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Combats drowsiness, temporarily boosts athletic performance, eases congestion due to colds and flu, prevents asthma attacks, enhances the pain-relieving effects of aspirin

Although most people don't think of it as such, coffee is America's most popular herbal beverage. It helps a sleepy nation wake up in the morning. It also has therapeutic value. It can act as a decongestant for colds. It may help prevent asthma attacks. It may boost athletic performance. And it increases the pain-relieving power of aspirin.

Of course, coffee can also cause problems — jitters and insomnia. But despite scare headlines that have linked coffee to many serious diseases, the latest medical review concludes: "Coffee appears to pose no particular threat in most people if consumed in moderation."

Coffee has been around for a long time. Our word coffee comes from Caffa, the region of Ethiopia where the fabled beans were first discovered. The beverage we know as coffee emerged around 1000 AD, when Arabians began roasting and grinding coffee beans and drinking the hot beverage as we do today. Until the 17th century, Arabia supplied all the world's coffee through the port of Mocha, which became one of coffee's names. Then the Dutch introduced the plant into Java, and the island quickly became synonymous with coffee.

The medically important constituent of coffee is, of course, caffeine, but coffee's caffeine content depends on how it's prepared. A cup of instant contains about 60 milligrams of caffeine. Drip or percolated coffee has about 100. A cup of espresso contains about 100 milligrams, too, but this is in a 2 1/2-ounce cup — the traditional serving size for espresso.

Boosting performance

Coffee is best known as the powerful stimulant that helps people stay awake during night drives and cramming before final exams. It does not, however, help anyone sober up after overindulging in alcohol. In fact, it can upset hungover stomachs.

Some over-the-counter cold formulas contain caffeine, partly to counteract the sedative effects of the antihistamines they contain. Caffeine may also help open the bronchial tubes, relieving the congestion of colds and flu. Coffee's action as a bronchodilator can also help prevent asthma attacks.

If you take aspirin for pain relief, perhaps you should take it with a cup of coffee. Several studies show that, compared with plain aspirin, the combination of aspirin and caffeine relieves pain significantly better than aspirin alone.

Coffee may also improve physical stamina, according to a report published in the journal The Physician and Sports Medicine. The International Olympic Committee forbids "caffeine loading" and tests urine for illegal amounts. To reach illegal levels, an endurance athlete would have to drink four or five cups in 30 minutes. Athletes who want coffee's benefits without risking disqualification typically drink three or four cups during the hour or two before an event.

How much is too much?

Caffeine is such an integral part of our culture, we seldom realize how much of a drug it is. The fact is, caffeine is classically addictive. Regular users develop a tolerance and require more to obtain the expected effect. Deprived of caffeine, regular users usually develop withdrawal symptoms, primarily a headache, which can last several days. Coffee is most notorious for causing insomnia and increasing anxiety, irritability and nervousness. It can also aggravate panic attacks. Coffee increases the secretion of stomach acids and can upset the stomach. Doctors say that people with ulcers or other gastrointestinal conditions should use it cautiously, if at all. Contrary to popular mythology, coffee does not cause ulcers. It can, however, make ulcers worse in people who already have them.

Coffee also raises blood pressure in those who are not accustomed to drinking it. But once Java junkies have developed a caffeine tolerance, the body adjusts, and normal consumption no longer affects blood pressure.

But coffee's worst press has concerned its association with heart disease. The subject is extremely controversial, with evidence supporting both sides of the argument. Most studies indicate that coffee can increase cholesterol levels. Oddly, decaffeinated coffee has the same cholesterol-boosting effect as regular, suggesting that caffeine is not the culprit. For reasons that remain a mystery, filtered coffee raises cholesterol less than boiled coffee. If your cholesterol is high, discuss your coffee consumption with your physician.

Independent of coffee's action on cholesterol and blood pressure, it may increase the risk of heart attack. The danger level is more than four cups a day.

There are also reports that coffee aggravates premenstrual syndrome in many women. And coffee has been accused of contributing to infertility, birth defects, gallstones, immune impairment and many forms of cancer. To date, none of these allegations has been proven.

"I'd advise limiting caffeine intake to 250 milligrams a day," says Varro E. Tyler, Ph.D., professor of pharmacognosy at Purdue University School of Pharmacy in West Lafayette, Indiana, and author of The Honest Herbal. "That's about two cups of brewed coffee."

"Personally, I drink five or six cups a day," says James A. Duke, Ph.D., a botanist retired from the U.S. Department of Agriculture and author of The CRC Handbook of Medicinal Herbs. "But I don't recommend drinking more than two."

Not everyone who quits or cuts back develops withdrawal symptoms, but most people do. The throbbing headache usually begins within 18 to 24 hours and lasts a few days. Constipation is also possible for a day or two.

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