Coffee is a popular drink – 54% of Americans drink coffee daily, resulting in $4 billion in annual coffee imports. I’ll admit up front I am not a coffee drinker myself. This probably has something to do with the fact that I am in the 25% of the population known as supertasters. Coffee is unpalatably bitter to me. As a headache specialist I also have a bit of a bias against daily intake of caffeine, a very common migraine trigger.
The majority of people, however, do not share my tastes. Historically coffee is popular in the US particularly since the Boston Tea Party. Coffee became a more patriotic drink, a thumb in the eye of our English overlords and their tea.
I also think that coffee’s popularity is at least partly due to the fact it is a legal drug delivery system, and that drug (caffeine) is somewhat addictive. The particular property of caffeine that hooks people is known as tolerance – after about 6 weeks of regular caffeine consumption your brain becomes tolerant to the stimulant effects of caffeine and instead experiences significant withdrawal symptoms if too much time goes by since your last mocha latte. Daily coffee drinkers end up chasing this withdrawal with more coffee, struggling just to get back to their baseline alertness, and convinced that they cannot function without their Frappuccino. If you have headaches then caffeine becomes a very effective treatment – for caffeine withdrawal headaches.
It’s not surprising, therefore, that coffee is also the focus of various forms of pseudoscience and snake oil. The classic coffee snake oil is the coffee enema. NaturalNews (not to be confused with Nature News) informs us:
“If you are truly serious about transforming your health in dramatic ways, implementing coffee enemas into your regular routine is essential for achieving the life-changing results you have always desired.”
They go on to claim that coffee enemas cleanse the colon, detoxify the body, and boost energy levels. That last claim may have some truth to it as you can absorb caffeine from the rectum (although 3.5 times less than when coffee is consumed the regular way). Coffee enemas are even offered as a treatment for cancer, without evidence or even a plausible rationale.
There is, unsurprisingly, no compelling scientific evidence to back any of the claims made for coffee enemas. Colonic irrigation is, in fact, 19th century quackery that is making a comeback in this golden age of medical nonsense we are currently enduring. Coffee enemas are also not without their risk. There are reports, for example, of rectal perforation either due to the procedure itself or burn damage from hot coffee.
Green Coffee Beans
Dr. Oz recently jumped on the coffee pseudoscience bandwagon by recommending green coffee beans for weight loss. Oz describes this as a “miracle pill” and offers some anecdotal evidence as justification. There is some published evidence on green (unroasted) coffee beans and weight loss, but of such terrible quality that it is completely unreliable. The study is small, poorly blinded, and was not registered with clinicaltrials.gov. In any case, the results, although touted as positive, are not convincing because they do not show a dose response relationship. During the study people lost weight, but it did not appear to have any relationship to when and what dose they were taking of green coffee beans.
The only thing better than snake oil is the marriage of snake oil and multi-level marketing – you get two scams for the price of one, and the MLMer gets to be both scammed and scammer at the same time. There is an endless list of dubious health products infesting the market these days. The latest to come to my attention is Organo Gold, which is, as far as I can tell, just coffee with some Ginseng. They claim:
“Featuring the Superior Panax Ginseng plant, which was considered an herb of such great value in the ancient world that it was only available to people of great power and privilege.
Ginseng is still highly prized and treasured in Asia as a key source of health and well-being.”
They proclaim that their product is “where ancient China meets modern science.” Let’s see – that is the argument from antiquity, the naturalistic fallacy, and appeals to popularity and authority. I have to say, as snake oil marketing evolves they sure are getting efficient at packing in the logical fallacies.
You also have to love the vagueness of the claims – “a key source of health and well-being.” Let’s see them measure that in a clinical trial. Ginseng has been studied quite extensively, but the quality of clinical trials is generally poor with unclear bias. At this point we have only poor quality preliminary studies with unimpressive results. These are the kinds of studies that are valuable to marketers as a source of cherry picking, but useless to science-based practitioners.
Coffee will definitely be with us for a long time as a popular beverage. The overall health risks vs benefits of consuming coffee on a regular basis are actually unclear. It seems to depend on what outcomes you measure and which variables are controlled. Overall it’s probably close to a wash.
The caffeine, however, is a stimulant with significant tolerance. This makes it an excellent legal drug to add to supplements or any consumed health product. It is for this reason that it is a popular additive for weight loss products. You get a good placebo effect out of the stimulant.
It is likely, therefore, that coffee will continue to be a popular target for purveyors of dubious health products.
Steven Novella, M.D. is the JREF's Senior Fellow and Director of the JREF’s Science-Based Medicine project.