What advice can I give on coffee consumption and cholesterol management?

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Background

Raised levels of specific types of cholesterol are a key risk factor for cardiovascular disease.  Data published by the WHO shows that the prevalence of elevated total cholesterol is highest in the WHO region of Europe (54% for both sexes). Lifestyle factors like an unhealthy diet and physical inactivity may result in raised cholesterol levels. Click here for more information.

Coffee and Cholesterol

Coffee’s effect on cholesterol levels is largely dependent on the method of brewing.  Unfiltered coffee raises serum cholesterol levels; this is not the case with filtered coffee because the cholesterol-raising compounds in coffee, e.g. cafestol and kahweol, are retained in the paper filter. Soluble coffee contains hardly any of the cholesterol-raising compounds.

Advice for patients

The summaries below will help with queries patients raise regarding coffee consumption and cholesterol:

Cholesterol Drinking filtered coffee has not been linked to increases in cholesterol levels. However, the consumption of unfiltered coffee in substantial amounts has been shown to increase blood levels of serum cholesterol. This is because the cholesterol-raising compounds in coffee are retained in the paper filter in filtered coffee.
Components of coffee linked with cholesterol The coffee components responsible for increasing cholesterol are cafestol and kahweol. These are naturally-occurring compounds found in coffee oil. Whether these compounds permeate in the brew and to what extent depends on the brewing method.
Method of coffee preparation Filtered coffee and soluble coffee contain hardly any cafestol or kahweol and have virtually no effect on the cholesterol levels. Moderate consumption of espresso also has a negligible effect as levels of cholesterol-raising compounds are approximately half that of unfiltered coffee and serving sizes are small. Scandinavian boiled coffee, Cafetière (plunger pot), Greek and Turkish coffee contain cafestol and kahweol in higher amounts. Consuming substantial amounts of these types of coffees can raise serum cholesterol levels. The effects on the cholesterol level are transient after the cessation of consumption.

Conclusion

Certain types of brewing methods of coffee are associated with increased serum cholesterol levels and those with raised cholesterol levels may be advised to choose coffees with negligible amounts of cafestol and kahweol.  Scientific evidence suggests that moderate coffee consumption of 3-4 cups per day does not increase the risk of coronary heart disease or stroke. In fact, in women, moderate coffee consumption has been associated with a reduced risk of stroke.  However, the mechanisms underlying these effects need further investigation.

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This information is intended for Healthcare professional audiences.
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