Coffee spikes your Cholesterol: the Cafestol and Kahweol effect

The bad news of a high cholesterol reading was a bit of a shock for me.

I knew my diet had slipped (too much red meat, too much cheese: I love cheese). Equally,  I knew that to reduce  cholesterol  “all you had to do”  was cut down on red meat and saturated fat.

I’d been doing blood work for some of my clients and was able to  use my home blood test machine to check my level.

I was horrified.

3 weeks after a major diet shift my cholesterol remained  stupidly high. I looked over  the guidelines again, and  focused on the fibre content, so I bought fibre ( oat and wheat) and added that. Rather than my horror 311 readings I was getting 270’s 280’s.

Still,  80 points over my threshold.

I then started daily tests and compared the results with my food diary. I saw days where I had nothing but some fruit and a few cups of coffee with stupid cholesterol levels.

Equally, I noticed a no coffee day, producing a low reading.

I started researching coffee.  A lot.

What I rediscovered was this.

By the turn of the  20th century, medical, and food researchers knew one thing for sure.

Unfiltered coffee is a cholesterol bomb. There were so many studies all saying the same thing, and much of the research can be seen in this report

“Cafestol and Kahweol.  Review of Toxicological Literature 1999”.

Source here

Drink unfiltered coffee and it sends your Cholesterol rocketing due to two chemicals in coffee called Cafestol and Kahweol.

The numerous tests and reports quoted in the review of Toxicological Literature nailed this fact to the mast  (see appendix 1)

So why doesn’t every coffee shop in the UK have a massive warning plastered all over it? Everybody hears how bad red meat and saturated fat  is for cholesaterol, so when you see your doctor after a high cholesterol test, why don’t they ask about your coffee consumption?

Well, everybody loves coffee. So there is an understandable bias in its favour.

Crucially in the 1990’s when this was discovered, most people drank filtered coffee “the cholesterol-raising effect seems to be limited to coffee that hasn’t been filtered, which includes Turkish coffee, coffee brewed in a French press, and the boiled coffee consumed in Scandinavia”   . (Harvard health in 2012 ) in fact “The cholesterol-raising ingredients in coffee are oily substances called diterpenes, and the two main types in coffee are cafestol (pronounced CAF-es-tol) and kahweol (pronounced KAH-we-awl).

But a paper filter traps most of the cafestol and kahweol, so coffee that’s been filtered probably has little, if any, effect on cholesterol levels.”

This was fine back in the last 20th century.  We mainly drank filtered coffee then . Im 58, I know.

But Guess what? Since the start of the 21st century unfiltered coffee consumption has rocketed. While some coffee shops have an unfiltered coffee option, most push and market unfiltered coffee

I don’t know how many coffee shops there were in 1999, but since 2008 the amount of coffee shops in the UK have grown from 10,000 to 25,000 in 2019. Most  coffee shops offer unfiltered coffee.

Thats a lot of cholesterol raising!

So, I should make it clear, I love coffee. The only effect  this  rediscovery has had  on me is to switch to filtered coffee. I’ve even cut filter paper into  small  circles to put into espresso machines. Some coffee shop don’t mind doing this.

The real horror is this.

If I had gone back to my doctor, they would have pushed me to go on statins. They would not have even mentioned coffee. Im guessing that anyone who has 2 cups of unfiltered coffee a day, and is on statins, should drink filtered coffee and get retested ( having chatted to their doctor first , ofcourse)

In balance I should say that coffee and caffeine have health effects. I think, almost all of which can be obtained through the filtered variety.

 

 

Appendix 1

In an open randomized study, healthy male and female volunteers who drank coffee containing 148 mg cafestol and kahweol daily for 30 days exhibited a considerable rise in total cholesterol (average mean, 31.6%), low density lipoprotein (LDL) cholesterol (50.2%), and triglyceride concentrations (87%) versus the control group (Heckers et al., 1994).

In three volunteers, consumption of highly purified cafestol (73 mg/day; 0.23 mmol/day) and kahweol (58 mg/day; 0.19 mmol/day) as the corresponding mono- and dipalmitates for 6 weeks increased the serum levels of cholesterol by 66 mg/dL (1.7 mmol/L) and triglycerides by 162 mg/dL (1.83 mmol/L) (Weusten-Van der Wouw et al., 1994).

