Unfiltered Coffee And Cholesterol

Cholesterol warnings have a way of flattening any nutrition story into one scary number, even when the bigger picture points the other way. We take on one of our favorite topics coffee and zoom in on the debate that keeps resurfacing: should you avoid unfiltered coffee because it contains cafestol, a compound known to raise cholesterol modestly?

We break down what actually changes when you switch from filtered coffee to unfiltered coffee methods like French press or Turkish coffee. Paper filters remove much of the coffee oil fraction, including diterpenes such as cafestol and kahweol, while leaving plenty of other valuable compounds like chlorogenic acids. Then we ask the more important question: if coffee consistently shows protective associations for cardiovascular health, metabolic health, and even brain health, why do so many public health messages treat a small lipid bump as the final verdict?

From endothelial function and inflammation to insulin sensitivity, fat oxidation, and LDL oxidation resistance, we explore why cafestol may be far more beneficial than the headlines suggest. We also connect this coffee debate to a broader problem in modern nutrition and medicine: prioritising a single biomarker over lived outcomes and overall risk. Finally, we get practical about brew choices, lighter roasts, steep time, and the easiest way to ruin a great cup by adding sugar, synthetic creamers, or highly processed sweeteners.

If you love coffee, keep loving it ! 

For video recording and slides: www.thehealthedgepodcast.com

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Transcript

Welcome And Summer Sports

SPEAKER_00 0:00

Welcome to the Health Edge, translating the science of self-care. I am Mark Pettis and with my friend and colleague John Bagnulo. John, good morning.

SPEAKER_02 0:08

Hey, good morning, Mark, and happy July. It's great to see you, buddy.

SPEAKER_00 0:12

Great to see you. Happy July. Well into the summer season. A lot going on around the world. And uh I've been um uh enjoying some of the soccer. I'm not a big soccer fan, but just the organization and coordination of this World Cup and the passion that these fans from all over the world have uh, you know, showing up at these games and the garb, the color. It's it's really kind of a cultural phenomenon. So uh even though I don't understand the game of soccer that well, I've I've enjoyed that a little bit. And of course, you know, baseball is in full swing and and soon uh the football season will be gearing up. So for the American sports enthusiasts, it's a a fun, a fun time right now.

SPEAKER_01 1:07

Um yeah, the passion for that the global passion for for this this World Cup action is incredible. It's incredible.

SPEAKER_00 1:16

It really is. And I've I've come to a of course, I grew up at a time where soccer was not uh you know the primary sport as it is today and in at the youth level and high school level. And um, it was generally all about baseball in in my neighborhoods growing up, and so it's come a long way, I think, um, as a uh popular sport in the US, but you can really appreciate how soccer is kind of the sports language of the world. Yeah um and there's something kind of fun about some of these small countries bringing these huge constituencies to their to their games and the competition, and so uh yeah, yeah.

Why Coffee Keeps Winning In Research

SPEAKER_00 2:03

So we had we one of our favorite topics is coffee. Without a doubt. It's our it's our it's our favorite uh beverage and one of our favorite uh subjects for for reviewing and interpreting clinical studies uh and public health messaging, and um uh all of our podcasts are unfiltered, and as this one will be unfiltered, and it will bring us to this theme that you brought to my attention recently, John, in your Substack posting of some of the attributes of unfiltered coffee and the uh disconnect between global health benefits and as weighed against uh this obsession with cholesterol. And and so uh we've got a paper we can look at, and I know you've got a lot to say and share about this topic, John, but coffee um is always a topic worth uh revisiting.

