I consider coffee to be a gray-area food, and by that I mean that the scientific research suggests that it’s beneficial when it’s well tolerated by the individual, but it’s not always well tolerated. Other foods that would fit into this category would be dairy products, properly prepared legumes, even properly prepared grains, dark chocolate, alcohol, even tea. These are things that our ancestors didn’t eat. They’re all relatively new agricultural foods, meaning they’ve only been around for the past 10,000 or 11,000 years or even less in other cases, and we don’t have as long of a history of being adapted to these foods, so there’s a higher chance that they may cause harm.
In this episode, we cover:
5:52 Individual responses to caffeine
13:00 Caffeine dependence and adrenal function
17:35 Coffee as a potential cross-reactive substance
Full Text Transcript:
Steve Wright: Hey, everyone. Welcome to another episode of the Revolution Health Radio Show. This show is brought to you by ChrisKresser.com. I’m your host, Steve Wright from SCDlifestyle.com, and with me is integrative medical practitioner and New York Times bestseller, Chris Kresser! Chris, how are you doing in that what looks like a studio? What are you doing in there?
Chris Kresser: Yeah, I’m in a studio in San Francisco. We’re going to be filming all day, doing some video content for a new program that we’re going to be launching in about six weeks, I think. It’s called the 14Four, and the idea is 14 days to make four big changes to transform your health and your life. The four things are diet, movement, sleep, and stress. It’s a diet and lifestyle change program, and we’re really excited about it. There are going to be video exercise demos, stress management demos, audio guided meditations, qigong – a lot of the stuff that we’ve talked about over the years but just delivered in a way that’s super easy for people to just follow along, especially if they’re new to it, or people who have done this stuff before but they’ve had a hard time integrating it all into their lives and keeping it up. The idea is this is a two-week total body, total health, body-mind-spirit reset. It helps people to develop these habits and get back on track and stick with this stuff over the long term. So this is something that people might want to do on a regular basis once every three or four months or just come back to when they feel like they’ve fallen off the wagon, so to speak. I’m really excited about it.
Steve Wright: Yeah, that sounds fabulous. I think 14 days is just long enough to be kind of painful, which is good, and hopefully start to make some habit change. I like it.
Chris Kresser: Yeah, and it’s doable. Two weeks, everybody can kind of get behind that. Even though, like you said, it might be a challenge in some ways, it feels within the realm of possibility.
Steve Wright: Yeah.
Chris Kresser: Whereas 30 days, again, it’s not too long for many people, but there are a lot of folks who just because of the craziness of daily life that seems like too big of a commitment, and so we wanted to make this as accessible to as many people as possible. And also, you know, sometimes if people are generally already doing pretty well, two weeks is enough to get back on track, and we’re talking about adding things that aren’t typically included in these programs. Most of these programs are just diet, which is great and important, but as we’ve discussed ad nauseam on this show now, sometimes physical activity, sleep, and stress management might even be more important in terms of changing your health, preventing and reversing disease, and just feeling better. I know you’ve seen that in your work with people, Steve, and I certainly do all the time.
Steve Wright: Heck, I see it with myself all the time.
Chris Kresser: Yeah, exactly! So this is what I’m doing today, but we’re going to sneak in a little episode before I get started with this stuff. We have a pretty quick question today. We’re going to have to keep it a little shorter because of the studio time, but let’s play it back.
Question: Hi, Chris. Love your show. I have Hashimoto’s disease and low cortisol. I stopped drinking caffeine back in January, but I’m not sure if that is really making a difference. I only drank about 6 to 8 ounces a day, and I love the idea of drinking the Bulletproof Coffee with very high quality coffee, coconut oil or MCT oil, and grass-fed butter. Do you feel that drinking one cup of coffee a day is detrimental to my health?
Chris Kresser: OK, that’s a great question, and the thing I like about this question is that it applies to a lot of other gray-area foods. I consider coffee to be a gray-area food, and by that I mean that the scientific research suggests that it’s beneficial when it’s well tolerated by the individual, but it’s not always well tolerated. Other foods that would fit into this category would be dairy products, properly prepared legumes, even properly prepared grains, dark chocolate, alcohol, even tea. These are things that our ancestors didn’t eat. They’re all relatively new agricultural foods, meaning they’ve only been around for the past 10,000 or 11,000 years or even less in other cases, and we don’t have as long of a history of being adapted to these foods, so there’s a higher chance that they may cause harm.
