Coffee, Caffeine, and Health- A NEJM review
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Coffee and tea are among the most popular beverages worldwide and contain substantial amounts of caffeine, making caffeine the most widely consumed psychoactive agent.

In addition, people use coffee beverages to increase wakefulness and work productivity. For a typical serving, the caffeine content is highest in coffee, energy drinks, and caffeine tablets; intermediate in tea; and lowest in soft drinks. Concerns have long existed that coffee and caffeine may increase the risks of cancer and cardiovascular diseases, but more recently, evidence of health benefits has also emerged.

A key issue in research on caffeine and coffee is that coffee contains hundreds of other biologically active phytochemicals, including polyphenols such as chlorogenic acid and lignans, the alkaloid trigonelline, melanoidins formed during roasting, and modest amounts of magnesium, potassium, and vitamin B3.

These coffee compounds may reduce oxidative stress, improve the gut microbiome, and modulate glucose and fat metabolism. In contrast, the diterpene cafestol, which is present in unfiltered coffee, increases serum cholesterol levels. Thus, research findings for coffee and other dietary sources of caffeine should be interpreted cautiously, since effects may not be due to caffeine itself.

This review summarizes the evidence about the varied physiological effects of caffeine and coffee and the risks of cardiovascular disease, insulin resistance, gallstones, cancer, and liver disease.

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