SPEAKER_02 3:10

Yeah, it is, you know, because I I think it's fun for so many reasons. I mean, number one is it's the third most commonly consumed beverage in the world, right? So you immediately have just massive numbers of people drinking coffee, but that coffee's in like thousand different forms. And so you can you can really start to pull things apart, uh, you know, in terms of the research around it, looking at different forms of coffee, how it's brewed, different types of beans, how those beans are roasted. So it's fun on that level, like when you get into some of those qualitative components of it. But you know, you and I have talked in the past about how favorable the data is about coffee in general, which, you know, I don't know, it wasn't that long ago. And many people, right? Not just, you know, not just health professionals, but even researchers had had serious questions about coffee. You know, did it contribute to hypertension? Now we know that it's protective. Um, because again, you know, caffeine had, I think caffeine's been, you know, I think it's been like misrepresented by and large, as because it's a stimulant and because it, you know, some of the effects it has that, you know, people looked at it as something that maybe had more adverse effects on health than favorable. We know now that that's that's just not the case. Um and I think that, you know, caffeine is just like, that's just on the surface. When you really start to get into the complexity of the of the different molecules and the phytonutrients found in in coffee beans, it's an incredibly complex uh food or beverage that brings so much to our physiology in the way of anti-inflammatory benefits, antioxidant benefits. Uh, you know, the list obviously grows each passing year. So, and it's something that a lot of us enjoy. You know, you and I obviously talk about it uh because of that as well. Like it's something we enjoy, but it's also healthy, which is which is remarkable because a lot of people don't have something like that in their diet or in their daily life, right? Something that they really enjoy, but also is good for them. So I liked all of this kind of the mayu, so to speak, of all of this. And one thing that has always caught my attention, Mark, is how different cultures enjoy coffee on a regular basis. So, like, you know, in the Middle East, for instance, um, and in countries like Turkey, the coffee's boiled like extensively. And then that coffee is just decantered off the top. So, you know, you're gonna end up with some sediment, you're gonna end up with all these oils that are part of that coffee being in your in the cup that you ultimately consume. And how is that different than, let's say, the cup of coffee that someone gets that, you know, is more or less mass-produced and run through several different types of filtration processes

Filtered Versus Unfiltered Coffee Explained

SPEAKER_02 6:05

or a paper filter if it's at home. Boy, those are really different cups of coffee in the end. And the good news is here for our listeners is that both cups are both cups can be really beneficial. But it's interesting that that that certain like health, public health advocacies, individuals that do a lot of, you know, have a lot of exposure or, you know, trendsetters, so to speak, in the area of nutrition and health, they advise against consuming unfiltered coffee because of its high cathistol content, which can raise cholesterol levels modestly, very modestly. It's not like we're seeing massive jumps here. But I think it's ironic that we're going to advise people to limit their consumption of unfiltered coffee based on cathistol content, because we know cathistol is so beneficial to the body for so many reasons, right? I mean, it it makes people more insulin sensitive, number one. Um, it tends to really promote more fat oxidation or beta-oxidation. We tend to burn more body fat. I mean, it's just got all these great benefits. But because it has a slightly cholesterol-raising effect, you know, there's people are taking the time to put out these public health messages, which, whether it's the American Heart Association or the Harvard School of Public Health, I just find it fascinating that these organizations are putting unfiltered coffee in their crosshairs despite the evidence we have around it. Neuroprotective benefits. I mean, there's there's studies show that it really helps prevent, you know, the tau uh tangles. And so it's just, it's just a really fascinating topic because I think it embodies so much, um, but it does shine light on this uh how cholesterol, how any how with where whatever happens to someone's cholesterol, that's what really kind of is let leveraged against any given food, or in this case a beverage, right? Like if it raises your cholesterol levels, like how can cheese, how can cheese be a good food? When we know that the studies on cheese consumption shows that it's very protective, right? That it you you have a reduced all-cause mortality in large studies with the more cheese you eat. And you know, we know the same thing about coffee. And unfiltered coffee is no exception, yet, again, just because of how it influences cholesterol levels, like that's how foods are determined to be healthy or unhealthy. So for me, that's fascinating.

SPEAKER_00 8:50

Yeah, it that's such a great uh summary framework that you've outlined there, John, and it's very uh aligned with this recurring theme that we often focus on in our health edge discussions, where um evidence and this growth of experience parts ways with consensus thinking. And the extent to which consensus thinking on the social psychology of it is so resistant to seeing what is right in front of your nose. Uh and it it makes me think of the

