Coffee, Osteoarthritis and Weight Loss

Losing weight helps to relieve pain from osteoarthritis and drinking black coffee can assist with weight loss.

Obesity and osteoarthritis (OA)

Obesity is the result of an imbalance between calorie intake and expenditure (1). Obesity is a risk factor for OA: Every 5kg of weight gain increases the chance of developing knee OA by 36% (2).

Weight loss can help relieve symptoms, especially pain (2). In people who have obesity and OA, losing at least 10% body weight is recommended (2).

Weight loss and coffee

There are different ideas about how to lose weight (2).

Several studies have shown that coffee can help with weight loss (3-6).

Coffee contains more than 1000 ingredients (7). Identifying exactly how coffee helps to reduce weight is challenging (7). Two main active components in coffee beans are caffeine and chlorogenic acids (CGAs) (3).

Caffeine assists weight loss in many ways. It increases energy use (8) even when the body is at rest (9). Caffeine also enhances the production of body heat (1) and facilitates fat metabolism (3). Caffeine may also have a role in acute suppression of appetite (7). It also helps to maintain performance when you are fatigued (10). Caffeine may prevent a decrease in metabolic rate which is seen with some weight loss (1).

The effect of caffeine on energy intake is dose-dependent (4) but a law of diminishing returns applies.

While caffeine does promote weight reduction, its effect on weight loss may be minimal in practice. Drinking coffee may modestly reduce daily energy intake by 230kJ (7). Caffeine consumption between 60 and 720mg/day for one month has been found to result in less than 2kg total weight loss (4).

Meanwhile, CGA regulates glucose metabolism and body fat distribution, and hinders fat storage (3), thereby helping weight loss.

Apart from caffeine and CGAs, other biologically active ingredients in coffee may also contribute to a change in eating habits (7).

Coffee and important health considerations

Moderate caffeine consumption of less than 400mg daily is relatively safe (3, 11). Overconsumption causes headaches, increased urination, gastric discomfort, nervousness, vomiting, insomnia, ear ringing, arrhythmias (3, 12) and addiction. Consumers can opt for darker roasted varieties that have lower caffeine content or drink filtered coffee to reduce its undesirable effects (13).

Several issues should be considered when you drink coffee.

Caffeine can increase systolic BP by 5-15 mmHg and diastolic BP by 5-10 mmHg (14). This effect can last for several hours and persist in long-time coffee drinkers (14). Regular coffee intake has been linked to uncontrolled BP in hypertensive elderly individuals (15). Meanwhile, whether coffee prevents or increases the risk of diabetes is uncertain (14).

While the acute negative impact of caffeine on BP and blood glucose has been established in different populations (14), it remains unclear if long-term consumption contributes to disease.

Coffee is addictive. During abstinent periods, habitual coffee drinkers may experience withdrawal symptoms such as low performance, depressed mood, headaches, sleepiness, fatigue (14) and irritability.

Coffee can also complicate the use of certain medications such as Adenosine, Fosamax, Clozapine, Dipyridamole, Fluvoxamine, Levothyroxine, some antibiotics, antidepressants, and anticoagulants (13). If you are taking these medications, consult your healthcare provider about coffee consumption (13).

Drinking coffee, especially when unfiltered, has been associated with a significant increase in total cholesterol (16). This is mainly due to the intake of oils present in coffee such as cafestol and kahweol (16). These are known to reduce bile acid excretion and facilitate cholesterol synthesis (16). Interestingly, we observe that PRP (platelet-rich plasma) from patients who have coffee just prior to their PRP treatment often appears ‘cloudy’ instead of being golden and clear. To ensure the best therapeutic effect of PRP and adipose stem cell therapy, where stored adipose stem cells are also mixed with PRP prior to administration, we recommend patients avoid coffee for a few hours before treatment.

Coffee doses and weight loss

Consuming low-to-moderate caffeine doses, i.e. 2-3 cups of coffee (3-4mg caffeine/kg body weight), is generally sufficient to achieve a healthy energy balance for people with obesity regardless of gender and levels of physical activity (1). Higher caffeine doses can be consumed for additional weight loss effect. Drinking up to 4 cups of coffee (6mg caffeine/kg body weight) has been associated with more significant reduction in food intake (17).

