Wednesday, October 20, 2010

Bump Alert: Embracing Coffee Moderation, Confronting My Addiction and Rediscovering Coffee

Several months ago I had to cut my coffee consumption way back. Though, on any normal day, I drink 4 to 6 cups a day, for the first few months of my pregnancy, I had to cut back, because according to the medical literature, coffee is associated with an increased risk of miscarriage.

In a study published in the American Journal of Obstetrics and Gynecology in 2007, 1063 women were followed by Dr. De-Kun Li and his colleagues. Their goal: determine whether there was a correlation between coffee intake and miscarriage. Women were divided into three categories: no caffeine; some caffeine, but less than 200 mg per day, and consumption of more than 200 mg per day. The miscarriage rate among the 200 mg-plus group was 25%, compared with 12% for the non-caffeine drinkers. So it seems that 200mg, or two cups, is the safety threshold. Note that the results were adjusted to take into consideration other risk factors.

For a long time, I was in deep denial about the correlation between drinking a lot of coffee and facing an increased risk of miscarriage. But I wasn't pregnant then. I also could not imagine that the very smell of coffee could send paroxysms of displeasure down my spine. So counterintuitive! But then, quite a bit about pregnancy is counterintuitive and quite honestly, not at all fun. Though the entire thing is quite worth it.

During the time I couldn’t drink coffee, I missed it and all of the paraphernalia that goes with it. I missed the hissing brew and the chugging of the coffee. I missed the morning ritual--- trying to decide between an oversize glass mug with blue appliqué flowers, or the mug from Mystic Seaport with an image of a seaman drinking an oily cup of hardcore 19th century java.

Because I have spent the past 5 years tracking the medical benefits of coffee, on one level I felt less healthy because I was not drinking it. I know, based on the data, that coffee significantly decreases the risk of type 2 diabetes, liver disease, Parkinson’s disease and depression. Coffee is full of health-bestowing chlorogenic acids.

Coffee has always been my favorite antidepressant. Mornings can be hard, and coffee is a trusted antidote. It works. Not all at once, but like a stealth bomber. Lying in bed in the morning, the list of things to do can seem overwhelming and completely discouraging, but coffee uncovers ambition for the quotidian. Coffee makes it possible to move forward and get everything done.

In contrast, coffee-free pregnancy felt like a prelude to death. A sad place without drive. I went approximately 1 week without any coffee. I became so completely de-energized that I existed like a vapor. When I came back to it, it was a very well considered decision. That is, the experts suggested that less than 200 mg per day (of caffeine) would be appropriate. That meant that 1 large steaming mug of coffee, with a little skim milk, would be safe. Less safe, I started to understand, was to consign myself to months of stunning depression and inactivity. Rather, it made sense to drink a much smaller than normal amount of coffee and feel better. And finally, I did.

So after a coffee-free week, I brewed myself a cup, and it was incredibly good. I was talking on the phone with a friend at that moment, explaining the depth of my depression.

“I would like it to end,” I said. “What?” he responded. “All of it,” I said. “I am sick of everything.” Then, between complaints, I mentioned, “By the way, I'm having a cup of coffee.”

“Good,” my friend said. Several moments passed—not minutes, but moments. “You know I am starting to feel better already,” I said more enthusiastically.

The conversation shifted away from my on-the-verge-of-wanting-to-die remarks to something different. Ambition and energy and a renewed sense of purpose---all thanks to the effects of coffee. Meaning, even if I have a bad morning, with lots of nausea, and whimpering on the sofa in despair and fatigue, in reality I can go to the gym. The gym always helps. Always.

Therefore, commitment to coffee and the gym---though definitely modulated and dialed back a bit during this pregnancy continued. Sometimes, less is more…