Coffee – what are the health benefits of coffee and how do different countries view coffee and health?

Coffee, Diet and Health- what are the health benefits of coffee and how do different countries view coffee and health?

Despite a cultural love of coffee, over a third (39%) of Europeans are uncertain about the potential health benefits of coffee. Coffee remains integrated into the European lifestyle: predominantly drunk at home, at work or in cafes, with 40% of respondents saying coffee gets their day off to a good start.

The consumer research, conducted by the Institute for Scientific Information on Coffee (ISIC), surveyed over 4,000 people across 10 European countries[1], to understand their beliefs, behaviours, and knowledge regarding a healthy diet.

The results show that although 70% of Europeans believe they are healthy, many still don’t know what lifestyle changes they can make to help reduce their risk of common, serious health conditions such as type 2 diabetes, Alzheimer’s disease, and cardiovascular disease. Age was an important determining factor: with the youngest and oldest respondents revealing the biggest knowledge gaps.

Coffee, Diet and Health
Coffee, Diet and Health

Key findings:

European respondents told us that they are healthy. Given the overall rise in obesity and related health problems in Europe, some respondents may be over-confident about their own health[2]:  

·         70% of Europeans overall described themselves as either ‘fairly healthy’ or ‘very healthy’

·         The French were most likely to describe themselves as either ‘fairly healthy’ or ‘very healthy’ (83%)

·         The Danes were most likely to describe themselves as either ‘fairly unhealthy’ or ‘very unhealthy’ (51%)

·         Coffee drinkers were 12% more likely to report better levels of health than non-coffee drinkers

·         76% of Europeans said they need more information on maintaining a healthy lifestyle

·         46% of women and 40% of men said their New Year’s resolution was to eat more healthily in 2016

Day-to-day health anxieties are prioritised over longer-term health risks, according to the survey results, despite the fact that cancer[3], cardiovascular (heart) disease[4] and excessive alcohol consumption[5] are some of the biggest public health concerns in Europe:

·         24% of respondents wanted to better manage their stress levels (the most stressed country was Italy, with 32% of Italians worried about stress), and 28% wanted to feel more energetic and less fatigued (the most tired country was Finland, with 45% of Finns worried about fatigue); compared to just 12% overall who were concerned about getting cancer, and 10% who were concerned about their heart health

·         18-24 year olds are as likely to cut down on coffee for their New Year’s resolution as they are to cut down on alcohol (9% for both). Danes are 2% more likely to cut down on alcohol than coffee

Respondents often struggled to recognise the potential health benefits of coffee: 

·         71% of Europeans believe that drinking coffee does not help to reduce the risk of type 2 diabetes (75% of those aged 55+ held this belief). However, scientific research suggests that drinking 3-4 cups of coffee a day is associated with an approximate 25% lower risk of developing type 2 diabetes[6,7]

·         63% of Europeans believe that drinking coffee does not help to reduce the risk of mental decline in older people, for example Alzheimer’s and Parkinson’s disease (64% of those aged 55+ who answered this question held this belief). Yet research suggests that moderate, life-long consumption of coffee is associated with a reduced risk of developing Alzheimer’s[8,9]

·         42% of Europeans believe that drinking coffee increases the risk of cardiovascular (heart) disease (54% of those aged 18-24 held this belief). But scientific studies have suggested an association between moderate coffee consumption and a reduced risk of cardiovascular disease[10,11]

Age plays a large role in defining respondents’ awareness of coffee’s role in a healthy diet:

·         On average, 18-24 year olds were the least successful at recognising the potential health benefits of coffee: for example, just over a quarter (28%) did not know that coffee can help increase concentration and alertness

·         Older respondents displayed very poor knowledge of diseases that could potentially pose the highest statistical risk to them: over half (56%) of those aged 35 and above are not aware of the potential health benefits of coffee relating specifically to cognitive decline, type 2 diabetes, and cardiovascular disease risk

67% of Europeans stated that they could not imagine life without coffee. The health effects of coffee consumption have been extensively researched: moderate consumption of coffee at 3-5 cups per day[12] has been associated with a range of desirable physiological effects and fits within a healthy diet and active lifestyle. Pregnant and breastfeeding women are advised by EFSA to consume no more than 200mg of caffeine, per day, from all sources. This is equivalent to no more than two cups per day[13].

