When it comes to health and Wellness, the average American's favorite morning beverage has been the subject of intense study and debate for decades. A generation ago, physicians were trained to see coffee as contributing to myriad health problems, and to counsel patients against drinking it. Caffeine, like many stimulants, has been linked to insomnia and high blood pressure and thus was cast as an evil that could worsen a number of serious conditions. More recent findings, however, suggest that a "cuppa joe" may actually reduce the risk of certain diseases. To understand why, food and nutrition scientists have been looking at hovif specific compounds found in coffee, such as the recently touted green coffee extract (GCE), work within us. For many chiropractors, these efforts have resulted in a tricky web of supplements and scientific claims that can confuse patients.
Coffee, the hot brew with which many Americans start their days, comes from grinding the roasted seeds of a tropical berry. Called a cherry, the ripe fruit of the coffea plant has a red outer skin, a pulp of pale pink or yellow-green and a sticky pectin layer called mucilage. Under those layers is a pair of seeds, each with a hull (referred to as parchment) and a silvery paper-like skin.
Coffee cherries go through many steps in order to become green (unroasted) coffee ready for shipment to consumer countries. How this happens depends on a large set of variables that includes local traditions, access to roads and equipment and the technical knowledge of those who ready them for transport. Every method for processing ripe coffee shares some basic steps: The skin, pulp and mucilage must be removed, and most processes also include a way to get rid of the parchment. Larger scale operations tend to use wet processing, or soaking the pulped beans in water, to take the mucilage off Organic copanies wse liquid carbon dioxide as a solvent to extract chlorogenic acid from the green bean, and other companies use harsher chemicals.
This antioxidant-rich powder would not taste very good on its own. "The main compounds responsible for bitterness in coffee are actually chlorogenic acids," explains Mario Fernandez- Alduenda, a coffee consultant pursuing a doctorate in food science. The strong, astringent flavor, a result of exraction, bears little resemblance to the pleasurable, smoky notes created when the seeds are roasted. This is a major reason why pills or flavored products are the ways in which corporations have introduced GCE to consumers.
Chlorogenic acid, a compound derived from green coffee, has been available for years but has recently taken on the role of weight-loss agent in the minds of many consumers. Interest in green coffee skyrocketed in the past year in part because Mehmet Oz, M.D., the popular physician and TV personality, trumpeted the news that it could help people reset how their bodies burn energy and store fat. The message to "just take one pill 30 minutes before you eat three times a day, and then have your usual meal" is what most people remember, though Oz and other GCE proponents are careful to suggest keeping a food diary if using these supplements.
Judging by the number of related patent applications in the United States and Europe, plenty of corporate food and supplement proponents jumped on GCE's weight-loss bandwagon. The compound, which is essentially a waste product of getting coffee beans ready for roasting, is turning up in a wide variety of products from pills to powders, and prepackaged lattes to lightly sparkling sodas. While not all are marketed as dieting aids, many can be found in big box retailers, grocers and food cooperatives nationwide. Though present in small amounts in brewed coffee and espresso, substantially more of this antioxidant is available in GCE.
Delma de la Fuente, a dietetics student at Life University who volunteers at a food co-op in the Little Five Points neighborhood of Atlanta, has seen the diet fad first hand. "Green coffee-seekers have been streaming there to buy the product since it was widely introduced to America's afternoon talk-show viewing audience last year," she says. "Most of the time, I'd hear, 'I saw it on the show, and they said you can eat whatever you want and still lose weight.'" Because of this heightened consumer interest, de la Fuente expresses concern. "Most of the customers I encountered were not interested in hearing about the other elements of the weight loss equation: the appropriate ratios and quality of carbohydrates, fats and proteins and of course, good ol' exercise," she says.
Oz's initial enthusiasm for products containing chlorogenic acid drew similar criticisms, enough so that he dedicated an entire episode to his own investigation to see if women taking a GCE supplement lost more weight than those who kept a food diary and took a placebo. His two-week experiment found results that paralleled those of trials that supplement companies tout as proof of efficacy. But, like those studies, Oz's program only followed dieters for a brief period of time.
Danielle Ven- Huizen, a registered dietitian in Seattle, remarks, "Time and time again we see diet products come out that seem to work well in the short term, but in the end, the users gain the weight back. The supplement companies make money and the end user is left worse off than before." All this attention has many chiropractors and dieticians wondering why some in the Wellness profession are so excited about these products, how natural they are and how to counsel clients who have started taking them.
Michael Smith, M.D., host of the weekly "Healthy Talk" radio show on WWNN-AM in the greater Miami area, became convinced that the connection between insulin and sugar explained why many struggled to keep off excess weight after losing it. "Overwhelmingly, when I [measured] fasting insulin blood levels and [did] insulin tolerance testing of overweight or obese people, the results were just off the charts," Smith says, referring to his years as a weight-loss business operator. While these spikes are probably the result of years of poor dietary habits, companies that make GCE products use them as evidence that these supplements may help reset the body's metabolism through insulin regulation.
Medically supervised weight-loss programs involve testing liver and pancreas function because these organs are involved in the production and reuptake of insulin. Normally, pancreatic beta cells make insulin, but in people too fast. For those with insulin spiking issues. Smith recommends taking GCE supplements before eating because "chlorogenic acid inhibits two digestive enzymes: amylase, which breaks down starches in your gut, and alphaglucosidase, which breaks down the more complex sugars." This use of GCE dampens the peaks and valleys of sugar-insulin spikes.
A study published in Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy in January 2012 reported on another way this antioxidant interferes with how the body converts food for storage. "To make energy, we store it in ATP (adenosine triphosphate)—it's our energy currency. We have an ability to make energy from glucose, a carbohydrate. Our [bodies like] to do it," explains Jay Bugai, national educator for Garden of Life, a whole food nutrition company. "We have a store of carbohydrate in our liver in the form of glycogen. When we want to tap some of that, we need this enzyme." Chlorogenic acid also has direct effects on insulin-regulating organs: It helps beta cells in the pancreas respond better to insulin and increases the signal proteins for insulin receptors in liver cells. The net effect is an overall increase in the body's sensitivity to insulin.
All the health care practitioners reached for comment on this diet supplement fad incorporate some elements of vitalism into their clinical practices, and many remain unconvinced of the benefits of GCE supplementation. "By extracting chlorogenic acid from the coffee bean, we are losing that synergistic effect of the whole bean and its various components," explains VenHuizen. "In fact, anything in excess, including chlorogenic acid, while having positive effects in some aspects, may throw the body off in other ways that we are not yet aware of." She urges caution when using anything in excess or in concentration and supports the use of whole foods to achieve balance. For her part, de la Fuente also prefers a "food first" approach to helping patients maintain health. "Some vitalists believe we can get absolutely everything we need from our food, and I am one of them," she says.
The green coffee phenomenon and other diet fads represent an opportunity for DCs to have an honest conversation with one another and their patients about nutrition and the role of supplements in our daily lives. While some initial findings may support GCE's role in weight loss, its use may not always represent the most vitalistic pathway to overall health and Wellness.
By Jenny Neill, Today's Chiropractic Lifestyle