1 00:00:09,360 --> 00:00:12,800 Speaker 1: Hey, everyone, welcome to another edition of Wisdom Wednesdays, in fact, 2 00:00:12,880 --> 00:00:16,919 Speaker 1: the first Wisdom Wednesday for twenty twenty six. Happy New Year. 3 00:00:17,600 --> 00:00:19,959 Speaker 1: So today we're going to talk about something that many 4 00:00:20,000 --> 00:00:23,639 Speaker 1: people reach for instinctively in the morning, and certainly my 5 00:00:23,760 --> 00:00:26,440 Speaker 1: wife Carley is in that bracket, and that is coffee. 6 00:00:26,840 --> 00:00:30,080 Speaker 1: But here's the question, could the timing of your coffee 7 00:00:30,520 --> 00:00:33,560 Speaker 1: be just as important as how much you drink when 8 00:00:33,560 --> 00:00:36,040 Speaker 1: it comes to your long term health. Well, a new 9 00:00:36,080 --> 00:00:40,040 Speaker 1: major study that was published in the European Heart Journal 10 00:00:40,479 --> 00:00:45,320 Speaker 1: offers probably the most detailed look yet at high coffee 11 00:00:45,360 --> 00:00:49,559 Speaker 1: intake amount and timing influence your risk of death from 12 00:00:49,640 --> 00:00:53,800 Speaker 1: both curry vastery disease and from all causes. And then, 13 00:00:53,840 --> 00:00:57,720 Speaker 1: when purred with another recent study on coffee and nature fibrillation, 14 00:00:58,240 --> 00:01:01,279 Speaker 1: we start now to get a clear picture, clearer than 15 00:01:01,360 --> 00:01:05,280 Speaker 1: ever before, of coffee's role in heart and metabolic health. 16 00:01:05,600 --> 00:01:09,000 Speaker 1: So let's break it down. Firstly, let's talk about the 17 00:01:09,000 --> 00:01:13,279 Speaker 1: study on coffee timing and mortality. So this was led 18 00:01:13,319 --> 00:01:16,880 Speaker 1: by doctor Wan Wang and published, as i said, in 19 00:01:16,880 --> 00:01:19,840 Speaker 1: the European Heart Journal, and it used data from the 20 00:01:19,920 --> 00:01:24,720 Speaker 1: United States National Health and Nutrition Examination Survey called the 21 00:01:24,880 --> 00:01:28,160 Speaker 1: en Henes, and we get lots of data from this. 22 00:01:28,160 --> 00:01:31,839 Speaker 1: This was done over between nineteen ninety nine twenty eighteen, 23 00:01:31,880 --> 00:01:35,600 Speaker 1: so nearly twenty years of data, and it included over 24 00:01:35,720 --> 00:01:40,160 Speaker 1: forty thousand US adults age twenty years and over. And 25 00:01:40,200 --> 00:01:44,160 Speaker 1: then they had an additional fourteen hundred and sixty three 26 00:01:44,200 --> 00:01:47,480 Speaker 1: adults from a different study called the Women's and Men's 27 00:01:47,520 --> 00:01:51,200 Speaker 1: Lifestyle Validation Studies, and all of the participants were followed 28 00:01:51,680 --> 00:01:55,680 Speaker 1: for a median of nearly ten years, and in that 29 00:01:55,800 --> 00:01:59,400 Speaker 1: time there were four and two hundred and ninety five deaths, 30 00:02:00,240 --> 00:02:02,880 Speaker 1: twelve hundred and sixty eight were from cardiovascular disease and 31 00:02:03,000 --> 00:02:06,840 Speaker 1: nine hundred and thirty four were from cancer. And then 32 00:02:07,000 --> 00:02:11,040 Speaker 1: by analyzing all the data, the researchers found that compared 33 00:02:11,240 --> 00:02:14,840 Speaker 1: with people who didn't drink any coffee, people who drank 34 00:02:15,000 --> 