy vegetables like potatoes (see how absurd this diet is here)) to Dr. Gundry’s Plant Paradox (aka lectin is the new gluten (see here for James Hambling’s wonderful Atlantic article on the huckster’s latest attempt to scare you into buying his useless supplements).

It turns out Carroll published a useful book recently, The Bad Food Bible which critically examines diet and I agree with the vast majority of what is in it.

The first three chapters are on butter, meat, eggs and salt. His conclusions on how we should approach these 4 are similar to ones I have reached and written about on this site (see here for dairy, here for meat, here for eggs and here for salt).  Essentially, the message is that the dangers of these four foods have been exaggerated or nonexistent, and that consuming them in moderation is fine.

The remaining chapters cover topics I have pondered extensively,  but have not written about: including gluten, GMOs, alcohol, coffee, diet-soda and non-organic foods.

I agree with his assessments on these topics. Below, I’ll present his viewpoint along with some of my own thoughts in these areas.

Gluten

Carroll does a good job of providing a scientific, but lay-person friendly background to understanding the infrequent (1 of 141 Americans), but quite serious gluten-related disorder, celiac disease.

However, surveys show that up to one-third of Americans, the vast majority of whom don’t have celiac disease, are seeking “gluten-free” foods, convinced that this is a healthier way of eating. Carroll points out that there is little scientific support for this; there are some individuals who are sensitive to wheat/gluten, but these are rare.

He concludes:

“If you have celiac disease, you need to be on a gluten-free diet. If you have a proven wheat allergy, you need to avoid wheat. But if you think you have gluten sensitivity? You’d probably be better off putting your energy and your dollars toward a different diet. Simply put, most people who think they have gluten sensitivity just don’t.

I do agree with him that the “gluten-free” explosion of foods (gluten-free sales have doubled from 2010 to 2014) is not justified.

However, I must point out that my 92 year old father has recently discovered that he has something that resembles gluten sensitivity. About a year ago, he noted that about one hour after eating a sandwich he would feel very weak and develop abdominal discomfort/bloating. He began suspecting these symptoms were due to the bread and experimented with different bread types without any symptom relief.

Finally, he tried gluten-free bread and the symptoms resolved.

If you have engaged in this type of observation and experimentation on your self, and noted improved symptoms when not consuming gluten, then I think you’re justified in diagnosing gluten sensitivity, and by all means consider minimizing/avoiding wheat.

GMOS

Carroll begins his chapter on genetically modified organisms (GMOs) with a description of the droughts that plagued India in the 1960s and the efforts of Norman Borlaug to breed strains of wheat that were resistant to fungus and yielded more grain. By crossbreeding various strains of wheat he was able to develop a “semi-dwarf” strain that increased what was produced in Mexico by six-fold.

Despite the fact that numerous scientific and health organizations around the world have examined the evidence regarding the safety of genetically modified organisms (GMOs) and found them to be completely safe, there remains a public controversy on this topic. In fact a Pew Poll found that while 88% of AAAS scientists believe that GMOs are safe for human consumption, only 37% of the public do – a 51% gap, the largest in the survey.

This gap is largely due to an aggressive anti-GMO propaganda campaign by certain environmental groups and the organic food industry, a competitor which stands to profit from anti-GMO sentiments. There is also a certain amount of generic discomfort with a new and complex technology involving our food.

The National Academy of Sciences analyzed in detail the health effects of GMOs in 2016. Their report concludes:

While recognizing the inherent difficulty of detecting subtle or long-term effects in health or the environment, the study committee found no substantiated evidence of a difference in risks to human health between currently commercialized genetically engi-neered (GE) crops and conventionally bred crops, nor did it find conclusive cause-and-effect evidence of environmental problems from the GE crops. GE crops have generally had favorable economic outcomes for producers in early years of adoption, but enduring and widespread gains will depend on institutional support and access to profitable local and global markets, especially for resource-poor farmers

Carroll does a good job of looking at the GMO issue from all sides. He touches on environmental downsides related to herbicide-resistant GMO crops and the problems created by patenting GMO seeds, but asserts that “these are the result of imperfect farming and the laws that regular agribusiness, not of GMOS themselves.”