In a randomized, crossover trial using healthy, normolipemic volunteers, six subjects received 2 g Arabica oil containing 72 mg (0.23 mmol) cafestol per day and 53 mg (0.17 mmol) kahweol per day, and five subjects received 2 g Robusta oil providing 40 mg (0.13 mmol) cafestol per day and 2 mg (0.006 mmol) kahweol per day (Mensink et al., 1995). Compared to a control group given placebo oil, serum triglyceride levels increased 71% in the group receiving Arabica oil and 61% in the group given Robusta oil. Serum cholesterol concentrations were increased by 13% for both oils.

references

Cafestol and Kahweol.  Review of Toxicological Literature 1999  accessed online  (Sept/Oct 2019) https://ntp.niehs.nih.gov/ntp/htdocs/chem_background/exsumpdf/cafestol_508.pdf

Heckers, H., U. Göbel, and U. Kleppel. 1994. End of the coffee mystery: Diterpene alcohols raise serum low-density lipoprotein cholesterol and triglyceride levels. J. Intern. Med. 235(2):192-193.

Weusten-Van der Wouw, M.P.M.E., M.B. Katan, R. Viani, A.C. Huggett, R. Liardon, P.G. Lund-Larsen, D.S. Thelle, I. Ahola, A. Aro, S. Meyboom, and A.C. Beynen. 1994. Identity of the cholesterol-raising factor from boiled coffee and its effects on liver function enzymes. J. Lipid Res. 35:721-733.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mensink, R.P., W.J. Lebbink, I.E. Lobbezoo, M.P. Weusten-Van der Wouw, P.L. Zock, and M.B. Katan. 1995. Diterpene composition of oils from Arabica and Robusta coffee beans and their effects on serum lipids in man. J. Intern. Med. 237(6):543-550.

In a randomized, double-blind parallel study, van Rooij et al. (1995) found that Arabica oil, containing 68 mg (0.21 mmol)/kg cafestol and 85 mg (0.27 mmol)/kg kahweol, raised serum total cholesterol by 44.1 mg/dL (1.14 mmol/L) and plasma triglycerides by 72 mg/dL (0.81 mmol/L) but that the effects of Robusta oil, providing 29 mg (0.092 mmol)/kg cafestol and 1 mg (0.003 mmol)/kg kahweol, were not statistically significant. At a daily dose of 3 g coffee oil for 4 weeks, subjects showed increases of 49 mg/dL (1.3 mmol/L) in serum cholesterol, 73 mg/dL (0.82 mmol/L) in serum triglycerides, and 41 U/L in serum alanine aminotranferase (ALT) activity (upper limit of normal = 53.5 U/L) (Weusten-Van der Wouw et al., 1994). When a coffee oil fraction enriched in non-triglyceride lipids (0.75 g/day, providing a daily dose of 81 mg [0.26 mmol] cafestol and 98 mg kahweol [0.31 mmol]) was given, similar increases resulted. In contrast, 2 g/day of coffee oil stripped of cafestol and kahweol had no effect. 14 ILS Integrated Laboratory Systems TOXICOLOGICAL SUMMARY FOR CAFESTOL AND KAHWEOL 10/99 Consumption of coffee including fine particles suspended in the coffee (fines) containing cafestol and kahweol was shown to be associated with an increase in serum cholesterol and ALT activity in volunteers in a randomized controlled parallel study (Urgert et al., 1995a). In the test group—members of which ingested 8 g fines with a mean of 39 mg (0.12 mmol) cafestol and 49 mg (0.16 mmol) kahweol daily for 21 days—the serum cholesterol level increased by 25 mg/dL (0.65 mmol/L), the triglyceride concentration by 27 mg/dL (0.30 mmol/L), and ALT activity increased by 18 U/L (upper limit of normal = 53.5 U/L), compared to control values. Levels returned to baseline 14 weeks after the trial. In a separate study on particle size, coarse coffee grounds, providing a daily intake of 37 mg (0.12 mmol) cafestol and 54 mg (0.17 mmol) kahweol, and fine coffee grounds, providing 48 mg (0.15 mmol) cafestol and 56 mg (0.18 mmol) kahweol per day, both resulted in a mean serum cholesterol concentration of 189 mg/dL (4.9 mmol/L). Mean triglyceride levels and ALT activity in serum, however, were higher with the consumption of the latter. In a study using unfiltered brewed coffee (cafetière) versus filtered coffee, Urgert et al. (1996b) found elevated levels of total cholesterol (specifically, LDL cholesterol), ALT activity, and triglycerides in individuals who had consumed 0.9 L cafetière coffee (38 mg [0.12 mmol] cafestol, 33 mg [0.10 mmol] kahweol) per day for 24 weeks; the filtered coffee provided <1 mg of the diterpenes. ALT activity was increased 80% above baseline values relative to filtered coffee. All increases, however, were reversible upon withdrawal of treatment. The elevation of ALT suggests the liver is the target organ of cafestol and kahweol (Weuston-Van der Wouw et al., 1994; Urgert et al., 1996c). However, a study of the chronic intake of coffee (consumption of 5 or more cups of boiled or filtered coffee per day and persons aged 40-42 years) found no increased ALT activity (Urgert et al., 1996c). The effects of kahweol on serum lipids and liver aminotransferases were studied by Urgert et al. (1997) through comparison of the effects of pure cafestol (60 mg; 0.19 mmol) with a mixture of cafestol and kahweol (60 mg plus 48-54 mg [0.15-0.17 mmol] kahweol) in a crossover trial. In ten male volunteers, consumption of pure cafestol increased total cholesterol by 17%, LDL cholesterol by 19%, and triglycerides by 86%. The mixture of cafestol and kahweol caused further increases of 2%, 4%, and 7%, respectively. Similar responses were obtained from both treatments on ALT activity.