00:02:19,680 Speaker 1: coffee had significantly lower risk of all cause mortality and 35 00:02:19,800 --> 00:02:26,040 Speaker 1: cardiovascular mortality, especially at moderate to high intake levels of coffee, 36 00:02:26,080 --> 00:02:30,280 Speaker 1: so two cups are more. But this seemed to be 37 00:02:30,639 --> 00:02:35,640 Speaker 1: specifically the morning type coffee drinkers, so they looked at 38 00:02:35,680 --> 00:02:37,560 Speaker 1: people who just drink it in the morning and then 39 00:02:37,840 --> 00:02:40,799 Speaker 1: what they called all day, which is morning, afternoon, and evening. 40 00:02:41,560 --> 00:02:44,880 Speaker 1: And here were the hazard ratios for all cause mortality. 41 00:02:44,919 --> 00:02:48,000 Speaker 1: This is for morning drinkers. If they had one to 42 00:02:48,080 --> 00:02:52,120 Speaker 1: two cups a day, their hazard ratio of death compared 43 00:02:52,120 --> 00:02:55,200 Speaker 1: to those who didn't drink any was zero point eight four. 44 00:02:55,440 --> 00:02:58,880 Speaker 1: That means it's a sixteen percent reduced risk of dying 45 00:02:58,919 --> 00:03:03,119 Speaker 1: from any cause, which is pretty bloody significant. Those who 46 00:03:03,160 --> 00:03:06,239 Speaker 1: had two to three cups a day, their hazard ratio 47 00:03:06,360 --> 00:03:09,120 Speaker 1: was zero point seven to two, which translates to a 48 00:03:09,240 --> 00:03:13,079 Speaker 1: twenty eight percent lower risk of all cous mortality. Now 49 00:03:13,280 --> 00:03:17,280 Speaker 1: we're getting pretty significant, and more than three cups a 50 00:03:17,360 --> 00:03:20,000 Speaker 1: day has a hazard ratio of zero point seventy nine, 51 00:03:20,120 --> 00:03:23,280 Speaker 1: or twenty one percent lower risk. So it appeared that 52 00:03:23,360 --> 00:03:26,640 Speaker 1: the best was two to three cups a day, but 53 00:03:26,720 --> 00:03:29,200 Speaker 1: this was just in the morning. Those who drank coffee 54 00:03:29,280 --> 00:03:33,440 Speaker 1: all day defined this morning, afternoon, and evening, they lost 55 00:03:33,520 --> 00:03:36,520 Speaker 1: that protection from the risk of dying from any cause 56 00:03:36,960 --> 00:03:40,600 Speaker 1: compared to those who drank it only in the morning, 57 00:03:40,840 --> 00:03:44,200 Speaker 1: but they still for slightly better than those who didn't 58 00:03:44,240 --> 00:03:47,280 Speaker 1: drink any coffee at all when it came to protection 59 00:03:47,520 --> 00:03:52,080 Speaker 1: against cardiovascular disease. But the big takeout really was that 60 00:03:52,280 --> 00:03:56,840 Speaker 1: drinking one to three maybe even more cups of coffee 61 00:03:56,920 --> 00:04:02,680 Speaker 1: in the morning was consistently associated with mortality and especially 62 00:04:02,680 --> 00:04:07,000 Speaker 1: from cardiovascular causes, and more coffee seem to be a 63 00:04:07,040 --> 00:04:09,680 Speaker 1: little bit better up to that three cups a day, 64 00:04:10,160 --> 00:04:13,920 Speaker 1: but for cancer mortality, there was no consistent associations in 65 00:04:13,960 --> 00:04:18,359 Speaker 1: either group. So simple terms, morning coffee helps, afternoon and 66 00:04:18,400 --> 00:04:23,120 Speaker 1: evening not so much. So why would the timing matter? Will? 67 00:04:23,240 --> 00:04:29,560 Speaker 1: The researchers propose several biological mechanisms that could well interact. 