Professor Chris Seal, Professor of Food and Human Nutrition at Newcastle University, UK said: “Many Europeans enjoy a cup of coffee, but clearly some feel guilty about drinking it – and unnecessarily so. Moderate, regular coffee consumption at 3-5 cups per day has been linked to a number of positive health benefits, such as reducing the risk of cardiovascular disease and type 2 diabetes. Hopefully, this means people will now enjoy their cup of coffee without the guilt.”



1.     4119 respondents across 10 European countries were surveyed by ISIC in November 2015

2.     World Health Organization, ‘Obesity: Data and Statistics’ Available at:

3.     World Health Organization, ‘Cancer: Data and Statistics’ Available at:

4.     World Health Organization, ‘Cardiovascular diseases: Data and Statistics’ Available at:

5.     World Health Organization, ‘Alcohol use: Data and Statistics’ Available at:

6.     Huxley R. et al. (2009) Coffee, Decaffeinated Coffee, and Tea Consumption in Relation to Incident Type 2 Diabetes Mellitus. Arch Intern Med, 169:2053-63

7.     Zhang Y. et al. (2011) Coffee consumption and the incidence of type 2 diabetes in men and women with normal glucose tolerance: The Strong Heart Study. Nutr Metab Cardiovasc Dis. 21(6):418-23

8.     Santos C. et al. (2010) Caffeine intake and dementia: systematic review and meta-analysis. J Alzheimers Dis, 20(1):187-204

9.     Barranco Quintana J.L. et al. (2007) Alzheimer’s disease and coffee: a quantitative review. Neurol Res, 29:91-5

10.  European Heart Network, ‘European Cardiovascular Disease Statistics 2012’ Available at:

11.  Ding M. et al (2014) Long-term coffee consumption and risk of cardiovascular disease: a systematic review and a dose-response meta-analysis of prospective cohort studies. Circulation. 129(6):643-59

12.  Harvard T.H. Chan School of Public Health, ‘Moderate coffee drinking may lower risk of premature death’

Available at:

13.  EFSA (2015) Scientific Opinion on the Safety of Caffeine, EFSA Journal, 13(5):4102

1 in 5 Getting Five Hours Sleep or Less – Check out these amazing ideas for getting better and more sleep!

Dr. Nerina Ramlakhan
Dr. Nerina Ramlakhan
New research shows that one in five Brits are regularly getting a dangerously low level of sleep, with one in six saying that their fatigue severely impacts activities like driving and socialising, with some struggling to stay awake at work. This could be down to stress, with nearly one in three saying that their work has negatively affected their sleep in the previous week. Sleep experts Dr. Nerina Ramlakhan and Dr. Anna Weighall run through the stark findings in their work in the interview below.

· Less than five hours sleep each night is associated with serious negative health outcomes including cardiovascular problems, obesity and diabetes.

· One in six (18%) report a high impact of tiredness on daily functioning (e.g., problems staying awake, socialising, feeling enthusiastic, driving, maintaining concentration).

· Six in seven (86%) of people use some kind of tech before they go to bed with 5% checking emails, 41% using social media, and 42% watching TV.

· Furthermore, more than one in four (27.6%) use technology if they wake in the night, 11% check emails, 15% use social media and 13% watch TV.

· Poor sleep patterns may be affected by the pressures of modern life, including the pressures of work. Nearly half (42%) of those questioned from the full sample reported that they found their jobs stressful and almost one in three (30%) indicated that their work has negatively affected their sleep during the previous week.

· The findings come from a new study by the University of Leeds in conjunction with Silentnight to be presented at the Newcastle British Sleep Society conference on 22nd October.

PatientTalk.Org – Ok so we are talking about sleep or not getting enough, first question I have for you guys is what the difference between tiredness and fatigue is?

Dr. Nerina Ramlakhan – I work a lot with fatigue, chronic fatigue and burnout as well as advising on sleep as well and one of the question that I often ask my patients is what is your energy levels like at the moment out of ten, ten being really high and one being exhausted and that gives me an idea just a quick idea and it also helps them be more aware as well as sort of where they are on the tiredness fatigue scale and I would say the difference between the two is that tiredness we can all experience and sometimes we can get a bit of a tiredness dip in the afternoon, some people tend to be more tired in the mornings when they are not a morning person but fatigue is when it starts to become more evasive and it really starts to effect the quality of life and the ability to function normally so the ability to do things that you would normally be able to do and the things that you would normally enjoy and that fatigue can affect you not just physically but also emotionally and mentality as well.

PatientTalk.Org – Ok that leads onto my next question actually, what medical conditions can result from a lack of sleep.

