Good for You, Bad for You: Coffee

Hello and welcome to The Cancer Pod. This podcast is for education, entertainment and informational purposes only. Do not apply any of this information without first speaking to your doctor. The views and opinions expressed in this podcast by the host and their guests are solely their own.

[Intro music]

Dr. Leah Sherman: Hi Tina.

Dr. Tina Kaczor: Hi Leah.

Dr. Leah Sherman: How are you doing?

Dr. Tina Kaczor: I am doing excellent today. How are you doing?

Dr. Leah Sherman: I am doing well. Our pod here on Good for You, Bad for You kind of got me thinking about this article that I read a week and a half ago. It was about – I don’t know if you saw it-It was about how eating a hotdog can take like 36 minutes off of your life per serving.

Dr. Tina Kaczor: I missed this. Was this kind of viral thing on the internet or what?

Dr. Leah Sherman: I mean every news channel source, they all – like it was everywhere. It was kind of crazy. So I looked up the original article and I just skimmed it. I didn’t go too deep into it. But it was really interesting because it talked about all different foods and it was not only looking at their impact on human health but also on global health… the impact that producing these products has on the environment overall.

It was kind of an interesting article but it kind of got a little ridiculous because you could be like… If a person removes – if they replace 10 percent of their processed meat intake with a plant-based diet, just 10 percent, then that could add – I don’t remember exactly the amount.... 40 something minutes to your life.

So, you know, in my head, in my kind of warped little brain, I’m like so for every hotdog, I just have to replace – like I started doing the math. Then what if I just have like some nuts and seeds along with the hotdog? Then do I gain 12 minutes? I mean it got really ridiculous. We were talking about clickbait in terms of food in the press and I think this article definitely was clickbait.

I mean it had interesting information in it and then, you know, the overall conclusion was – you know, it was interesting in that like it did look at things globally. I do think that is important but it was kind of putting it on the individual, which is fine and like I personally have no problem with replacing 10 percent. I probably already have 10 percent of my diet as plant-based. It’s probably more – it’s more than that.

Dr. Tina Kaczor: You know, I was going to say like 70 percent of your diet is probably plant-based.

Dr. Leah Sherman: Yeah. But it doesn’t look at the industry that produces these products, that are actually having the environmental impact. So it’s like telling the consumer, the individual consumer, “Oh, if you cut this out of your diet, you’re going to add blank amount of minutes to your life and help to save the earth instead of looking at various industries that are creating these products.” So I just thought that that whole thing was like super interesting and it was kind of relevant even though we’re not talking about meat.

Dr. Tina Kaczor: OK. I have a burning question though.

Dr. Leah Sherman: Yeah.

Dr. Tina Kaczor: How do they figure this out? Where is this data coming from? 

Dr. Leah Sherman: I’m going to send you the article. I’m just going to send you the article because it has got like pretty little graphs and it – what’s super interesting is that because you – you know, I always scroll down to the ... 

Dr. Tina Kaczor: Yeah.

Dr. Leah Sherman: I’m the kind of person – I always scroll to the end of a book. I go to the last page and I want to know how it ends. So when I see an article like this, I scroll to the bottom and I believe it was sponsored by – I have it here in my computer somewhere. Hold on. The research was funded by an unrestricted grant from the National Dairy Council and the University of Michigan Dow Sustainability Fellowship. So I thought that was super interesting that it was sponsored in part by the National Dairy Council.

Dr. Tina Kaczor: Give up your hotdogs and pick up a milkshake? I’m just kidding.

Dr. Leah Sherman: And this is a good time to mention we don’t have a website where we upload things but we do have a Pinterest page. I do put links to some of the things that I talk about on our Pinterest page. I will open up our Pinterest page and have a link to that actual article.

Dr. Tina Kaczor: Yeah.

Dr. Leah Sherman: And then I’m going to actually put a link to a – sort of a rebuttal from a statistician.

Dr. Tina Kaczor: Well, yeah. I’m pretty sure if I read it, I would want to rebut it because just givin the information sounds so crazy and off the wall.

Dr. Leah Sherman: Well, just the fact that they looked at like over 5800 foods to see what the impact was like on the individual as well as on the environment.

Dr. Tina Kaczor: Right.

Dr. Leah Sherman: I mean you could get to like, OK, so if I have a serving of wings, then how many sesame seeds do I need to eat– I mean it just – it’s really crazy and I don’t think it should be looked at the way that the media is kind of picking it up. 

Dr. Tina Kaczor: Sure. This is a classic spin zone.

Dr. Leah Sherman: It is. It really is. So – but I think that kind of applies to what we’re going to talk about today with coffee, right?