Source here Cafestol and Kahweol Review of Toxicological Literature 1999

references

Heckers, H., U. Göbel, and U. Kleppel. 1994. End of the coffee mystery: Diterpene alcohols raise serum low-density lipoprotein cholesterol and triglyceride levels. J. Intern. Med. 235(2):192-193.

Weusten-Van der Wouw, M.P.M.E., M.B. Katan, R. Viani, A.C. Huggett, R. Liardon, P.G. Lund-Larsen, D.S. Thelle, I. Ahola, A. Aro, S. Meyboom, and A.C. Beynen. 1994. Identity of the cholesterol-raising factor from boiled coffee and its effects on liver function enzymes. J. Lipid Res. 35:721-733.

Mensink, R.P., W.J. Lebbink, I.E. Lobbezoo, M.P. Weusten-Van der Wouw, P.L. Zock, and M.B. Katan. 1995. Diterpene composition of oils from Arabica and Robusta coffee beans and their effects on serum lipids in man. J. Intern. Med. 237(6):543-550.

Urgert, R., S. Meyboom, M. Kuilman, H. Rexwinkel, M.N. Vissers, M. Klerk, and M.B. Katan. 1996b. Comparison of effect of cafetière and filtered coffee on serum concentrations of liver aminotransferases and lipids: Six month randomized controlled trial. Br. Med. J. 313:1362- 1366.

Urgert, R., M.P.M.E. Weusten-Van der Wouw, R. Hovenier, P.G. Lund-Larsen, and M.B. Katan. 1996c. Chronic consumers of boiled coffee have elevated levels of lipoprotein(a). J. Intern. Med. 240:367-371.

Urgert, R., N. Essed, G. van der Weg, T.G. Kosmeijer-Schuil, and M.B. Katan. 1997. Separate effects of the coffee diterpenes cafestol and kahweol on serum lipids and liver aminotransferases. Am. J. Clin. Nutr. 65(2):519-524.

Weusten-Van der Wouw, M.P.M.E., M.B. Katan, R. Viani, A.C. Huggett, R. Liardon, P.G. Lund-Larsen, D.S. Thelle, I. Ahola, A. Aro, S. Meyboom, and A.C. Beynen. 1994. Identity of the cholesterol-raising factor from boiled coffee and its effects on liver function enzymes. J. Lipid Res. 35:721-733.

NPR from 2012 discusses fasting before a cholesterol test “Black coffee, thank goodness, is usually allowed”.

“Unfiltered coffee has much less effect on your heart disease risk than smoking, high blood pressure or being overweight,” says Dr. Martijn B. Katan, a professor at the Wageningen Center for Food Sciences and Wageningen University.

