Craig, as you read the following post and the grin begins to permeate, please pause before you dial my number, compose yourself and spend a moment reflecting on the evils of self-rightousness. Seriously, I can hear the 'I-told-you-so' face over the phone and I'm sure to respond with that flavor of snippy you like so much. All together an unpleasant and unecessary interaction, dontcha think?

On July 5th - that would be the day after late night fireworks - I had a 5:30a client. I refuse to get up any earlier than my usual 4:30a but with with less preening and less pausing for thoughtful contemplation of BBC Worldwide as I ate my breakfast, I could still get to work on time. Oh, and I elected not to spit-shine my flip flops, touch-up my toenail polish or iron and starch my best go-to-meetin' sweats. The blueberry antioxidant face mask gauranteed to spackle over, smooth out or generate an attention-deflecting Jedi mind trick to hide my crows feet would have to go too. Unfortunately, the life I chose always forces me to eliminate 'girl' from my world first leaving me plain but prepared.

I remembered too late that my diva scheduling demands of no-earlier-than 6a (and only the green M&Ms), was not based on sleep demands and self care, but the operating hours of Starbuck's. Nothing opens that early. Nothing. Nobody but me was thinking about coffee in my neighborhood where the vampires were just making their way home from a night of bloodletting debauchery as I eased out of the 'hood and onto the highway.

No bother, really.

At about 6a, as my client sweated and strained, I was blaming my unnatural sluggishness to lack of sleep, tough recovery from a workout, old age and/or voodoo stink-eye curse (I'm sure it wasn't meant for me - it ricocheted and I walked into it like a lingering toxic cloud of Axe Body Spray). Between 6:30a and 7:00a, I dodged out for coffee while I longed for a nap between clean, crisp sheets. Oh, and cancellations. Sorry folks - love ya' - but sometimes, only sometimes, I'm a bad trainer and I like it just a little when you're not here. I grow fonder in your absence, I swear.

At 8a, I was chipper. Could it be the coffee that I've told Craig again and again that I really like but don't 'need'?

Caf-fiendish

Here in Seattle we treat people who can't drink coffee a lot like New Englanders treat folk who can't hold their liquor. It's a certain disdain.

From a perspective of health, is the daily

1. In your practice, how much is caffeine consumption affecting the overall health of your patients? Are you seeing an impact? I think there is a "moderate" effect on the health of my patients from the overconsumption of caffeine. See question #3 below...

2. Some studies have argued that the body adapts to caffeine consumption to a degree in which the diuretic effect is insignificant. How do you feel about the body's ability to adapt to caffeine and at what levels would you suggest are safe in terms of consumption? This is very difficult to answer. Of course a "safe" level of consumption would be different for each person. I do think that the body adapts to consumption in a way, but I'll have to get back to you on this one.

3. Do you see health issues contributable to caffeine consumption and if so what do you feel is the biggest health issue associated with it? I do see health issues stemming from the overconsumption of caffeine. This effect is indirect - meaning that my patients (the ones that overconsume caffiene) are fatigued and burned out because their bodies have been overstimulated by the caffeineand left exhausted -decreasing their healing response, increasing mood disorders such as anxiety and depression, and of course - making them more tired than they ought to be!

4. You here the term 'Adrenal Fatigue' associated with caffeine. How much of that is caffeine consumption alone and how much of it is associated with a persons lifestyle as a whole? Hard to tell. I'd have to look into research on that one, but usually caffeine consumption and stress go hand in hand (haha) Stress draws on the adrenals for their reserves, and caffiene depletes the reserves, so it is a double wammy that can be very damaging long term (depending on the patients overall state of health)

5. If adrenal fatique is an issue, how difficult is that to recover from and what other health implications go with that? It can be very difficult to recover from depending on the state of health that the patient was in going into it. Ideally, you'd go to a tropical island and have no stress and eat nuts and berries for a year and then you'd MAYBE be back to where you were before the adrenals started depleting, but that is not an option for most people (lol) So I've found a "workaround" that is THE BEST for rebuilding the adrenals that I can answer later if you're intersted.

