Coffee Cholesterol Is There a Connection

Do you drink coffee? If the answer is yes, you’re in good company. A majority of Americans—64%—drink two cups a day. But there’s one more thing that many Americans have: high cholesterol. In fact, well over 100 million Americans have elevated cholesterol or are at serious risk for it.

So research scientists have posed an intriguing question: Is there a possible connection between coffee and cholesterol?

The short answer: Yes. But the complete answer is a bit more complicated.

What Is Cholesterol?

Let’s first understand what “cholesterol” is. For many people, even the term can spark apprehension. But, the fact is, our bodies need cholesterol—it’s an essential fat.

In the proper quantity, it serves as a building block for cell membranes, nerve tissue, and critical hormones. It enables our bodies to make vitamin D from sunlight. And it’s a key component of liver function, aiding in the digestive process. The liver makes most of the cholesterol that our bodies need in order to function well.

So, what causes high cholesterol? Most problems with unhealthy levels of cholesterol begin when we take in too much fat and too many calories from food, yet don’t get appropriate levels of exercise. And occasionally, a patient may simply be genetically predisposed to elevated cholesterol—their liver makes too much.

There’s reason for concern: high cholesterol is a well-known contributor to cardiovascular disease. It encourages the formation of plaque, a sticky deposit that coats the inner walls of our blood vessels. Like rust within an old pipe, plaque restricts blood flow, leading to heart attack, stroke, and peripheral artery disease.

Understanding the Numbers

When a cardiologist reviews a patient’s lipid panel—the blood test that measures low- and high-density lipoprotein and triglycerides—we like to see a total cholesterol level under 200. But we carefully consider each number individually.

• Although low-density lipoprotein (LDL) is often dubbed the “bad” cholesterol, it is actually the one we can reduce and control most easily, through diet, exercise, and medication. LDL cholesterol should be below 100 in men over age 45 and women over 55, or below 130 in younger people.
• High-density lipoprotein (HDL) is regarded as “good” cholesterol because it can protect against cardiovascular disease. But that effect is limited. If LDL rises to unhealthy levels, there’s only so much that HDL can do to help. And little can be done to increase levels of HDL, which are dictated mainly by genetics and metabolism. HDL should be at least 40 for men and 50 for women.
• Triglycerides are a source of energy for the body but having too much in the blood can point to potential problems down the road. Triglycerides should be below 150 for everybody.

The Research on Coffee and Cholesterol

Interestingly, a number of studies have already explored the potential connection between coffee and cholesterol. Although most have been small studies, they’ve produced enough data to show that coffee consumption can indeed increase cholesterol. A meta-analysis, published in the American Journal of Epidemiology and consolidating results from several studies, showed that, in 89 percent of the results reviewed, coffee had increased patients’ cholesterol levels by an average of nearly 12 points.

What element within coffee is causing this increase? It’s the natural fats in the coffee bean—particularly the oils cafestol and kahweol.

But before you discard your coffee cup permanently, this news may not be as ominous as it seems. Here’s why: Most Americans drink a coffee brew that’s been passed through a paper filter, which blocks those natural oils from ever making it into the cup.

Researchers found that the coffees with the greatest likelihood to increase cholesterol levels are unfiltered, either boiled or steeped, such as French press or percolated coffee. If you’re a coffee drinker who favors one of these methods, you may want to consider changing the way you brew your coffee, particularly if your doctor says your LDL cholesterol is too high.

And what about that occasional coffee treat, espresso? Because its brewing process does not involve a filter, espresso is likewise high in natural oils. But, because it tends to be consumed in small quantities, its overall impact on the espresso drinker’s cholesterol is likely negligible.

Moderation Is Key

In studies examining coffee’s impact on cholesterol, people who experienced increased cholesterol levels were those who drank about five cups or more each day. So, moderation can also be important.

The research studies made sure to data-correct in order to report reliable results specific to the coffee itself. But keep in mind that flavorful additives to your coffee can increase the calorie count of each cup by 300–500 calories—or, in the case of flavored coffees served at national franchises, as much as 1000 calories per cup. So, those additives can increase your LDL as well.

Use moderation when you add the creamy and sweet stuff to avoid increasing bad cholesterol. A 500-calorie coffee may be fine as an occasional treat, but avoid having it become a regular indulgence. And don’t forget: most cases of high LDL can also be attributed to excess weight and lack of exercise—so try to achieve at least 20–30 minutes of some form of activity every day.

The Caffeine Effect

On another note, caffeine and other components of coffee may likewise create issues for occasional coffee lovers, depending on their individual sensitivity. Some can drink coffee without a problem; others may experience sleeplessness, increased blood pressure, and heart rate problems. Coffee can contribute to anxiety, panic attacks, and “brain fog,” and may also interfere with medications, including certain antibiotics, antidepressants, and drugs for asthma, thyroid, and osteoporosis.

It’s a good idea to moderate caffeine each day from all sources, including soda, tea, and energy drinks that you may be consuming in addition to coffee. Your daily total caffeine intake should be less than 400 mg.

Interestingly, once the body becomes accustomed to the beverage over time, many of coffee’s perceived negative effects tend to decrease. In fact, a number of studies point out the potential benefits of regular coffee consumption: It may lower the risk of heart failure, help with weight loss, and improve our thinking and our mood. It offers some protection against diabetes, Alzheimer’s, and certain cancers. There is also evidence that women who drink coffee are at lower risk for stroke.

Again, like most things, moderation is key.

Pursue a Healthy Lifestyle

To summarize, when it comes to cholesterol, the research confidently states that unfiltered coffee brews can increase cholesterol levels, primarily if you drink more than two cups per day and have other risks for high cholesterol; for example, if you’re ordering a “grande” specialty drink or refilling a jumbo mug at your favorite cafe, your intake of cholesterol-spiking additives is probably greater than you think.

But rather than worry too much about coffee, I recommend that my patients focus on other critical factors that impact their health—controllable factors such as nutrition, weight, exercise, and use of tobacco and alcohol. It’s wise for everyone, coffee drinker or not, to exercise most days (for a total of 150 minutes each week), to avoid smoking, and to make an effort to eat healthy.

I recommend the low-sodium Mediterranean diet, which emphasizes fish, whole grains, fruit, vegetables, oils, and nuts—an excellent blend of nutrients to help protect against long-term disease. And quantity is as important as quality. Excess food consumption creates excess weight, putting you at risk for cardiovascular and other diseases. Moderation is the key to health, no matter what you eat or drink.

Self-Care Is Important

High cholesterol and many other cardiovascular problems are preventable.

Be sure to choose a primary care doctor that you are comfortable with and will see regularly. He or she will keep an eye on your general heart health, including cholesterol levels, and recommend a consultation with a cardiologist if any risk factors exist. MedStar Washington Hospital Center adopts all precautions and protocols to keep our patients safe, during the current pandemic and always.

If the pandemic has one silver lining, it’s that it has caused many of us to do a better job of prioritizing our exercise goals and dietary habits. We’re not going out as much, so it’s a great time to create your own healthy meals, rather than depend on fast food. That’s what I’ve been doing, and I’ve never felt better. It can work for you, too.