Coffee Consumption and Prostate Cancer Risk and Progression in the Health Professionals Fo

https://jnci.oxfordjournals.org/cont...d-09fcd2b2224e

[Aha! Good for the liver, now good for the prostate!]

Coffee Consumption and Prostate Cancer Risk and Progression in the Health Professionals Follow-up Study

Kathryn M. Wilson, Julie L. Kasperzyk, Jennifer R. Rider, Stacey Kenfield, Rob M. van Dam, Meir J. Stampfer, Edward Giovannucci and Lorelei A. Mucci
+ Author Affiliations

Affiliations of authors: Department of Epidemiology (KMW, JLK, SK, MJS, EG, LAM) and Department of Nutrition (RMvD, MJS, EG), Harvard School of Public Health, Boston, MA; Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (KMW, JLK, JRR, SK, MJS, EG, LAM); Department of Urology, Örebro University Hospital, Örebro, Sweden (JRR); Department of Epidemiology and Department of Public Health and Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (RMvD)
Correspondence to: Kathryn M. Wilson, ScD, Department of Epidemiology, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115 (e-mail: [email protected]).
Received September 1, 2010.
Revision received March 31, 2011.
Accepted April 1, 2011.
Abstract

Background Coffee contains many biologically active compounds, including caffeine and phenolic acids, that have potent antioxidant activity and can affect glucose metabolism and sex hormone levels. Because of these biological activities, coffee may be associated with a reduced risk of prostate cancer.

Methods We conducted a prospective analysis of 47 911 men in the Health Professionals Follow-up Study who reported intake of regular and decaffeinated coffee in 1986 and every 4 years thereafter. From 1986 to 2006, 5035 patients with prostate cancer were identified, including 642 patients with lethal prostate cancers, defined as fatal or metastatic. We used Cox proportional hazards models to assess the association between coffee and prostate cancer, adjusting for potential confounding by smoking, obesity, and other variables. All P values were from two-sided tests.

Results The average intake of coffee in 1986 was 1.9 cups per day. Men who consumed six or more cups per day had a lower adjusted relative risk for overall prostate cancer compared with nondrinkers (RR = 0.82, 95% confidence interval [CI] = 0.68 to 0.98, Ptrend = .10). The association was stronger for lethal prostate cancer (consumers of more than six cups of coffee per day: RR = 0.40, 95% CI = 0.22 to 0.75, Ptrend = .03). Coffee consumption was not associated with the risk of nonadvanced or low-grade cancers and was only weakly inversely associated with high-grade cancer. The inverse association with lethal cancer was similar for regular and decaffeinated coffee (each one cup per day increment: RR = 0.94, 95% CI = 0.88 to 1.01, P = .08 for regular coffee and RR = 0.91, 95% CI = 0.83 to 1.00, P = .05 for decaffeinated coffee). The age-adjusted incidence rates for men who had the highest (≥6 cups per day) and lowest (no coffee) coffee consumption were 425 and 519 total prostate cancers, respectively, per 100 000 person-years and 34 and 79 lethal prostate cancers, respectively, per 100 000 person-years.

Conclusions We observed a strong inverse association between coffee consumption and risk of lethal prostate cancer. The association appears to be related to non-caffeine components of coffee.

© The Author 2011. Published by Oxford University Press.

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Posted in reply to the post by geomancer:

Conclusions We observed a strong inverse association between coffee consumption and risk of lethal prostate cancer. The association appears to be related to non-caffeine components of coffee.

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As a coffee lover myself, I enjoy hearing about the potential health benefits of coffee. But as a person who likes to weight all of the risks against the benefits, I'd like to also add that caffeine (along with all stimulants) is very hard on the adrenal glands. Before people start drinking 6 or more cups of coffee a day (!) to prevent prostate cancer, they might want to consider the adrenal devastation that is likely to occur with such a high intake of stimulants. I can say from personal experience that adrenal fatigue is not fun at all!

Another factor to consider is that coffee is a diuretic, meaning that the overall effect of drinking it is a loss of fluids from the body. As a general rule, it's wise to drink an extra cup and a half of water for every cup of diuretic consumed. A person drinking 6 cups of coffee per day would need to drink about 9 cups of water just to avoid fluid loss! I'd recommend keeping coffee consumption to 2 cups per day max for this reason alone.

The study also is not a controlled trial, so it's possible that the reduction in prostate cancer risk could be due to some other factor.

Laurel Blair, NTP
www.dynamicbalancenutrition.com

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Posted in reply to the post by DynamicBalance:

... I'd like to also add that caffeine (along with all stimulants) is very hard on the adrenal glands. ...

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Where does this notion come from and what's the downside? Please explain and give a little science based backup. I've heard this a lot but never with anything to back it up.

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Posted in reply to the post by DynamicBalance:

... As a general rule, it's wise to drink an extra cup and a half of water for every cup of diuretic consumed. A person drinking 6 cups of coffee per day would need to drink about 9 cups of water just to avoid fluid loss! ...

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This is, of course, just nonsense. I know you can't back that one up, but do try. I'd appreciate real trained medical authorities, not some homeopath or chiropractor as your expert.

