LiveLongAgeWell

I chuckled to myself as I sat down to write this Part III of “mind drugs”, because I just read an article in today’s online New York Times about how caffeinated coffee—conclusively shown to be a performance enhancer in many sports—is the only supplement that truly enhances athletic performance that is not banned by anti-doping regulations. Caffeine is a mind drug as well as a body drug, but somehow—probably because it is ubiquitous, accepted everywhere—it would be too hard to regulate out of sports competitions, yet those who use it have a clear edge over those who do not.

In the post two days ago I addressed some safety concerns regarding mind drugs (known otherwise as “cognitive enhancers”), including the risk of addiction. Beyond safety issues, others object to cognitive enhancers because they are not “natural” for the brain, and further, that use is not moral as they give some people an unfair advantage.

The first issue regarding “natural” I don’t believe has credence. Much of what is done today in medicine—to people and by people—is not “natural”, and the pace of what is acceptable yet unnatural seems to be accelerating. I suspect only the most religiously orthodox today would protest contraceptive pills or condoms (not natural), though I know many who might be squeamish about Viagra or breast implants as unnatural, but they might well accept kidney transplants or in vitro fertilization; certainly far from natural. I think it’s very difficult to condemn anything in medicine today as unnatural.

The issue regarding morality and cognitive enhancers is a thornier topic, but it seems that over time, more mainstream scientists and doctors are saying yes, it’s fine for otherwise normal people to take a prescription drug that enhances one’s brain function temporarily by helping them think more clearly and delaying their need for sleep.

The moral question brings us back to coffee. Caffeine enhances calcium release from muscles, which allows those athletes who take it before competition (in pill form or as coffee) to run faster and longer—and as it also acts on the brain—with less sense of fatigue. Those who use it get at least a five percent performance boost over non-users.

Cognitive enhancers such as modafinal (Provigil), our model drug for this mini-series, likely improves the test-taking performance of those who take it before, say, a college-entrance exam, or a police qualification test (consider the comment from last post). There is no way to blood-test and know who took it versus those who did not. Is this mental-doping moral? Certainly it is less of an issue if everyone has equal chance to take an enhancer beforehand, but many would choose not to for a number of reasons: moral or fear of short term side effects or addiction or the possibility of long term brain damage. Modern medicine and advanced pharmaceuticals are presenting us ever more with these dilemmas, running faster than our answers.

Next….Indecisive Medical “Experts”, Dr. Oz, And Real Age®

Last post I gave some background information on coffee, and today I am offering some practical pointers on how to maximize the health benefits of coffee. This is from my upcoming book How To Drop Dead Dancing In Your 90s: Live Long Age Well. If you have any thoughts or comments about coffee drinking and health, please leave a comment! In the meantime, I suggest you grab a cup and read on…

• Choose caffeinated coffee if you can, because it has greater health benefits as far as decreasing your risk of Parkinson’s disease and diabetes, and caffeine tends to increase your HDL (good) cholesterol. Decaffeinated coffee can raise your cholesterol level. If you cannot tolerate much caffeine, try caffeinated in the morning, and decaf later in the day. If that’s still too much caffeine, at least limit your decaf to one to two cups per day. If you drink decaf, buy high-quality, water-processed decaf that has been prepared through a filter (not the espresso style).

• The ideal healthy amount of caffeinated coffee is one to four cups per day, ideally two to three, spaced throughout the day to avoid caffeine rebound when the coffee jolt wears off.  If coffee keeps you up at night, try drinking earlier in the day before resorting to decaf. When you consider “bad health behaviors”, drinking more than four cups a day is not so bad, but if you drink a lot, you are more likely to become caffeine addicted (one of the easier addictions to beat if needed), and you need to keep an eye on your blood pressure. If you get jittery or notice heart palpitations, cut back.

• If you often drink “fancy” coffee drinks, think about the calories. If you order one of the über-marketed (whatever)-ccinos, you could ingesting over 500 calories in that one tasty drink. (Hint: be suspicious of any drink that has the ® symbol…it’s probably full of unhealthy calories.)  If you drink a ® coffee regularly, probably you have moved coffee from something healthy to something that could make you fat and harm your heart.