Dr. Tina Kaczor: Oh. So you’re saying what the media makes of some of the coffee research is not necessarily always what the research is saying.

Dr. Leah Sherman: I do and I think that they’re going to go with whatever is the most sensational at the moment because you will find articles that go back and forth within a week. But then I also think it is a good way to look at, well, maybe the next two subjects, coffee and soy. It’s looking at the global impact, the sustainability impact too.

So those are things that I like to consider when I consume things. I’m not 100 percent that way. I’m not fanatical. I will go to eat in a restaurant where maybe they don’t have grass-fed beef because I want something that looks delicious on the menu. But it is something that I am very aware of. I do think that as an individual, you know, just being mindful of those types of global impacts is important.

Dr. Tina Kaczor: Yes. Well, you know, that brings to mind. Did you ever – I know you didn’t watch the show much…neither did I to be perfectly honest but on Portlandia, there’s one episode where they’re sitting in a restaurant and of course they’re in Portland. They get to the point where they keep asking so many questions about the chicken, and they get to the point that they’re going to visit the farm where the chicken was raised.

Dr. Leah Sherman: Yeah. I saw that episode and I thought that was really funny up to a certain point because I recognize myself in that. You know – but in Portland it’s common. But if you go – like in Arizona, when I lived down there, and I’m like “So, what was this chicken’s background?” 

Dr. Tina Kaczor: Yeah.

Dr. Leah Sherman: I find myself doing that in other places. But yeah. No, it is an important thing. But at the same time, it’s the individual but it’s also the greater corporation. 

Dr. Tina Kaczor: Well, there was a woman that was a patient of mine in my early days of my practice, a successful business-woman. She said it so concisely. She said, “You vote with your dollars,” and you basically, when you spend money, are endorsing or not endorsing that money flow, right?

You’re saying, when I shop local and I know that there are families nearby that – or there are farms nearby-- that are sustained with that, there’s a little bit of that in that piece where they’re – I think they’re trying to get people to create the – either demand or lack of demand by changing people’s spending habits. So, I think that’s part of our capitalist structure.

Dr. Leah Sherman: But I don’t – I have to go back and look at the other articles that I saw on the internet. I don’t remember them really delving into the ecological impact. They were more interested in the hours you’re going to lose from eating …

Dr. Tina Kaczor: Yeah.

Dr. Leah Sherman: … from eating processed meat. So that was just my like kind of – that was my little tangent but it really – it does apply to coffee and I think it does apply to soy as well. You just have to know your sources.

Dr. Tina Kaczor: Ah, ah, so that the source of the coffee in this case-in the discussion today-counts as to whether it’s healthy or not healthy.

Dr. Leah Sherman: To the earth.

Dr. Tina Kaczor: To the earth. I would say to the person too but that’s just …

Dr. Leah Sherman: To the person and to the earth, right? Because when we think of things like organic versus not organic, I think we tend to think about ourselves. But there’s also the impact of non-organic coffee farming practices that can affect the bigger picture. 

Dr. Tina Kaczor: Yes. I see what you’re saying now. All right. Let’s talk about coffee.

Dr. Leah Sherman: Let’s talk about coffee and neither of us – are you drinking – I’m drinking water right now.

Dr. Tina Kaczor: It’s too late in the day for coffee for me.

Dr. Leah Sherman: Yeah.

Dr. Tina Kaczor: I mean I did my share of coffee this morning. Now I am drinking kombucha.

Dr. Leah Sherman: Nice. 

Dr. Tina Kaczor: Brew Dr. Love. That’s what they call it. Love. It has got lavender, chamomile and jasmine green.

Dr. Leah Sherman: Lovely.

Dr. Tina Kaczor: Uh-huh. See?

Dr. Leah Sherman: They’re not even a sponsor… yet.

Dr. Tina Kaczor: No. That’s funny. Not that there’s anything wrong with that.

Dr. Leah Sherman: No. OK. So coffee, let’s start with the positive note because the first episode in this pod was a bit of a downer. So, let’s start on the positive note of coffee being good for you.

Dr. Tina Kaczor: All right. Well, the most positive note for those of us who like coffee is that it’s delicious.

Dr. Leah Sherman: It is delicious, and I mean I drink my coffee black. Do you drink yours black as well?

Dr. Tina Kaczor: No. I put a little dollop of cream in mine.

Dr. Leah Sherman: OK.

Dr. Tina Kaczor: I will admit it. I can tolerate dairy just fine and I like it – it’s smoother, a little smoother than black. You know, the mouth feel.

Dr. Leah Sherman: I think you need to try the cold brew. I mean the weird thing with the cold brew is that I do end up heating it up because I do – because I’m not going to drink iced coffee in the winter in the Pacific Northwest. But it is smoother.

