[HN Gopher] Caffeinated coffee consumption or abstinence to redu...
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       Caffeinated coffee consumption or abstinence to reduce atrial
       fibrillation
        
       Author : stared
       Score  : 56 points
       Date   : 2025-11-15 19:43 UTC (3 hours ago)
        
 (HTM) web link (jamanetwork.com)
 (TXT) w3m dump (jamanetwork.com)
        
       | zengid wrote:
       | love to hear good news even if it's a relatively small sample
       | size. anecdotal, but i've heard that the antioxidants in fresh
       | ground coffee is also very good!
        
       | embedding-shape wrote:
       | > If allocated to caffeinated coffee consumption, patients were
       | encouraged to drink at least 1 cup of caffeinated coffee (or at
       | least 1 espresso shot) and other caffeine-containing products
       | every day as per their usual lifestyle
       | 
       | I tried to skim to figure out how much caffeine/ml was actually
       | in the drinks, but seems the researchers don't know themselves
       | either? Wouldn't there be a huge difference depending on the
       | beans, how it's made and so on? 1 espresso can be made very
       | strong with packed coffee, or it can be made very weak, "1 cup of
       | caffeinated coffee" basically says nothing at all, unless I'm
       | missing the true definition elsewhere in the paper.
        
         | brnt wrote:
         | A weak espresso sounds like you're just making a small amount
         | of American/German coffee. How could that be passed of as an
         | espresso? It's not just a measure of volume.
        
         | wcunning wrote:
         | James Hoffman did some interesting videos on that -- espresso
         | is a more efficient extraction method than Aeropress, but less
         | complete than a very high water to coffee ratio pour over for
         | the same weight of ground coffee. Extraction of caffeine is
         | very directly tied to contact time and temperature, so two
         | double shots of espresso (40g coffee) can actually be less
         | caffeine extracted than a single large pour over (25g coffee)
         | when the pour over is upwards of 22% extraction (typical of
         | 20:1 water to coffee ratios and modern zero-bypass brewers).
         | Similarly, there are large differences in beans, so 22%
         | extraction on weak caffeine beans might be way less than 18%
         | extraction on much higher caffeine beans. This is most obvious
         | in the fact that Robusta has much higher caffeine on average
         | than Arabica. Also, 22% extraction has a lot more unpleasant
         | bitter compounds, not just more caffeine, so it's not my
         | preference for taste in general.
        
           | sroussey wrote:
           | Coffee makes me jittery but espresso (or lattes) do not. Is
           | this why?
        
             | nosianu wrote:
             | Maybe?
             | 
             | As an espresso drinker with a good machine and grinder, and
             | lots of variety with mostly Italian beans, it depends, as
             | the OP already indicated. I only buy low or at most middle
             | caffein content beans to begin with, but you can get high
             | caffeine beans for espresso easily. Easiest method:
             | Increase the amount of Robusta.
             | 
             | Good vendors should have things like caffein content in
             | their product description. I mostly buy from an online
             | vendor that lists the exact roast date and also shows
             | caffein content for each product (https://www.espresso-
             | international.com/ - their only disadvantage is the use of
             | some pretty light GRAY for most text, another topic, too
             | many websites do this for reasons I cannot understand).
             | 
             | Many years ago, when I still lived in the Bay Area, the
             | Cappuccino I got at a certain Berkeley coffee shop always
             | made my heart go BOOM BOOM BOOM. Whatever concoction they
             | brewed certainly had very high caffein (and I hated it, but
             | the place was great). The ones I make myself now I can
             | drink at 10 pm and be completely fine (I only drink 2-4 max
             | espresso per day, and can easily drink zero if I'm away and
             | have no access to good espresso, so I'm not addicted and
             | just "used to it").
             | 
             | Sometimes I compromise and buy medium caffein beans when
             | it's something good, but those I can feel just a little.
             | 
             | All of that just means you have to exert some control over
             | which beans you consume, if you want to keep caffein low.
             | On the plus side, if you stick to 80%-100% Arabica (the
             | rest Robusta) it's not hard at all. If you like mixes with
             | high Robusta ratio it gets much harder. Caffein free roasts
             | exist though (examples: https://www.espresso-
             | international.com/decaffeinated-coffee), but that choice
             | severely limits your options.
        
             | jorvi wrote:
             | Yes, but it might also be that you're drinking "coffee" (I
             | assume you mean drip / pour-over) in the morning when you
             | are just out of bed and have almost nothing in your
             | stomach. Whereas the espresso you're drinking at a shop
             | later in the day, probably already with breakfast in your
             | stomach and maybe you're ordering a snack with it.
        
             | dilyevsky wrote:
             | Espresso beans typically have different (darker) roast
             | profile from filter so some of it maybe due to that
        
             | wcunning wrote:
             | The biggest thing is what kind of "coffee" you mean by
             | coffee -- cold brew in particular tends to be a much higher
             | extraction % since the bitter notes you get on higher
             | extractions are less noticeable at colder temperatures. The
             | rest is what the sibling responses mention -- time of day
             | and speed of absorption in the digestive system can have
             | big impacts.
        
         | AJMaxwell wrote:
         | It's probably whatever "1 cup" means to the patient. The
         | researchers would want them to stick to their status quo for
         | the best results.
         | 
         | For example, 1 cup of coffee for my wife involves a blend of
         | coffee and espresso beans with no adders, but 1 cup to her dad
         | means lighter roast bean with milk. Both options have different
         | caffeine contents and nutritional values.
        