Unless you’re drinking significant amounts of unfiltered or French press coffee on a daily basis, raised cholesterol levels shouldn’t be much of a concern — at least, not when it comes to coffee. On the contrary, coffee may be able to deliver numerous health benefits. here

comforting phrases  nudge people off the scent  “Studies by a co-author – Dr. Martijn B. Katan of Vriye Univeriteit Amsterdam, Institute for Health Sciences, The Netherlands – indicate that consuming five cups of French press coffee per day (30 milligrams of cafestol) for four weeks raises cholesterol in the blood 6 to 8 percent”

“Coffee drinkers concerned about cholesterol weren’t happy about some early study results showing that coffee seems to increase cholesterol levels, and “bad” LDL cholesterol levels in particular. But upon closer inspection, the bad news turned out to be not so bad, because the cholesterol-raising effect seems to be limited to coffee that hasn’t been filtered, which includes Turkish coffee, coffee brewed in a French press, and the boiled coffee consumed in Scandinavia”  and “Espresso contains more cafestol and kahweol than paper-filtered coffee, but because it is consumed in smaller amounts, it may not have much of an effect on people’s LDL level”    . (Harvard health in 2012 )

Short term skipping of meals produces an immediate increase in cholesterol levels.

Just a personal reflection.

I was reviewing my food diary/cholesterol log. On those days when I had a tiny  breakfast, and  in effect, fasted throughout the day ( with some cups of tea and a bit of fruit), on those days, I noticed the cholesterol went back up!

superficially the report

Intermountain Medical Center. “Fasting reduces cholesterol levels in prediabetic people over extended period of time, new research finds.” ScienceDaily. ScienceDaily, 14 June 2014.

States that fasting reduces cholesterol over the longer term however  “During actual fasting days, cholesterol went up slightly in this study, as it did in our prior study of healthy people, but we did notice that over a six-week period cholesterol levels decreased by about 12 percent in addition to the weight loss,” said Dr. Horne

“Because we expect that the cholesterol was used for energy during the fasting episodes and likely came from fat cells, this leads us to believe fasting may be an effective diabetes intervention.”

The process of extracting LDL cholesterol from the fat cells for energy should help negate insulin resistance. In insulin resistance, the pancreas produces more and more insulin until it can no longer produce sufficient insulin for the body’s demands, then blood sugar rises.

“The fat cells themselves are a major contributor to insulin resistance, which can lead to diabetes,” he said. “Because fasting may help to eliminate and break down fat cells, insulin resistance may be frustrated by fasting.”

Dr. Horne says that more in-depth study is needed, but the findings lay the groundwork for that future study.

“Although fasting may protect against diabetes,” said Dr. Horne. “It’s important to keep in mind that these results were not instantaneous in the studies that we performed. It takes time. How long and how often people should fast for health benefits are additional questions we’re just beginning to examine.”

This clearly leads into a re-evaluation of intermittent fasting

The European Society of Endocrinology asked  “Could intermittent fasting diets increase diabetes risk? Fasting every other day to lose weight impairs the action of sugar-regulating hormone, insulin, which may increase diabetes risk.” ScienceDaily. 20 May 2018.

Their conclusion  was “Fasting every other day to lose weight impairs the action of sugar-regulating hormone, insulin, which may increase diabetes risk, according to data presented in Barcelona at the European Society of Endocrinology annual meeting, ECE 2018. These findings suggest that fasting-based diets may be associated with long-term health risks and careful consideration should be made before starting such weight loss programmes”

Anecdotally this makes me think about lots of thin/skinny people I know, who have poor health!

Does temperature affect Cholesterol levels

If you start thinking about the function of cholesterol,  it allegedly  (among other things) modulates membrane fluidity over a range of temperatures.

in Habitat temperature is an important determinant of cholesterol contents in copepods where it states “The most consistent trend is the positive relationship between cholesterol content and habitat temperature. Species residing in warmer habitats (e.g. Centropages typicus, Eurytemora affinis) had approximately twice the cholesterol of species living in colder waters (e.g. Calanus glacialis, Euchaeta norvegica). A similar pattern was observed for comparisons of species within genera (Calanus, Acartia and Centropages), with the species abundant at lower latitudes having more cholesterol than the northern congener. These data indicate that habitat temperature is an important determinant of cholesterol content, and cholesterol endows membranes with the stability required for a range of body temperatures”.

