High Coffee Consumption May Boost Survival Among Those with Genetic Polymorphisms

Coffee drinkers with genetic polymorphisms may not need to be concerned with their coffee consumption based on new research. Recent evidence suggests that coffee consumption may have health benefits and even reduce the risk of death.¹ Other health benefits of coffee include a reduced risk of cardiovascular disease, type 2 diabetes, Parkinson’s disease, cirrhosis, and gout. Pharmacists can also play an important role in counseling individuals regarding the benefits versus risks of coffee based on patients’ health conditions.

Genetic Polymorphisms and Caffeine

Some individuals may be more susceptible to the effects of caffeine based on their genetic makeup. Caffeine is absorbed from the gastrointestinal tract and is metabolized by cytochrome P-450 enzymes.² Individuals with variations in their genes such as CYP1A2 may either be fast or slow metabolizers of caffeine. Studies have previously demonstrated mixed evidence regarding the effects of caffeine consumption in those with genetic polymorphisms.²

Coffee Consumption Study

In a recent study published in JAMA Internal Medicine, researchers from the National Cancer Institute examined the associations of coffee drinking with mortality.³ The UK Biobank population-based study took place in Britain and invited about 9.2 million individuals from across the United Kingdom to participate. More than 500,000 patients with an average age of 57 years participated in the coffee drinking study, and baseline demographics, lifestyle, and genetic polymorphisms were analyzed over a 10 year period. (Pregnant patients were excluded from the study.)

The study found that coffee drinking was associated with a decreased risk of mortality compared with non-coffee drinkers, even in participants consuming at least 8 cups a day and those with genetic polymorphisms. Additionally, these effects were consistent among all coffee types, including decaffeinated coffee.³ This is an observational study, and a correlation was found, but further research is necessary.

Pharmacist’s Role in Counseling about Coffee Consumption

Pharmacists can play an important role in counseling patients about coffee consumption. Warn patients to avoid dietary supplements consisting of pure or highly concentrated caffeine powder or liquid forms that are illegal when sold directly to consumers in bulk packaging. One teaspoon of powdered pure caffeine is equivalent to about 20-28 cups of coffee, which can be a toxic dose.⁴ In fact, the FDA has issued warning letters to companies to stop selling these products that have been linked to 2 deaths in healthy individuals.⁴

Patients drinking coffee beverages should try to avoid regular consumption of specialty drinks that may contain a lot of sugar, and choose healthy options. Pregnant patients should avoid heavy consumption, and stick to one 12 ounce cup of coffee a day, as large amounts of caffeine may be linked to an increased risk of miscarriage. Pharmacists can become involved in pharmacogenomics studies to further assess the safety of coffee consumption in patients with genetic polymorphisms.

References:

• Gunter MJ, Murphy N, Cross AJ, et al. Coffee drinking and mortality in 10 European countries: A multinational cohort study. Ann Intern Med. 2017;167(4):236-247.
• Yang A, Palmer AA, Wit HD, et al. Psychopharmacology. 2010;211(3):245-257.
• Loftfield E, Cornelis MC, Caporaso N, et al. Association of coffee drinking with mortality by genetic variation in caffeine metabolism. JAMA Intern Med. July 2, 2018. doi:10.1001/jamainternmed.2018.2425.
• U.S. Food and Drug Administration. FDA warns companies to stop selling dangerous and illegal pure and highly concentrated caffeine products. https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm609862.htm. Accessed July 3, 2018.