         | dehrmann wrote:
         | I researched this a bit and found there really is no
         | standardized "cup of coffee" for research purposes. Even for
         | volume, I've seen it range from 6 to 12 fl oz. The main
         | mechanisms of action are caffeine and flavonoids, and there's
         | so much variation across beans and brewing methods that you'd
         | think researchers would try to include that in their data to
         | normalize it.
        
         | _alternator_ wrote:
         | They were advised to drink at least one cup per day IIUC /
         | maintain their current lifestyle. So there is no consistent
         | amount, but it's still meaningful vs being advised not to have
         | any caffeine.
        
       | hereme888 wrote:
       | Poor title. This is specific to patients who already underwent
       | cardioversion (shocking the heart back into normal rhythm) AND
       | were habitual coffee drinkers, who now have reduced coffee to 1
       | cup/day rather than sudden complete abstinence. Recurrence at 6
       | months was 47% instead of 64%. And this only applies to those who
       | don't have clear caffeine-associated episodes.
        
         | carbocation wrote:
         | To add more information, the intervention was _guidance about
         | caffeine intake_. From the Methods:
         | 
         | > _If allocated to caffeinated coffee consumption, patients
         | were encouraged to drink at least 1 cup of caffeinated coffee
         | (or at least 1 espresso shot) and other caffeine-containing
         | products every day as per their usual lifestyle. It was
         | recommended that patients in the coffee consumption group not
         | intentionally increase or decrease consumption of coffee or
         | other caffeine-containing products._
         | 
         | > _If allocated to the abstinence group, patients were
         | encouraged to completely abstain from coffee, including
         | decaffeinated coffee, and other caffeine containing products._
        
         | 827a wrote:
         | The people who were selected into the study were not
         | necessarily "habitual coffee drinkers". The only requirement
         | was "was a habitual coffee drinker sometime in the past five
         | years". The difference between the two is subtle, but its
         | possible there were people in the study who had already
         | abstained for some amount of time.
        
       | FrankWilhoit wrote:
       | I, too, have found that in the presence of a-fib, the optimal
       | amount of caffeine is not zero; but I must think that every
       | patient is different. Most people with diagnosed a-fib also take
       | a beta blocker, and I (just only me) found that an excess of the
       | beta blocker had paradoxical effects. So there is another
       | potential interaction. Then, I also voted myself a small dose of
       | OTC lithium, and subjectively derived obvious and substantial
       | benefit from it, but there is (as yet) no science behind that, so
       | I will not assert causation.
        
       | bell-cot wrote:
       | In the context of HN, the title is fairly misleading.
       | 
       | Suggestion: Got to the article, hit PgDn a few times, and look at
       | the "Visual Abstract" graphic - which is both _very_ short, and
       | packed with important details.
        
       | jerlam wrote:
       | > The DECAF Randomized Clinical Trial
       | 
       | > The DECAF (Does Eliminating Coffee Avoid Fibrillation?)
       | trial...
       | 
       | Fantastic naming.
        
       | silexia wrote:
       | The title does not match the conclusion. I would like to see
       | lifetime abstainers from caffeine vs regular coffee drinkers.
       | Remember caffeine is a form of a neurotoxin.
        
       | theoldgreybeard wrote:
       | I've been doing my own personal experiments on myself trying to
       | reduce caffeine intake to help with stress and anxiety. I've felt
       | much better with just a small cutting back of my caffeine intake
       | by taking my "main" cup of coffee (12oz cup) in the morning like
       | I usually do and then just drinking 1/3 caffeinated, 2/3 decaf
       | the rest of the day and going full decaf after 2pm if I have any
       | at all.
       | 
       | I used to drink minimum 36oz (~150mg of caffeine per cup) of
       | coffee per day and it was just turning me into an absolute wreck
       | and just cutting back that little bit has made a huge difference.
       | So instead of 450mg of caffeine, I'm getting ~270mg, so just a
       | little above half the intake and it's made a huge difference.
       | 
       | A-fib just seemed like a natural consequence of the "caffeine
       | peak" and reducing my consumption helped quite a bit.
        
         | veverkap wrote:
         | Have you compared any other factors? I find that my most
         | consistent factor for a-fib is dehydration.
        
           | theoldgreybeard wrote:
           | I would say it does. Lots of things improve overall when I am
           | sufficiently hydrated...but I pee way more lol
        
         | iancmceachern wrote:
         | Me too, less caffeine means less stress and anxiety for me.
         | 
         | The key is to find other warm beverages to drink and get
         | protein and sugar into you in the morning.
         | 
         | We've been loving Golden Lattes!
        
         | _alternator_ wrote:
         | Note that study suggests that coffee consumption decreases
         | arrhythmia. (The title is horribly confusing, I know.)
         | 
         | From a quick skim, the protocol seemed to be "advise the
         | patient to drink at least one cup of coffee per day or continue
         | drinking your usual amount." So it seems the results don't
         | track with your experience (or my own experience of improved
         | stress and happiness when I cut down on coffee) which is why I
         | think it's surprising / possibly a fluke.
        
         | hereme888 wrote:
         | I've found great difference in how I feel based on the source
         | of caffeine.
         | 
         | From best to worst, for me: Yerba mate > healthi-ish energy
         | drinks > white/green/black tea > coffee.
         | 
         | Coffee almost always results in significant anxiety (at same
         | caffeine dose), jitteriness, and acid reflux. Yerba mate is by
         | far the best for me.
        
       | _alternator_ wrote:
       | The quick summary is that being advised to drink coffee (for
       | habitual coffee drinkers with arrhythmia) leads to less
       | arrhythmia, not more. This is surprising since caffeine is a
       | stimulant and usually thought to be pro-arrhythmic.
        
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       (page generated 2025-11-15 23:00 UTC)