Thanks for your efforts.

-Jeff

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Posted in reply to the post by geomancer:

We observed a strong inverse association between coffee consumption and risk of lethal prostate cancer.

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Damn! I hate coffee! Maybe chocolate will work?

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Posted in reply to the post by Dixon:

Damn! I hate coffee! Maybe chocolate will work?

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I can help Dixon.

You can try some of my homemade coffee liqueur over vanilla ice cream.

That will be a good start.

Chin up. There's hope for you.

-Jeff

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Posted in reply to the post by Braggi:

I can help Dixon. You can try some of my homemade coffee liqueur over vanilla ice cream.
That will be a good start. Chin up. There's hope for you.

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No there's not. I HATE coffee. I don't even like mocha, 'cause it tastes too much like goddamn coffee. Much less coffee ice cream or coffee candy. I appreciate your intention, but coffee liqueur is NOT the answer.

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Posted in reply to the post by Braggi:

Where does this notion come from and what's the downside? Please explain and give a little science based backup. I've heard this a lot but never with anything to back it up.

This is, of course, just nonsense. I know you can't back that one up, but do try. I'd appreciate real trained medical authorities, not some homeopath or chiropractor as your expert.

Thanks for your efforts.

-Jeff

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Gee Jeff, there's no need to be so condescending. It reflects very poorly on you.

It is a well-established medical fact that caffeine increases levels of epinephrine or adrenaline, which is a fight-or-flight hormone manufactured by the adrenal glands. In the fight-or-flight response, the body believes it is in a state of emergency. For many thousands of years, stressful situations that humans were exposed to included attacks by wild animals or other tribes, and less commonly circumstances such as extreme cold or heat and low blood sugar. The fight-or-flight response is clearly a response to a perceived threat in the environment (usually something about to attack, like a tiger). Blood flow is directed towards the brain and extremities (and away from things like digestion that are not essential in an emergency situation) so that we can think and move quickly. This is why caffeine temporarily improves mental alertness and energy. Blood sugar increases, to provide plenty of energy to get away from the tiger. Heart rate and lung activity are increased. Water retention is increased.

For thousands of years, humans were periodically exposed to stressful events, but in most cases they had plenty of time to rest and recover afterward. But in our modern world, stress is a fact of daily life: between trying to make enough money to survive, stressful relationships, eating foods that our physiology is not designed for (white sugar and flour), low blood sugar, being late for work, etc., our adrenal glands never get a chance to rest. The body can't tell the difference between being chased by a tiger and feeling stressed out. Stimulants like coffee just add insult to injury! Even if your life has zero stress (unlikely), drinking 6 cups of coffee a day causes your adrenals to fire 6 times a day!

If the stressor continues for long enough, as in our stressful modern lives, our bodies enter the resistance phase. The adrenals enlarge in order to rise to the challenge it faces. While the adrenal medulla is busy pumping out adrenaline, the adrenal cortex also gets busy making anti-inflammatory and stress-reduction hormones to counteract the effects of the adrenaline. Cortisol levels become chronically high. The thyroid is also stimulated. Large amounts of insulin responding to increased glucose can cause hypoglycemia, which in turn causes the adrenals to fire again, perpetuating the cycle.

And if the stress continues in the resistance phase for long enough, the adrenals enter a state of exhaustion. Chronically high cortisol levels cause wasting of muscles, suppression of the immune system, ulceration of the GI tract, and failure of pancreatic beta cells.

Like I said before, adrenal fatigue is no fun. It involves difficulty waking up in the morning, difficulty falling asleep, fatigue not relieved by sleep, craving for salt, low energy, trouble performing everyday tasks, decreased sex drive, drastically decreased ability to handle minor stress, poor immunity, light-headedness when standing up quickly, depression, lack of enjoyment in life, increased PMS in women, symptoms of low blood sugar between meals, reliance on sugar or caffeine for energy, brain fog, poor memory, and decreased tolerance for minor annoyances. I have personally experienced this condition. It got to the point where the most minor stress would provoke a near nervous breakdown in me.

My sources of information for the above facts are my anatomy and physiology textbook, and a great book called Adrenal Fatigue: The 21st Century Stress Syndrome by James L. Wilson, N.D., D.C., Ph.D. Dr. Wilson is an expert on adrenal and endocrine imbalance, and he holds 3 doctorate degrees and 2 master's degrees. Other sources that mention this phenomenon (caffeine consumption leading to adrenal fatigue) include the books Staying Healthy with Nutrition by Elson M Haas, MD, and Nourishing Traditions by Sally Fallon and Mary Enig, Ph.D (an internationally-renowned expert in the field of lipid chemistry and a pioneer of the research that proved that man-made trans fats are dangerous). It is also emphasized in my coursework from the Nutritional Therapy Association.

As far as the dehydrating effects of coffee go, F. Batmanghelidj, MD, states in his book Your Body's Many Cries for Water that coffee is a dehydrating agent, and that coffee is no substitute for water. Dr. B is an expert on dehydration and has spent 20 years researching the effects of dehydration on the body and applying his knowledge clinically. His book is full of very impressive testimonials from professors, doctors, and regular people alike, many of which include contact information.