Ultimately, despite these concerns, I agree with Carroll’s conclusion that:

“Foods that contain GMOs aren’t inherently unhealthy, any more are  than foods that don’t contain them. The companies that are trying to see you foods by declaring them ‘GMO-free” are using the absence of GMOs to their advantage–not yours.”

Alcohol, Coffee, and Diet-Soda

Carroll does a good job of summarizing and analyzing the research for these three topics and reaches the same conclusions I have reached in regard to coffee, alcohol and diet-soda:

-alcohol in moderation lowers your risk of  dying, primarily by reducing cardiovascular death

-coffee, although widely perceived as unhealthy, is actually good for the vast majority of people

For those seeking more details a few quotes


on alcohol:

“Taken together, all of this evidence points to a few conclusions. First, the majority of the research suggests that moderate alcohol consumption is associated with decreased rates of cardiovascular disease, diabetes, and death. Second, it also seems to be associated with increased rates of some cancers (especially breast cancer), cirrhosis, chronic pancreatitis, and accidents, although this negative impact from alcohol seems to be smaller than its positive impact on cardiovascular health. Indeed, the gains in cardiovascular disease seem to outweigh the losses in all the other diseases combined. The most recent report of the USDA Scientific Advisory Panel agrees that “moderate alcohol consumption can be incorporated into the calorie limits of most healthy eating patterns.”

Keep in mind that moderate consumption is up to one drink per day for women, and two drinks for men (my apologies to women in general and the Eternal Fiancee’ of the Skeptical Cardiologist in particular) and be aware of what constitutes “one drink.”

Also keep in mind that any alcohol consumption raises the risk of atrial fibrillation (see here) and that if you have a cardiomyopathy caused by alcohol you should avoid it altogether.


on coffee:

“It’s time people stopped viewing coffee as something to be limited or avoided. It’s a completely reasonable part of a healthy diet, and it appears to have more potential benefits than almost any other beverage we consume.
Coffee is more than my favorite breakfast drink; it’s usually my breakfast, period. And I feel better about that now than ever before. It’s time we started treating coffee as the wonderful elixir it is, not the witch’s brew that C. W. Post made it out to be.”

Strangely enough, coffee is usually my breakfast as well (although I recommend against adding titanium oxide to your morning java).  Why am I not compelled to consume food in the morning?  Because breakfast is not the most important meal of the day and I don’t eat until I’m hungry.


on diet-soda:

Carroll notes that many Americans are convinced that artificial sweeteners are highly toxic:

“no article I’ve written has been met with as much anger and vitriol as the first piece I wrote on this subject for the New York Times, in July 2015, in which I admitted, “My wife and I limit our children’s consumption of soda to around four to five times a week. When we let them have soda, it’s . . . almost always sugar-free.”

He notes, as I have done, that added sugar is the real public enemy number one in our diets. He reviews the scientific studies that look at toxicity of the various artificial sweeteners and finds that they don’t convincingly prove any significant health effects in humans.

Some believe that artificial sweeteners contribute to obesity, but the only evidence supporting this idea comes from observational studies. For many reasons, we should not highly value observational studies but one factor, “reverse causation,” is highly likely to be present in studies of diet sodas. If diet soda consumption is associated with obesity, is it the cause, or do those who are obese tend to drink diet soda. Observational studies cannot answer this question but randomized studies can.

Carroll points out that:

the randomized controlled trials (which are almost always better and can show causality) showed that diet drinks significantly reduced weight, BMI, fat, and waist circumference.”

Simple Rules For Healthy Eating

Carroll concludes with some overall advice for healthy eating:

-Get as much of your nutrition as possible from a variety of completely unprocessed foods

-Eat lightly processed foods less often

-Eat heavily processed foods even less often

-Eat as much home-cooked food as possible, preparing it according to rules 1, 2, and 3

-Use salt and fats, including butter and oil, as needed in food preparation

-When you do eat out, try to eat at restaurants that follow the same rules

-Drink mostly water, but some alcohol, coffee, and other beverages are fine

-Treat all calorie-containing beverages as you would alcohol

-Eat with other people, especially people you care about, as often as possible

These are solid, albeit not shocking or book-selling, rules that  correspond closely to what I have adopted in my own diet.