Dr. Tina Kaczor: All right. I will try it.

Dr. Leah Sherman: When you’re up here, I will give you some. I will make you some.

Dr. Tina Kaczor: I will definitely try it.

Dr. Leah Sherman: So, number one on the good list is it tastes good.

Dr. Tina Kaczor: Yeah. I mean come on. If you don’t like it, then you would disagree with me. But if you’re a coffee – people don’t like coffee…they love coffee. You’re going to love it or you don’t drink it. You’re someone who likes it or you don’t like the taste of it.

Dr. Leah Sherman: Or you drink it because like I started drinking it in art school because it kept me up, and I just drink disgusting instant and I probably put the water right in the half-used jar. I was drinking it for the caffeine in art school.

Dr. Tina Kaczor: Yeah. I became a bit of a coffee connoisseur because I was a barista for a while.

Dr. Leah Sherman: I was a barista too. 

Dr. Tina Kaczor: Yeah, super fun.

Dr. Leah Sherman: A lot of fun. Were you a barista in the Pacific Northwest?

Dr. Tina Kaczor: I was living in San Diego at the time.

Dr. Leah Sherman: OK. So that’s probably – it’s hard to be a barista here in the Portland area because people really know what they want from their coffee and it’s different when I was on the East Coast and when I was living in New Mexico. I learned things differently. So it’s a whole different culture here. So it’s probably different in San Diego as well.

Dr. Tina Kaczor: Yeah, I don’t know. It was the mid-90s in San Diego and I had a few barista jobs. One of them was actually at a place that only did nighttime entertainment and coffee and I would – it’s the place where Jewel got her start …

Dr. Leah Sherman: Oh, cool.

Dr. Tina Kaczor: She was only sixteen years old at the time, so nobody knew her. So there was nobody there but like three people and Jewel was on stage doing her thing with the guitar. So anyway, that’s kind of my big memory of the whole place. I did work in other places and, you know what, I don’t think people were that picky yet because it was the mid-90s and people didn’t know enough to be picky about their coffee.

Dr. Leah Sherman: And when I worked here, it was the summer before I started naturopathic medical school. I had never experienced something like that. I mean people were ordering cappuccinos wet or dry. They were requesting certain temperatures for their coffee. It was – like I had never learned that when I was a barista. You know, like in other states, it was strange. The coffee culture here is strong.

Dr. Tina Kaczor: Yes. Well, and I could tell you, I drank a lot of coffee when I was a barista because I drank my mistakes. You know, you might make six mistakes a day. This was easily six or ten shots of espresso in a day in my 20s, early 20s.

Dr. Leah Sherman: I actually had given up coffee when I was living in New York and I think even when I moved down to Richmond, Virginia, I had given up coffee. So when I moved out to Portland and I got the job, I wasn’t drinking coffee. Then I started drinking decaf and then I moved on to the hard stuff once school started.

Dr. Tina Kaczor: Oh, yeah. Once they make you open those places up at like 5:00 in the morning, so you need your – you need a shot of espresso just at the start of the day.

Dr. Leah Sherman: I was doing great until – yeah, until I fell off the wagon. But yeah, I actually was a barista and was not drinking coffee at the time. I loved it and I could talk about coffee all day. But I just wasn’t drinking it. Well, I think because this is The Cancer Pod, like there has been news about the association of drinking coffee, the positive association of drinking coffee and the risk of certain cancers.

Dr. Tina Kaczor: Yeah. It’s overwhelming. The evidence is overwhelming. One caveat too – and I know this show is only for kind of the good stuff. But since we’re talking about risk of cancer, there’s not a lot of cancers that coffee has been linked to. The only two that I know of that are significant is a lot of consumption, like a pot of coffee or more a day, is linked to bladder cancer. We could talk about why that might be. And the other is when women are pregnant and they drink a ton of coffee like – again when I say a ton, I’m talking about a lot, like a pot of coffee. That is linked to higher rates of leukemia in their child.

Dr. Leah Sherman: Oh, wow. I don’t remember seeing that. That’s interesting.

Dr. Tina Kaczor: So those are the only two that I know of in the data that are fairly consistent and come up more than once in my… you know, I’m usually reading review studies and meta-analysis because we have so much data on coffee. I will read a few of the original articles. But most of the time I’m looking at systematic reviews because there’s a ton of data

Dr. Leah Sherman: I remember there was a saying when I was growing up and so it’s probably from the ‘80s that talked about like the risk of cancer from drinking coffee. But that was the ‘80s. So that information – I think it has been shown to not be valid at this point because there are a lot of benefits from coffee, but it’s in moderation.

Dr. Tina Kaczor: Yeah.