6. What do you make of studies that say that caffeine consumption in women is associated with a decrease in type II diabetes risk? It's just like any study - is it a 1% benefit or 20% benefit - I agree that there are benefits to coffee and green tea in "moderation" which means 4 oz. for some people, but most people go overboard thinking if a little bit is good, a lot is better and it just doesn't work that way...

I appreciate the opportunity to answer your insightful questions and let's do this again!

Genetic polymorphism of the adenosine A2A receptor is associated with habitual caffeine consumption.
Cornelis MC, El-Sohemy A, Campos H.
Department of Nutritional Sciences, University of Toronto, Canada.
Our findings show that the probability of having the ADORA2A 1083TT genotype decreases as habitual caffeine consumption increases. This observation provides a biologic basis for caffeine consumption behavior and suggests that persons with this genotype may be less vulnerable to caffeine dependence.

Coffee and health: a review of recent human research.
Higdon JV, Frei B.
Linus Pauling Institute, Oregon State University, Corvallis, OR 97331, USA. jane.higdon@oregonstate.edu
Coffee is a complex mixture of chemicals that provides significant amounts of chlorogenic acid and caffeine. Unfiltered coffee is a significant source of cafestol and kahweol, which are diterpenes that have been implicated in the cholesterol-raising effects of coffee. The results of epidemiological research suggest that coffee consumption may help prevent several chronic diseases, including type 2 diabetes mellitus, Parkinson's disease and liver disease (cirrhosis and hepatocellular carcinoma). Most prospective cohort studies have not found coffee consumption to be associated with significantly increased cardiovascular disease risk. However, coffee consumption is associated with increases in several cardiovascular disease risk factors, including blood pressure and plasma homocysteine. At present, there is little evidence that coffee consumption increases the risk of cancer. For adults consuming moderate amounts of coffee (3-4 cups/d providing 300-400 mg/d of caffeine), there is little evidence of health risks and some evidence of health benefits. However, some groups, including people with hypertension, children, adolescents, and the elderly, may be more vulnerable to the adverse effects of caffeine. In addition, currently available evidence suggests that it may be prudent for pregnant women to limit coffee consumption to 3 cups/d providing no more than 300 mg/d of caffeine to exclude any increased probability of spontaneous abortion or impaired fetal growth.

Coffee consumption and human health--beneficial or detrimental?--Mechanisms for effects of coffee consumption on different risk factors for cardiovascular disease and type 2 diabetes mellitus.
Ranheim T, Halvorsen B.
Department of Medical Genetics, Rikshospitalet University Hospital, Oslo, Norway.
Coffee is probably the most frequently ingested beverage worldwide. Especially Scandinavia has a high prevalence of coffee-drinkers, and they traditionally make their coffee by boiling ground coffee beans and water. Because of its consumption in most countries in the world, it is interesting, from both a public and a scientific perspective, to discuss its potential benefits or adverse aspects in relation to especially two main health problems, namely cardiovascular disease and type 2 diabetes mellitus. Epidemiological studies suggest that consumption of boiled coffee is associated with elevated risk for cardiovascular disease. This is mainly due to the two diterpenes identified in the lipid fraction of coffee grounds, cafestol and kahweol. These compounds promote increased plasma concentration of cholesterol in humans. Coffee is also a rich source of many other ingredients that may contribute to its biological activity, like heterocyclic compounds that exhibit strong antioxidant activity. Based on the literature reviewed, it is apparent that moderate daily filtered, coffee intake is not associated with any adverse effects on cardiovascular outcome. On the contrary, the data shows that coffee has a significant antioxidant activity, and may have an inverse association with the risk of type 2 diabetes mellitus.

