If you're a coffee drinker, here's one more of one of those "good-news/bad-news" situations that muddles your mind and drives you to straight to the coffee pot for another hit of joe. Coffee has garnered media and especially Internet attention ever since a 2000 publication in the Annals of the Rheumatic Diseases linked coffee consumption to a heightened risk of rheumatoid arthritis. But since that publication, research has yielded mixed findings, with some even suggesting positive effects of coffee for health and for joint pain in particular.
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The epidemiological study, by Dr Markku Heliovaara of the National Public Health Institute in Helsinki, Finland, struck fear in the heart, if not pain in the joints, of coffee lovers around the world. Heliovaara found that the number of cups of coffee people drank each day was directly proportional to their risk of developing rheumatoid arthritis "rheumatoid factor," a serum measure of a type of protein that plays a role in the development of rheumatoid arthritis. People who drank four or more cups of coffee a day had twice the risk of those who drank no coffee, and those who drank more than 10 cups a day were about 15 times more likely to have rheumatoid factor.
More Bad News
Heliovaara's study couldn't identify if caffeine in the coffee or something else potentially caused the increase in rheumatoid factor. An 11-year study by rheumatologist Ted R. Mikuls of the University of Alabama-Birmingham found women who drank four or more cups of decaffeinated coffee had increased risk of rheumatoid arthritis. Coffee without caffeine increased the rheumatoid factor, so it is not simply the caffeine that may increase the risk, but perhaps something else. And there's more. Both coffee and caffeine are widely considered to be proinflammatory agents, meaning they are thought to heighten inflammation, especially when consumed in excess. It is often recommended that you should avoid coffee and caffeine if you have arthritis or joint pain.
On the bright side, there is increased research that fails to replicate earlier studies that sullied coffee's already murky reputation. A large prospective study reported in Arthritis and Rheumatism found scant evidence of a link between consuming coffee or decaffeinated coffee and the risk of rheumatoid arthritis.
Many new studies more carefully control other contributing risk factors such as smoking, poor diet and alcohol use; coffee drinkers apparently have multiple vices. These studies not only fail to replicate earlier findings, but also find that moderate coffee use is linked to health benefits, according to Arthritis.org. For example moderate to low coffee consumption may decrease the risk of various illnesses including Parkinson's, Alzheimer's, cardiovascular disease, several types of cancer, type 2 diabetes and gout, an inflammatory autoimmune disease that causes joint pain in peripheral joints and especially in the big toe.
The initial Finnish study that started the coffee-controversy ball rolling investigated coffee consumption among people who drank unfiltered, boiled coffee that was brewed using a French Press, as is common in Finland. The popular use of filtered coffee, instant coffee or percolated coffee could very well contribute to differences between studies. There are also contradictory findings that cannot easily be explained, and the underlying mechanisms and specific causal factors that link coffee to arthritis still have not been identified. The jury isn't out; it hasn't even left the room. It's still in court hearing evidence.
There are a few recommendations you can take from this. Don't drink unfiltered, boiled coffee. If you have joint pain, you can try eliminating coffee and caffeine for a week or so and see if your pain improves. Otherwise, it's a wait-and-see-what-the-researchers-come-up-with-next situation. So while waiting, lean back, take another sip of your paradoxically rejuvenating yet calming java and mull over the possibilities. Just try not to take more than two or three cups worth of sips on a daily basis.
- “Annals of the Rheumatic Diseases”; Coffee Consumption, Rheumatoid Factor, and the Risk of Rheumatoid Arthritis; 2000
- “Arthritis and Rheumatism”; Coffee Consumption and Risk of Rheumatoid Arthritis; November 2003
- Harvard School of Public Health: Coffee and Health
- HowToDoThings: How to Understand the Link Between Caffeine and Arthritis