The Cholesterol Obsession Problem

SPEAKER_00 9:35

um uh you know, consulting, working with a client, and let's say it's Mrs. Smith and she's overweight and she's a diabetic and hypertensive, and and you know, her um uh lipids are not in a very good place, and you put Mrs. Smith on a carbohydrate restricted, higher fat, higher protein, and two months later she goes to see her doctor and follow-up, and her weight is down 20 pounds, her pressure's down, her insulin resistance has disappeared. Mrs. Smith says, I feel better than I've ever felt. And and then the doctor will look at Mrs. Smith and say, You're eating way too much fat. Um, don't you know you're killing yourself? Yeah. Occasionally they might say, Well, just keep doing what you're doing. Uh but the ability to break from a belief system that is so deeply entrenched, uh, that that challenge is so formidable, particularly in the medical enterprise, uh, that uh what is that which is obvious becomes harder to see. And and this is just another great example of that, John. So we have a paper, and I know there are many papers you've reviewed, and and I would highly recommend John's Substack to anyone who likes a deep dive. Um, it's just really beautifully done what you do, John. Uh, but this this topic um highlights uh the the 99.9% benefits of a whole food uh that cannot be extracted from a single lab value that has that we now know today has very little, if any, bearing on on outcomes, cardiovascular or otherwise.

SPEAKER_02 11:38

Your analogy, Mark, your analogy about the patient is spot on because you know what we see with so many aspects of diet and nutrition is we see improved outcomes, but the biomarkers don't align with what the system believes they should move in the direction, right? So, you know, in this case, all the studies on coffee consumption, filtered, unfiltered, show all of these amazing benefits. But all of it, all of it is washed away by the final statements in so many papers that go along the lines of something like, yeah, these results are surprising, these results are, you know, shine light on the potential of this food or this beverage. But we also know that these foods or beverages raise cholesterol levels, so caution should be used. Yeah. And that, you know, again, it just washes away the significance, I feel, of of many of these findings. And this is this is no exception. But it's it's that inability to appreciate outcomes and stay focused on a particular biomarker, which to your point that you just made, we know has very little value, very little value.

SPEAKER_00 12:56

And the experience, the other unintended consequence of just to that use that analogy that we were we were talking about with the sort of the patient-client encounter, is that the experience of that individual, which has been profoundly transformed, is dismissed, completely dismissed in the eyes of the expert who cannot move beyond a paradigm that that allows them to see things differently. And um it it's it's pervasive. And we've talked about this in in many other episodes. You've talked about um full-fat dairy, John, and we've looked at this with eggs. Um we we we've talked about this a lot with sunlight. Um all of the you know, it's the lottery. It it is winning the lottery every time you go out into sunshine, and yet the expert cannot move beyond the this connection between ultraviolet light and skin cancer. And it all ends there. Uh and it's uh I think it's um it it always gives me pause um uh as a clinician, and um it it uh makes me realize more and

When Biomarkers Override Real Outcomes

SPEAKER_00 14:20

more of the importance of people taking more of their health matters into their own hands, this sovereignty of your your body, your health, and and a growing awareness that the experts um aren't nearly as expert as they think they are. Um this is this uh is the scientific community, the medical community, unfortunately, in my opinion, has become so dogmatic uh that despite this um pervasive discontent with the system and and and how people are received, um that that train continues to sort of move forward with it it's unfortunate. And yet, if there's a silver lining to it, John, I think it's people are becoming more empowered from the experiences that they're having. Uh I've never felt better, you know, with with some of the things that I'm currently doing. Um I my doctor says this, and I'm experiencing this. I the the um Harvard School of Public Health, you know, just you know, they just crank out these papers. Uh you know, they're uh an epidemiologic public health publishing machine. Um and yet, you know, the we've often talked about the shortcomings of those methodologies and the difference between correlation and causation, and yet those those caveats, those big disconnects really struggle to find their way into the enterprises that we look to to guide us. And so I it's it becomes easier to understand why people are so untrusting of the expert, of the headline, and and and sadly for me, I don't see um the incentive shifting in a way that is likely to bring great change to that, because I do think these are enterprises that are just riddled with uh perverse incentives and uh and biases and and the inherent challenges of of uh uh locked-in beliefs. And um those are uh hard things to sort of get around. But um so let's look at this. I've got some a few slides, John, that I'll let you

Meet Cafestol And Coffee’s Key Compounds

SPEAKER_00 16:45

run with. And these are uh really they epitomize all that you um uh summarized uh with respect to the the many, many benefits, the mechanisms that are felt to underlie those benefits. Thank you, Mark.