Individual Responses to Caffeine
It’s really interesting that when you look at the research on coffee, if that’s all you did and didn’t consider any individual reaction, you would come away with the impression that coffee is an incredibly healthy substance. If you look at the scientific studies comparing mortality, risk of death, risk of different diseases of coffee drinkers – and quite a bit of coffee, too; sometimes in these studies people are drinking three to five cups of coffee a day – they generally have lower risk of early death, lower risk of metabolic diseases like diabetes, lower risk of cardiovascular disease, lower risk of disease across the board, so it’s really fascinating to just look at it from that perspective because if you only did that, you would say, “Hey! There’s no problem at all! Everyone should be drinking three to five cups of coffee a day.” Right? Well, maybe not right, because we know that there are individual differences. And I like this question, too, because it also highlights a really important thing to understand about scientific research, which is that it only deals in averages.
If you do a study and the goal of the study is to track the difference in mortality with coffee drinkers, then you’ll find inevitably that some people who drank more coffee had a higher risk of death, some people had the same risk of death, and some people had a lower risk of death. But then to make the study useful, of course, they average that all out and they come up with a conclusion. They say most people in the study on average had a lower risk of death when they were drinking more coffee, but what doesn’t come across in that conclusion is that some individuals in that study actually may have had a higher risk of death, they may have had other side effects that weren’t discussed or tracked in that study or were but were statistically insignificant because only a few people had them, so these studies are helpful because they give us a general idea of the overall benefit or consequence of a particular substance, but we’re all individuals. As a clinician, I work with people who are individuals. We don’t work with averages. We don’t treat large groups of people at the same time typically, so there are other important considerations with coffee.
Steve Wright: Yeah, especially when you start breaking down the quality of the coffee. One of the most fun parts of coffee is the caffeine, and people like myself who have gene variance, I can only handle so much caffeine in a day.
Chris Kresser: Mm-hmm.
Steve Wright: And actually my mom has, like, zero tolerance almost.
Chris Kresser: Right.
Steve Wright: So these studies never are going into any sort of, I don’t think, work into that kind of thing.
Chris Kresser: Yeah, they’re not talking about that. Coffee now is one of the most heavily sprayed crops, so there could be a difference between organic and nonorganic coffee, although you would expect that maybe to show up in the mortality numbers. If those differences were significant in terms of how they were affecting our health, you might think that that would show up in the mortality numbers, so it’s possible that there are differences and they’re not significant enough to change the numbers, or it’s possible that the studies aren’t really detecting that.
But I’m actually thinking more on the level that you just mentioned, Steve, which is that people have really different responses to caffeine, and that depends not only on genetics, like you mentioned, but it also depends on where they are in their life, especially their adrenal status. If you’re burning the candle at both ends, you’re sleep deprived, you’re overtrained, and you’re dealing with a chronic illness, coffee could be an absolutely terrible idea for you. You drink coffee and you just get totally jittery and wired or it makes you more tired paradoxically, which is interesting. A lot of people aren’t aware of this, but when they’re drinking coffee regularly, they feel more tired, which, of course, leads to drinking more coffee, and it’s only when they stop drinking the coffee that they figure out that, “Hey, that was actually making me more tired not more awake.” So if you have any of these conditions that I just mentioned – I’ll go over it again. If you’re tired, you’re not sleeping well, you have difficulty falling asleep or difficulty staying asleep, you wake up feeling really tired in the morning, you feel you have energy crashes in the afternoon, you’re having difficulty recovering from exercise or you have exercise intolerance, you have postural hypotension where you get dizzy when you stand up quickly –
Steve Wright: You’re addicted to exercise.
Chris Kresser: Yeah, or you’re overtrained, you’re exhausted from your workouts, you really crash after your workouts, you’re not progressing – all of this stuff points to what we call adrenal fatigue syndrome. The more accurate term would be hypothalamic-pituitary axis dysregulation.
Steve Wright: Didn’t we call it HPA-D, like, three years ago?
Chris Kresser: HPA-D, yeah. We need to bring that back because adrenal fatigue is just such a problem. It makes doctors roll their eyes and tune out, whereas if they really understood what people meant when they say that is HPA axis dysregulation, I think they’d be more open to it, but that’s a whole other thing.
If you have any of those issues, coffee is probably a bad idea – or at least a lot of coffee. You may be able to tolerate small amounts, like a half-decaf, half-regular cup of coffee or something like that occasionally, but it’s generally best to stay away from that until your adrenal situation recovers.
Steve Wright: You know, Chris, I’ve been thinking about this a lot with our recent leaky gut product.
Chris Kresser: Yeah.
Steve Wright: I think it was Pedram from Well.org who put it to me best, which is that the business of trying to help other people get healthy is inherently unhealthy. What I kind of noticed is you mentioned something really important earlier, which is where you’re at in your health curve, like, where you’re at currently with your health and adrenal function might dictate your tolerance to coffee. So as I entered into that stressful period of time, I stuck to my one cup, maybe two cups a day. As the stress piled on, I seemed to have more tolerance. Even though I don’t metabolize caffeine, I was like, “Man, I can do, like, six cups now.” But then it just all crashed and all of a sudden I couldn’t handle one cup.