68 00:04:29,920 --> 00:04:34,720 Speaker 1: The first was sleep disruption and circadian misalignment. I think 69 00:04:34,760 --> 00:04:38,479 Speaker 1: everybody knows that coffee is a stimulant. It blocks the 70 00:04:39,120 --> 00:04:43,040 Speaker 1: it blocks a dinnazine, and it delays melatone in secretion, 71 00:04:43,320 --> 00:04:47,720 Speaker 1: potentially imperning sleep if it is consumed late in the day, 72 00:04:48,279 --> 00:04:51,800 Speaker 1: and poer sleep is strongly linked to higher cardiovascar risk 73 00:04:51,920 --> 00:04:56,000 Speaker 1: and increase mortality. So that was one mechanism. The second 74 00:04:56,000 --> 00:05:02,040 Speaker 1: proposing mechanism is autonomic nervous system load. So caffeine stimulates 75 00:05:02,040 --> 00:05:04,799 Speaker 1: our sympathetic nervous system, our fire or flight nervous system. 76 00:05:04,839 --> 00:05:08,680 Speaker 1: That's why it wakes us up. But that afternoon caffeine 77 00:05:08,720 --> 00:05:12,560 Speaker 1: may overactivate our sympathetic nervous system when it should be 78 00:05:12,680 --> 00:05:16,240 Speaker 1: winding down and that can affect your blood pressure and 79 00:05:16,320 --> 00:05:21,359 Speaker 1: cause metabolic dysregulation. And then the third it was sleep 80 00:05:21,560 --> 00:05:26,719 Speaker 1: independent metabolic pathways. So even after they adjusted for total sleep, 81 00:05:27,200 --> 00:05:31,680 Speaker 1: the timing of caffeine intake may alter glucose metabolism. We 82 00:05:31,839 --> 00:05:34,800 Speaker 1: know that it can can spike that. It also affects 83 00:05:34,839 --> 00:05:39,920 Speaker 1: your vascular tone and inflammation as well, and a lot 84 00:05:39,960 --> 00:05:43,279 Speaker 1: of the inflammation that occurs in people happens in the morning, 85 00:05:43,680 --> 00:05:47,200 Speaker 1: and so that anti inflammatory effect may be more potent then. 86 00:05:47,760 --> 00:05:51,480 Speaker 1: So it's not just about getting enough sleep, it's about 87 00:05:51,600 --> 00:05:53,920 Speaker 1: when you drink the caffeine and how it affects your 88 00:05:53,920 --> 00:05:58,600 Speaker 1: physiology across that day night cycle. Then I want to 89 00:05:58,640 --> 00:06:02,359 Speaker 1: switch over and about coffee and atrial fibrillation because some 90 00:06:02,400 --> 00:06:06,440 Speaker 1: of my early studies suggested that it could affect AF 91 00:06:06,600 --> 00:06:10,360 Speaker 1: which is a form of a regular heartbeat that tends 92 00:06:10,440 --> 00:06:13,960 Speaker 1: to increase with the age. So there's another study that 93 00:06:14,080 --> 00:06:19,720 Speaker 1: was in the in JAMA Journal of American Medical Association 94 00:06:20,000 --> 00:06:22,880 Speaker 1: Internal Medicine, and it was published in twenty twenty three, 95 00:06:23,520 --> 00:06:26,200 Speaker 1: and they followed about four hundred thousand adults in the 96 00:06:26,279 --> 00:06:30,239 Speaker 1: UK Biobank study and they didn't have any AF vitual 97 00:06:30,279 --> 00:06:33,320 Speaker 1: fibrillation at baseline, and then they tracked them over twelve 98 00:06:33,320 --> 00:06:36,440 Speaker 1: and a half years, and they found that drinking two 99 00:06:36,480 --> 00:06:38,560 Speaker 1: to five cups of coffee per day, and I don't know, 100 