• Filtered coffee or percolated or instant is the healthiest. Less healthy is French press, boiled, and (unfortunately) the espresso types, because those styles, taken as an espresso, or mixed into a latte or cappuccino and into any number of other chic-ccinos, can increase your cholesterol. A coffee filter removes harmful chemicals that naturally are found in coffee (such as kahweol and cafestol), and espresso drinks are not filtered.  Of course once in a while it’s fine to drink espresso or lattes or cappuccinos, but for your basic coffee, remember that regular filtered coffee is healthiest. If you want to be both chic and healthy when you order, ask for a “Caffé Misto” or “Café au Lait” (filtered coffee with steamed milk). You can still use the French name, but the barista should make your drink with filtered coffee rather than the less-healthy espresso type.

• Coffee and osteoporosis: if you take enough calcium in your diet, 1000 to 1200 mg. per day, you probably don’t have to worry about coffee lowering your calcium level. But if you have a concern about bone thinning, take your coffee with milk or better, soy or skim milk, and if you have a serious issue, talk to your doctor. If you are pregnant or lactating, many doctors feel a cup of coffee is probably OK, but discuss with your physician.

• If you have high or borderline blood pressure, occasionally check your pressure after coffee. If you have coronary artery disease (narrowed blood vessels in the arteries of your heart), you should wait an hour after drinking coffee before doing significant exercise.

• For some reason I don’t understand, anti-oxidants have the nasty tendency to stain your teeth... nothing is perfect.  But be careful—coffee can ruin your smile, so swish water after drinking to avoid the un-sexy dark teeth look. Or chew a stick of sugar-free gum (especially good is gum with xylitol) after coffee to freshen your breath and keep your teeth white.

Occasionally I will post an excerpt from the draft of the book I am writing: How To Drop Dead Dancing In Your 90s: Live Long Age Well. Frequently people ask me about coffee: is it really good for you? is caffeinated OK?  So I chose to include this sample. Here is Part One from the coffee section of my upcoming book…

Antioxidant Rich…Drink It…Especially Caffeinated

It seems almost natural to think that all those great anti-oxidants are found only in colorful fruits and vegetables, so we might find it hard to believe that something so colorless and flat and black as coffee could be so healthy for you, but it is. If you drink caffeinated coffee, lose your guilt, because you are enjoying something that, it turns out, is really good for you, and as a bonus gives you a natural mental and physical boost. Coffee is full of anti-oxidants and there are many studies now that show coffee is almost a new super-food, with little downside. It doesn’t lead to ulcers, hypertension, or cancer. Quite the opposite is true. Recently an international research group rated the per-serving antioxidant content of foods and amazingly, coffee ranked higher on the list than either blueberries or red wine. In the American diet, coffee may be the #1 source of anti-oxidants.

There is excellent evidence coffee protects your liver from damage and decreases the risk of cirrhosis and gallstones, so especially if you do drink more alcohol—even wine or beer—than generally advised (one to two drinks per day), you should probably also drink a few cups of coffee daily (although cutting down on the alcohol would be better). A 2005 Japanese study showed that people who drank 3 or more cups of coffee per day had a 50% less risk of liver cancer, and there is evidence coffee drinkers also have a lower risk for colon cancer. Coffee can temporarily raise your blood pressure and heart rate, but does not lead to the disease of hypertension.

For diabetics and for those worried about becoming diabetic as they get older: coffee should be fine for you. While there is still some controversy, both decaf and caffeinated coffee seem to lower the chance of developing diabetes, though the protective effect is better with caffeinated coffee. Another advantage of caffeinated coffee is that while decaf can lead to an increase in both your total and LDL (bad) cholesterol,  caffeinated coffee will not; in fact, the caffeinated version is most likely good for your heart, as it tends to raise your HDL (good) cholesterol level.

Let’s talk about your brain on coffee. We all know that regular coffee will boost your energy level, temporarily at least, but more important, caffeinated coffee seems to have what is called a “neuroprotective effect”, and a number of studies have shown a 40-80% decreased risk of Parkinson’s disease in people who regularly drink more than one cup of (caffeinated, not decaf) coffee per day. However, if you are a post-menopausal woman who has been on estrogen therapy, this anti-Parkinson’s effect apparently does not hold for you.

All this is remarkable enough, but further studies now are suggesting that caffeinated coffee probably protects you from long-term memory loss, and even cuts your chance of developing Alzheimer’s disease. Researchers are now working to develop various coffee-related compounds that might result in treatments for Parkinson’s disease, alcoholism, alcoholic liver disease, and even depression.

On Monday…practical pointers on ways to maximize the health benefits of coffee.