To: SiouxPal who wrote (60379 ) 3/9/2006 3:53:24 AM From: stockman_scott Read Replies (2) | Respond to of 361022 Coffee drinkers get a jolt in study By Denise Gellene and Jia-Rui Chong The Los Angeles Times Wednesday, March 8, 2006 The findings of a new medical study may be enough to make you spit out your morning coffee. And that could be a good thing — at least for half of you. A study of 4,000 coffee drinkers has found that two or more cups each day can increase the risk of heart disease — but only for those with a genetic mutation that slows the breakdown of caffeine in the body. In diverse urban areas, the mutation is found in roughly half of all people. People without the mutation can drink as much coffee as they wish with no added risk of a heart attack, scientists said. Unfortunately for coffee drinkers, there's no commercial test for the mutation, and staying awake all night if you drink coffee during midday doesn't mean you're a slow metabolizer. "I don't know what to think," Donna Carmichael, 50, said as she waited for a train in Los Angeles. "How do you know if you've got the gene?" she asked, explaining that she usually drinks about three cups of coffee a day. "If it's genetic, though, who's going to go out and get tested?" The findings, conducted by researchers from the University of Toronto, Harvard's School of Public Health and the University of Costa Rica, are published today in the Journal of the American Medical Association. They could explain why previous investigations into caffeine's effect on the heart have produced conflicting results. Ahmed El-Sohemy, a University of Toronto scientist, said earlier reports failed to account for the genetic differences among people. "One size does not fit all," he said. People who metabolized caffeine slowly and drank two to three cups of coffee each day had a 32 percent higher risk of heart attack, according to the study. Those consuming four cups or more had a 64 percent greater risk. A cup of coffee had no effect on heart-attack risk, researchers found. How this will affect America's addiction to caffeine remains to be seen. Coffee drinkers in the United States — about half of all adults — gulp an average of three cups of coffee daily and spend more than $17 billion a year keeping themselves caffeinated. The findings are "interesting, plausible and worthy of further study," said Dr. David Robertson, a professor of medicine and pharmacology at Vanderbilt University, adding that additional research is needed and that consumers shouldn't worry about changing their coffee-drinking habits. "I think we should keep in mind that coffee has been studied more than any other drug," he said. "This is not something that should scare people to death about coffee." Even if future research confirms the findings, it's likely that caffeine plays a much smaller role in heart attacks than conventional risk factors such as high blood pressure, cholesterol and smoking, said Dr. Roger Blumenthal, a cardiologist at Johns Hopkins Medical School. Caffeine's possible effect on heart disease has been studied for years because the chemical is a stimulant that causes blood vessels to constrict, interfering with their normal function. Whatever the risk attributable to caffeine, the overall risk of heart attack is small, ranging from 2 percent to 5 percent a year among elderly Americans, depending on age, race and gender. The new research, which involved scientists from the United States and Costa Rica, compared 2,014 men and women in Costa Rica who had recovered from a first heart attack to an equal number of healthy adults. Genetic tests determined whether participants had the gene for breaking caffeine down slowly. The study was conducted in Costa Rica because health records for a large number of patients were available and one of the researchers already was there on another study. The gene, CY1A2, was first identified in the 1990s. All people have two copies of the gene. People with a mutation in one or both genes will break down caffeine slowly. The study found that 54 percent of participants were "slow metabolizers," who broke down caffeine four times more slowly than people without the mutation, El-Sohemy said. The longer caffeine remains in the bloodstream, the greater potential for harm, he said. Women with the defective gene had a higher risk than men, and adults 59 and younger faced worse odds than older coffee drinkers with the gene mutation. El-Sohemy said coffee was less of a factor in the elderly because they face multiple cardiac risks, including weight gain, higher cholesterol and other problems that would obscure the effects of caffeine. Los Angeles Times reporter Alan Zarembo contributed to this report. Blumenthal's comment was reported by The Associated Press.