Category Archives: Math & Science

The Case for Drinking as Much Coffee as You Like

By Lindsay Abrams

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“What I tell patients is, if you like coffee, go ahead and drink as much as you want and can,” says Dr. Peter Martin, director of the Institute for Coffee Studies at Vanderbilt University. He’s even developed a metric for monitoring your dosage: If you are having trouble sleeping, cut back on your last cup of the day. From there, he says, “If you drink that much, it’s not going to do you any harm, and it might actually help you. A lot.”

Officially, the American Medical Association recommends conservatively that “moderate tea or coffee drinking likely has no negative effect on health, as long as you live an otherwise healthy lifestyle.” That is a lackluster endorsement in light of so much recent glowing research. Not only have most of coffee’s purported ill effects been disproven — the most recent review fails to link it the development of hypertension — but we have so, so much information about its benefits. We believe they extend from preventing Alzheimer’s disease to protecting the liver. What we know goes beyond small-scale studies or limited observations. The past couple of years have seen findings, that, taken together, suggest that we should embrace coffee for reasons beyond the benefits of caffeine, and that we might go so far as to consider it a nutrient.

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The most recent findings that support coffee as a panacea will make their premiere this December in the American Journal of Clinical Nutrition. Coffee, researchers found, appears to reduce the risk of type 2 diabetes.

“There have been many metabolic studies that have shown that caffeine, in the short term, increases your blood glucose levels and increases insulin resistance,” Shilpa Bhupathiraju, a research fellow at the Harvard School of Public Health’s Department of Nutrition and the study’s lead author, told me. But “those findings really didn’t translate into an increased risk for diabetes long-term.” During the over 20 years of follow-up, and controlling for all major lifestyle and dietary risk factors, coffee consumption, regardless of caffeine content, was associated with an 8 percent decrease in the risk of type 2 diabetes in women. In men, the reduction was 4 percent for regular coffee and 7 percent for decaf.

coffeecase-2The findings were arrived at rigorously, relying on data from the Nurses’ Health Study and the Health Professionals Follow-Up Study, two prospective studies that followed almost 80,000 women and over 40,000 men from the 1980s through 2008. Although self-reported, the data is believed to be extremely reliable because it comes from individuals who know more about health and disease than the average American (the downside, of course, is that results won’t always apply to the general population — but in this case, Bhupathuraju explained that there’s no reason to believe that the biological effects seen in health professionals wouldn’t be seen in everyone else).

That there were no major differences in risk reduction between regular and decaf coffee suggests there’s something in it, aside from its caffeine content, that could be contributing to these observed benefits. It also demonstrates that caffeine was in no way mitigating coffee’s therapeutic effects. Of course, what we choose to add to coffee can just as easily negate the benefits — various sugar-sweetened beverages were all significantly associated with an increased risk of diabetes. A learned taste for cream and sugar (made all the more enticing when they’re designed to smell like seasonal celebrations) is likely one of the reasons why we associate coffee more with decadence than prudence.

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“Coffee and caffeine have been inexorably intertwined in our thinking, but truth is coffee contains a whole lot of other stuff with biological benefits,” said Martin. And most concerns about caffeine’s negative effects on the heart have been dispelled. In June, a meta-analysis of ten years of research went so far as to find an inverse association between habitual, moderate consumption and risk of heart failure. The association peaked at four cups per day, and coffee didn’t stop being beneficial until subjects had increased their daily consumption to beyond ten cups.

Caffeine might also function as a pain reliever. A study from September suggested as much when its authors stumbled across caffeinated coffee as a possible confounding variable in its study of the back, neck, and shoulder pains plaguing office drones: Those who reported drinking coffee before the experiment experienced less intense pain.

The data is even more intriguing — and more convincing — for caffeine’s effects as a salve against more existential pains. While a small study this month found that concentrated amounts of caffeine can increase positivity in the moment, last September the nurses’ cohort demonstrated a neat reduction in depression rates among women that became stronger with increased consumption of caffeinated coffee.