Dr Anna Weighall – So one of the things that can happen if someone has chronic fatigue is that they can go on to develop quite serious health conditions for example , obesity, diabetes and cardiovascular disease are all more common in those who report low levels of sleep over a period of time.

PatientTalk.Org – Ok and what are the underlying reasons for people having a lack of sleep?

Dr Anna Weighall – So in a piece of research that we have recently conducted in association with silent night we asked our respondents, over a thousand people from across the UK about their sleep habits and about their ability to get a good night’s sleep, we found a couple of things that were practically key so one of them is work stress and work life balance so 30% that’s one in three of our participants reported that work affected their sleep in some way, the other thing that we noticed was that we asked people about their sleep habits ,what they do around bedtime ,what they do when they wake in the night and we found that 86% of our participants used screens or technology of some sort before they go to bed and many of them will use technology if they wake in the night as well .

PatientTalk.Org – Ok I’m sure many of us can understand the work one, in terms of insomnia how can it be treated?

Dr. Nerina Ramlakhan – Well Perry I work with sleep problems I’m a practitioner and I work at a psychiatrist clinic one day a week where we are working with really hard core sleeping patterns and the treatment will go from medication in worst case scenario though too psychology programmes into personal therapy, cognitive behavioural therapy, all the way through to practical advice and I can throw some of the tips and techniques out now but you know I teach my patients and clients all sorts of things from nutritional strategies which can help them to sleep all the way through to technology, hygiene , how to wind down before they go to bed, how to manage over busy minds and even breathing and mindfulness, if you direct your viewers and listeners to the Silentnight website we have got lots of the tips and techniques on there as well.

PatientTalk.Org – Yeah I was going to ask what is the best bedtime routine to get the most amount of sleep?

Dr. Nerina Ramlakhan – Well sleep is so individual, so personal, so what I guide my patients and clients to do is to become more aware of what it is they themselves need in order to be able to let go of the day and rest and relax and then sleep and for some people it might be having a relaxing bath, personally that would make me too hot before I got to bed so it is quite individual, things like what you watch on television even the types of books you read before you go to bed, what you eat before you go to bed, I encourage people to start becoming more aware of these things but the hour to an hour and a half what you choose to do in that time will really set you up for how you are going to sleep. So ideally you would start to disconnect form work, you would start to disconnect from technology, if you are a sensitive sleeper then don’t watch television in your bedroom watch it in another room, preferably don’t watch the news, don’t check the share prices, if you are going through a lot of stress in life then read something that’s uplifting and I even talk to my clients and patients about gratitude exercises before you go to bed keeping a gratitude journal but the idea really is to really bring the levels of stimulation down so the mind and body can prepare to relax and let go off the day.

PatientTalk.Org – What is a gratitude exercise?

Dr. Nerina Ramlakhan – Well in a nutshell and we won’t talk about this now as it’s a 60 minute exercise but right now think about the day you have had so far from when you woke up this morning until now so it’s just gone 1 o’clock and try and find so just go through your day and do it with your eyes closed and try and find as many small positive things that have happened in your day so far and you can think about them or you can take them to the next level which is what I call breathing into your heart and actually giving thanks to them and what it does is an amazing dropping of the shoulders , unclenching of the jaw, relaxing and anite sense of trust and it’s not all woo woo stuff, I mean there is a good degree of science behind this a branch of science called psycho neuro immunology ( PNI) which shows that people who regularly do gratitude exercises have more robust immune systems and their heart is stronger but it also helps promote good sleep , does that answer your question ?

PatientTalk.Org – Yes I was very interested, so how has the research in sleep conducted and what was the main findings?

Dr Anna Weighall – Ok so the research that we conducted in association with Silentnight as part of my work at the University of Leeds was really about getting a detailed picture of the nation’s sleep, the key findings are that many people are not getting enough sleep and reporting less than 5 hours sleep a night which is a worrying low amount of sleep but interestingly the majority of participants reported that they didn’t know how much sleep they thought they should be getting so it was a great awareness that ideally you should be getting around about 8 hours sleep per night which is what the NHS recommend . However when we asked people how much they intended to sleep they report something in that ball park, when we asked people to reflect on how much sleep they actually get they start to report much lower levels than that so we see what we call a sleep debt, so what people need or want in terms of amount of sleep and what they actually get in terms of their sleep behaviour.

PatientTalk.Org – Ok and what would be the one piece of advice you would give to somebody who does not or cannot get a good night’s sleep?

