Is Coffee Increasing Your Risk for Heart Disease?

Once touted as cancer-causing, coffee is now glorified for helping prevent cancer, type 2 diabetes, and liver, heart, and Parkinson's diseases. However, despite its health benefits, evidence suggests it may raise cholesterol levels, which may increase your cardiovascular disease risk. Let's dig into the research about coffee and cholesterol.

Does coffee raise cholesterol levels?

Coffee beans are rich in diterpenes, compounds praised for their potential antimicrobial, antiviral, antioxidant, anti-inflammatory, anti-obesity, and anti-tumor properties. Many different diterpenes exist, but the ones mostly found in coffee oils are cafestol and kahweol. While many antioxidants have been previously linked to have cholesterol-lowering properties, recent studies show that cafestol and kahweol may increase total cholesterol and low-density lipoprotein (LDL) cholesterol.

A 2007 study published in Molecular Endocrinology has reported that cafestol might elevate cholesterol levels by interacting with a receptor in an intestinal pathway involved in its regulation. Additional studies have reported a 6–8% increase in cholesterol levels after drinking five cups daily (about 240 mg or 8 oz each) of French press coffee for four weeks. This data sounds startling to coffee lovers at first glance. However, in light of more recent studies, coffee in moderation is key.

The authors of a 2020 meta-analysis published in Nutrition, Metabolism and Cardiovascular Diseases reviewed 12 randomized controlled trials studying coffee consumption and cholesterol levels. After evaluating the data, they recommend a moderate coffee intake of less than three daily cups to prevent an increase in LDL cholesterol.

Interestingly, it is currently estimated that around 7% of people face cardiovascular disease (CVD), while around 80% of Americans drink coffee everyday.

Most studies show that coffee can increase total and LDL cholesterol levels, depending on how much and what type of coffee you drink. Three cups of daily coffee or less appears might be considered safe for those with normal cholesterol levels. For those with high LDL cholesterol levels, however, consult your doctor about your coffee intake and continue to monitor your lipid panel.

Roasting and brewing methods

Studies suggest that different roasts and brewing methods cause variations in diterpene levels, and therefore may change how coffee may impact cholesterol levels.

Paper-filtered vs. unfiltered brews

A 2021 systematic review of accumulated data about food and cholesterol found that unfiltered coffee increases cholesterol levels more than filtered. As a result, the general recommendation is to use paper-filtered brewing methods more often than unfiltered coffee, like French press or Turkish coffee.

Scientists aren't sure why paper-filtered coffee is better. Some data suggests it catches fine particles better than in metal-filtered and unfiltered coffee.

Cold brew coffee

Researchers have yet to study the cafestol and kahweol levels in cold-brewed coffee.

Cold brew coffee is typically brewed for extended periods (usually more than 16 hours). The increased brewing time of cold brew may increase diterpene levels. Additionally, the coffee grounds used in this preparation method are very coarse, and therefore usually are filtered out using metal meshes, potentially leaving all the diterpene coffee behind.

Therefore, it is likely that cold brew coffee might have the highest diterepene content, and hence have an effect on blood cholesterol levels.

Light vs. dark roasted coffee beans

The scientific literature is inconclusive about whether light, medium, or dark roast coffee impacts cholesterol levels differently. Some studies show that dark roast may increase total cholesterol slightly more than light roast, while others show very little difference.

However, a 2019 study showed an unusual improvement in oxidized LDL cholesterol levels after drinking 750 mg (about three 8 oz cups) of dark-roast coffee daily for eight weeks.

The study's authors hypothesize that this improvement may be related to the particular antioxidants in dark-roast coffee. These antioxidants may help the body break down and use fat molecules for energy, a process called lipolysis, which can help with healthy cholesterol management.

More human trials are needed to fully understand the protective power of antioxidants and their ability to offset coffee's impact on cholesterol levels.

Tips to minimize coffee’s impact on cholesterol levels

Scientific experimentation is ongoing to understand coffee’s impact on human health. Since cholesterol levels are easy to test, each person can monitor their lipid levels and make an informed decision whether or not to drink coffee.

Here are some helpful tips if you’re concerned about the effect of coffee on your cholesterol levels:

1. Test your cholesterol levels with your doctor’s guidance. To measure coffee's impact on your lipid profile, visit your doctor for a blood test and ask for two follow-up tests after a coffee trial. Based on current studies, the next test could occur after four weeks without coffee intake. The third could be drawn after you reintroduce coffee intake for eight weeks.
2. Drink coffee in moderation. For most people, 2–4 cups of coffee (about 500–1000 mg) is the sweet spot to experience health benefits without increased risk.
3. Know your body. Despite coffee's health benefits, the risks may outweigh the benefits for some people, depending on their unique bodies. Monitor how coffee makes you feel and get cholesterol levels checked yearly.
4. Increase your intake of fruits, veggies, and other plant-based foods and follow a wholesome diet. Ample research shows that plant-based compounds are packed with fibre and might help reduce your cholesterol levels.
5. Consider using a paper-filtered brewing method. For those concerned about cholesterol levels, consider drinking paper-filtered coffee regularly and leaving unfiltered coffee for special occasions.
6. Be mindful of cream and sugar. Like your coffee intake, add cream and sugar in moderation.

Benefits and risks of coffee

With all the available data, let's examine the pros and cons of coffee consumption.

The health benefits

As previously noted, many studies show robust evidence of coffee's health benefits, typically within 2–4 cups daily.

A 2017 review of 201 meta-analyses of observational research on coffee intake found that coffee is associated with more health benefits than risks.

Another review published in 2021 demonstrated that coffee intake is linked with reduced risk of obesity, metabolic syndrome, type 2 diabetes, several types of cancer, and all-cause mortality. However, the authors noted the need for more randomized controlled studies to identify the direct causes of these outcomes.

The health risks

Most potential risks of drinking coffee (shown below) — including a possible increase in total cholesterol and LDL cholesterol — are associated with elevated levels of consumption, which most studies suggest is more than four cups daily.

The pros and cons of coffee intake

Healthy coffee consumption is mainly related to moderation. Drinking more than four daily cups of coffee may cause risks to outweigh the benefits. Since each person is unique, knowing one's body and testing one's response to coffee is the best way to confirm healthy coffee consumption.