But that caffeine is only mechanism behind coffee’s health effects is supported by a small study of 554 Japanese adults from October that looked at coffee and green tea drinking habits in relation to the bundle of risk factors for coronary artery disease, stroke, and type 2 diabetes known together as metabolic syndrome. Only coffee — not tea — was associated with reduced risk, mostly because of dramatic reductions observed in serum triglyceride levels.

So aside from caffeine, just what are you getting in a cup, or two, or six? Thousands of mostly understudied chemicals that contribute to flavor and aroma, including plant phenols, chlorogenic acids, and quinides, all of which function as antioxidants. Diterpenoids in unfiltered coffee may raise good cholesterol and lower bad cholesterol. And, okay, there’s also ash which, to be fair, is no more healthful than you would think — though it certainly isn’t bad for you.

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Some of the chemicals in coffee are known carcinogens, though as far as we know that’s only been seen in rodents, not in the small levels we encounter in everyday consumption. Findings, on the other hand, have been supporting that coffee can protect against some cancers. When the Harvard School of Public Health visited the Health Professionals Follow-Up cohort in May 2011, it found that coffee’s protective effects extend only to some types of prostate cancer (the most aggressive types, actually). In a separate study of the same population from this past July, they also found a reduced risk of basal cell carcinoma with increased caffeine intake.

The association was strongest for those who drank six or more cups per day.

That same high dosage is also effective in fighting against colorectal cancer, according to a prospective study from June of almost 500,000  adults conducted by the American Society for Nutrition. While the association was greatest for caffeinated varieties, decaf made a small but significant showing. A meta-analysis of 16 independent studies this past January added endometrial cancer to the group of cancers whose relative risk decreases with increased “dosage” of coffee. And in 2011, a large population of post-menopausal women in Sweden saw a “modest” reduction in breast cancer risk with immoderate consumption of 5 or more daily cups.

coffeecase-3Taking the benefits of coffee any further requires being patient-specific, but findings apply to a broad range of populations and conditions:

If you have fatty liver disease, a study from last December found that unspecified amounts can reduce your risk of fibrosis.

If you’re on a road trip, you may respond like the 24 volunteers for an experiment from February who were subjected to two hours of simulated “monotonous highway driving,” given a short break, then sent back out for two more hours. Those given a cup of coffee during the break weaved less, and showed reductions in driving speed, mental effort, and subjective sleepiness. If you’re on a weight-training regimen, it can provide a mild (and legal) doping effect.

If you’re trying to enhance your workout, the results of one experiment from October found that drinks containing caffeine enhances performance. And then another one from Dr. Martin in 2008: He coauthored a study of people enrolled in Alcoholics Anonymous in which there appeared to be an association between upping coffee intake and staying sober.

Nothing can be all good, and there is still information working against coffee — in October, The Atlantic reported on a study from the health professionals cohort that suggested a link between excessive coffee consumption and glaucoma. “The current recommendation is that if somebody’s not drinking coffee, you don’t tell them to start,” said Bhupathiraju.

But she agrees that drinking coffee, and more of it, does appear to be beneficial. The evidence remains overwhelmingly in coffee’s favor. Yes, it was observational, but the study published in May in the New England Journal of Medicine looked at hundreds of thousands of men and women and found this bottom line result: people who drank coffee lived longer than those who didn’t.

And the more they drank, the longer they lived. If you’re into that sort of thing.

Source: theatlantic.com

Scientists agree: Coffee naps are better than coffee or naps alone

By Joseph Stromberg

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If you’re feeling sleepy and want to wake yourself up — and have 20 minutes or so to spare before you need to be fully alert — there’s something you should try. It’s more effective than drinking a cup of coffee or taking a quick nap.

It’s drinking a cup of coffee and then taking a quick nap. This is called a coffee nap.

It might sound crazy: conventional wisdom is that caffeine interferes with sleep. But if you caffeinate immediately before napping and sleep for 20 minutes or less, you can exploit a quirk in the way both sleep and caffeine affect your brain to maximize alertness. Here’s the science behind the idea.