Dr. Leah Sherman: Because it’s not just – it’s just not – like it has been shown to reduce the risk of liver cancer and pancreatic cancer. It has also been shown in some studies and these aren’t – I mean these are – what do they call it? 

Dr. Tina Kaczor: Observational?

Dr. Leah Sherman: You know, because it’s not like – they’re not like double-blind placebo-based studies that they’re – you know, it’s – they’re just –

Dr. Tina Kaczor: They’re looking at a cohort study, like a population.

Dr. Leah Sherman: Right. It’s a population study and so, you know, like up to three cups of coffee a day may be preventative for things like dementia.

Dr. Tina Kaczor: Yeah, because coffee, you know, coffee is a complex food like all other natural foods. So it has got a lot of compounds in it of benefit. It’s not just the caffeine or the lack of caffeine. It’s really complex food and there are compounds definitely that enhance cognition in coffee.

Dr. Leah Sherman: Which I think when we drink caffeinated coffee, we experience that like firsthand. Like that’s kind of why – you know, it’s that alertness that we experience.

Dr. Tina Kaczor: Yeah, yeah, and there are – one of the compounds since we said we can talk positives. So the most – the evidence as far as I know, the evidence shows that there’s a reduction in the incidence of liver cancer. There’s a reduction in the incidence of endometrial cancers, sometimes called uterus or uterine cancer.

For sure like that’s the strongest data. But there’s also some associated reduction in the risk of breast cancer, colorectal cancer. There are several others and because there’s only a couple of cancers that are linked to increased risk and that’s a very high dose, you know, you can safely say that coffee is not going to raise the risk or be detrimental to people in the way of increasing risk of cancer or recurrence of cancer for anyone across the board in moderate levels.

So if someone wakes up and has a cup of coffee, two cups of coffee in the morning, we can safely say that is not linked to an increased recurrence or any type of cancer. Again, this is something we have a ton of data on because coffee is such a common drink, right? So it’s not like this is just a small subset of people. This is around the world and it’s consistent. 

Dr. Leah Sherman: So when they look at these – when they gather the data, are they taking into account how people are drinking their coffee? Because they could be putting as I call it Creamora® wall of fire in each. You know, tons of sugar. You know, like those additive syrups that you get in coffee shops. Like to me that’s not coffee.

Dr. Tina Kaczor: Right.

Dr. Leah Sherman: And I know it is to many people. But I’m not seeing that as being like, oh, well, coffee is good for you…so I’m going to have three of these like $14 coffee drinks.

Dr. Tina Kaczor: I don’t see that being teased out at all. So – and it could be that the coffee provides enough underlying benefit or doesn’t cause any detriments, so that no matter what people do, there’s still not a detriment to it. I don’t know. But I haven’t seen it teased out that way at all, like black versus not black and all that kind of stuff.

Dr. Leah Sherman: And I would –I would add that putting multiple pumps of flavoring and heavy cream and sugars, that leads to weight gain, which then is a risk. So that would be a concern. I mean I’m not telling everyone to go out and drink blank coffee but just be mindful of how yours is being prepared.

Dr. Tina Kaczor: Yeah. So one of the types of compounds that has benefit that we – there’s polysaccharides, right? So there are all these different sugars that are inherent in coffee, in a cup of coffee and some of those can be beneficial to immune function, something like – a little bit like what you get out of mushrooms. Kind of like the same type of compound, these polysaccharides, right?

So there’s arabinogalactans, which, you know, there are supplements that have arabinogalactans. So this is a really decent molecule to say, OK, that probably affects your immune function in a positive way. So the mechanism, I should be clear, the mechanism is how coffee intake reduces cancer risk or risk of recurrence depending what studies you’re looking at. The mechanism isn’t that well-studied. I mean all we can do is say, oh, those compounds are in there, maybe they’re having an effect but it’s not clear. The other thing is it’s really high in antioxidants, right?

Dr. Leah Sherman: Right. And we did talk about that, that it’s the heat that extracts the antioxidants. So something like a cold brew isn’t going to have the same antioxidant effect.

Dr. Tina Kaczor: It would be less antioxidants, yeah. You know, antioxidants are always nice to have, some flowing in from food. I mean this is kind of like the reason we eat so many colorful fruits and vegetables. There’s this type of compound. They’re called chlorogenic acid and they’re unique to coffee and it is thought that – because some studies showed that decaffeinated coffee also is a benefit. Chlorogenic acid could be one of the reasons. This is – oh, vanillic acid is one of the chlorogenic acids. So vanillic acid is something that we know is anti-inflammatory and has really nice benefits. In any case, if that is the substance, then paper can remove that. So a paper …

Dr. Leah Sherman: Remove the beneficial substance?