SPEAKER_02 17:06

I really appreciate you putting these together. This is you know awesome for our listeners.

SPEAKER_00 17:12

And the other thing, John, I'll I'll just touch on one last thing before I I kind of hand this over, because you you touch on this often. When I look at a paper like this, um uh and the um the sophistication of the of the science and the mechanistic uh uh uh evaluation assessment, um you you're reminded, I mean, here we're talking about kaphistol, we're talking about one of just a uh uh thousands of these bioactive molecules. Uh it's really uh breathtaking for me when I am reminded at the diversity of biologic output that one sees as a consequence of consumption of these bioactive compounds. The biology is just um uh incredible. And and and you see that here with this particular molecule. So anyhow, Sean.

SPEAKER_02 18:15

Yeah, no, absolutely, Mark. So I chose caffistol for a couple reasons uh to highlight here. Number one, it's one of, I'd say, the five most well-known, studied, um, and appreciated phytonutrients or compounds found in coffee. The others are uh cowiol, which is also a diterpene. And then there's obviously chlorogenic acid, right? There's caffeine. Um, you know, you you've got these, again, these really, like you just said, these really amazing substances found in coffee. And I, but I chose caffistol because it's one of, it's one of the more controversial, I guess, would be the best way to describe it. It's one of the more controversial or kind of catch-22 nutrients. That's how most health professionals would consider it, because it does increase cholesterol levels somewhere. It's very, very subtle. It's like, I think it's 1.3 milligrams of cholesterol per deciliter, right? So if you had a serum cholesterol of, let's say, 200, for every cup of coffee you have per day that's unfiltered and contains caffestol, you're raising your cholesterol levels around 1.3 to 1.4 milligrams per deciliter, which is, again, if you have five cups of coffee, you're gonna be at a two, at the end of a month, you might, your cholesterol might be 207 or 208. So these aren't massive changes. Statistically, they're very, very small. But that being said, again, the the lens at which foods, in this case, a beverage is looked at, is as often, you know, really skewed by the how they change cholesterol levels. So that's I chose caffistol because it it will be removed

Anti-Inflammatory And Metabolic Effects

SPEAKER_02 20:05

from unfiltered. It will be removed from filtered coffee. So the paper filter is going to clear the cowil, it's gonna clear the caffistol. All of that is really, it's found in the oily, um, the oily components of a coffee bean, which a lot of times you'll see on the surface of a cup of coffee if it is unfiltered. But uh and so you have this molecule which is really easy to um to say, okay, it's infiltered, it's not, it's not in filtered coffee, but it is in unfiltered coffee. So we can kind of go from there with it. And it serves a purpose as like if you see all the benefits, the benefits that cathistol provides to human physiology, especially in this case with the lining of the of the artery, the endothelial lining, which is maintained, like it's more subple, more elastic, like when there's caffistol in metabolism in place. So, you know, I think that really speaks volumes to the nature of this. Because cathistol, again, being found in unfiltered coffee, it is the reason why certain organizations say don't drink unfiltered coffee because it's going to raise your cholesterol levels. However, when you see the research on caffestol and you see how favorable it is with respect to inflammation, but also when you really get down to the mechanism on the endothelial lining, it's really clear that here's a substance that might be as medicinal as anything found in coffee. And yet we're advising, you know, we're advising people not to drink unfiltered coffee because of the caffistol. So it's just, it's really a it's a backwards way of approaching this, a lack of critical thinking, obviously. Um so I really like it on that level. But you know, caffestol, as you can see, it contains all of those. Those rings that have the hydroxyl change makes it an antioxidant. Just by looking at it, it's very easy for it to give up hydrogens or electrons to neutralize free radicals. It also shares that ring structure with many other anti-inflammatory compounds. It is fat-soluble, and I think this is also a really important part of the conversation. When our bodies transport cholesterol in these LDLs, these low-density lipoproteins that everybody knows as bad cholesterol, when catfistol is transported in those LDLs, it has a very, very powerful antioxidant effect in terms of protecting the LDL. So, and this is also true of cowiol, which is the other diterpene. Both of those, because they're fat soluble, they're going to be in the lipoproteins, they're going to make those LDLs much more resistant to oxidation. So that in itself is also very protective. If you have something in those LDLs that protects those LDLs against oxidation, that in itself makes it very beneficial with respect to risk reduction with respect to heart disease. There's also evidence where these fat-soluble substances increase the size and the buoyancy of the LDL. So that also makes it resistant to oxidation. So you have all these things really working in favor of LDL qualities, which is all none of it's really discussed or appreciated on this epidemiological front. So that's why I think catfistol is a fascinating molecule to use as a what we call like a surrogate or a marker, a tracer, so to speak, for the food in itself. If you have more catastolyn in a food, sure it's going to raise cholesterol levels very modestly, but it's going to offer this host of benefits, not only to those lipoproteins, but to other areas of our physiology. So that's why I found this paper, you know, just really a it's a really kind of big overview of that molecule's interaction with different facets of our cellular physiology. And in this case, you can see liver lipid metabolism. Um, but you're only going to get caffistol in unfiltered coffee. And so that's really, you know, a big part of the reason that I included it here in this.

