Coffee. Tea. Do They Help or Hurt Us? Dr. Kadish concludes his conversation with Dr. Philip Greenland.

Dr. Kadish: A lot of people drink coffee or tea and there have been studies that looked at the positive or negative effects of those beverages on cardiovascular and other outcomes.  Can you summarize these for a recommendation to people about coffee and tea consumption?

Dr. Greenland: Another good question. This is one that I think people can be generally more liberal. I’ve followed these studies for a long time, as I’m sure you have, Alan, so we know that occasionally somebody comes out with a paper that says, “Too much coffee is bad,” and other times it’s tea. There certainly are certain indications where, in a cardiac case, repeated episodes of atrial fibrillation seem to be closely related to caffeine intake. That person should probably watch their caffeine intake because you can see the connection, but for the average person, most of the evidence seems pretty reassuring that coffee or tea are part of a healthy overall diet. I tend to think that the literature is now favoring up to four to five cups of coffee a day—four or five 8-oz. cups, not four or five 20-oz. cups.

Dr. Kadish: Last question. Many studies look at vitamin supplements and things like Omega-3, and their risk of heart disease. Many of those, which held initial promise, haven’t really held up well.  Do you recommend any of that routinely?

Dr. Greenland: The simple answer is no. This is one of those areas where, again, there have been a few actual large trials. The average type of fish oil supplement that people are taking without a prescription does not replace eating fish—I’m not talking about fried fish but rather baked fish, even tuna fish; those seem to be quite consistent in showing a health benefit. And then there are all the dietary recommendations from the Heart Association and from the U.S. Dept. of Agriculture. Fish is considered part of a healthy diet, but supplements are not.