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Coffee and psoriasis

Statistics show coffee is the most commonly drunk beverage in the world. Linked with both positive and negative health effects1, we know it can make us feel more alert and energised, but is it helpful or harmful for people with psoriasis?

What do we know about coffee and psoriasis?

Researchers first identified a link between coffee consumption and psoriasis risk during the 1980’s2. Although the reasons for the link weren’t clear, researchers suggested that coffee might increase levels of omega-6 in the body, aggravating inflammation.

Since then other studies have failed to find a link between coffee and psoriasis risk3, 4, although based on personal experience, some people report improvements in psoriasis severity when they reduce their coffee intake. 

Learning Points

→ From the evidence we have, coffee or caffeine intake does not appear to increase the risk of developing psoriasis.

→ There is not enough evidence to confidently say whether coffee drinking makes psoriasis severity better or worse. Some people report an improvement when reducing coffee as part of an overall change to their diet. Others report no impact.

→ There is no evidence that caffeine intake reduces the effectiveness of drug treatments

 

If we look outside of psoriasis, coffee consumption has been linked with both anti-inflammatory and pro-inflammatory effects5, 6, 7, making it difficult to draw firm conclusions. This might be because of genetic differences, which affect how quickly or slowly we metabolise caffeine8.

Two of the compounds in coffee (cafestol and kahweol) have been shown to raise levels of cholesterol and homocysteine9, markers for heart disease risk. 10 Researchers don’t believe coffee intake increases heart disease risk for the majority of people 11, but the effects in people with psoriasis aren’t known.

On the other hand, coffee has been shown to exert strong antioxidant activity12, which is thought to be one of the reasons coffee consumption is linked with a lower risk of diabetes and some cancers13. People with psoriasis tend to have high levels of oxidative stress and low antioxidant defences, an imbalance which can aggravate inflammation, so consuming antioxidant rich foods may be of benefit.

What does the science say?

Identifying a relationship between coffee and psoriasis is complicated because it’s not practical or ethical to ask people to drink lots of coffee over long periods to see whether they develop psoriasis, or whether it gets worse. It’s also difficult to separate coffee drinking from other habits, such as smoking, or the effects of any added sugar or fat that is added to coffee.

Instead, we have to rely on studies that look at patterns of habitual coffee consumption and the incidence of psoriasis. Although early studies found a link between coffee consumption and psoriasis14, these findings were not confirmed in later studies of men or women1516 in studies of twins with and without psoriasis17 or case-control studies, where lifestyle factor of people with psoriasis are compared to healthy controls18.

More recently19, researchers monitored a group of over 80,000 American women free from psoriasis for a period of 14 years using questionnaires to record information on their food and drink intakes at various time points over the study period.

At the end of the study period, around 1.2 per cent of the women had gone on to develop psoriasis, but there was no association between coffee or caffeine intake and the risk of developing psoriasis after adjusting for smoking habits. The researchers concluded that smoking was the factor underlying the early links between coffee intake and psoriasis.

There’s also no evidence to suggest that coffee reduces the effectiveness of drug therapy in psoriasis20. In one survey of 21 patients with moderate to severe psoriasis undergoing treatment with a chemotherapy agent, researchers found that patients drinking more than 10 cups of coffee a week reported a small improvement in treatment response, compared to those who drank less. Researchers suggested this might be because caffeine prevents the breakdown of a compound called Cyclic AMP or cAMP, which affects cell growth. We know that the growth of skin cells is elevated in psoriasis, so this could potentially be of benefit.

While coffee doesn’t seem to affect the risk of developing psoriasis, the effects on psoriasis severity aren’t known. Some studies have found that reducing coffee as part of an overall change to diet (which typically involves an increase in fruit and vegetables and whole grains, a reduction in red meat and increase in omega-3 fats) can improve psoriasis severity 21 22.

Side effects

Because caffeine is a stimulant it can disturb sleep and aggravate anxiety 2324. If you suffer from sleep problems, avoiding caffeine in the evening can help to improve sleep quality25.

How much is too much?

It’s difficult to say, as different levels of caffeine affect people in different ways and there’s limited research in people with psoriasis.