Maybe crustations and humans probably  don’t have that much in common.

If you are curious about cholesterol, here is an interesting slide share

Cholesterol Units Converter

 

What do you thincs about Cholesterol

Ive only just discovered the existence of  Thincs, a body that questions the link between saturated fats , cholesterol and  heart disease.

According to their website,  “The International Network of Cholesterol Skeptics (THINCS) is a steadily growing group of scientists, physicians, other academicians and science writers from various countries. Members of this group represent different views about the causation of atherosclerosis and cardiovascular disease, some of them are in conflict with others, but this is a normal part of science. What we all oppose is that animal fat and high cholesterol play a role. The aim with this website is to inform our colleagues and the public that this idea is not supported by scientific evidence; in fact, for many years a huge number of scientific studies have directly contradicted it”. 

It seems to be accumulating studies here

Is Fructose the villain?

This is an amazing read, and is part of my cholesterol studies

“Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans” found here

take home message is here:

“Studies in animals have documented that, compared with glucose, dietary fructose induces dyslipidemia and insulin resistance. To assess the relative effects of these dietary sugars during sustained consumption in humans, overweight and obese subjects consumed glucose- or fructose-sweetened beverages providing 25% of energy requirements for 10 weeks. Although both groups exhibited similar weight gain during the intervention, visceral adipose volume was significantly increased only in subjects consuming fructose. Fasting plasma triglyceride concentrations increased by approximately 10% during 10 weeks of glucose consumption but not after fructose consumption. In contrast, hepatic de novo lipogenesis (DNL) and the 23-hour postprandial triglyceride AUC were increased specifically during fructose consumption. Similarly, markers of altered lipid metabolism and lipoprotein remodeling, including fasting apoB, LDL, small dense LDL, oxidized LDL, and postprandial concentrations of remnant-like particle–triglyceride and –cholesterol significantly increased during fructose but not glucose consumption. In addition, fasting plasma glucose and insulin levels increased and insulin sensitivity decreased in subjects consuming fructose but not in those consuming glucose. These data suggest that dietary fructose specifically increases DNL, promotes dyslipidemia, decreases insulin sensitivity, and increases visceral adiposity in overweight/obese adults”

Psyllium: is magic

Throughout the fitness industry,  people are busting a gut to sell you dubious pills and potions.

However there are naturally occurring, non controversial  substances that cure or alleviate many  dangerous  medical conditions. I’ve discussed Chia seeds here, today its  Psyllium.

Pysllium is magic.

 

Some fun Pysllium facts

 

  1. Psyllium is a soluble fiber derived from the seeds of Plantago ovata. Grown mainly  in India
  2. Because of its great water solubility, psyllium can absorb water and become a thick, viscous compound that resists digestion in the small intestine.

    Its resistance to digestion allows it to help regulate high cholesterol, triglycerides and blood sugar levels.  For me, there are 2 notable areas where it helps

A) Blood sugar regulation

One study treated 56 diabetic men with 5.1 grams of psyllium twice per day for eight weeks. It reduced their daily blood sugar levels by 11% (see here for reference). 

Other studies indicate the same , with a guess that 10gms a day is the magic figure

B) Cholesterol

A review of 21 studies reported that reductions in total and LDL cholesterol are dose dependent. This means greater results were observed with treatments of 20.4 grams of psyllium per day than 3 grams per day

Prescription

5 gms  x 3 times a day with a glass of water, but increase water consumption in general. It is a bit difficult to get that much  down!

 

 

Chia seeds

Well, its all chia seeds now!

29 grams of chia seeds provides up to 42% of your daily recommended fiber,  plus phosphorus, magnesium, calcium and omega-3 fatty acids ( which are good btw!). Don’t take my dubious word for it. Look up :

“A dietary pattern including nopal, chia seed, soy protein, and oat reduces serum triglycerides and glucose intolerance in patients with metabolic syndrome” says so (check it out here).

What a read.

But, what this really means is that if you don’t include things like chia seeds and psyllium husks in your diet, you are a bit of a moron.

I should say,  however, that I’d never heard of “nopal” until I read the above  study. It’s a prickly pear cactus, comes from  Mexico and has a high   antioxidant, vitamin, mineral, and fiber content.