Drinker’s Sex Plus Brewing Method May Be Key to Coffee’s Link to Raised Cholesterol

Summary: The sex of the drinker in addition to the brewing method may explain coffee’s link to increased cholesterol. Drinking 3-5 cups of espresso per day increased serum total cholesterol, especially in males.

Source: BMJ

The sex of the drinker as well as the brewing method may be key to coffee’s link with raised cholesterol, a known risk factor for heart disease, suggests research published in the open access journal Open Heart.

Drinking espresso was associated with the widest gender difference in cholesterol level; plunger (cafetière) coffee was associated with the narrowest, the findings show.

Naturally occurring chemicals in coffee—diterpenes, cafestol, and kahweol—raise levels of cholesterol in the blood. Brewing method is influential, but it’s not clear what impact espresso coffee might have, and in what quantities.

The researchers therefore wanted to compare espresso coffee with other brewing methods among adults aged 40 and older (average age 56).

They drew on data from 21,083 participants (11074 women;10009 men) responding to the seventh survey of the Tromsø Study in 2015-16, a long term population study, which began in 1974, involving residents of the Norwegian city of Tromsø.

Participants were asked how many daily cups of coffee they drank—none, 1–2 cups; 3–5; and 6 or more—and what brew type they drank—filtered; plunger (cafetière); espresso from coffee machines, pods, mocha pots, etc; and instant.

Blood samples were taken, and height and weight measured. Information was also sought on potentially influential factors: diet and lifestyle, including smoking, alcohol intake and physical activity; educational attainment; and whether type 2 diabetes had been diagnosed.

Women drank an average of just under 4 cups of coffee every day while men drank an average of nearly 5.

Analysis of the data showed that the association between coffee and serum total cholesterol varied, depending on brewing method, with significant sex differences for all brew types bar plunger coffee.

Drinking 3–5 daily cups of espresso was significantly associated with increased serum total cholesterol, particularly among the men.

Compared with those who drank none, this pattern of consumption was associated with 0.09 mmol/l higher serum cholesterol among the women vs 0.16 mmol/l higher among the men.

A daily tally of 6 or more cups of plunger coffee was also associated with raised cholesterol, and to a similar degree in both sexes: 0.30 mmol/l higher among the women vs 0.23 mmol/l higher among the men.

And getting through 6 or more cups of filtered coffee every day was associated with 0.11 mmol/l higher cholesterol among the women, but not among the men, when compared with those not drinking filtered coffee.

While instant coffee was associated with an increase in cholesterol in both sexes, this didn’t rise in tandem with the number of cups drunk, when compared with those who didn’t opt for coffee powder/granules.

The researchers point out that there was no standardized cup size used in their study; Norwegians tend to drink out of larger espresso cups than Italians do, for example.

Different types of espresso–from coffee machines, capsules, or mocha pots—are also likely to contain different levels of the key naturally occurring chemicals.

This shows a cup of coffee
Naturally occurring chemicals in coffee—diterpenes, cafestol, and kahweol—raise levels of cholesterol in the blood. Image is in the public domain

And there are as yet no obvious explanations for the gender discrepancy in cholesterol response to coffee drinking, they add.

“Interestingly, coffee contains more than a thousand diverse phytochemicals. The intake of each compound also depends on the variety of coffee species, roasting degree, type of brewing method and serving size,” they explain.

Experimental studies show that cafestol and kahweol, as well as increasing total cholesterol, have anti-inflammatory effects, protect the liver, and lessen the risks of cancer and diabetes, they add.

“This demonstrates how coffee contains compounds that may lead to multiple mechanisms operating simultaneously,” highlight the researchers.

And they note: “Coffee is the most frequently consumed central stimulant worldwide. Because of the high consumption of coffee, even small health effects can have considerable health consequences.”

About this coffee and cholesterol research news

Author: Press Office
Source: BMJ
Contact: Press Office – BMJ
Image: The image is in the public domain

Original Research: Open access.
Association between espresso coffee and serum total cholesterol: the Tromsø Study 2015–2016” by Tom Wilsgaard et al. Open Heart


Association between espresso coffee and serum total cholesterol: the Tromsø Study 2015–2016


Coffee raises serum cholesterol because of its diterpenes, cafestol and kahweol, and the effect varies by brewing method. Population-based research on espresso coffee’s impact on serum cholesterol is scarce. Our aim was to examine how various brewing methods, in particular espresso, were associated with serum total cholesterol (S-TC).


We used cross-sectional population data from the seventh survey of the Tromsø Study in Northern Norway (N=21 083, age ≥40 years). Multivariable linear regression was used to assess the association between S-TC as the dependent variable and each level of coffee consumption using 0 cups as the reference level, adjusting for relevant covariates and testing for sex differences.


Consumption of 3–5 cups of espresso daily was significantly associated with increased S-TC (0.09 mmol/L, 95% CI 0.01 to 0.17 for women and 0.16 mmol/L, 95% CI 0.07 to 0.24 for men), compared with participants drinking 0 cups of espresso per day. Consumption of ≥6 cups of boiled/plunger coffee daily was also associated with increased S-TC (0.30 mmol/L, 95% CI 0.13 to 0.48 for women and 0.23 mmol/L, 95% CI 0.08 to 0.38 for men), compared with participants drinking 0 cups of boiled/plunger coffee. Consumption of ≥6 cups of filtered coffee daily was associated with 0.11 mmol/L (95% CI 0.03 to 0.19) higher S-TC levels for women but not for men. Instant coffee consumption had a significant linear trend but showed no dose–response relationship when excluding participants not drinking instant coffee. There were significant sex differences for all coffee types except boiled/plunger coffee.


Espresso coffee consumption was associated with increased S-TC with significantly stronger association for men compared with women. Boiled/plunger coffee was associated with increased S-TC in both sexes and with similar magnitude as shown in previous research. Filtered coffee was associated with a small increase in S-TC in women. Further research on espresso and S-TC is warranted.

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