The health consequences of caffeine.
Curatolo PW, Robertson D.
Acutely administered caffeine modestly increases blood pressure, plasma catecholamine levels, plasma renin activity, serum free fatty acid levels, urine production, and gastric acid secretion. It alters the electroencephalographic spectrum, mood, and sleep patterns of normal volunteers. Chronic caffeine consumption has no effect on blood pressure, plasma catecholamine levels, plasma renin activity, serum cholesterol concentration, blood glucose levels, or urine production. Caffeine does not appear to be useful for increasing the motility of hypomotile sperm in artificial insemination or in the therapy of minimal brain dysfunction, cancer, or Parkinson's syndrome, but it may be effective as a topical treatment of atopic dermatitis and as systemic therapy for neonatal apnea. Caffeine does not seem to be associated with myocardial infarction; lower urinary tract, renal, or pancreatic cancer; teratogenicity; or fibrocystic breast disease. The role of caffeine in the production of cardiac arrhythmias or gastric or duodenal ulcers remains uncertain.

Effects of eight weeks of caffeine supplementation and endurance training on aerobic fitness and body composition.
Malek MH, Housh TJ, Coburn JW, Beck TW, Schmidt RJ, Housh DJ, Johnson GO.
University of Nebraska-Lincoln Human Performance Laboratory, Department of Nutrition and Health Sciences, Lincoln, NE 68583, USA. mmalek@unlserve.unl.edu
The purpose of this study was to examine the effects of daily administration of a supplement that contained caffeine in conjunction with 8 weeks of aerobic training on VO(2)peak, time to running exhaustion at 90% VO(2)peak, body weight, and body composition. Thirty-six college students (14 men and 22 women; mean +/- SD, age 22.4 +/- 2.9 years) volunteered for this investigation and were randomized into either a placebo (n = 18) or supplement group (n = 18). The subjects ingested 1 dose (3 pills = 201 mg of caffeine) of the placebo or supplement per day during the study period. In addition, the subjects performed treadmill running for 45 minutes at 75% of the heart rate at VO(2)peak, three times per week for 8 weeks. All subjects were tested pretraining and posttraining for VO(2)peak, time to running exhaustion (TRE) at 90% VO(2)peak, body weight (BW), percentage body fat (%FAT), fat weight (FW), and fat-free weight (FFW). The results indicated that there were equivalent training-induced increases (p <> 0.05) in BW, %FAT, FW, or FFW for either group. These findings indicated that chronic use of the caffeine-containing supplement in the present study, in conjunction with aerobic training, provided no ergogenic effects as measured by VO(2)peak and TRE, and the supplement was of no benefit for altering body weight or body composition.

The acute effects of a caffeine-containing supplement on strength, muscular endurance, and anaerobic capabilities.
Beck TW, Housh TJ, Schmidt RJ, Johnson GO, Housh DJ, Coburn JW, Malek MH.
Department of Nutrition and Health Sciences, Human Performance Laboratory, University of Nebraska-Lincoln, Lincoln, NE 68588, USA. tbeck@unlserve.unl.edu
The purpose of this study was to examine the acute effects of a caffeine-containing supplement on upper- and lower-body strength and muscular endurance as well as anaerobic capabilities. Thirty-seven resistance-trained men (mean +/- SD, age: 21 +/- 2 years) volunteered to participate in this study. On the first laboratory visit, the subjects performed 2 Wingate Anaerobic Tests (WAnTs) to determine peak power (PP) and mean power (MP), as well as tests for 1 repetition maximum (1RM), dynamic constant external resistance strength, and muscular endurance (TOTV; total volume of weight lifted during an endurance test with 80% of the 1RM) on the bilateral leg extension (LE) and free-weight bench press (BP) exercises. Following a minimum of 48 hours of rest, the subjects returned to the laboratory for the second testing session and were randomly assigned to 1 of 2 groups: a supplement group (SUPP; n = 17), which ingested a caffeine-containing supplement, or a placebo group (PLAC; n = 20), which ingested a cellulose placebo. One hour after ingesting either the caffeine-containing supplement or the placebo, the subjects performed 2 WAnTs and were tested for 1RM strength and muscular endurance on the LE and BP exercises. The results indicated that there was a significant (p < 0.05) increase in BP 1RM for the SUPP group, but not for the PLAC group. The caffeine-containing supplement had no effect, however, on LE 1RM, LE TOTV, BP TOTV, PP, and MP. Thus, the caffeine-containing supplement may be an effective supplement for increasing upper-body strength and, therefore, could be useful for competitive and recreational athletes who perform resistance training.