An approach to caffeine consumption

There is always a lot of curiosity and misinformation around caffeine as a component of a healthy nutritional regimen. Of course, a lot of the desire to consume caffeine regularly comes from its short-term effects, including enhanced energy, focus, and even improvements in mood. It's also intuitive that a lot of these short-term effects can be beneficial from a health perspective, as more energy allows us to be more active, increase the intensity of exercise, be more productive, and feel better doing so. This is indeed the case, as several studies have linked caffeine to improving athletic performance, as well as cognitive function and mood.

The appeal to caffeine is clear, but the question has long been present around the downsides of caffeine from a health perspective, both short-term and long-term. First off, there is often concern about caffeine's predisposition to anxiety, particularly in at-risk individuals. It does appear to have this effect, however, this takes place significantly more at doses of caffeine above 400 milligrams at a time as opposed to below, according to one meta-analysis. Note that this will, of course, vary based on the person, as everyone has different levels of caffeine tolerance both genetically and environmentally. Genetically, we have a lot of variability in our receptors for caffeine, which can impact how sensitive we are to it. Then, we are able to develop tolerance to caffeine and other substances as we consume them more, and become less sensitive to them as our body gets accustomed to the stimulus.

A commonly proposed harm of caffeine is its damage to the cardiovascular system, namely via predisposition to cardiac arrhythmias such as atrial fibrillation. Studies have shown that even in vulnerable patients with heart failure, high doses of caffeine up to 500 mg did not increase incidence of arrhythmias relative to a placebo. Additionally, observational studies have found no correlation between caffeine consumption and risk of developing atrial fibrillation among the general population, which makes us more confident that there is not really a signal there. Caffeine is also known to raise blood pressure in the short-term, however long-term risk of hypertension (high blood pressure) is not increased with regular caffeine consumption, again emphasizing that we never want to infer chronic impacts from acute stressors. The classic example of this is exercise, which is acutely stressful but chronically quite beneficial.

One effect of caffeine that is worth considering is its disruption of sleep. Now you may be thinking that you have no difficulty falling asleep or trouble with insomnia, and perhaps you drink plenty of caffeine and have never felt this to be an issue. It’s worth noting, though, that multiple studies actually demonstrate that caffeine can have negative impacts on sleep which are often not even perceived by those experiencing them. One study showed dramatic increases in sleep fragmentation and destruction of sleep architecture when 400 mg of caffeine was consumed 12 hours before bedtime, however, participants did not note any significant subjective changes in their sleep. In other words, their sleep was quite disrupted, but they were not even aware.

Now you may be thinking, "no problem, I never consume 400 mg of caffeine,” but it's important to understand that caffeine has a relatively long half-life in the body of 5-6 hours. This means that if you were to consume 200mg of caffeine at 7 am, then at 1 pm you could expect to have 100 mg still in your system, and at 7 pm you could expect to have 50 mg still in your system; think of the number being cut in half every 6 hours or so. One study I keep finding myself coming back to did just this, and found that just 200 mg of caffeine at 7 am could still have an impact on one's sleep architecture if they went to bed at 11 pm.

You may be thinking that you feel well-rested, have no issues with insomnia, etc., but we have long discussed sleep's numerous benefits for health outside of just improving wakefulness and removing tiredness from our lives, and therefore we should take this effect seriously even if we're not perceiving a change. Because of this, I strongly recommend having caffeine as early in your day as possible if you're going to consume it in order to avoid or minimize deleterious effects on sleep.

Additionally, there appears to be nothing in claims that caffeine predisposes to the risk of diabetes or glucose intolerance. In fact, if anything, the reverse effect has been shown, as caffeine consumption can lead to as much as a 40% decrease in risk of type 2 diabetes. However, it does not seem to be a reliable vehicle for weight loss, at least based on studies thus far. This effect can also be very difficult to tease out. You might recall how we have previously stated that long-term nutritional studies, with such a gross outcome as weight loss with several variables contributing, are tough to assess which variables are truly causing what.

The final consideration, then, is what the caffeine is coming with or the form that it is taking. Of course, it is important to assure that we are not consuming caffeine with large quantities of sugar, as it regularly occurs in energy drinks, commercial coffee and tea beverages, etc. The detriments of drinking sugar would far outweigh any of the effect sizes, positive or negative, that we are discussing with caffeine here, and we should prioritize avoiding this first and foremost. Also, we generally want to stick to clean ingredients in our diet and generally avoid additives and preservatives, often linked to metabolic dysregulation, irritation of the gut and alteration of gut flora, etc. Thus, I would generally advise getting your caffeine from pure, natural sources like coffee or tea, particularly as they are accompanied by other beneficial nutrients and antioxidants.

In summary, for my personal routine, I do consume caffeine fairly regularly, typically between 100-200 mg/day. I consume it first thing in the morning, not only to provide early wakefulness at the time I want to be as wakeful as can be for circadian purposes, but also to minimize sleep disturbances (perceived or not) much later on when I go to bed. My favorite is just to have black coffee (if anyone is curious, a nitro cold brew is my preferred), but I also enjoy unsweetened or monkfruit- or stevia-sweetened yerba mate, green tea, and matcha. There are some good, relatively minimal-ingredient and minimally chemical-laden energy drinks out there that I will occasionally utilize for convenience, but these are something I try to restrict when I have so many other quality alternatives.

Keep in mind that it’s important not to take a one-size-fits-all sort of approach with caffeine or with just about any health intervention, and use it as it works for you. We all will respond to it in different ways, but I hope this post provides some clarity regarding its general effects, utility, and considerations, positive or negative.

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