Consumption of coffee and tea and risk of developing stroke and dementia
journals.plos.org
journals.plos.org
Compared with those who did not drink tea and coffee, drinking 2 to 3 cups of coffee and 2 to 3 cups of tea per day was associated with a 32% (HR 0.68, 95% CI, 0.59 to 0.79; P < 0.001) lower risk of stroke and a 28% (HR, 0.72, 95% CI, 0.59 to 0.89; P = 0.002) lower risk of dementia. Moreover, the combination of coffee and tea consumption was associated with lower risk of ischemic stroke and vascular dementia. Additionally, the combination of tea and coffee was associated with a lower risk of poststroke dementia, with the lowest risk of incident poststroke dementia at a daily consumption level of 3 to 6 cups of coffee and tea (HR, 0.52, 95% CI, 0.32 to 0.83; P = 0.007).
So if we were worried about that, at least there is no obvious relationship.
The decrease from coffee/tea might make you cross the line back into healthy state, perhaps?
I don't usually take conclusions from single studies like this, though. It's too easy to fool ourselves with statistics.
Yeah, statistics and graphs can be a special type of evil
If the media ran this endlessly, saying you'll have 30% less chance of stroke or dementia if you drink coffee and tea, people would probably panic on that too.
DISCLAIMER: I am not downplaying the severity of Covid. My words mean exactly what they say.
It's not a spin, it's just the daily struggle of the health care system right now. I see no other solution but to take that seriously.
That doesn't mean we should take this study as serious just because it discusses something that may lead to something that, by itself, with a theoretical (large enough) uptick would overrun the system too.
Some hypothetical, stroke-causing, meme-like behavior which can spread rapidly would have to be quite insidious to spread as effectively as COVID-19, cause a temporally correlated medical event, and not be self-limiting. The closest I can think of, off hand, are spikes in drug overdoses or things like suicide clusters. But those are examples are self-limiting, in that most people seem to recognize that they do not want to have that outcome.
That it's a relative risk reduction is not particularly relevant to that.
That said, I do agree that changes in relative risk are confusing and/or misleading to many people. A more interesting way of presenting this data, IMO, is the "number needed to treat", that is in order to reduce 1 stroke from occurring, ie, roughly 120 people need to drink 2 cups of coffee/tea per day to reduce 1 stroke, based on the numbers given here. This is obviously a lot more than the naive "30% means roughly 1 in 3 would see improvement" interpretation that the headline number pushes you towards.
IMHO, that’s a higher burden of proof than a correlation study like this can offer.
As in, if I didn’t already drink coffee, and I was worried about stroke, I don’t think this study would be enough to confidently prescribe coffee as a stroke-prevention tool.
But if I do drink coffee and I am worried about stroke, this study makes me a little less worried, because the answer to “well did coffee-drinkers disproportionately get stroke?” is “no.” The fact that it goes the other way just makes it a stronger “no”.
Reasonable people could differ in interpreting this.
Could it be that tea and coffee drinkers in general drink less soda?
Was that controlled for?
Alternatively maybe the soda studies are just proxies for tea and coffee.
Very little can be controlled for in studies like this. There are just too many factors to slice on, and before long you're just reading into noise.
I know this barely scratches the surface of the uncontrolled factors, but I wanted to throw this point out there.
It seems like anybody can tell you that Soda is worse for you than tea/coffee (possible exception of sweet tea).
Could it be that people who do mentally taxing work for a living drink more tea and coffee per capita, especially as they approach a certain age, so that coffee and dementia are negatively correlated but not causal?
Re-read the title and then the article conclusion, and slurped it back up off my desk
The conclusion, for those of you that are wondering:
> We found that drinking coffee and tea separately or in combination were associated with lower risk of stroke and dementia. Intake of coffee alone or in combination with tea was associated with lower risk of poststroke dementia.
Separately, enzymes in the coffee bean (not caffeine) also act as a peristaltic.
Hmm, I hear the call of the biscuit tin....
I have a genetic disorder. A lot of my food preferences turn out to be "medicinal" so to speak for that condition.
Discovered the gene thanks to consumer genetic testing, and the heart rate thing with a fitbit. I'm more careful these days.
All the study claimed was an „association“, nothing more.
That thought crossed my mind, actually.