SPEAKER_00 24:24

Yeah, great, great overview, John. And this this graphic summarizes uh

LDL Oxidation And Why Context Matters

SPEAKER_00 24:30

many of the uh positive effects, not just cardiovascular, lipid, uh, anti-inflammatory, anti-oxidant, all of the all of the sort of the uh uh these are these are the metabolic drivers of aging and longevity. Uh and so if if uh big pharma were involved in a uh drug discovery, looking at the plant world and trying to isolate compounds that had potential for future pharmacologic development, you'd look at this and you'd say, Oh man, we let's get that in a pill. Look at all of the amazing things that that this this does. And um you and this is just another graphic. Uh apologies to those that are listening to this and can't see these slides. We'll we'll put them up on our uh website. But um uh, you know, these are um whether it's uh uh fat oxidation, as you point to, John, um, and and you the beta oxidation of fat, allowing you to burn fat more effectively, uh reducing fatty liver, reducing visceral fat, um, these effects on uh literally uh these epigenetic effects on gene expression. And we we we've talked a lot about NF kappa B as a sort of a master molecule for inflammation, uh which goes down here. Um and then the you know the endothelial uh and the reactivity of these of these blood vessels and capillaries. I mean, all of these things we know to be central to cardiovascular health, to brain health, and certainly um one I think could extrapolate that to just um uh longevity and and aging, and and some of that we're beginning to see with uh DNA methylation uh uh values and biologic clock uh analysis as that technology continues to evolve. So um and and then and then this important distinction, John, right? Between uh there would some some who, as we touched on, would say, well, um cathistol, you know, raises cholesterol. Uh that a priori is unacceptable to me. So if you're gonna drink coffee, make sure it's filtered. Uh the opposite school of thought would be uh in doing so, you're depriving what might be one of the more valuable bioactive compounds in coffee. And if and if you love coffee, consider drinking it uh non-filtered, as you say. Uh and that to me just makes so much more sense. But that it it's um it's a much more nuanced sort of take on this uh research.

SPEAKER_02 27:31

Yeah, and again, the good news is if you like filtered coffee, that still has great benefits. So it's not as though you have to you have to change the way you know you drink your coffee. Um, but I do think it just highlights that just kind of lack of critical thinking. Um, and as you pointed out a moment ago, just a dogma around food and this lipid theory. Because it is, again, it's a theory. It's not, it's, it's, it's never been fully validated, that's for sure, right? And it's, you know, it's one of those things where heresy becomes uh after a certain point, it just becomes accepted. Yeah, regardless of the lack of science or the lack of a mechanism. It's it's you know, it's remarkable. But I um I'll just and again, I'll kind of conclude on this with respect to caffistol and it its benefits. It's it's fat-soluble, right? And and so is cowiol, both of those are. Um and then there are the water-soluble components, chlorogenic acid as well, which is just as remarkable in terms of the benefits. And chlorogenic acid is found in filtered coffee. Um, but the thing about chlorogenic acid is the longer coffee beans steep