How a coffee nap works

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To understand a coffee nap, you have to understand how caffeine affects you. After it’s absorbed through your small intestine and passes into your bloodstream, it crosses into your brain. There, it fits into receptors that are normally filled by a similarly shaped molecule called adenosine.

Adenosine is a byproduct of brain activity, and when it accumulates at high enough levels, it plugs into these receptors and makes you feel tired. But with the caffeine blocking the receptors, it’s unable to do so. AsStephen R. Braun writes in Buzz: The Science and Lore of Alcohol and Caffeine, it’s like “putting a block of wood under one of the brain’s primary brake pedals.”

Now, caffeine doesn’t block every single adenosine receptor — it competes with adenosine for these spots, filling some, but not others.

But here’s the trick of the coffee nap:sleeping naturally clears adenosinefrom the brain. If you nap for longer than 15 or 20 minutes, your brain is more likely to enter deeper stages of sleep that take some time to recover from. But shorter naps generally don’t lead to this so-called “sleep inertia” — and it takes around 20 minutes for the caffeine to get through your gastrointestinal tract and bloodstream anyway.

So if you nap for those 20 minutes, you’ll reduce your levels of adenosine just in time for the caffeine to kick in. The caffeine will have less adenosine to compete with, and will thereby be even more effective in making you alert.

Experiments show coffee naps are better than coffee or naps

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Scientists haven’t directly observed this going on in the brain after a coffee nap — it’s all based on their knowledge of how caffeine, adenosine, and sleep each affect the brain independently.

But they have directly observed the effects of coffee naps, and experiments have shown they’re more effective than coffee or naps alone in maximizing alertness.

In a few different studies, researchers at Loughborough University in the UK found that when tired participants took a 15-minute coffee nap, they went on to commit fewer errors in a driving simulator than when they were given only coffee, or only took a nap (or were given a decaf placebo). This was true even if they had trouble falling asleep, and just laid in bed half-asleep during the 15 minutes.

Meanwhile, a Japanese study found that people who took a caffeine nap before taking a series of memory tests performed significantly better on them compared with people who solely took a nap, or took a nap and then washed their faces or had a bright light shone in their eyes. Theyalso subjectively rated themselves as less tired.

Interestingly, there’s even some evidence that caffeine naps can help people go for relatively long periods without proper sleep. As part of one study, 24 young men went without proper sleep for a 24-hour period, taking only short naps. Twelve of them, who were given just a placebo, performed markedly worse on a series of cognition tests, compared with their baseline scores. Twelve others, who had caffeine before their naps, managed scores roughly the same as their baselines for the entire day.

How to take a coffee nap

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Taking a coffee nap is pretty straightforward. First, drink coffee. Theoretically, you could drink another caffeinated beverage, but tea and soda generally have much less caffeine than coffee, and energy drinks are disgusting. Here’s a good database of the amount of caffeine in many types of drinks.

You need to drink it quickly, to give yourself a decently long window of time to sleep as it’s going through your gastrointestinal tract and entering your bloodstream. If it’s tough for you to drink a lot of hot coffee quickly, good options might be iced coffee or espresso.

Right after you’re finished, immediately try to go to sleep. Don’t worry if it doesn’t come easily — just reaching a tranquil half-asleep stage can be helpful.

Finally, make sure to wake up within 20 minutes, so you don’t enter the deeper stages of sleep and you’re awake when the caffeine is just starting to hit your brain.

Voilà: the perfect coffee nap.

Source: vox.com

Why French Kids Don’t Have ADHD

French children don’t need medications to control their behavior.

By Marilyn Wedge

In the United States, at least 9% of school-aged children have been diagnosed with ADHD, and are taking pharmaceutical medications. In France, the percentage of kids diagnosed and medicated for ADHD is less than .5%. How come the epidemic of ADHD—which has become firmly established in the United States—has almost completely passed over children in France?

Is ADHD a biological-neurological disorder? Surprisingly, the answer to this question depends on whether you live in France or in the United States. In the United States, child psychiatrists consider ADHD to be a biological disorder with biological causes. The preferred treatment is also biological–psycho stimulant medications such as Ritalin and Adderall.