Coffee, caffeine and calories

The type of beans, how beans are roasted (lighter roasts contain more caffeine than darker varieties), how coffee is prepared (e.g. brewed, espresso, instant, decaf) and serving size (30-700ml) will affect caffeine levels (18).

• One cup (240ml) of brewed coffee (with/without filter): 70-140mg caffeine

• One shot (30-50ml) of espresso: 63mg caffeine*

• One shot of Starbucks espresso: 75mg caffeine*

• One cup of instant coffee (1-2 teaspoons of dried coffee): 30-90mg caffeine

• One cup of decaf coffee: 0-7mg caffeine

*espresso-based beverages with added milk, e.g. lattes, cappuccinos, macchiatos and Americanos, contain the same amount of caffeine as straight espresso, depending on the number of shots.

Black coffee is very low in energy: One cup (240ml) of black brewed coffee contains just 2 calories (19). Adding milk, sugar and other additives to your coffee will increase your coffee’s calories (7). For instance, one Grande cup of Starbucks (470ml) Caramel Frappuccino contains 420 calories and more than 66g sugar (19).

Observations from Australian coffee stores show that customers who opt for blended coffee beverages such as Frappuccino or choose to have full cream milk with their coffee consume more energy (7). Regular consumption of sugary drinks has been linked to weight gain as well as risks of metabolic syndrome and type 2 diabetes (20-22).

Choosing plain coffee instead of its sweetened varieties and other sugary drinks, e.g. soda or juice, is a good way to lower calorie consumption (19). Avoid syrup, flavoured creamers and pre-mixed latte products, which adds sugar to your coffee (19).

If you prefer to have some flavour while keeping your coffee’s calorie count low, try having your coffee with cinnamon sprinkles, unsweetened milk, a few drops of vanilla extract or even mix your coffee with a small square of dark chocolate (19). Gradually reducing the amount of sweetening additives will help you to better tolerate the natural bitter taste of black coffee (19).

Make your own coffee! This will enable you to control the amount of sugar in your coffee (19).

Coffee, exercise, diet and weight loss

Drinking coffee before exercise has been found to increase post-exercise fat oxidation (23), i.e. fat burning. Caffeine intake both before and after exercise also induces greater energy loss and makes exercise a more pleasurable experience than without coffee (24). Having coffee before a meal can help you eat less (7).

If you track your calorie intake and want to calculate your burnt calories after a workout, you can use a Calories Burnt Calculator. It is important to remember that this provides an estimate, as the number of calories burnt would depend on several factors, such as body composition, fitness levels and vital signs.

Combining a weight loss diet (e.g. intermittent fasting) with drinking coffee may have added benefits for weight loss (6).

Key messages

Obesity is a risk factor for osteoarthritis.

• Every 5kg gained increases the risk of knee osteoarthritis by 36% (2).

• Coffee, especially black coffee, is beneficial for weight loss.

• The main active ingredients for weight loss are caffeine and CGA.

• Moderate daily caffeine intake of less than 400mg is generally safe (11).

Risk of developing uncontrolled hypertension, withdrawal symptoms, addiction and interaction with certain medications must be considered before drinking coffee.

For the best therapeutic effect of your platelet-rich plasma (PRP) and adipose stem cell treatment (ASCT), avoid coffee for a few hours before your treatment.

Reference

1. Harpaz E, Tamir S, Weinstein A, Weinstein Y. The effect of caffeine on energy balance. Journal of basic and clinical physiology and pharmacology. 2017;28(1):1-10.

2. Bliddal H, Leeds AR, Christensen R. Osteoarthritis, obesity and weight loss: Evidence, hypotheses and horizons – A scoping review. Obesity Reviews. 2014;15(7):578-86.

3. Quick M. Weighing in: Green coffee bean extract – A potential safe and effective weight loss supplement? Integrative Medicine Alert. 2013;16(9).

4. Tabrizi R, Saneei P, Lankarani KB, Akbari M, Kolahdooz F, Esmaillzadeh A, et al. The effects of caffeine intake on weight loss: A systematic review and dos-response meta-analysis of randomized controlled trials. 2019. p. 2688-96.

5. Icken D, Feller S, Engeli S, Mayr A, Müller A, Hilbert A, et al. Caffeine intake is related to successful weight loss maintenance. European Journal of Clinical Nutrition. 2015;70(4).