In comparison to the bizarre advice from nutrition books which dominate the best-selling diet books, I found The Bad Food Bible to be a consistent, well-written, extensively researched, scientifically-based, unbiased guide to diet and can highly recommend it to my readers and patients.

Semibiblically Yours,

-ACP

Is Green Tea Better For Your Heart Than Black Tea?

Coffee is the  caffeinated beverage most consumed by Americans and the skeptical cardiologist. It is good for the heart (unless adulterated by titanium dioxide or lots of sugar, a horror that Starbucks likes to promote).

coffee_teaWorldwide, however, as this cool graphic demonstrates (interactive at the Economist)  tea dominates over coffee in lots of places.

Tea in general and particularly green tea is perceived by many to be incredibly healthy: fighting cancer, dementia, obesity and heart disease. But is this perception justified?

The Green Tea Superfood Hype

If you Google search the health benefits of green tea you might conclude that it is a panacea for all that ails modern civilization. However, bad nutritional advice is the norm on the internet and even  websites like Web MD, which you might consider to be reliable, spread inaccurate, misleading and poorly researched information regularly.

WebMD has an article on green tea that starts off

“Green tea is so good for you that it’s even got some researchers raving.“It’s the healthiest thing I can think of to drink,” says Christopher Ochner, PhD. He’s a research scientist in nutrition at the Icahn School of Medicine at Mount Sinai Hospital.”

Who is Chris Ochner and why is he “raving” about the health benefits of green tea you might ask? That’s certainly what I wanted to know, particularly since this same quote or variations on it are all over the internet on sites like “Herbal Republic” which ups the green tea ante with the title “”Green Tea is Beyond a Superfood”-Dr. Christopher Ochner”  (by the way, any source of nutritional information that uses the term superfood should be considered bogus.)

ochnerAlthough no source is provided for this quote from Dr. Ochner, there is a Christopher Ochner, Ph.D listed on the Icahn Medical School Staff. His Ph. D. is in psychology and he works in the areas of adolescent obesity (perhaps he pushes green tea on his obese adolescents).  I can find no publications by him on the topic of green tea and no evidence that he made these comments. I have sent him an email asking for clarification and edification.

The website,  juicing for health.com lists “5 scientifically proven reasons to drink green tea” (by the way, I consider articles with headlines that start with a number, i.e.  “3 health foods that are actually killing you from the inside”,  “5 veggies that kill stomach fat”, and “35 celebs who’ve aged horribly” are worthless and should be ignored and avoided at all costs)

Green Tea and Catechins: Magical Weight Loss elixir?

It’s hard to find good studies on green tea that aren’t somehow funded by the tea, nutraceutical or food industry.  For example, one “S Wolfram” has written extensively on the benefits of green tea in marginal scientific journals. He works for DSM Nutritional Products, LTd., a Swiss food conglomerate.(“DSM Nutritional Products is the world’s largest nutritional ingredient supplier to producers of foods, beverages, dietary supplements, feed and personal care products” says one DSM PR release”).

DSM developed a highly concentrated extract of  a catechin called Epigallocatechin Gallate (EGCG) in green tea that had been identified as having potential health benefits for humans.

In one recent “review” Wolfram wrote  in somewhat vague but highly optimistic terms

“Dose-response relationships observed in several epidemiological studies have indicated that pronounced cardiovascular and metabolic health benefits can be obtained by regular consumption of 5-6 or more cups of green tea per day. Furthermore, intervention studies using similar amounts of green tea, containing 200-300 mg of EGCG, have demonstrated its usefulness for maintaining cardiovascular and metabolic health. Additionally, there are numerous in vivo studies demonstrating that green tea and EGCG exert cardiovascular and metabolic benefits in these model systems.”

I’m not sure what “model systems” he is referring to but it is certainly not humans. He may be talking about rodents, because in 2005  Wolfram published  a paper entitled:

“TEAVIGO (epigallocatechin gallate) supplementation prevents obesity in rodents by reducing adipose tissue mass”

In the conclusions of this “landmark” study performed in mice and rats he wrote

“Thus, dietary supplementation with EGCG should be considered as a valuable natural treatment option for obesity.”