My recommendation to replace 1 cup of diuretic with 1.5 cups water is based on the recommendations of my teacher from the Nutritional Therapy Association. It is also common sense based on Dr. Batmanghelidj's assertion that coffee is dehydrating, and the classification of caffeine as a diuretic causing increased urinary output by my anatomy textbook. If something is dehydrating, then you need to replace the water lost. Other sources that name caffeine as a diuretic include Judith Valentine, Ph.D and Mary Enig, Ph.D. My recommendation to keep coffee consumption to 2 cups per day max is based on advice in my anatomy textbook. An individual's response to caffeine is also based on genetics; some people may be more adapted to caffeine than others, and in these individuals less fluid loss is experienced. Studies of caffeine's effects as a diuretic have been mixed, but higher doses of caffeine are more likely to be diuretic than low doses. The mixed results may be due in part to difference in genetics. Regular users of coffee tend to build a tolerance to it's diuretic effects.

My personal experience has been that coffee is dehydrating. For many years I was a very heavy coffee drinker, and I barely drank any water at that time. I had frequent headaches and migraines, which were sometimes relieved by drinking water. I also had many other symptoms of dehydration. After cutting back on my coffee consumption and drinking more water, my headaches are much rarer, and my other symptoms have decreased as well. If coffee were indeed just as good as water for hydration, I should have been perfectly hydrated in my caffeine junkie days. I also notice that drinking coffee makes me feel noticeably dehydrated, and drinking a similar amount of water as coffee doesn't seem to help; hence my recommendation that people replace diuretics with a larger amount of water. Obviously there will be difference in individual responses to caffeine, but this is a good starting point.

I am aware of the standard advice that coffee is just as hydrating as water, but I have a unique viewpoint as someone who realizes that much of our standard dietary and health advice is completely backwards, and I'm not inclined to believe something just because it is commonly accepted as true, especially if it contradicts my personal experience.

Incidentally, caffeine or coffee have also been linked to pancreatic cancer (which is much, much more deadly than prostate cancer), and to birth defects in animal studies.

Thanks for reading,

Laurel Blair, NTP
www.dynamicbalancenutrition.com

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Posted in reply to the post by DynamicBalance:

Gee Jeff, there's no need to be so condescending. It reflects very poorly on you. ...

... As far as the dehydrating effects of coffee go, F. Batmanghelidj, MD, states in his book Your Body's Many Cries for Water that coffee is a dehydrating agent, and that coffee is no substitute for water. ...

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Sorry to sound ... that way. It's just that it's kind of exhausting chasing down all the phony sources and attempting to bring science into the light of day.

First, let me give you my experience of water. I live in a truly blessed place with a year-round spring that flows out of the ground between the roots of a giant redwood tree. It tastes like water from THE source. I drink a lot of it. I do a lot of physical work and I have a high metabolism so I go through a lot of water; probably more than the average person. I always have. I enjoy water a lot and it's truly my beverage of choice. I do not carry a bottle of water with me everywhere I go nor do I think anyone needs to. A great many people in Sonoma County take the water thing to extremes. Some of the people who work out at my gym buy a big bottle of "Smart" water every day. What a waste of money and plastic. I happily drink from the drinking fountain when I'm there. It tastes just fine to me. I think I'm the smart one since I get plenty of water and I get to keep my money.

I like to drink coffee in the morning and sometimes I drink little or no water until after noon. I never feel dehydrated. I agree that dehydration causes headaches and I'll bet a lot of people that reach for their favorite pain reliever get as much action out of the glass of water as they do out of their pill.

Every time somebody urinates they get a free test for dehydration. If it's darkly colored and aromatic, they need more water. If it's completely clear and odorless, they're probably drinking too much water. A healthy balance is somewhere in between. Reasonable, yes?

I do not think coffee hydrates me equally well as the same quantity of water, but it's pretty close. I think if I drank nothing but coffee all day I would be fine. Well, I'd be pretty antsy and I wouldn't sleep so well, but I wouldn't be dehydrated.

The fact is, nobody I've ever heard of has ever done any research on the topic and your Dr. Batmanghelidj is no exception. In fact, I doubt he was ever a real doctor. He was never registered or licensed as a Dr. of any kind in the United States though he lived here for many years and ran a "clinic" where he gave people ... water. In fact, he never published any studies nor is there any record of him doing any studies. It seems he was a fake and a fraud.

I do think it's a good idea to drink plenty of water. I don't think it's necessary to flood your system with vast quantities of water. I think that's a very unhealthy practice and can cause death. I'll agree with you that drinking coffee alone all day is not a healthy practice, but someone who drinks 6 cups of coffee a day certainly does not need to balance that by drinking 9 glasses of water in the same day. That's just ... well, it doesn't make sense to me. :wink:

-Jeff

PS. I'm not willing to look up the writings of naturopaths or chiropractors. Sorry, I don't consider them credible sources. Your Batmanghelidj used an MD after his name, though it appears, without earning the honor.