> Covariates
> In the present study, the selection of covariates based on (1) demographic variables, including sex, age, ethnicity background, education level, and income; and (2) a priori knowledge of potential confounding factors associated with incident stroke and dementia [30,31]. Covariates were documented including sex, age, ethnicity (White, Asian or Asian British, Black or Black British, and Other ethnic group), qualification (college or university degree, Advanced [A] levels/Advanced Subsidiary [AS] levels or equivalent, Ordinary [O] levels/General Certificate of Secondary Education [GCSE] or equivalent, Certificate of Secondary Education [CSE] or equivalent, National Vocational Qualification [NVQ] or Higher National Diploma [HND] or Higher National Certificate [HNC] or equivalent, other professional qualifications, or none of the above), income (less than £18,000, 18,000 to 30,999, 31,000 to 51,999, 52,000 to 100,000, and greater than 100,000), BMI (<25, 25 to <30, 30 to <35, and ≥35 kg/m2), smoking status (never, former, and current), alcohol status (never, former, and current), physical activity (low, moderate, and high), consumption of sugar-sweetened beverages, history of diabetes, history of coronary artery disease, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and diet pattern (healthy and unhealthy, healthy diet was based on consumption of at least 4 of 7 dietary components: (1) fruits: ≥3 servings/day; (2) vegetables: ≥3 servings/day; (3) fish: ≥2 servings/week; (4) processed meats: ≤1 serving/week; (5) unprocessed red meats: ≤1.5 servings/week; (6) whole grains: ≥3 servings/day; (7) refined grains: ≤1.5 servings/day [32–35]) (S1 Table).
> Information on cardiovascular arterial disease (CAD) was derived from medical records (ICD-10 codes I20 to I25). Diabetes was ascertained on the basis of medical records (ICD-10 codes E10 to E14), glycated hemoglobin ≥6.5%, and the use of antidiabetic drugs. Hypertension was defined as systolic blood pressure (SBP) ≥140 mm Hg or diastolic blood pressure (DBP) ≥90 mm Hg, use of antihypertension agents, or medical records (ICD-10 codes I10 to I13 and I15). Cancer was identified through linkage to the National Health Service (NHS) Central Register (ICD-10 codes C00 to C97).
> We used Cox proportional hazards models to estimate the associations between coffee/tea consumption and incident stroke and dementia, adjusting for sex, age, ethnicity, qualification, income, body mass index (BMI), physical activity, alcohol status, smoking status, diet pattern, consumption of sugar-sweetened beverages, high-density lipoprotein (HDL), low-density lipoprotein (LDL), history of cancer, history of diabetes, history of cardiovascular arterial disease (CAD), and hypertension.
It's extremely difficult to do this in practice because people lie, there are other factors they might have missed and so on.
Typically the easiest way to turn it around is to switch where the authors chose to place the word "risk" and see if the new statement (with some appropriate changes, and adding "predisposition" to account for future events) still makes sense.
E.g. Predisposition to dementia lowers lifetime "risk " of coffee consumption.
For example, while that would mean that simply increasing coffee consumption wouldn't directly lower your risk of dementia and stroke, we can improve our assessment of the risk of a certain patient developing these conditions by asking whether they consume coffee. Even though the coffee isn't the cause, since it correlates with the cause, we still get information by doing that.
[1] https://www.hsph.harvard.edu/news/press-releases/genetic-var...
Beyond this, there are so many other health benefits to reasonable coffee/tea drinking. It's one of the few addictions that probably ends up being good for you.
Then there are infusions of fruits, leaves, etc which are not strictly tea.
And there are the above teas with other plants or oils mixed in (e.g. jasmine flower, bergamotte, ...). As long as you don't add much sugar I doubt these have much different impact unless these are plants with known effects of their own (ginseng, ginko, lemongrass, ...).
If this effect is being observed in both coffee and tea, my guesses would be it's either caffeine, something with the roasting, possibly fermentation (but I'm not sure if all tea is fermented), something with fluid consumption, or something with the mental ritual of drinking mild stimulants.
[0] https://brandongaille.com/20-uk-tea-industry-statistics-and-...
Which parts of the world prefer green? Chinese and some Asian restaurants here (Poland) feature green tea quite prominently, but that’s the limit of my experience.
I thought that for a long time, until I realized that afternoon caffeine was correlated with my inability to fall asleep at night. Cutting coffee (even dark chocolate) after lunch has greatly improved my sleep quality. Still love it in the mornings though.