Dr. Nerina Ramlakhan – I would say to really start to prioritise your sleep you know make it important because often in today’s busy busy technology driving world we take our sleep for granted and we run ourselves ragged all day and then we expect ourselves to get into bed and switch off these hyper active minds and body so I would say start giving sleep the respect it deserves. Build rest into your day whenever you can, ideally every 90 minutes to 2 hour get away from technology even if it’s for a few minutes and that in itself becomes a rest , aim to get to bed before midnight at least 3 or 4 times a week and if you can go onto the Silentnight website and have a look at some of those tips because there is some really practical things that you can do just for the next week or so and it can really make a difference to your sleep , I would also say that if you are not sleeping well and it’s been going on for some time believe that it is possible to get a good night sleep , I speak to people who come to my clinic and say ‘ I’ve never slept well since childhood and my parents didn’t sleep well or my grandmother and it’s in my genes in my genetics’ and that’s part of the problem as they just don’t believe that they can sleep well and we can learn behaviours that will give us the sleep that we need and deserve and believe that you can and seek out the advice and respect your sleep.

PatientTalk.Org – Yeah I mean if like me you work in a really stressful environment how do you find the time to grab a few minutes rest when there’s people ringing you and emailing you every two seconds and you’re like please stop this madness.

Dr. Nerina Ramlakhan – Yeah I really hear what you are saying, I work in a lot of very stressful environments apart from the clinic, I go into a lot of big companies and banks, last week I worked in a trading floor of 500 bankers and I taught them how in 60 seconds they can create a physiological state of rest in their body even when things are going fairly crazy around them, so we can make the choice for 10 seconds, 30 seconds to out the phone down or sorry to be basic about this but when we go to the bathroom don’t take the phone with us or to take a 5 / 10 minute lunch break where all we are doing is eating not in front of our technology or for half an hour before we get into bed to mindfully engage with your family with no technology around you , these are choices that we can change and make and increasingly this is what I am showing people and urging them to do , if we start to value our sleep and if we get that sleep, one or two night of good sleep and you will get hooked on it and you will do what it takes to get it.

Dr Anna Weighall – And if I can just come back on that I would say that one of the reasons we wanted to conduct this research is to raise people’s awareness of the importance of sleep because I think very much we have fallen into a snooze and you lose kind of a culture and in fact if we start to realise that sleep is part of our health, part of our emotional and mental wellbeing and we start to treat it in the same way of physical exercise, we know we need exercise and we also now know that we need good sleep, we need to find gaps in our busy life’s to make sure that we are getting the things that we need for as healthy life, In our research Perry the other thing that was really important as a take home message is the very strong relationship between a good sleep and good health, so people who reported good sleep quality on the whole reported a better quality of life and that meant they were enjoying their life’s more, having more positive interactions with their families, having less physical ill health and generally being emotionally prepared for the day ahead sop we really can’t underestimate the value of sleep.

3-5 cups of coffee per day may reduce Cardiovascular Disease mortality risk by up to 21%

Coffee and Cardiovascular disease
Coffee and Cardiovascular disease

A recent report by the Institute for Scientific Information on Coffee (ISIC), a not-for-profit organisation devoted to the study and disclosure of science related to coffee and health, highlights the potential role of coffee consumption in reducing Cardiovascular Disease (CVD) mortality risk.

The report concludes that, based on current research, moderate coffee consumption at approximately 3–5 cups per day may have a protective effect against CVD mortality risk. The finding is significant given that coronary heart disease and stroke remain the primary cause of death across Europe; responsible for 51% of all deaths in women and 42% of all deaths in men. Over four million people die from CVD annually in Europe and overall, CVD is estimated to cost the EU economy €196 billion every year.

Carlo La Vecchia, Professor of Epidemiology, Department of Clinical Sciences and Community, University of Milan, commented:  “It is important to acknowledge factors which might have a protective effect against CVD mortality. Moderate coffee consumption could play a significant role in reducing CVD mortality risk which would impact health outcomes and healthcare spending across Europe.”