Dr. Tina Kaczor: Yeah. So we don’t know what the beneficial substances are in coffee. So not using a paper filter will at least ensure that whatever is in there, you’re still getting it. 

Dr. Leah Sherman: But I thought – and this could be old information. I thought that drinking unfiltered coffee can lead to elevated homocysteine levels.

Dr. Tina Kaczor: Oh.

Dr. Leah Sherman: And affect heart health.

Dr. Tina Kaczor: If it doesn’t go through a paper filter?

Dr. Leah Sherman: Uh-huh.

Dr. Tina Kaczor: I don’t remember that. I’m not aware of it.

Dr. Leah Sherman: I learned that in school but I don’t know like if that has been refuted. I’m not quite sure like what is going on with that information because I just thought of that.

Dr. Tina Kaczor: Yeah. We could check that out. I’m not aware of anything because generally speaking – I mean you can overdo caffeine of course, right? Like we’re not telling people who are sensitive to caffeine to go out and find a way to drink it. That’s not going to be good. Some people have – 

Dr. Leah Sherman: No.

Dr. Tina Kaczor: Yeah, underlying anxiety, or whatever, or stomach acid issues or …

Dr. Leah Sherman: Yeah, reflux, reflux.

Dr. Tina Kaczor: Reflux, big reason, not to drink coffee. Yeah[TK1] .

Dr. Leah Sherman: For sure. That’s why I like to run my cold brew through a filter. I love – I used to love doing my percolated coffee. But now I can’t tolerate that. One of the things that I thought was interesting where coffee has been shown to potentially reduce the risk of breast cancer is that it is – it can be synergistic with tamoxifen.

Dr. Tina Kaczor: Yeah.

Dr. Leah Sherman: Which is crazy because we talk about tamoxifen a lot, not just because I take it, but because there’s so much potential for interactions. So, not all interactions are bad, but there were some articles talking about how it worked with the tamoxifen in order to reduce the risk. 

Dr. Tina Kaczor: Yeah. That’s another link I can – I know I have that handy in my kind of catalog of papers. So, I will hand you that one to put on Pinterest in case people want to see that. [ paper mentioned concluded, “The clinical and experimental findings demonstrate various anticancer properties of caffeine and caffeic acid against both ER+ and ER− breast cancer that may sensitize tumor cells to tamoxifen and reduce breast cancer growth.” [ Reference: Rosendahl AH, Perks CM, Zeng L, et al. Caffeine and Caffeic Acid Inhibit Growth and Modify Estrogen Receptor and Insulin-like Growth Factor I Receptor Levels in Human Breast Cancer. Clin Cancer Res. 2015;21(8):1877-1887.]

Dr. Leah Sherman: Cool.

Dr. Tina Kaczor: Since you’ve mentioned tamoxifen and I’m thinking – that makes me think about breast cancer. There’s also evidence that people – and this is men and women with a BRCA1 mutation – may benefit from coffee consumption. [Reference: Nkondjock A, Ghadirian P, Kotsopoulos J, et al. Coffee consumption and breast cancer risk among BRCA1 and BRCA2 mutation carriers. Int J Cancer. 2006;118(1):103-107. doi:10.1002/ijc.21296 ]

Dr. Leah Sherman: Wow.

Dr. Tina Kaczor: Yeah. So there was – those with BRCA1 mutation. They found that there was a correlation. The more coffee that people drink, the less they had breast cancer diagnosed. It was a significant amount. I mean people were drinking – I think it was up to four to six cups. I mean I’m not advocating that again, it’s just that’s what the study had because I think – you know …

Dr. Leah Sherman: And the study wasn’t putting people in a room and saying this is what you’re going to do and then having a control group. That’s not what they’re looking at…so, all of this information, it’s just kind of looking at populations.

Dr. Tina Kaczor: Yeah, yeah. So that’s an observation. And, you know, that brings up a good point and this is true as an aside for population studies in general including the one that you started talking about at the very beginning about hotdogs.

When they’re doing any kind of association like that, we don’t always know the other habits that go along with that. So does the act of drinking coffee make people, I don’t know, more active in the morning because they have more energy to get stuff done? I don’t know. Does it inherently mean that people who aren’t drinking coffee are people who already have anxiety or a nervous system that’s already jacked up? So, you know, they naturally avoid coffee consumption. But in other words, you don’t always know if the action is the cause of the association or if it’s just associated and there’s some other reason that this is happening. We don’t know.

Dr. Leah Sherman: I think that has kind of triggered something in my mind. I think like the old information on coffee, you know, all of the bad information was because of things like that where – well, maybe people when they’re having a coffee in the morning, they’re having a cigarette.