Chris Kresser: Yeah.
Steve Wright: I don’t know if there’s some sort of theory of caffeine dependence and adrenal function.
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Caffeine Dependence and Adrenal Function
Chris Kresser: Oh, sure. Yeah. Caffeine is addictive, and if someone is going to get off coffee, I always recommend that they do it slowly instead of doing it cold-turkey. It can be pretty brutal if you do it cold-turkey because you have habituated to it, so it’s often a good idea to just generally ramp down over a period of maybe two to four weeks depending on how long you’ve been drinking coffee and how much you’ve been drinking for that exact reason.
You also want to pay attention to your response, obviously. This probably goes without saying, but often people don’t actually pay attention to these things, so I just want to mention it. If you drink coffee and later in the day you feel exhausted and your energy crashes, you might think that that actually is a sign that you need more coffee, as I said, but it’s often a sign that the coffee is screwing with your adrenal function. If you drink it and you feel jittery and kind of wired afterwards or hyper-stimulated, that’s probably not a good idea. What you should feel if you’re doing well with it is just kind of a natural lift, maybe an improvement in mood and just a natural improvement in mental clarity, and it shouldn’t have a really big systemic effect on energy production.
Steve Wright: I think those people who claim to be able to just live on coffee, I’ve been in that state before, and I think that’s right before the crash, too.
Chris Kresser: You’re right.
Steve Wright: So if someone’s listening to this right now and just staunchly in their head defending, “I can drink it all day long,” I’d say you’re right at the risk point here of something bad.
Chris Kresser: Maybe, because that’s the other side of this. There are people – I don’t know that many of them, to be honest, but they’re out there and they’re in some of these studies – that are able to drink three to four cups of coffee a day with no apparent ill effects. They sleep well. They’re able to exercise and improve and they’re not exhausted. They don’t have any other signs or symptoms of adrenal fatigue. They don’t feel jittery or agitated after they drink the coffee. For these people, it’s hard to make an argument against drinking that much coffee. If it’s not affecting you in any noticeable way and you feel good when you drink it, that’s where the research comes in and says, yeah, that coffee is beneficial. And the reason for that, there have been lots of different proposed mechanisms, but one of the main ones is that coffee is loaded with phytochemicals and antioxidants that are really beneficial. In fact, a recent study just came out that said that middle-aged people who drink coffee have a lower risk of Alzheimer’s and dementia. That may be because of the antioxidant effect because both of those conditions are really kind of driven by oxidative damage in the brain.
Steve Wright: So you think three to four is kind of pushing it? In my head I was thinking six to ten because I know a large portion of America is still really on that, and I’m thinking of a cup as in a caffeine load.
Chris Kresser: Right.
Steve Wright: So if you get a double mocha chocolatto-whatever, you’re pushing three cups.
Chris Kresser: Yeah. That’s a good point. We have to define what we’re talking about. An 8-ounce cup of Dunkin’ Donuts brewed coffee is one thing, but a grande triple-shot espresso is obviously a different story even if from an ounce-to-ounce perspective it’s roughly similar.
Yeah, I think that the most important takeaway here is tolerance to caffeine and coffee depends entirely on your individual circumstances. So use some of the guidelines that we’ve talked about to figure out where you fall on that spectrum. If you’re dealing with chronic illness, you’re dealing with adrenal fatigue syndrome, you’re not sleeping well, you’re overstressed or overtrained, coffee is probably a bad idea, but at the very least, you should be really cautious. If you’re doing pretty well overall, you’re mostly healthy, your sleep is good, your training regimen is solid, I guess we could say drink as much coffee as you can tolerate without screwing all of that up! That’s basically what the research is telling us.
Coffee as a Potential Cross-Reactive Substance
There is one other consideration, though, when it comes to coffee that has nothing to do with caffeine, and that’s its potential as a cross-reactive substance for people who are gluten intolerant. I do a lot of testing of people for gluten intolerance, of course, but if they are gluten intolerant, we often will go on and do the Cyrex Array 4, which is the cross-reactive protein test. What that test does is it looks at a bunch of different proteins in different foods that people who are gluten intolerant also tend to react to. These are things like dairy; corn; soy; potato; some of the alternative grains like quinoa, amaranth, millet, tapioca, teff; and then things like chocolate and coffee; and much to probably a lot of people’s disappointment who are listening to this show, from talking to Cyrex Labs, they say that the substance that the is most common cross-reactant for people with gluten intolerance is – drumroll – coffee! That means if you’re gluten intolerant, if you’ve been diagnosed with either celiac or non-celiac gluten sensitivity, I would recommend if you can get the Cyrex Array 4 to see if you’re reacting to coffee because if you are, it’s to the protein which are both in decaf and caffeinated coffee. So if you can’t tolerate coffee and you wonder why, it may not have anything to do with caffeine. It may have to do with the proteins in the coffee, especially if you’re gluten intolerant.