Key report highlights:

  • The lowest CVD mortality risk is seen at an intake of approximately 3 cups of coffee per day, with a percentage risk reduction of up to 21%.1
  • Two 2014 meta-analyses suggest an association between coffee consumption and CVD risk, proposing a ‘U-shaped’ pattern whereby optimal protective effects were achieved with 3-5 cups of coffee per day.3,4
  • Drinking 3-4 cups of coffee per day is associated with an approximate 25% lower risk of developing type 2 diabetes compared to consuming none or less than 2 cups per day.1 People with diabetes typically have a higher CVD mortality risk, therefore this association may be linked to a decreased CVD risk.5
  • Half of CVD cases in women could be avoided by modifying lifestyle choices, as approximately 73% of CHD cases and 46% of clinical CVD are attributable to an unhealthy lifestyle.6

The mechanisms of action behind the associations are unclear, however areas of interest for future research include the anti-inflammatory and antioxidant properties of coffee, and the known association between coffee consumption and type 2 diabetes risk reduction as CVD mortality is typically higher in this group.  It is important to note that results differ between varying populations; it is suggested that 2 cups of coffee per day may offer the greatest protection in a Japanese population, whilst 3 cups may provide the greatest protection in UK and US populations.

For more information on coffee and cardiovascular health, click here

Heart attack and stroke patients in UK called on to take part in global study to reduce risk of secondary attack or stroke

Healthcare professionals
Healthcare professionals
3,000 people in the UK who have suffered a heart attack or stroke or have peripheral arterial disease are being recruited for a world-wide study which will investigate medication that could lower the risk of patients having a second cardiovascular event.

The new study called FOURIER (sponsored by Amgen Inc. and supported by the Imperial College Clinical Trials Unit) has been launched in the UK as part of a global programme (also taking place across Europe, US, Canada, Australia, Asia and Latin America) to provide more evidence to inform and guide future strategies in the secondary prevention of cardiovascular disease

The study will investigate whether taking a new type of treatment, which studies so far suggest can reduce LDL cholesterol by about 50%, on top of a statin will reduce the risk of major cardiovascular events compared to just taking statin therapy.

22,500 people who have had an ischaemic stroke, a heart attack or who have peripheral arterial disease are being recruited world-wide for the trial which is expected to last 5 years. People taking part in the study will receive an experimental cholesterol lowering study drug in combination with optimal statin therapy OR optimal statin therapy alone.

Over 1800 people have taken part in earlier phase studies with this agent to date and studies where it was given on top of a statin indicate it can reduce LDL cholesterol by over 50% compared to statin therapy alone. The new medication currently being researched is not yet licensed for use.

More people die from cardiovascular disease (CVD) each year than any other cause.[ii] In the UK the main cause of death was CVD, accounting for almost 180,000 deaths in 2010 – around 1 in 3 of all deaths.[iii] Almost half (48%) of all CVD deaths was due to coronary heart disease (CHD) and over a quarter (28%) are from stroke.3

If you have already had a heart attack or stroke or have peripheral arterial disease this puts you at greater risk of having a second cardiovascular event.2

However, the risk of recurrence or death can be substantially lowered with a combination of drugs – statins to lower cholesterol, drugs to lower blood pressure, and aspirin.2

High cholesterol is a major contributor to cardiovascular disease.  Every 1 mmol/L reduction in LDL cholesterol (the bad cholesterol) reduces the annual risk of a heart attack or stroke by 20%.[iv]

European heart guidelines state that patients with disease causing stroke merit the same degree of attention to treatment of lipids as to patients with heart disease.[v]

The vast majority of patients are discharged from hospital on statin therapy following an ischaemic stroke.  However, the British Regional Heart Study found that only half continue to receive long-term statin therapy and only 31% receive all three recommended treatments (antiplatelet, blood pressure lowering, and statin).[vi]

The FOURIER study is recruiting patients to determine whether lowering LDL cholesterol by about 50% with a new kind of medication on TOP of a statin will further reduce the risk of having another heart attack or stroke.[vii]  It is the first study investigating this new kind of treatment to specifically include patients who have already suffered an ischaemic stroke.

If you are interested in taking part in the study, watch our video with Professor Neil Poulter – Professor of Preventive Cardiovascular Medicine at Imperial College, London to hear more about how you can put yourself forward for the trials.

[ii] WHO Fact Sheet 317.  March 2013.

[iii] Townsend N et al.  Coronary Heart Disease Statistics 2012 edition.  British Heart Foundation:London.

[iv] Cholesterol Treatment Trialists’ Collaboration. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170 000 participants in 26 randomised trials. Lancet 2010;376:1670–81

[v] ESC guidelines on cardiovascular disease prevention in clinical practice (version 2012).  Eur Heart J 2012; 33:1635–1701 – page 1686 – accessed September 2013.

[vi] Ramsay S et al. Missed opportunities for secondary prevention of cerebrovascular disease in elderly British men from 1999 to 2005: a population-based study. J Public Health 2007;29:251-57.