How To Brew For More Benefits

SPEAKER_02 28:50

in hot water and the lighter the roast of the bean, the more chlorogenic acid. So we do have control over that variable as well. And I highlight this because you said it just a moment ago, here you have more of a whole version of a food than a than refined, right? So we're leaving some of the oils from the coffee bean ultimately in that cup of coffee. We're leaving very, very small amounts of solids in that cup of coffee because it's not ultra refined. So it's interesting that you've got this, because coffee is really a fruit. It's a member of, it's a berry, right? It's a berry with high antioxidant value. And we know that berries across the board offer us so much. Um, so here you have a plant-based food. This is where I find it really, I find this really funny. So we're told, you know, eat more plants, eat whole plants, um, and that if you eat whole plants, like things tend to always work out well for human health, right? Well, we've got a great example of it here where we're eating, it's a plant-based food rich in antioxidants, a member of the berry family, so to speak. I know it's not in the vaccinium family like blueberries and cranberries, but it's a berry. It has all the attributes that we see in other berries. Um again, plant-based. We're recommending that you have it in more of a whole version than a refined version. Yet, wait a minute, but we got there's a catch with this one.

unknown 30:15

Right?

SPEAKER_02 30:16

There's a catch with this one. This is the one more whole plant-based food from the berry family we don't want you to have because it might raise your cholesterol levels. That's where the irony really comes in in all of this, right? So, you know, I chuckle about that. Um, but yeah, we we have uh you have 101 different ways you can make coffee. Uh, you know, and I think that if people are open to it, try a lighter roast, uh, let it spend a little more time in hot water, whether that be something that you're percolating, whether that be in a French press, and you might like it, and you might end up with a lot more in that cup of coffee than, you know, than you than you'd imagine.

SPEAKER_00 30:56

Yeah, that's a that's a great summary and a good note to uh conclude on, John. Uh and as we often talk about in our coffee conversations, it's really what you it

The Fastest Ways To Ruin Coffee

SPEAKER_00 31:10

it put in the coffee that can negate so many of the benefits, whether the coffee is filtered or not. And um uh these are these are um really big issues. Uh if you are using a lot of sugar and these synthetic creamers and sweeteners, many of these potential health benefits uh become negated.

SPEAKER_02 31:33

And um, it's a great point. That's a great it's a very important point, you know, especially with you know with the use of artificial sweeteners and a lot of these non-dairy creamers that are made with seed oils and they're hydrogenated. Uh right. There's a some of those non-dairy creamers are basically chemical cocktails. Exactly. The fastest way to adulterate a beautiful cup of coffee.

SPEAKER_00 32:02

Exactly. Well, great discussion, John. And uh I'll make this this paper available with in our slides on our website. If you love coffee, keep loving it and uh honor it for all that nature uh uh places in these remarkable plant-based molecules. And and and it's a it's a good reminder, John, as we often talk about, when you start to embrace a more sort of holistic view of this ecosystem, isn't it interesting that uh that a berry that we call coffee, uh when consumed in a minimally adulterated way, uh just these these molecules are seem familiar to human biology. There's a there's a relationship there. These aren't random uh events, uh and so you really see this sort of co-evolution of of our species, the plants that that we cohabitate with, um, and the extent to which uh we probably have everything

Resources, Slides, And Closing

SPEAKER_00 33:10

we need in the ecosystems that we subside in to address most of our uh health needs. And and so this is just another good example of a plant that does many, many amazing things.

SPEAKER_02 33:22

So that's thank you, John. That's well said. Well said. Thank you, Mark. I really appreciate it.

SPEAKER_00 33:30

We appreciate people listening to the Health Edge. Um please share this content with friends and family if if you find some value there. We do have a YouTube channel for those that that want to uh see the slides with this. Uh just go to the uh the Health Edge um on YouTube. And uh there's you know, there are no membership fees, we don't we don't accept any sponsorship. So everything that we put out there is just for you and for anyone who's interested. And our website is thehealth edgepodcast.com, and that that has a nice repository of references and slides, and and we uh appreciate uh people listening in. And uh, John, enjoy this uh summer season, and I hope to see you next week.

SPEAKER_02 34:17

Absolutely, Mark. You as well. Take care, buddy. Peace, brother.