Steve Wright: And we know that caffeine and coffee in some studies has been shown to be a gut irritant, so the population of celiac and non-celiac gluten sensitivity are dealing with a gut that’s already inflamed, broken down or at least more susceptible to that if you’ve already healed from it, and so just being careful with any sort of gut irritant is probably wise.
Chris Kresser: Exactly. Yeah.
Steve Wright: We’re touching a lightning rod right now of cross-reactivity with coffee. I thought most of the studies were on instant coffee. Cyrex is saying that they’re doing something different than the instant coffee studies?
Chris Kresser: Yeah, that’s my understanding. I could be wrong, but I’ve also had a lot of patients who have done this kind of experimentation under my guidance or just on their own steam where they experiment with organic coffee, both caffeinated and decaf, to see if it’s maybe the pesticide that they were reacting to. Then if they still react to organic caffeinated coffee, they do organic decaf. Then even beyond that, they switch to water-filtered decaf or even cold-brewed decaf to reduce the tannin content because some people really react to the tannins in coffee and the cold-brewed stuff doesn’t have as much tannin in it. So they’ve done all these experiments and they still react, and then we do the Cyrex panel and find out that they’re reacting to coffee.
I think we’ve talked about my general opinion of these tests. I don’t think they’re all necessarily ready for primetime, and I don’t take the results of any of the food intolerance, cross-reactive protein testing as a black-and-white thing. If somebody comes back as positive for one of these substances, I don’t suggest that they avoid that food for the rest of their life based only on these test results. What I suggest is that we use the results as a starting place to do some experimentation. So we would remove those foods for a period of time and then add them back in and see what happens. And if they have a response that corroborates the test results, then I would be much more inclined to believe that they’re legitimate. But even then, it’s possible that after a gut-healing program they may be able to start tolerating some of those foods again, and I’ve definitely seen that happen.
Steve Wright: Yeah, I’ve totally seen that happen. Actually Jordan, the producer of this show and my buddy, he had the same thing. He couldn’t do coffee for, like, two years, and now he’s fine with one or two cups a day.
Chris Kresser: That’s also true for me. In the throes of my illness and journey back to health, I couldn’t even get close to coffee, even decaf. Decaf actually made me feel worse than caffeinated coffee, and I think in part that might have been my sensitivity at that point to the chemicals that were used to process decaf, although I even sometimes had it with water-filtered decaf. I still don’t do well with lots and lots of coffee, but I can have a coffee on most days, and if I’m on vacation and my stress levels are really low, I could probably drink three cups of coffee in a day. That’s something really interesting, too, that other people listening to this may have noticed, and this gets to our earlier point about how coffee and caffeine is so individual based on your circumstances. I know a lot of people, a lot of my patients have said this, too. When they go on vacation, they have no trouble with coffee, but when they’re at home in the context of their daily life, they can’t drink it. And that’s because they’re already kind of operating at a stress level up here and coffee just pushes them over the edge, but when they’re lying on a beach in Hawaii or something, they have a little bit more of a buffer and it doesn’t make as big of a difference.
So once again, there’s no one-size-fits-all approach. Pay attention to your body, listen to what it tells you, and that will be your guide.
Steve Wright: Yeah. I think it’s so sometimes, like, hair-pulling maddening when you go down rabbit holes like this and you can scour the research, then you can scour the biology of the plant and the interactions of the body, and you come out the other side and you realize that, “Oh man, I just have to pay attention to my own body!” There are just too many variables.
Chris Kresser: That’s right. Well, that was why I wrote my first book, to try to help people do that. I thought that then, and I still think it now. It’s probably the most important thing that we can learn to do, is pay attention to our own experience and our bodies because that’s what’s going to lead us to the thing that works best for us.
All right, I have to duck out. I think the videographer is about to show up any minute. I have a fun day in the studio, and I can’t wait to introduce 14Four to you guys in a few weeks.
Steve Wright: All right. Thanks, Chris. In between now and 14Four, I’m sure Chris will be giving lots of updates on Facebook, and you can go to Facebook.com/ChrisKresserLAc and Twitter.com/ChrisKresser for updates and show notes and good ideas in between shows, so make sure you check him out over there.
Chris Kresser: Bye-bye, everyone!
Steve Wright: See ya!
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