In a recent report from the USDA, researchers concluded that 3 to 5 cups per day or up to 400 mg/d caffeine) is not associated with increased long-term health risks among healthy individuals 26.

What the dietician says

Although studies show coffee is commonly consumed by patients with psoriasis27, this doesn’t mean it causes the condition, and research has failed to find an association between coffee intake and the risk of developing psoriasis.

However, there’s not enough evidence to confidently say whether caffeine makes psoriasis better or worse once you have the condition.

As part of an overall change to diet, some patients find improvements in their psoriasis severity when excluding coffee, but this may be because the coffee intake is linked to other habits (such as smoking) or a poor diet in general, which can make psoriasis worsen.

We do know that caffeine can affect sleep quality – and this seems more of an issue in middle-aged adults than young adults28. People with psoriasis tend to have more problems sleeping29 and this can be emotionally challenging, so it’s worth evaluating how much coffee you drink, and evaluating whether it linked to other habits that need changing (late nights or processed food).

Bear in mind that it can take 6 hours or more for the stimulatory effects of caffeine to start to wear off 30, so if you are drinking coffee, it’s best to limit it to the morning to avoid it interrupting sleep.


Reference list

  1. Higdon J V, Frei B. Coffee and Health: A Review of Recent Human Research. Crit. Rev. Food Sci. Nutr. 2006;46(2):101-123. doi:10.1080/10408390500400009.

  2. Kavli G, Førde OH, Arnesen E, Stenvold SE. Psoriasis: familial predisposition and environmental factors. Br. Med. J. (Clin. Res. Ed). 1985;291(6501):999-1000. doi:10.1136/bmj.291.6501.999.

  3. Poikolainen K, Reunala T, Karvonen J, Lauharanta J, Kärkkäinen P. Alcohol intake: a risk factor for psoriasis in young and middle aged men? BMJ 1990;300(6727):780-3. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1662565&tool=pmcentrez&rendertype=abstract

  4. Li W, Han J, Qureshi AA. No Association Between Coffee and Caffeine Intake and Risk of Psoriasis in US women. Arch. Dermatol. 2012;148(3):395-397. doi:10.1001/archdermatol.2011.2933.Psoriasis.

  5. Zampelas A, Panagiotakos DB, Pitsavos C, Chrysohoou C, Stefanadis C. Associations between coffee consumption and inflammatory markers in healthy persons: The ATTICA study. Am. J. Clin. Nutr. 2004;80(4):862-867. doi:10.1016/S1567-5688(04)90099-8.

  6. Whayne Tf JR. Coffee: A Selected Overview of Beneficial or Harmful Effects on the Cardiovascular System? Curr. Vasc. Pharmacol. 2014. Available at: http://www.ncbi.nlm.nih.gov/pubmed/25277696

  7. Corrêa TAF, Rogero MM, Mioto BM, et al. Paper-filtered coffee increases cholesterol and inflammation biomarkers independent of roasting degree: A clinical trial. Nutrition 2013;29(7-8):977-981. doi:10.1016/j.nut.2013.01.003.

  8. Whayne Tf JR. Coffee: A Selected Overview of Beneficial or Harmful Effects on the Cardiovascular System? Curr. Vasc. Pharmacol. 2014. Available at: http://www.ncbi.nlm.nih.gov/pubmed/25277696

  9. Panagiotakos DB, Pitsavos C, Zampelas A, et al. The association between coffee consumption and plasma total homocysteine levels: The “ATTICA” study. Heart Vessels 2004;19(6):280-286. doi:10.1007/s00380-004-0779-3.

  10. Festugato M. Pilot study on which foods should be avoided by patients with psoriasis. An. Bras. Dermatol. 2011;86(6):1103-8. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22281896

  11. Whayne Tf JR. Coffee: A Selected Overview of Beneficial or Harmful Effects on the Cardiovascular System? Curr. Vasc. Pharmacol. 2014. Available at: http://www.ncbi.nlm.nih.gov/pubmed/25277696

  12. Cämmerer B, Kroh LW. Antioxidant activity of coffee brews. Eur. Food Res. Technol. 2006;223(4):469-474. doi:10.1007/s00217-005-0226-4.