Voila! From a few experiments in rodents and a few short-term, small studies in humans performed by heavily biased scientists, DSM’s version of EGCG emerged as a leading nutraceutical (I prefer the term, snakeoil) and now you can buy this online from a host of bogus supplement/nutraceutical sites as Teavigo.

The production and marketing of TeaVigo is a classic example of how the cynical food/supplement/nutraceutical industry creates a product that has a thin veneer of scientific credibility for health promotion but is considered “natural” (despite being manufactured)

teavigo
It’s Really Pure…. and Really Useless!

and therefore appeals to Americans who are seeking “natural” ways to prevent or treat the common  chronic  diseases of Western civilization.

Because there is no good scientific evidence supporting a role for green tea extracts or ECGC in preventing any specific disease, there is no FDA scrutiny of

Screen Shot 2015-12-27 at 7.51.35 AM
Teavigo: Good for everything that ails you plus can be put in anything you would like to consume and spread on your face! The perfect nutraceutical!

the drug for efficacy and safety. This is fine for nutraceutical manufacturers as they have been granted the ability to  sell their useless products without any regulatory or FDA approval.

Companies like DSM avoid making any specific health claims for their supplements (such as this drug reduces your chances of having a heart attack or stroke) because the FDA can then go after them.
Instead, the Teavigo website makes vague but optimistic statements such as
“Green tea has long been used for health benefits and Teavigo® is the purest and most natural form of the most active substance in green tea – Epigallocatechin Gallate (EGCG). EGCG contains potent natural antioxidants and efficient free-radical scavengers (free radicals being the highly reactive compounds that cause cellular damage).
Notice the key marketing buzzwords in this statement
-Purest
-Natural
-Active
-Antioxidants
-Efficient
-Free-Radical Scavengers
-Cellular Damage
Who wouldn’t want to take a pill that is pure and natural and full of those wonderful antioxidants that stop those nasty free-radicals  from causing cellular damage?
Unfortunately, any time a proposed powerful “anti-oxidant” ( b-carotene, vitamin E, vitamin C, selenium, retinol, zinc, riboflavin, and molybdenum ) has been studied in a well done scientific trial for prevention of cancer or cardiovascular disease it has failed.
We don’ know if this is because the wrong anti-oxidants have  been chosen (for example in green tea  there are hundreds of potential beneficial chemicals)  or because extracting a single chemical from its milieu in a complex food/beverage makes it inactive or if the whole idea of stopping free-radical damage is misguided.
Why take the time to actually brew and drink green tea the website points out after all:
“To get the optimal benefits from ordinary green tea would take an intake of four to eight cups of green tea a day. With Teavigo® you get the same pure, natural and healthy effects, with more convenience and without the caffeine.”
Finally, consumers of Teavigo can be reassured because it is produced using
“A patented and unique production process with constant product quality”
Let me see here, Teavigo is natural but it is made by a “production process” with “constant product quality”.  Isn’t natural production process an oxymoron?
I have asked the Teavigo people to tell me their “production process” but so far I’ve gotten no response. Your guess is as good as mine as to what chemicals or other potentially damaging processes tea undergoes to reach the colorless and tasteless powder that is Teavigo.
 Green Tea Reality

The evidence supporting tea and green tea health benefits  is weak, coming from observational studies.  A recent review of all these observational studies (supported in part by the tea industry) concluded that

Although the evidence appears to be stronger for green tea than for black tea, which differ greatly in their flavonoid profiles, it is difficult to compare this evidence because the populations and their baseline risks of cardiovascular disease differ greatly between the individual studies on these 2 types of tea, and few studies of green tea provide evidence in non-Asian populations.

Whereas there is reasonable observational evidence that high tea consumption is associated with lower cardiovascular risk, the evidence for green tea being healthier is mostly marketing hype.

