Caffeine: Perks and Pitfalls


Dr. Malaya Pimentel-Santos is a long-time community health advocate, having worked with several nongovernment health organizations. She is a fellow of the Philippine Dermatological Society and a professor of microbiology at the St. Luke’s College of Medicine.

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Last month, I visited the original Starbucks coffee shop at Pike Place Market in Seattle. Established in 1971 and arguably the birthplace of the global coffee industry as we know it today, it is now a tourist attraction easily identified by the long line winding its way outside the entrance. Ironically, the espresso and all its variants (see below) actually originated in Italy, half a world away from Seattle.

Espresso, drip or French press

Coffee is prepared in many ways, and perhaps the most popular is the espresso, which also forms the base for many other popular beverages. An espresso is a shot of concentrated coffee made by quickly passing hot water through ground coffee beans under intense, high pressure. A ristretto is prepared in a similar manner, but with slightly less water; alungo (long shot), on the other hand, has slightly more water. An americano is a shot of espresso diluted with hot water. A shot of espresso mixedwith steamed and foamed milk (instead of water) is a cappuccino, so named because it resembles the color of the robes of Capuchin monks. A café latte is a creamier version that uses more steamed milk and less foam. Café mocha is espresso and steamed milk, with added chocolate. A machiattois a shot of espresso mixed with a small amount of foamed milk and often flavored with either caramel or chocolate.

Other methods of brewing coffee include the French press (a device where coffee grounds are immersed in hot water and later filtered out using a plunger), and the traditional ‘drip’ coffee maker. There is an optimum ‘grind’ for each method or preparation above: fine for espresso, coarse for the French press and medium grind for Photo by Nathan Dumlao on Unsplash drip coffee machines.

Caffeine Perks and Pitfalls 2Benefits and risks of caffeine

Most people take coffee to increase alertness and concentration, improve mental and physical performance, and counteract fatigue. I personally rely on coffee to perk me up in the morning, and at other times of the day when my energy level tends to dip. This energizing effect is due to a substance called caffeine, that is found naturally in plants such as coffee beans, kola nuts, tea leaves and cacao.

Synthetic caffeine is also added to energy drinks and snacks and some prescription and over the counter medications such as cold tablets and diet pills. Notwithstanding these benefits, caffeine can also be harmful and, in extreme cases, even fatal. Among healthy adults, too much caffeine may result in unwanted symptoms such as irritability, palpitations, anxiety, nervousness, tremors, hyperacidity and inability to sleep.

Caffeine (by definition) is a drug that acts as a central nervous system stimulant. Like other drugs, it has both benefits and risks, and as such can be subject to abuse and addiction. Regular intake of caffeine may result in tolerance or a decreased responsiveness to its stimulant effects; it also leads to dependence, and its sudden removal can induce withdrawal symptoms such as headaches, nausea and drowsiness.

There are also situations when stimulant effects may not be desirable and caffeine intake should be restricted. Those with cardiovascular disease, hypertension, insomnia, anxiety disorders and acid peptic disease are more susceptible to the harmful effects of caffeine. There is evidence linking caffeine to sleep and behavioural problems among children and adolescents, and the safety limit for caffeine in these age groups has not yet been established with certainty. Excess caffeine intake during pregnancy has been associated with fetal growth restriction, low birth weight, stillbirth and premature delivery. Breastfeeding mothers are also advised to avoid caffeine to prevent it from being passed on to the infant.

How much is safe?

The United States Food and Drug Administration (US FDA) estimates that nine out of ten people worldwide use some form of caffeine. In the US, eight out of ten adults consume caffeine everyday, with an average daily intake of 200mg. According to the Mayo Clinic, about 400 mg of caffeine in a day is safe for most healthy adults. However, accurately tracking one’s cumulative caffeine intake can be tricky because it is found in many different dietary sources, and some people may actually be taking in more caffeine than they realize. Nevertheless, meticulously reading labels and calculating total consumption is crucial in order to avoid inadvertently overdosing on caffeine.

According to the US National Institutes of Health, an 8-oz cup of coffee (‘short’ size at the popular coffee chain) can contain between 100-200mg of caffeine. For reference, the approximate amount of caffeine in the following sources is as follows: 12-ounce soda: 35-45mg, 8-ounce cup of tea: 14-60mg, 1.5-ounce chocolate bar: 20-45mg (with relatively higher amounts of caffeine in dark chocolate), 16-ounce energy drink: 160mg. Some medications may contain as much as 500mg of caffeine.

Coffee through the centuries

Coffee has been around since the 11th century, first making an appearance on the African continent and spreading from there to Europe and South America. Coffee is not really new in the Philippines, with the famed Kalinga and Batangas coffee coming instantly to mind. In a 2017 article in The Telegraph, Oliver Smith reported that the world’s biggest coffee drinkers – in terms of per capita consumption – are Iceland, Norway and Finland.

For many of us, the thought of coffee invokes a warm sense of comfort and companionship. Today, from the ubiquitous three-in-one coffee sachets to the specialty coffee shops in every mall and nearly every street corner, coffee is deeply entrenched in modern-day life and popular culture. Coffee enthusiasts recommend that coffee always be made from freshly ground, perfectly roasted, carefully selected coffee beans. But regardless of one’s chosen brew or beverage, it is best enjoyed together with great conversation, and in the company of good friends.