Dr. Tina Kaczor: Absolutely.

Dr. Leah Sherman: You know, or like …

Dr. Tina Kaczor: Back in the day.

Dr. Leah Sherman: Running into – yeah, back in the day and I mean people still do that. But I think it was just a lot more of that looking at other aspects of their lifestyle. I do – before we talk about the bad, we’re going to – I want to kind of transition with there are issues with consuming coffee during cancer treatment. I have had numerous patients who do or did drink a pot of coffee, plus. I had at least one patient that I know of that would drink two pots a day of coffee, related to work. You know, having to work different shifts. Coffee is a diuretic.

And so,when you’re going through chemotherapy, you know, remaining hydrated is really important. So, limiting… that was always such a hard thing to talk about. I would have a patient come in and they would meet me for the first time and they’re like, “You’re going to take me off the coffee, aren’t you?” and I was like, “Well, how much do you drink?”

Dr. Tina Kaczor: Right.

Dr. Leah Sherman: And they would tell me, and I was like, “Well, let’s cut back. You know, go talk to the dietician more, but I would like to see you reduce your intake and let’s try to throw in more hydrating things.” So that is one big conversation I always would have with patients who are big coffee fans.

Then the other issue which you touched on are stomach issues. So, with nausea being one of the most common symptoms of going through chemotherapy and for some people as well with radiation, your taste buds change and the way you tolerate foods change when you’re going through treatment as those of us who have been through treatment know.

So anything that can contribute to reflux because reflux can mimic – I mean it can create nausea which, you know, then everyone is investigating the medications that you’re taking and they’re changing your medications. It could be the foods that you’re eating that are triggering that reflux and maybe you just needed to make some diet modifications and you didn’t have to go onto this whole like antiemetic cocktail.

Dr. Tina Kaczor: Right, right. Yeah, and on that same note of reflux is also gastritis because gastritis is a very common thing.

Dr. Leah Sherman: Super common.

Dr. Tina Kaczor: Yeah. So definitely not help your gastritis.

Dr. Leah Sherman: And then bowel issues, right? I mean people drink coffee because it stimulates their bowels in the morning. First thing in the morning you’re having a hot beverage. You’ve got that caffeine. It makes people go to the bathroom and sometimes you just don’t want that depending on your treatment. So if someone is experiencing a lot of diarrhea and loose stools and they’re drinking coffee, consider cutting back because that could be aggravating it. So those are always my issues, and that would be a conversation I would have with a patient who – and there are more – I wish I kept track of the patients who literally would sit down and be like, “You’re going to stop my coffee,” and like first of all, I’m not the dietician. 

Dr. Tina Kaczor: I’ll let her do that.

Dr. Leah Sherman: I’m going to let her do that. But this is my take on it. So that’s kind of the transition to the bad-for-you part of coffee. 

Dr. Tina Kaczor: Yeah. I think those immediate effects, whether you’re getting chemo or not, they’re just more like – you know, more – it might happen to you during treatment, even when you don’t normally have reflux, you don’t normally have gastritis, right? Because the treatment induces those symptoms. But for anyone with those symptoms already, just chemo aside, it definitely can aggravate. You know, the other thing coffee can aggravate is bladder stuff.

When people have sensitive bladders, urinary bladder, so the coffee can be an irritant to the bladder. So it’s one of those things that you cut out and see if you have less irritation because, you know, especially post-menopausally, the bladder can become very sensitive to its own acidity. So caffeine in coffee is a classic stimulant for bladder irritation.

Dr. Leah Sherman: And once going through menopause, I mean you just – it’s not always as easy to hold your urine.

Dr. Tina Kaczor: Right.

Dr. Leah Sherman: So kind of reducing those things that create that urgency.

Dr. Tina Kaczor: Yeah, the diuretic, yeah.

Dr. Leah Sherman: The diuretic and yeah, it’s not always easy to hold it. That might be TMI but we’re all family here apparently.

Dr. Tina Kaczor: Yeah, it’s OK. Everyone listening is family.

Dr. Leah Sherman: That’s right. So, looking at the bad side of coffee, what I found super interesting because this is the good and the bad is back in 2018, don’t you remember how California with their Prop 65 declared coffee a carcinogen?

Dr. Tina Kaczor: Oh, I do remember that, yes.

Dr. Leah Sherman: That was because of the – what is it? Acrylamide?

Dr. Tina Kaczor: Uh-huh, uh-huh.

Dr. Leah Sherman: And then a year later, they like rescinded that.

Dr. Tina Kaczor: Yeah, that was a – you know, back to your hotdog story, that was just a spin that got out of control.

Dr. Leah Sherman: But that’s – yeah, so that’s kind of what I’m saying. But there is a substance not only in coffee but in other things, other foods and I’m saying it right, right?