If you like green tea by all means drink it in whatever quantity you desire. It’s not bad for you. Weak observational data suggests it may reduce your stroke risk, especially if you are Asian.
On the other hand, if you like black tea or oolong tea you can feel very comfortable that it is not bad for you.  It might also reduce your risk of stroke.
There is nothing to suggest tea is healthier than coffee.
Don’t add sugar or titanium dioxide to your tea but feel free to add cream or full fat milk.
Don’t worry about caffeine unless it makes you jittery or brings on palpitations. Common sense should tell you what amount you can tolerate.
Please don’t buy or consume green tea extracts or Teavigo or any other nutraceutical.
The makers of these products are cynically preying on consumer desire for “natural” treatments, selling chemicals which have not been proven either safe or effective, and employing  misleading marketing and promotional material that implies “scientific” support that is either nonexistent or comes from very weak studies, often run by researchers employed by the industry.
 I guarantea this post was unbiased
-ACP

 

The Skeptical Cardiologist Gives Dietary Thanks

IMG_5566
Something I’m not thankful for:Vitamin Water. It consists of water, 32 grams of sugar and lots of useless vitamins. People, stop buying this stuff. You are only helping Coca-Cola fill Americans with TOO MUCH SUGAR!

On this fourth Thursday of November, 2015 the skeptical cardiologist would like to record some Thanksgiving thanks.

  • I’m thankful I’m not a turkey today.

I hear Americans consume 45 million turkeys on Thanksgiving, one sixth of the total during the year.

Americans have embraced turkeys nutritionally because they are low in saturated fat and provide lots of protein. Most nutritional advice suggests avoiding the dark meat and the skin, but I prefer to seek those portions out because they taste better and as I pointed out here last Thanksgiving, Up To Date, the major medical reference for physicians, now says “Don’t Worry About Saturated Fat Consumption.”

  • I’m thankful that dairy fat is good for you.
IMG_6510
The Eternal Fiancee’ (For whose presence in my life I am eternally grateful) Cutting Tomatoes for Crabmeat Ravigote, a traditional cajun dish full of cholesterol from eggs and crustaceans

The eternal fiancee’ and I took a cooking class in New Orleans (New Orleans School of Cooking) recently, and butter seemed to be the basis for every dish we cooked: from dark roux in our gator sauce piquante’, to the blonde roux in the Louisiana meat pies.

When the  teacher of the class, chef Austin, asked the students to introduce themselves, I told him I was the skeptical cardiologist and I was there to evaluate New Orleans dishes for my patients.

Chef Austin didn’t think I would be recommending the dishes to my patients, but I heartily endorsed them ( See here and here).

  • I’m thankful that cholesterol is no longer considered by the Dietary Guidelines for Americans Committee (DGAC) a nutrient of concern.

All may eat eggs and crustaceans without fear now.

However, there is a backlash from the vegans on this revelation: the weirdly named Physicians Committee for Responsible Medicine (PCRM’s goal seems to be elimination of all animal testing and consumption, not responsible medicine) has erected billboards in Texas targeting the chairman of the House Agriculture Committee (K Michael Conoway (R-TX)).

The final guidelines have yet to be issued, but I’m betting on the egg industry over the vegans on this one, despite the billboards.

  • I’m thankful that studies continue to come out showing coffee is not bad for you.

This study, for example, followed 90 thousand Japanese for 19 years and found that the more coffee you drink, the lower your risk of dying-from cardiac, respiratory and cerebrovascular disease. Those consuming 3-4 cups/day were 25% less likely to die than those who never drank coffee.

-I’m thankful that correlation does not equal causation.

This means that I don’t have to stop eating bacon or beef brisket (assuming I am insensitive to global sustainability concerns). On the other hand, that association between higher coffee consumption  and lower risk of dying over 19 years doesn’t mean that drinking more coffee is actually lowering the risk; but it’s certainly not increasing it.

Screenshot 2015-11-26 11.50.04Finally, I’m thankful that moderate alcohol consumption is good for your heart and I raise a toast of gratitude to patient patients, readers and correspondents.

-ACP

 

You’re The Titanium Dioxide In My Coffee

What do you put in your coffee?

Apparently 2/3 of Americans put either a sweetener or a creamer/whitener in their cup.