  13. Farah A, Donangelo CM. Phenolic compounds in coffee. Brazilian J. Plant Physiol. 2006;18(1):23-36. doi:10.1590/S1677-04202006000100003.

  14. Kavli G, Førde OH, Arnesen E, Stenvold SE. Psoriasis: familial predisposition and environmental factors. Br. Med. J. (Clin. Res. Ed). 1985;291(6501):999-1000. doi:10.1136/bmj.291.6501.999.

  15. Poikolainen K, Reunala T, Karvonen J. Smoking, alcohol and life events related to psoriasis among women. Br. J. Dermatol. 1994;130(4):473-7. doi:10.1111/j.1365-2133.1994.tb03380.x.

  16. Poikolainen K, Reunala T, Karvonen J, Lauharanta J, Kärkkäinen P. Alcohol intake: a risk factor for psoriasis in young and middle aged men? BMJ 1990;300(6727):780-3. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1662565&tool=pmcentrez&rendertype=abstract

  17. Duffy DL, Spelman LS, Martin NG. Psoriasis in Australian twins. J. Am. Acad. Dermatol. 1993;29(3):428-434. doi:10.1016/0190-9622(93)70206-9.

  18. Naldi L, Parazzini F, Brevi A, et al. Family history, smoking habits, alcohol consumption and risk of psoriasis. Br. J. Dermatol. 1992;127(3):212-7. Available at: http://www.ncbi.nlm.nih.gov/pubmed/1390163

  19. Li W, Han J, Qureshi AA. No Association Between Coffee and Caffeine Intake and Risk of Psoriasis in US women. Arch. Dermatol. 2012;148(3):395-397. doi:10.1001/archdermatol.2011.2933.Psoriasis.

  20. Swanson DL, Barnes SA, Mengden Koon SJ, El-azhary RA. Caffeine consumption and […] dosing requirement in psoriasis and psoriatic arthritis. Int. J. Dermatol. 2007;46(2):157-159. doi:10.1111/j.1365-4632.2006.02954.x.

  21. Festugato M. Pilot study on which foods should be avoided by patients with psoriasis. An. Bras. Dermatol. 2011;86(6):1103-8. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22281896

  22. Brown AC, Hairfield M, Richards DG, McMillin DL, Mein E a, Nelson CD. Medical nutrition therapy as a potential complementary treatment for psoriasis–five case reports. Altern. Med. Rev. 2004;9(3):297-307. Available at: http://www.altmedrev.com/publications/9/3/297.pdf

  23. Burke TM, Markwald RR, McHill AW, et al. Effects of caffeine on the human circadian clock in vivo and in vitro. Sci. Transl. Med. 2015;7(305):305ra146-305ra146. doi:10.1126/scitranslmed.aac5125.

  24. Smith A. Effects of caffeine on human behavior. Food Chem. Toxicol. 2002;40(9):1243-1255. doi:10.1016/S0278-6915(02)00096-0.

  25. Sin CWM, Ho JSC, Chung JWY. Systematic review on the effectiveness of caffeine abstinence on the quality of sleep. J. Clin. Nurs. 2009;18(1):13-21. doi:10.1111/j.1365-2702.2008.02375.x.

  26. US Department of Health & Human Services. Scientific Report of the 2015 Dietary Guidelines.; 2015. Available at: http://health.gov/dietaryguidelines/2015-scientific-report/pdfs/scientific-report-of-the-2015-dietary-guidelines-advisory-committee.pdf

  27. Festugato M. Pilot study on which foods should be avoided by patients with psoriasis. An. Bras. Dermatol. 2011;86(6):1103-8. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22281896

  28. Robillard R, Bouchard M, Cartier A, Nicolau L, Carrier J. Sleep is more sensitive to high doses of caffeine in the middle years of life. J. Psychopharmacol. 2015;29(6):688-97. doi:10.1177/0269881115575535.

  29. Shutty BG, West C, Huang KE, et al. Sleep disturbances in psoriasis. Dermatol. Online J. 2013;19(1):1.

  30. Statland BE, Demas TJ. Serum caffeine half-lives. Healthy subjects vs patients having alcoholic hepatic disease. Am. J. Clin. Pathol. 1980;73(3):390-393.

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