That sounds like it wasn't obvious to you from the start.
You see me flabbergasted. How is that even possible?
First was an underestimation of the half life of caffeine. It stays in your system for a while, and stacks when you have multiple throughout the day.
Another was my personal sensitivity to caffeine with regards to sleep. I know many people who can't drink coffee at all and others who can drink it as a digestif. I'm somewhere in the middle.
The last is being embedded in a coffee-drinking culture, without personal awareness of the above two points. So I would drink it later than I should with people who didn't (or didn't know they) have a problem drinking it at that time.
Then, I wonder if better cardio health removes one stress factor causing these diseases.
Not remotely a biologist, and heavy coffee drinker.
My gut feeling is telling me that coffee and digital devices are responsible for big parts of the population suffering from mental illnesses, caused via chronic sleep deprivation. Of course majority of those mental illnesses are under reported - being sleep deprived for months does not make you bipolar maybe, but depression can and does happen (as well as myriad of other issues).
There are too many studies who show relationship between sleep and all kinds of illnesses (majority - mental), and nobody can argue that coffee is NOT responsible for that at least partially.
When I recently quit on coffee, I had such strong withdrawal symptoms, I was unable to function for 4 days. I had strong headaches and was almost vomiting.
No study will convince me this is a good/healthy thing for a human body. It is drug which is so omni-present, if you look around it is scary.
1. I periodically go off coffee, for various reasons, but frankly never notice much difference to my sleep quality.
2. I have 2 kids that deprive me of sleep much more effectively. Or, put otherwise, no matter how much I drank during the day, I fall asleep like a log. And then it's not coffee disturbing my sleep, but crying children.
I can see though that coffee abuse _could_ lead to sleep deprivation and related issues. But it's like alcohol could lead to alcoholism, but doesn't have to. Though, incidentally, apparently deliberate sleep deprivation is one method of tackling depression - so it's not all bad.
https://www.scientificamerican.com/article/why-sleep-depriva...
Briefly and temporarily, but efficacy quickly drops off with near-term repetition. As (apparently) with psychedelics, it's good for a temporary change of perspective that can be leveraged with the right techniques into lasting improvement, but much more of an adjuvant to therapy than a therapy in its own right.
But I agree that abuse is what is causing majority of the problems (and it was in my personal case)
A lot of it doesn't require any domain knowledge to verify.
But different rates of caffeine tolerance and digestion certainly conform with my personal observations, Walker or not.
It shaves off 10 to 20 IQ points in me when I'm on a bad streak. I have failed FAANG interviews because of bad sleep. I still probably would've failed them, but it'd have been much closer. I literally remember one coding interview where I was thinking "if I just had enough sleep, I'd have a solid shot" (the other coding interview was so easy I could even do it in my half-ragged sleep-deprived state).
No matter what I tried I could not get the code to compile.
I still laugh about it now but it definitely highlights the importance of sleep.
The next day, well rested, I realized I could do the same thing with a for loop because I already had all the data I needed.
There seems to be a wide variety in different people's caffeine sensitivity, but for me, a coffee habit leads to a downwards spiral that ends with permanent tension and migraine episodes. I have tried this cycle enough times by now to know the cause and effect. I have to wonder what other effects the continued stimulation of caffeine has.
I drink espresso in the morning, black coffee through out the day and stop before dinner. It's around 4-8 mugs every day. On holidays I often go a days without any coffee for various reasons with no ill effects. I have gone an entire month substituting coffee with water to test the hypothesis that it doesn't really affect me and I felt no different. HR, BP, sleep quality, tiredness, mental performance, digestion all remained stable.
My neighbour gets a headache if he skips coffee for a day.
I for one have coffee in the mornings and stare at my phone until I fall asleep, and I sleep like the dead at night. But, that's purely anecdotal.
I don't think people will listen to others saying 'stop drinking coffee!' or 'stop looking at screens!' if they don't actually have problems. On that note, one shouldn't start self-medicating with sleep hormones (currently available over the counter) to try and optimize their sleep. If you have to force yourself to sleep so you can min/max your day, you're heading to a crash and burnout.
I abstain from coffee (normally eight cups daily) and alcohol (normally three bottles of beer weekly) for a two-week period as a prescription against chemical dependency.