Dr. Tina Kaczor: Yeah, acrylamide, yeah.

Dr. Leah Sherman: Acrylamide. That is a known carcinogen.

Dr. Tina Kaczor: Yeah. Acrylamide is a known carcinogen. It’s about the quantity you would have to ingest. So, you know, people who are in an industry where acrylamide is being formed, you know, it’s an occupational carcinogen because they get – you know, industrial places like plastics and some water treatment products have acrylamide. 

Even some cosmetics. You know, obviously not naturally-derived ones but others. So I think that’s more of an issue. I think that the – I don’t even know how much occurs on coffee or that kind of thing. I didn’t look at the numbers.

But it’s not enough to add up to having a net carcinogenic effect which I’m going to say it one more time. Look at this up, down and all around. I think if we saw an increase in cancers, I think it would have been borne out in the data by now because of such a common drink worldwide. You know, what really high and maybe if anything was going to be labeled, potatoes, fried potatoes. 

Dr. Leah Sherman: Right. I know and I do love my French fries …

Dr. Tina Kaczor: Tater tots.

Dr. Leah Sherman: … and my tater tots.

Dr. Tina Kaczor: Tater tots are – I love them.

Dr. Leah Sherman: Potato chips like the Kettle.

Dr. Tina Kaczor: Oh, yeah. See, I know. So that’s when you look and you’re like, “Ah, acrylamide, be damned I’m eating a potato chip…”

Dr. Leah Sherman: Well, I know and there was a period. Like I go through these phases where suddenly I’m just like no potato chips and only buying like the baked chips which are so hard to find, and I tried making my own with an air fryer. I mean it was a disaster. But, you know, every once in a while, these bugs get in my brain where it’s just like I just kind of go on a “OK, I’m going to reduce this in my diet” because, you know, I’m trying to reduce the risk of recurrence and I just kind of like, you know-

Dr. Tina Kaczor: Well, it’s good that you settle back to – you know, moderation is the key. The question is always what is moderation? So just acrylamide is a product of sugar and an amino acid and it creates acrylamide with heat. So the high heat is required for the sugar and the amino acid which is asparagine. For anyone wh wants to know.

But then amino acid and sugars bind together and that’s what makes the molecule acrylamide when you just kind of – and the reason that frying, that deep frying is bad because of course like it enters the oil and you get a lot better production of the sugars and the amino acids binding in that.

Dr. Leah Sherman: Right. And from what I remember is like the more you use… because restaurants, they reuse the oil. So the longer the oil is around, the more oil that gets reused.

Dr. Leah Sherman: Then the greater that acrylamide build-up.

Dr. Tina Kaczor: That makes sense.

Dr. Leah Sherman: So going back to good for you, bad for you as that is our theme, where coffee has been shown, up to three cups a day, to be beneficial in terms of reducing the risk of dementia. Over six cups has been shown to increase the risk of dementia. So again, moderation.

Dr. Tina Kaczor: But is this an association again? Like …

Dr. Leah Sherman: Yeah. I think all of this I believe is association. They found people drinking over six cups a day had a greater risk of dementia and yeah, is it they’re drinking more coffee because it helps them think clearer and they had dementia – you know, the onset of dementia anyways or are they drinking the coffee kind of like to self-medicate?

Dr. Tina Kaczor: Right. This is the question.

Dr. Leah Sherman: Yeah. So it’s – I do believe it all comes as we always say back to moderation.

Dr. Tina Kaczor: Yeah, yeah. And, you know, back to the sourcing thing that you talked about in the beginning too. You know, when you buy a large commercial coffee whose names I will not say because I don’t want to get in trouble. But let’s just say it’s a large brand that sold anywhere for very inexpensive prices and they’re kind of taking – remember where coffee grows. Coffee grows in jungle-like settings where the plants, you know, will come and the weeds and the bugs and the critters that you have to keep off of coffee are significant if you’re going to just monocrop it... like you take down a bunch of native trees, and you put a plantation in of coffee beans. You have to spray that with some serious stuff to keep the jungle off of it. So I’m saying this because the source really counts with coffee. Like, it’s one of those things when people are going to do organic or buy with a really – a good sense of where it’s being grown. I put coffee high on that list of to-dos because of where it grows. It doesn’t grow in temperate climates without – you know, like I don’t know- here in Oregon, I just bought blueberries and they weren’t organic. I’ll admit it. They were locally-grown but blueberries in Oregon grow very easily and you really don’t have to manage pests that much especially in the valley where – you know, Portland and down in Eugene, that whole area.

