Which is better for you?

Q) Which is better for you?

A) Not all questions we receive at the pharmacy are drug related ones. Frequently they concern lifestyle type issues and, in particular, dietary choices we all face but don’t always think about.

While a registered dietician would be far better qualified to answer any of these queries, they are not always so easy to see on a moment’s notice and many of these inquiries are based more on curiosity rather than massive heath concerns.

Before starting, I would like to note that it seems like we are always contradicting ourselves when it comes to new research in the medical field and I believe that holds even truer when it comes to dietary recommendations (see Atkins, Paleo diets, chocolate, red wine ….).  Please keep that in mind when the next study comes out in a week or so and rebuts much of what is written here leading you to wonder just what to believe. Anyway, let’s move on to the questions.

Which is better for you, caffeinated or decaffeinated coffee?

This really comes down to the debate about the relative merits of caffeine itself. Caffeine undoubtedly makes you feel more awake, alert and able to better concentrate to some degree. It is also rapidly absorbed into your blood and does not accumulate so its effects in this regard are temporary. On the medical side of things it can improve the effectiveness of painkillers (like acetaminophen and ibuprofen) by up to 40%, may provide protection against Parkinson’s disease, is associated with a much lower risk of liver damage, enhances athletic performance, is associated with a reduced risk of mild depression in women and can improve lung function for up to 4 hours (although it is unknown if this correlates to less asthma type symptoms). On the downside, caffeine, especially in large amounts, can elevate blood pressure, make you nervous, cause you to urinate more often (than an equal volume of water would) affect your ability to sleep (who knew??) and increase the production of gastric acid in your stomach which can be problematic for those with heartburn and bloating/ gas issues.  As well, if you have certain heart issues, it can trigger an irregular heart rate. Regular use can also lead to a physical dependence (says I madly sipping on a cup of java right now in a desperate attempt to ward off a headache and fatigue).

Both types of coffee have been linked to a reduced risk of type 2 diabetes and seem to have a protective effect on neurons in the brain (although there is more evidence for regular coffee at this point than there is for decaf) which perhaps explains why people who drink coffee have a lower risk of Alzheimer’s. Interestingly, drinking 2 or more cups of decaf coffee per day has been linked with up to a 48% lower risk of developing rectal cancer. As far as nutritional content, both coffees are almost identical with respect to vitamins, calories etc.. with the major difference being that decaf may have up to 15% less antioxidants than its rival does (although decaf is still an excellent source of these, for most North Americans, coffee is the single biggest provider of antioxidants in their entire diet). Decaf tends to have a milder taste and aroma which may or may not be a drawback depending on personal preference of course. As well, it should be noted that decaf is not completely caffeine free as a cup usually has between 1 to 7mg of caffeine (as opposed to regular coffee which tends to range from 70-140mg of caffeine). So, in summary, coffee is one of the healthiest beverages on the planet (note the cream and sugar so many of us add probably more than negates any positives) and both types have many health benefits associated with it. However, for some, decaf is the safer route to go.

Another question we have received is – which type of cow’s milk is the healthiest. When it comes to comparing skim versus whole fat milk the answer seems to have shifted dramatically in the last few years. Skim milk (or low fat milks) gained massive popularity starting in the 1960’s due to the belief that saturated fats were associated with weight gain and heart disease. However, numerous studies have come out in the last decade which have debunked this and have in fact shown that whole milk (3.25% fat content) seems to reduce our risk of obesity. Researchers speculate that this is because it causes us to feel full for a longer period of time causing us to consume less carbohydrates and sugars later in the day.

Another piece of evidence supporting full fat milk comes from a study conducted by Tufts University. In this 15 year project looking at over 3000 people, those with higher levels of full fat dairy in their diet had a 46% less chance of developing diabetes mellitus than those who tended to consume low fat dairy in their diet. Skim, low and whole fat milks are all processed similarly with the cream being separated from the whey and then being added back in, or not, as in the case of skim milk. Whole milk contains fewer carbohydrates per litre than its rivals and has slightly less protein as well. Sugars may be added to the low fat milks to make up for the loss of taste when the fat is removed and the more we learn about the links between diet and health, sugar is increasingly looking like the villain over and over again.

In summary, while nobody should be drinking so much milk that the type they consume should be having a major impact on their health, it is likely that whole fat milk may be a better choice, especially if it allows you to fight off those carb cravings later in the day