Typically this results in one day in which I am more irritable, nothing more.
Any consumptive habit can be evil in the absence of moderation and discipline.
Like Agent Dale Cooper[0] would have put it, that's a damn fine study.
[0] https://www.eater.com/2017/5/18/15656720/twin-peaks-dale-coo...
Never make the mistake of taking research in plos seriously.
1) Fussy coffee
2) A clicky keyboard
3) Over carbonated water
(Possibly poorly remembered).
So I've gone back to my touchstone brew: Harar Hyena (it's from the Harar region in Ethiopia; the "hyena" bit is because the town is famous for being infested with hyenas). It costs half as much. I was warned the first time I bought it that it's not to everyone's taste; well, it's certainly to mine. It's fruity and complex. I certainly wouldn't describe it as acidic.
I can't write tasting notes, I can't bear to be that pretentious; but The Spruce Eats says: "This flavor is often described as fruity and winey with a mocha note, medium acidity, and a full body."
I don't have any local suppliers for _specific_ towns or farms, but me and the wife always scour the local coffeeshops for Ethiopian sourced coffee.
Usually ~50 Lei ( £8.50 ) for 250g And is also usually excellent coffee
usually they are hiting flavor compounds that are in the coffee. in the example you gave, knowing what usually make it into coffee:
fruity i associate with citric acid.
winey is probably acetic acid.
mocha is the classic chocolate flavor of the maillard reaction from roast and bitterness
Minor exception: "Exotic" fruits like mango or pineapple may mean there are fermentation flavors present, e.g. with naturally processed beans (vs washed process).
Good introduction by James Hoffmann: https://youtu.be/O9YnLFrM7Fs (decoding descriptions starts at 12:53)
Then pick out any comparisons that come to mind but don’t think too hard about “is it a strawberry or raspberry”. Doesn’t matter. Whatever comes to mind. I can’t even pick fruits is just think “acidic, sweet”
The purpose, rather than to sound sophisticated is to get an idea of what coffee you like.
For me a dark roast and chuck in some milk can’t be beaten, but it’s interesting trying the fruity stuff. And when I say fruity … it ain’t subtle like wine. Some coffees taste like tea!
The thing I like about blue mountain is a strong coffee flavour, very smooth, without any acidity or sourness. That's what I value from it. I'm not looking for fruity acidic or sour because I don't like any of those things. I'm looking for smooth bold coffee flavours without those things.
You can enjoy your coffee that you enjoy. I certainly wouldn't, but I'm glad you do.
In my experience all the etheopian coffees I've had were unacceptably sour. But taste is personal and you are free to enjoy it.
Until quite recently it was still cheaper for me to be drinking blue mountain than it was to be using those keurig pods. I just have decided to spend less on coffee in general, but haven't found anything to replace the blue mountain or even approximate it.
For example, money problems, dangerous job, working in toxic environments etc.
I reckon we don't put enough "science" into working out the life-extending properties of a non-toxic job and a health bank balance.
FWIW I was diagnosed in September as having stable angina. I eat really healthy, don't smoke or drink, no family history of heart issues, and all my blood work was great. However, I have been under immense stress for the last two years to the point of sleepless nights etc (won't go into the details).
I am convinced it's stress that did it!
Edit: I'm fixed now btw :)
I wonder what's the mechanism involved.
On the other hand Mendelian randomization studies are a brilliant and actually useful way to explore such associations.
What if drinking more coffee or tea makes you die younger? This would result in the same data they base their conclusions on.
E.g. dementia en strokes correlate with age. If you die young because of high coffee consumption you wouldn't show up in the "drank coffee and subsequently had a stroke" group.
This is a prospective cohort study - it is not meant to cover all limitations. Every scientific study will have strength and weaknesses, an RCT won't ever have 350 000 participants. Studies with large sample sizes almost always have to resort to either self reporting or interviews in order to collect at least some of the data.
You're not meant to take an individual study's results as the truth - it's the overall body of research that's important. When you see the same or very similar results from studies with varying study designs from different populations done by different researchers with different methods the results become more credible.
Though this specific study is notable as the effect size is quite large, the bias from self reported coffee or tea intake would have to be quite large itself to remove it.
And with regards to coffee and tea consumption and research, this is a pretty well researched area already, and the general consenus is that consuming tea or coffee does have health benefits.