Peteris Apinis: American Heart Association Allows Up to Five Cups of Coffee a Day
The American Heart Association's new guidance states that up to five cups of coffee a day are safe for most adults and may have a protective health effect. Peteris Apinis stresses that preparation matters – filtered coffee is more favourable for cholesterol.
Physician and public figure Peteris Apinis has highlighted new guidelines from the American Heart Association that challenge long-standing advice about coffee. For years, doctors recommended that heart patients avoid coffee, but the association now says most adults can safely drink up to five cups a day, and that coffee may act as a protective factor.
Key conclusions
The guidance is based on a review of recent research linking moderate coffee consumption to a lower risk of high blood pressure, coronary artery disease, stroke, heart failure, atrial fibrillation and type 2 diabetes. One cup is defined as eight fluid ounces, or about 236 millilitres – a litre of coffee would require four such cups.
Apinis emphasises that how coffee is prepared matters. Filtered coffee, including drip-brewed or poured through a filter, is better for cholesterol than unfiltered methods such as French press or Turkish coffee. A paper filter removes almost all diterpenes, oily compounds known to raise LDL cholesterol.
Coffee and the gut microbiome
Apinis refers to a recent Irish study showing that coffee alters the gut microbiome in ways that affect mood, cognitive abilities and inflammatory processes. Daily coffee drinkers had a different gut microbiome from non-drinkers. Researchers observed increased levels of paraxanthine, which has neuroprotective and antioxidant effects, and theophylline, linked to anti-inflammatory action and a lower risk of Parkinson's disease.
A striking finding was that decaffeinated coffee also changed several gut microbiota indicators similarly to regular coffee. Both groups experienced lower stress, depression and inflammation. Caffeinated coffee was associated with lower morning cortisol, while decaf drinkers showed improvements in sleep quality, physical activity and learning performance.
Blood pressure and caffeine
The evidence suggests that drinking more than three cups per day is linked to a lower risk of high blood pressure, possibly due to tolerance to the temporary spike. Energy drinks, unlike coffee, can raise blood pressure and lack proper research support. Apinis notes that coffee's effect is individual, depending on amount, preparation and personal health status.
Although the findings are encouraging, most data come from observational studies that cannot prove causation. Apinis concludes that if coffee causes no symptoms, there is no reason to stop – but a heart-healthy lifestyle, balanced diet, good sleep and regular health checks remain the true foundation of cardiovascular health.