For the longest time I put skim milk in my coffee

When I was doing my cardiology training in the mid 1980s at Saint Louis University, one of the cardiology faculty was obsessed with the dangers of putting cream in coffee. He and mainstream nutritional guidelines convinced me  that putting this dangerous liquid in my coffee would clog my coronary arteries and give me a heart attack.  This was during the hey-day of the “saturated fat is bad so it’s better to substitute anything for it even if it was made in a factory and contains umpteen chemicals whose effects on the body are unknown” era.

Thus, was born the dreaded industrial trans-fats, and a host of food transformed to be low fat by adding high fructose corn syrup.

As a result of nutritional advice to avoid all saturated fats, Americans feared cream in their coffee and a variety of Frankensteinian coffee additives was born.

I encountered such a monstrosity the other day, as I was waiting in a gargantuan, luxurious medical waiting room when i felt the urge to have a cup of coffee to stimulate me while I waited interminably for my name to be called. Coffee was offered free of charge to those of us in the waiting room, but there was no container of milk or cream, not even boring skim milk. Instead, I found in a drawer filled with packets of sugar and artificial sweeteners, a product that calls itself “Coffee Creamer”

coffecreaerMade by “Wholesome Farms” a creation of Sysco, the giant food conglomerate, Wholesome Farms (?more appropriately Unwholesome Factory Produced) Coffee Creamer contains a  long list of barely recognizable chemicals and industrially processed natural foods as follows

  • corn syrup solids
  • partially hydrogenated soybean oil
  • sodium caseinate ( a milk derivate)
  • dipotassiumphosphate
  • mono and diglycerides
  • sodium silicoaluminate
  • sodium tripoliphosphate
  • diacetyl tartaric acid esters of mono and di glycerides
  • artifical flavor
  • beta carotene
  • riboflavin
  • titanium dioxide
  • artifical colors

Wholesome Farms Coffee Creamer is a microcosm of the food industry reaction to misguided nutritional recommendations to cut back on saturated fat and cholesterol in the diet: substitute  industrially produced chemical, sugars and oils and add in factory processed vitamins to create the illusion of healthiness.

The obvious advantages of this coffee additive are that it can sit in a drawer, unrefrigerated for years without spoiling because there is no real food in it but why on earth would anyone willingly choose to adulterate a perfectly good cup of coffee with it?

After realizing that full fat dairy does not raise the risk of cardiovascular disease (see here and here) about two years ago I began using whole milk (from Trader’s Point Creamery’s happy, grass-fed cows) in my morning coffee and it is a lot more satisfying than the skim milk I used for 30 years. In most coffee shops I’m presented with half and half or skim milk as options and I have no heart health  concerns about cream as a coffee additive.

Indeed, we can now appreciate cream in coffee as a very good thing as Annette Henshaw sung in 1928.

Soon we shall have to discuss “the salt in my stew”.

 

 

 

How Starbucks is Making Heart-Healthy Coffee into A Stealth Dessert

Chemex
The Skeptical Cardiologist’s preferred method of making coffee-hand poured over freshly ground beans, filtered through a Chemex filter (yes, I know it’s laborious and the pictures aren’t as pretty as Starbucks, but it is really good!)

Many of my patients believe that coffee is bad for them. I’m not sure where this belief comes from; perhaps the general belief that anything that they really like and are potentially addicted to cannot be healthy.

It’s not uncommon for a patient to tell me after a heart attack that they have “really cleaned up their act” and have stopped drinking alcohol and cut back on coffee. They seem disappointed when I tell them that moderate alcohol consumption and coffee consumption are heart healthy behaviors.

In contrast to what the public believes, the scientific evidence very consistently suggests that drinking coffee is associated with living longer and having less heart attacks and strokes. Multiple publications in major cardiology journals in the last few  years have confirmed this.