00:06:38,600 --> 00:06:41,359 Speaker 1: it's quite a big range, but that was associated with 101 00:06:41,400 --> 00:06:46,320 Speaker 1: the lower risk of developing autro fibrillation. And the hazard 102 00:06:46,400 --> 00:06:50,719 Speaker 1: ratios for moderate range from zero pointy eight five to 103 00:06:50,839 --> 00:06:54,240 Speaker 1: zero point ninety two, so at fifteen percent reduction at 104 00:06:54,279 --> 00:06:56,560 Speaker 1: the lower level and an eight percent reduction at the 105 00:06:56,640 --> 00:07:00,240 Speaker 1: higher level. But they didn't find any increased risk of 106 00:07:00,279 --> 00:07:04,520 Speaker 1: a fib even drinking five cups per day, and that 107 00:07:04,640 --> 00:07:08,880 Speaker 1: reassures us that moderate caffeine and some people say five 108 00:07:08,960 --> 00:07:12,840 Speaker 1: cups is not moderate, but even five cups doesn't seem 109 00:07:12,840 --> 00:07:15,600 Speaker 1: to be a trigger for arrhythmius in the general population 110 00:07:15,760 --> 00:07:20,520 Speaker 1: and appears even to be protective. Now that study did 111 00:07:20,560 --> 00:07:24,239 Speaker 1: not look at timing, but based on the previous study, 112 00:07:25,520 --> 00:07:30,360 Speaker 1: we could potentially hypothesize that late day coffee might still 113 00:07:30,480 --> 00:07:35,360 Speaker 1: carry indirect risks via that sleep disruption and autonomic stress. 114 00:07:35,400 --> 00:07:41,800 Speaker 1: So practical takeaways is drinking two to three plus cups 115 00:07:41,840 --> 00:07:45,239 Speaker 1: of coffee a day, as if they're consumed in the morning, 116 00:07:46,000 --> 00:07:49,720 Speaker 1: you get a lower risk of death, particularly from cardiovascular disease. 117 00:07:50,320 --> 00:07:53,120 Speaker 1: Drinking it into the afternoon and evening appears to negate 118 00:07:53,160 --> 00:07:56,720 Speaker 1: those benefits for most people, and there is simply no 119 00:07:56,840 --> 00:08:00,360 Speaker 1: evidence that it increases a FIB risk and may even 120 00:08:00,560 --> 00:08:03,240 Speaker 1: lower it. So the big take on here is that 121 00:08:03,320 --> 00:08:06,400 Speaker 1: little ritual of having a cup of coffee, particularly in 122 00:08:06,440 --> 00:08:10,559 Speaker 1: the morning, could actually be a longevity to but try 123 00:08:10,600 --> 00:08:14,240 Speaker 1: to avoid it particularly afternoon. The guide that I use 124 00:08:14,760 --> 00:08:17,200 Speaker 1: for people is trying to be done eight ours before 125 00:08:17,200 --> 00:08:20,240 Speaker 1: you go to bed, and then it really won't affect 126 00:08:20,240 --> 00:08:22,720 Speaker 1: your sleep, but you'll get all of those benefits. Now, 127 00:08:22,800 --> 00:08:27,120 Speaker 1: the big question that hasn't been answered on this, and 128 00:08:27,360 --> 00:08:29,520 Speaker 1: a particular interest for people like me who don't drink 129 00:08:29,560 --> 00:08:33,000 Speaker 1: coffee but do drink tea, is does tea have the 130 00:08:33,040 --> 00:08:37,160 Speaker 1: same effect. I am now motivated to dig into literature 131 00:08:37,240 --> 00:08:39,320 Speaker 1: and see if we can find anything, so stand by 132 00:08:39,360 --> 00:08:42,720 Speaker 1: on that one until then. That's it for this week 133 00:08:42,760 --> 00:08:44,720 Speaker 1: of Wisdom Wednesdays. Catch you next time.