What You Need to Know About Coffee and Cholesterol

Coffee is a popular beverage that can help boost energy. Research suggests that it may also provide antioxidants and nutrients that are good for your health. But coffee has a downside, potentially causing insomnia, restlessness, and stomach upset, especially if consumed in excess. Adding to the risks are studies that suggest that coffee may not be good for you if you have high cholesterol.

Coffee is a central part of many people's daily rituals, and the question is whether the benefits of coffee outweigh the risks? And, if risks do exist, are there ways to reduce them if you're struggling to control your cholesterol?

Unfiltered Coffee and Cholesterol

When it comes to the benefits and risks of coffee, how you prepare a cup can make a big difference.

There are many different varieties of coffees, but they are fundamentally prepared in two ways: filtered and unfiltered. Filtered coffees are the most common method of preparation in the United States and involve brewing the coffee through a filter. Unfiltered coffees, also known as “boiled coffees," do not employ a filter and include espresso, Turkish coffees, and French press coffees.

Generally speaking, unfiltered coffee poses higher potential risks if you have been diagnosed with hyperlipidemia (high blood lipids, including cholesterol).

A 2012 review in the European Journal of Clinical Nutrition, evaluating 12 different studies with over 1,000 participants, concluded that regular consumption of unfiltered coffee increases total cholesterol (TC) and harmful low-density lipoprotein (LDL) cholesterol.

According to the researchers, the effects were dose-dependent, meaning that higher consumption of unfiltered coffee corresponded to higher TC and LDL increases. By contrast, drinking filtered coffee had no notable effect on either TC or LDL levels.

Other studies have suggested that smoking amplifies the risk of unfiltered coffee (in part because smoking causes narrowing of blood vessels). When combined, unfiltered coffee and smoking may increase LDL levels and decrease beneficial high-density lipoprotein (HDL) levels. This risk is highest in smokers who consume 3 or more cups per day.

As interesting as the findings are, they are not consistent. A small but relevant trial in Experimental and Therapeutic Medicine could not find an association between regular consumption of unfiltered coffee—in this case Turkish coffee—and elevated blood lipids. The same was true whether or not the coffee was consumed with cream or if the person was a smoker or non-smoker.

Realistic Effects

Based on the current body of research, there is no clear-cut answer as to whether coffee on its own is going to detrimentally influence cholesterol levels. As with all things related to cholesterol and heart disease, the causes are complex and involve a mix of diet, exercise, genetics, and lifestyle habits.

While there is a chance that coffee may increase your cholesterol levels, there is also evidence that daily coffee consumption may decrease your cardiovascular risk by up to 15%. Moreover, there is no evidence that coffee increases the risk of cardiovascular disease, even in those with a prior cardiovascular event.

If you have trouble controlling your cholesterol, speak with your doctor. Your doctor may advise you to reduce your intake if you're a heavy coffee drinker, but will more likely focus on interventions with proven benefits.

Coffee Ingredients

A single cup of coffee contains a surprising number of bioactive ingredients that can directly influence a person's physical and mental health and well-being.

These include:

• Caffeine (which decreases fatigue and improves mental functioning)
• Essential minerals (like calcium, magnesium, phosphorus, and potassium)
• Polyphenols (that reduce blood sugar and relax arteries)
• Melanoidins (that aid in fat metabolism)
• Chlorogenic acid (a potent antioxidant)
• Diterpenes (said to have anti-inflammatory and antispasmodic properties)

Among those thought to contribute to increased cholesterol levels are the diterpenes cafestol and kahweol. What isn't known is how much cafestol or kahweol it takes to affect cholesterol levels (studies vary on this effect) or if other bioactive ingredients in coffee, such as polyphenols, potentially mitigate this risk.

It's also worth noting that cafestol and kahweol both have anti-inflammatory and anti-diabetes effects that are beneficial to one's health.

Coffee Drink Ingredients

These days, coffee is consumed in many different forms. When visiting the typical coffee house, you are likely to be faced with an extensive menu of hot and cold coffee beverages, including lattes, cappuccinos, frappes, mochaccinos, cold brews, and a plethora of flavored coffees.

As much as you might worry about coffee's effect on your cholesterol, arguably the bigger concern is the other added ingredients in coffee drinks, which may increase the risk of heart disease, obesity, and type 2 diabetes.

Consider for example that a 16-ounce serving of Starbucks cinnamon dolce creme frappucino delivers at least 360 calories, 130 of which are from fat. On top of this, you're consuming 55 grams of dietary cholesterol (18% of your recommended daily intake) and 9 grams of saturated fat (45% of your recommended daily intake).

