Ask Dr. Mike: How Much Coffee Can I Actually Drink Daily?

Dr. Mike talks about the study that says that drinking five cups of coffee a day can be good for you

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Meet internal medicine physician Michael Cirigliano, affectionately known as “Dr. Mike” to not only his 2,000 patients, who love his unfussy brilliance, tenacity, humor, and warmth (he’s a hugger!), but also to viewers of FOX 29’s Good Day Philadelphia, where he’s been a long-time contributor. For 32 years, he’s been on the faculty at Penn, where he trained. And he’s been named a Philadelphia magazine Top Doc every year since 2008. Now, he’s our in-house doc for the questions you’ve been itching (perhaps literally) to ask a medical expert who’ll answer in words you actually understand. Here, we talk about a recent study that drinking five cups of cofffee each day can be good for you. Got a doozy for him? Ask Dr. Mike at victor@phillymag.com.

I think a lot of people were surprised by the American Heart Association’s recent statement noting that not only can most people drink five cups of coffee each day, but that doing so can have health benefits. True?
Absolutely! I’ve got to tell you, my friend: Coffee is one of the elixirs of life. It is full of antioxidants and polyphenols, and has anti-inflammatory properties.

I’ve never thought of a caffeinated beverage as being something that is good for me.
Not only does caffeine reduce the risk of dementia, but it has been shown to be associated with a reduction in cardiovascular disease and many other health benefits.

But when we are talking about drinking five cups of coffee each day, I’m assuming we’re not talking about whatever concoction my daughter orders at Wawa with vanilla this and triple something that.
Coffee is great — except when you turn it into a toxic swill and add cream and tons of sugar. That’s when you turn it from an elixir of life into a toxic waste site!

At what age can somebody safely start drinking coffee? I feel like it’s something most parents have their kids steer clear of until they are 16 or so.
Well, I think given that high school kids now require an assistant to handle their schedules, I would much rather see them drink a cup of coffee that has all these wonderful things in it than drink these sugary energy drinks filled with chemicals.

Is there anybody who shouldn’t drink coffee?
Those who are pregnant or breastfeeding should limit their coffee consumption. The use of excessive amounts of coffee during pregnancy can be associated with preterm birth, low birth weight, and pregnancy loss. For others, coffee isn’t really associated with high blood pressure or atrial fibrillation, but I was always taught that if you are a coffee virgin, it may actually cause a temporary bump in your blood pressure. And if you have a history of palpitations, arrhythmias, or any issue involving your heart and rhythm, you might want to check with your electrophysiologist or your cardiologist regarding your coffee consumption. But that’s only with caffeinated coffee. You can definitely drink decaf. I, for one, favor the whole enchilada. I like my caffeine.

One of my colleagues pointed out that too much coffee gives her stomach acid issues. I told her maybe just drink less coffee.
People with acid reflux may have some worsening symptoms of reflux but, in general, your weight and the time between when you eat dinner and when you go to bed are bigger factors. There’s a condition known as Barrett’s esophagus in which the lining of your esophagus gets damaged by stomach acid and changes into a different type of tissue, but there is no association between drinking coffee and an increased risk of developing Barrett’s esophagus.

Does it matter how people prepare their coffee?
There’s some data that if you drink unfiltered coffee like Turkish coffee or boiled coffee or French press coffee, this may raise your LDL or so-called “bad” cholesterol, whereas filtered, drip coffee has negligible effects on the LDL.

Tell the truth: Do you get a triple Venti pumpkin spice latte with vanilla at Starbucks?
No. It’s probably got 1,000 calories in it. Beverages are the quickest way to get calories into your body. I drink my coffee black, but do add Stevia, which is a non-nutritive plant-based sweetener. If you want it a little sweet, I always say to use Stevia or, if you want sugar, use the raw stuff.

I have a few cups of coffee in the morning. Am I doing it right?
I like to have a sip or two all day long. There are some studies that if you do that, you’ll have more alertness, because you are getting a little bit of caffeine throughout the day rather than in one big slug. Now, I watch these people go to Wawa and get a 24-ounce coffee filled with all sorts of cream and sugary things and they get a pack of cigarettes and a doughnut. If you get on the Schuylkill Expressway with them and cut them off, they are all nicotine’d and caffeine’d and sugar-rushed up. They might come after you!