So my point is I know that those don’t need nasty chemicals sprayed on them. But coffee, yeah, you’re growing coffee in jungle regions basically, jungle-like. So, you want shade-grown. When you say shade-grown, now automatically- even if it’s not organic, if it’s shade-grown, you know that it’s not a giant plantation that they have to kind of keep spraying it. And, it’s aerial sprays, whatever gets sprayed on the beans, remember they’re picked, they’re green, then they get roasted and then you extract them. So, you actually extract the chemical compounds that are put on those beans. They go into your body very readily. We don’t know what all of them are because you just roasted them. So you take chemical compounds, you throw it through whatever that is, 500 degrees, I don’t know, 800 degrees? I don’t know how high it is but it’s a high temperature.

Now you got kind of all sorts of end products that shouldn’t be there chemical-wise and then you extract it and you’re going to drink that. So, I would say sourcing a clean coffee bean, shade-grown- definitely. Organic- hopefully.

Dr. Leah Sherman: Especially with a decaf coffee, right? I mean the processing that goes into removing the caffeine, you know, making sure that the coffee says that it’s organic because if they use the strong chemicals to remove the caffeine, then they can’t label it organic.

Dr. Tina Kaczor: Right. So, for decaf – because they used to use in that kind of a methylene or some other kind of nasty chemical, and now they can do it through a water process. Swiss Water process was the first one they made kind of popular but I think there might be some other things out there. So if it says water processed, decaf, yeah, you’re more likely to get a clean one without unnecessary chemicals. So that’s what we’re concerned about, right? It’s the ingestion of nasty chemicals.

Dr. Leah Sherman: And the impact of the nasty chemicals on the planet.

Dr. Tina Kaczor: There is that. So, this was our take on coffee. That’s a good discussion, I think. I think we hit all the high points. I hit all of mine. Did you hit all of yours?

Dr. Leah Sherman: We hit the high points, we hit the low points. We hit the points in between.

Dr. Tina Kaczor: Oh, we did hit more points.

Dr. Leah Sherman: Yeah. No, I think we did. I think it’s not as – what is the word? It’s not as ... 

Dr. Tina Kaczor: Polarizing?

Dr. Leah Sherman: Polarizing as like the alcohol talk. I think that really brings up a lot.

Dr. Tina Kaczor: Sure.

Dr. Leah Sherman: And people do love their coffee. So finding like that there is benefit to drinking coffee within limits. You know, with limits set around that. I think this one ends a little happier.

Dr. Tina Kaczor: Yes, we end in a happy note.

Dr. Leah Sherman: Yeah.

Dr. Tina Kaczor: I think. Yeah, because I’ve had the same experience you’ve had which is that people sit down and go, “They’re going to take away my coffee.”

Dr. Leah Sherman: Right.

Dr. Tina Kaczor: But if that’s the case, you’re going to tell me not to drink coffee. So they’re pleasantly surprised when I say, “No, go ahead enjoy a cup.”

Dr. Leah Sherman: Enjoy a cup. Yeah, let’s talk about how you prepare that coffee and maybe we will make some alterations. But …

Dr. Tina Kaczor: Yeah, exactly. I might ask you to modify a little bit. But I’m not going to ask you to stop.

Dr. Leah Sherman: Yeah. Well, cool. So our next talk will be on soy.

Dr. Tina Kaczor: Uh-huh, another bean.

[Caveat/ Friendly reminder: Coffee is a berry, not a bean.]

Dr. Leah Sherman: Another bean. Good for you, bad for you.

Dr. Tina Kaczor: This is the question.

Dr. Leah Sherman: This is the question.

Dr. Tina Kaczor: So, you know, we’re going to be informed by the data. We’re going to go forward. I don’t have any – we don’t have any allegiances to any one or any company.

Dr. Leah Sherman: I have my biases against soy. So I will try to be as neutral, as soy-neutral as possible.

Dr. Tina Kaczor: You should voice your biases.

Dr. Leah Sherman: I will. Oh, I will. I will.

Dr. Tina Kaczor: Oh, right, right, right.

Dr. Leah Sherman: But yeah, so I am Dr. Leah Sherman.

Dr. Tina Kaczor: And I’m Dr. Tina Kaczor.

Dr. Leah Sherman: And this has been The Cancer Pod.

Dr. Tina Kaczor: We will talk to you next time. Until then.

Dr. Leah Sherman: Thanks for listening to the Cancer Pod. Remember to subscribe, review and rate us wherever you get your podcasts. Follow us on social media for updates and as always, this is not medical advice. These are our opinions. Talk to your doctor before changing anything related to your treatment plan. The Cancer Pod is hosted by me Dr. Leah Sherman and by Dr. Tina Kaczor. Music is by Kevin McCloud. See you next time.