French child psychiatrists, on the other hand, view ADHD as a medical condition that has psycho-social and situational causes. Instead of treating children’s focusing and behavioral problems with drugs, French doctors prefer to look for the underlying issue that is causing the child distress—not in the child’s brain but in the child’s social context. They then choose to treat the underlying social context problem with psychotherapy or family counseling. This is a very different way of seeing things from the American tendency to attribute all symptoms to a biological dysfunction such as a chemical imbalance in the child’s brain.

French child psychiatrists don’t use the same system of classification ofchildhood emotional problems as American psychiatrists. They do not use the Diagnostic and Statistical Manual of Mental Disorders or DSM.According to Sociologist Manuel Vallee, the French Federation ofPsychiatry developed an alternative classification system as a resistance to the influence of the DSM-3. This alternative was the CFTMEA(Classification Française des Troubles Mentaux de L’Enfant et de L’Adolescent), first released in 1983, and updated in 1988 and 2000. The focus of CFTMEA is on identifying and addressing the underlying psychosocial causes of children’s symptoms, not on finding the best pharmacological bandaids with which to mask symptoms.

To the extent that French clinicians are successful at finding and repairing what has gone awry in the child’s social context, fewer children qualify for the ADHD diagnosis. Moreover, the definition of ADHD is not as broad as in the American system, which, in my view, tends to “pathologize” much of what is normal childhood behavior. The DSMspecifically does not consider underlying causes. It thus leads clinicians to give the ADHD diagnosis to a much larger number of symptomatic children, while also encouraging them to treat those children with pharmaceuticals.

The French holistic, psychosocial approach also allows for considering nutritional causes for ADHD-type symptoms—specifically the fact that the behavior of some children is worsened after eating foods with artificial colors, certain preservatives, and/or allergens. Clinicians who work with troubled children in this country—not to mention parents of many ADHD kids—are well aware that dietary interventions can sometimes help a child’s problem. In the United States, the strict focus on pharmaceutical treatment of ADHD, however, encourages clinicians to ignore the influence of dietary factors on children’s behavior.

And then, of course, there are the vastly different philosophies of child-rearing in the United States and France. These divergent philosophies could account for why French children are generally better-behaved than their American counterparts. Pamela Druckerman highlights the divergent parenting styles in her recent book, Bringing up Bébé. I believe her insights are relevant to a discussion of why French children are not diagnosed with ADHD in anything like the numbers we are seeing in the United States.

From the time their children are born, French parents provide them with a firm cadre—the word means “frame” or “structure.” Children are not allowed, for example, to snack whenever they want. Mealtimes are at four specific times of the day. French children learn to wait patiently for meals, rather than eating snack foods whenever they feel like it. French babies, too, are expected to conform to limits set by parents and not by their crying selves. French parents let their babies “cry it out” if they are not sleeping through the night at the age of four months.

French parents, Druckerman observes, love their children just as much as American parents. They give them piano lessons, take them to sportspractice, and encourage them to make the most of their talents. But French parents have a different philosophy of discipline. Consistently enforced limits, in the French view, make children feel safe and secure. Clear limits, they believe, actually make a child feel happier and safer—something that is congruent with my own experience as both a therapist and a parent. Finally, French parents believe that hearing the word “no” rescues children from the “tyranny of their own desires.” And spanking, when used judiciously, is not considered child abuse in France. (Author’s note: I am not personally in favor of spanking children).

As a therapist who works with children, it makes perfect sense to me that French children don’t need medications to control their behavior because they learn self-control early in their lives. The children grow up in families in which the rules are well-understood, and a clear family hierarchy is firmly in place. In French families, as Druckerman describes them, parents are firmly in charge of their kids—instead of the American family style, in which the situation is all too often vice versa.

Copyright © Marilyn Wedge, Ph.D.
Marilyn Wedge is the author of Pills Are Not for Preschoolers: A Drug-Free Approach for Troubled Kids

Source: psychologytoday.com