6. Davoodi S, Hajimiresmaiel SJ, Ajami M, Mohseni-Bandpei A, Ayatollahi SA, Dowlatshahi K, et al. Caffeine treatment prevented from weight regain after calorie shifting diet induced weight loss. Iran J Pharm Res. 2014;13(2):707-18.

7. Schubert MM, Irwin C, Seay RF, Clarke HE, Allegro D, Desbrow B. Caffeine, coffee, and appetite control: A review. International Journal of Food Sciences and Nutrition. 2017;68(8):901-12.

8. Hursel R, Viechtbauer W, Dulloo AG, Tremblay A, Tappy L, Rumpler W, et al. The effects of catechin rich teas and caffeine on energy expenditure and fat oxidation: A meta-analysis. Obesity reviews : an official journal of the International Association for the Study of Obesity. 2011;12(7):e573-e81.

9. Acheson KJ, Gremaud G, Meirim I, Montigon F, Krebs Y, Fay LB, et al. Metabolic effects of caffeine in humans: lipid oxidation or futile cycling? The American journal of clinical nutrition. 2004;79(1):40.

10. Correa M, Sanmiguel N, López-Cruz L, Carratalá-Ros C, Olivares-García R, Salamone JD. Caffeine modulates food intake depending on the context that gives access to food: comparison with dopamine depletion. Frontiers in psychiatry. 2018;9:411-.

11. Wikoff D, Welsh BT, Henderson R, Brorby GP, Britt J, Myers E, et al. Systematic review of the potential adverse effects of caffeine consumption in healthy adults, pregnant women, adolescents, and children. Food and Chemical Toxicology. 2017;109(Pt 1):585-648.

12. Yan L, Huang Y, Li S-S. Cardiac arrest: A case-based review. World journal of emergency medicine. 2014;5(3):171-4.

13. Coffee: RxList; 2019 [Available from: https://www.rxlist.com/coffee/supplements.htm

14. James JE. Are coffee’s alleged health protective effects real or artifact? The enduring disjunction between relevant experimental and observational evidence. Journal of Psychopharmacology. 2018;32(8):850-4.

15. Lopez-Garcia E, Orozco-Arbeláez E, Leon-Muñoz LM, Guallar-Castillon P, Graciani A, Banegas JR, et al. Habitual coffee consumption and 24-h blood pressure control in older adults with hypertension. Clinical Nutrition. 2016;35(6):1457-63.

16. Cai L, Ma D, Zhang Y, Liu Z, Wang P. The effect of coffee consumption on serum lipids: A meta-analysis of randomized controlled trials. European journal of clinical nutrition. 2012;66(8):872-7.

17. Gavrieli A, Karfopoulou E, Kardatou E, Spyreli E, Fragopoulou E, Mantzoros CS, et al. Effect of different amounts of coffee on dietary intake and appetite of normal‐weight and overweight/obese individuals. Obesity. 2013;21(6):1127-32.

18. Bjarnadottir A. How much caffeine in a cup of coffee? A detailed guide: Healthline; 2017 [Available from: https://www.healthline.com/nutrition/how-much-caffeine-in-coffee.

19. Zamarripa M. How does coffee affect weight? : Healthline; 2019 [Available from: https://www.healthline.com/nutrition/coffee-and-weight-gain.

20. Wang M, Yu M, Fang L, Hu R. Association between sugar-sweetened beverages and type 2 diabetes: A meta-analysis. J Diabetes Investig. 2015;6(3):360-6.

21. Malik VS, Popkin BM, Bray GA, Després J-P, Willett WC, Hu FB. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: A meta-analysis. Diabetes Care. 2010;33(11):2477-83.

22. Imamura F, O'Connor L, Ye Z, Mursu J, Hayashino Y, Bhupathiraju S, et al. Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: Systematic review, meta-analysis, and estimation of population attributable fraction. Br J Sports Med. 2016;50(8):496-U84.

23. Kurobe K, Nakao S, Nishiwaki M, Matsumoto N. Combined effect of coffee ingestion and repeated bouts of low‐intensity exercise on fat oxidation. Clinical Physiology and Functional Imaging. 2017;37(2):148-54.

24. Schubert MM, Hall S, Leveritt M, Grant G, Sabapathy S, Desbrow B. Caffeine consumption around an exercise bout: effects on energy expenditure, energy intake, and exercise enjoyment. Journal of applied physiology (Bethesda, Md : 1985). 2014;117(7):745-54.