Compare this to a 16-ounce serving of plain coffee that delivers only 5 calories and has no fat, cholesterol, sodium, or carbohydrates.

Coffee's Other Effects on Cholesterol

When we think about cholesterol, we generally think that "high" means "bad." And, while this is certainly true with LDL cholesterol, increased levels of HDL cholesterol are generally considered a good thing.

Among its benefits, HDL cholesterol absorbs excess cholesterol in the blood and carries it back to the liver where it is flushed out of the body. Increases in HDL generally correspond to decreases in the risk of heart disease and stroke.

A 2020 study in the Journal of Nutrition reported that while high consumption of unfiltered espresso did, in fact, increase TC and LDL levels in both men and women, it also increased HDL and decreased triglyceride levels. Decreased triglycerides are linked to a lower risk of heart disease.

The same study also noted that regular consumption of tea and instant coffee had no detrimental effect on a person's blood lipid profile.

Risks of Drinking Coffee

Although there has been much published about the benefits of coffee, it is important to consider the possible risk, particularly if you are a heavy coffee drinker.

Among them:

• The high caffeine content can overstimulate the central nervous system, triggering anxiety, restlessness, headaches, insomnia, and heart palpitations. Poor sleep causes daytime sleepiness and reduced alertness and mental performance.
• Coffee is acidic and can promote stomach upset in some people, particularly those with chronic gastritis or irritable bowel syndrome (IBS). It can also speed up gastric emptying and can make diarrhea worse in people with IBS or inflammatory bowel disease (IBD).
• High consumption of coffee in females (8 or more cups per day) increases the risk of bone fractures by 150%. The same is not seen in males.
• High consumption of coffee during pregnancy may also increase the risk of low birth weight, preterm birth, and pregnancy loss compared to low to moderate consumption.

Drug Interactions

The caffeine content in coffee may amplify the effects of certain drugs, especially stimulants. Taking coffee and stimulants together can increase both your heart rate and blood pressure, sometimes severely.

Examples of stimulants include:

• Appetite suppressants
• Epinephrine (adrenaline)
• Lomaira (phentermine)
• Provigil (modafinil)
• Sudafed (pseudoephedrine)
• Tenuate (diethylpropion)
• Recreational drugs like cocaine and methamphetamine

Caffeine and other organic compounds in coffee can also interfere with the absorption of some pharmaceutical drugs, making them less effective.

These include:

• Iron supplements
• Levothyroxine (T4)
• Phenothiazine drugs like Thorazine (chlorpromazine)
• Versed (midazolam)

Coffee can increase the absorption of drugs like aspirin and levodopa, increasing the risk of side effects.

Frequently Asked Questions

Is there a link between coffee and cholesterol?

Based on inconsistencies in current evidence, it is unclear if there is a meaningful link between coffee and cholesterol. According to research, the daily consumption of 10 milligrams (mg) of cafestol—equal to around five cups of espresso—increases cholesterol by 0.13 mmol/L after four weeks. Although this is a significant increase, it may not necessarily push you into the abnormal range if your LDL is below 2.6 mmol/L (considered the normal range).

Is French press coffee bad for you?

Unfiltered French press coffee contains far more cafestol (2.6 milligrams) than an equivalent cup of filtered coffee (O.1 milligram). Cafestol and kahweol are two substances in coffee thought to increase LDL cholesterol. Other unfiltered coffees have even higher cafestol content, including Turkish coffee (4.2 milligrams) and Scandanavian boiled coffee (6.2 milligrams).

Is coffee bad when you have high blood pressure?

Caffeine can trigger a short but dramatic increase in blood pressure, even for people who have normal blood pressure. Caffeine stimulates the release of calcium from the lining of the stomach which causes blood vessels to contract, increasing blood pressure. Because the effect is temporary, it may not necessarily be harmful, but it certainly doesn't help if your blood pressure is out of control.

A Word From Verywell

While many of us enjoy coffee and feel as if we can't live without it, moderate consumption is key to reaping the benefits while lowering potential risks—including those relating to high cholesterol.

A 2017 review of studies in the British Medical Journal summarizes it best by suggesting that drinking no more than 3 to 4 cups per day is "more likely to benefit health than harm."

If you drink coffee and/or experience edginess, insomnia, or other adverse effects, speak with your doctor about ways to reduce your intake. This may involve gradually tapering off until you don't experience these effects anymore.