You can read the details here and here. The bottom line is that higher levels of coffee consumption (>1 cup per day in the US and >2 cups per day in Europe) are NOT associated with:

  • Hypertension (if you are a habitual consumer)
  • Higher total or bad cholesterol  (unless you consume unfiltered coffee like Turkish, Greek or French Press types, which allow a fair amount of the cholesterol-raising diterpenes into the brew)
  • Increase in dangerous (atrial fibrillation/ventricular tachycardia) or benign (premature ventricular or supra-ventricular contractions) irregularities in heart rhythm

Higher levels of coffee consumption compared to no or lower levels IS associated with:

  • lower risk of Type 2 Diabetes
  • lower risk of dying, more specifically lower mortality from cardiovascular disease
  • Lower risk of stroke

So, if you like coffee and it makes you feel good, drink it without guilt, there is nothing to suggest it is hurting your cardiovascular health. It’s a real food. These tend to be good for you.

Making Coffee Unhealthy: Dessert as Stealth Food

People have always added things to coffee – cream, half and half, milk, skim milk, sugar, artificial sweeteners. The coffee data doesn’t reveal to us what the consequences of these additions are, but given the consistent positive health associations of coffee, they must have had a minor effect.

However, in the last 20 years, the food industry, led by the behemoth Starbucks (which controls 1/3 of the coffee served in the US and has 11,000 stores and growing) has turned coffee into a stealth dessert. Starbucks offers the consumer (by their own admission) 87,000 different choices of coffee drinks.
A basic coffee house drink is a latte’. This consists of one or more shots of espresso combined with steamed milk (skim, 2% or whole) and topped with foam. According to Starbucks, the 16 ounce, medium (I refuse to use their size terminology), cafe latte’ made with 2% milk, contains 17 grams of sugar and 7 grams of fat, yielding a reasonable 190 calories. Those who drink these should understand that they are consuming a glass of milk, plus coffee. Dairy products have consistently been associated with lower cardiovascular risk. They would arguably be better off consuming a whole milk (11 grams fat, 16 grams sugar, 220 calories) latte’ as I’ve pointed out in previous blogs here and here.

 

 

( Cinnamon Dolce Latte . Picture taken from Starbucks web site.

Most of the latte’s consumed at Starbucks aren’t plain latte’s, however; they are nightmares of added sugar. Let’s take the Cinnamon Dolce Latte’: (A complete nutritional breakdown is available from Starbucks’ website (I do congratulate Starbucks for finally capitulating and presenting nutritional data on their products at stores, allowing the public to draw back the curtain on the Starbucks Oz. Their website provides a cool way to compare your drink with whole/2%/skim/soy milk or with and without whipped cream)) It contains 38 grams of sugar, 6 grams of fat, and 11 grams of protein, yielding 260 calories, 152 of which are coming from sugar. That’s 22 grams more sugar, compared to their unadulterated latte’. (There must be an internet site devoted to promoting the health benefits of cinnamon since I hear about them so often from my patients but this claim is not evidence-based)

 

 

mochae frap
Picture of the Mocha Frappacino “Dessert” from the Starbuck website

My 17 year old daughter’s drink of choice at Starbucks is the Mocha Frappuccino® Blended Beverage, which, according to Starbucks, is “Coffee with rich mocha-flavored sauce, blended with milk and ice. Topped with sweetened whipped cream.” It contains 60 grams of sugar, 15 grams of fat and has 400 calories.

Such concoctions have no right to consider themselves coffee, they should be labeled as a sugar-laden dessert that happens to have some coffee in it. To give some perspective, the typical 20 ounce soda contains 40 grams of sugar (the equivalent of 10 packs of sugar).  Starbucks has added 44 grams of sugar to coffee and milk in order to draw children, teens and unsuspecting adults to consume more “coffee.”

There is growing evidence that sugar, not fat, is the major toxin in our diet. The misguided concept that cutting fat in the diet and replacing it with anything, including sugar, will reduce cardiovascular disease is gradually being rolled back. Nutritional advocates are now zeroing in on appropriate targets like sugary beverages.

It’s sad that Starbucks, which started out making a good, real product that was actually good for you, has morphed into an international, growth-obsessed, behemoth that is pumping billions of grams of added sugar into our stomachs.

But, as the significant other of the skeptical cardiologist (SOSC) often muses, people are always looking for new ways to con themselves into thinking they are eating/drinking something healthy, when in fact, they are just eating/drinking cleverly disguised desserts. Starbucks has made a huge success for themselves by providing people what they want: a way to kid themselves.