Drinking lots of coffee need not pose risk of heart disease

Go ahead and have that second cup of coffee or third, or fourth. A study published last week shows heavy, long-term coffee drinking does not raise the risk of heart disease for most people. The study, which followed 128,000 men and women for as long as 20 years, showed that drinking filtered coffee not espresso or French-style brews did not raise the risk of heart disease. Heavy coffee drinkers did tend to smoke and drink alcohol more often and those two factors clearly do raise heart risk, the researchers report in the journal Circulation.

“We believe this study clearly shows there is no association between filtered coffee consumption and coronary heart disease,” said Esther Lopez-Garcia, an instructor in the School of Medicine at the Universidad Autonoma de Madrid in Spain, who worked on the study. “This lack of effect is good news, because coffee is one of the most widely consumed beverages in the world.”

Researchers also found no link between heart disease and how much caffeine, tea or decaffeinated coffee people drank. But this does not mean that everyone can overload on coffee with impunity, said Rob van Dam of the Harvard School of Public Health in Boston. “We can’t exclude the association between coffee consumption and the risk of (heart disease) in small groups of people,” Van Dam said in a statement. In March, a study published in the Journal of the American Medical Association showed that people with a ‘slow’ version of a particular liver enzyme gene had a higher risk of heart disease if they drank more coffee, compared to those with a fastmetabolising version. Liver enzymes metabolise coffee and many other compounds. And several studies have shown a link with heart disease and copious drinking of French press coffee, made using a mesh filter instead of a paper drip filter, or perked coffee.

The Harvard and Madrid teams used data from two ongoing studies the all-male Health Professionals Follow-up Study, which began in 1986, and the all-female Nurses’ Health Study, which started in 1976. Volunteers in both studies fill out periodic questionnaires about their diet, exercise and other health habits and undergo regular physical exams. The researchers found more than half the women and 30 per cent of men who drank six or more cups of coffee a day were also more likely to smoke cigarettes, drink alcohol and use aspirin, and were less likely to drink tea, exercise or take vitamin supplements. But once these factors were accounted for, there was no difference in heart attack risks between the very light and heavy coffee drinkers.

DYING WITH DIGNITY

With the recent case of a family in Dharavi, Mumbai seeking permission for mercy killing, the focus is back on euthanasia.


Life comes replete with its share of peaks and troughs, but the sad plight of a family in Dharavi who want to euthanise themselves, throws the subject of euthanasia to light. The family members have filed a petition in the supreme court to allow them to die on account of two of its members suffering from the incurable disease limb girdle muscular dystrophy and financial inadequacy. Even though India has not legalised euthanasia, requests for such abound, whether nationally or abroad. But let’s recap a little. How did the term euthanasia come into being? Where is it legal abroad?

Euthanasia: Its origins
A quick look-up of an encyclopedia will reveal that ‘euthanasia’ is a Greek term that literally means ‘assisted dying’. The assistance ends the life of a person or an animal in a painless or minimally painful way. Euthanasia is most often performed in a painless way, in order to end suffering. The controversy lays between two different perspectives; moral view of life versus the rational view of life. By itself, euthanasia as a topic is often highlycharged — emotionally, politically, and morally. Laws and meanings abroad change over time.

Types of euthanasia
(a) Indirect This includes the involvement of a physician, clinical nurse, pharmacist) as an agent who participates only by providing treatment for symptoms (for example pain) with a known side effect being an early death. This kind of assistance is currently legal in state of Oregon in the US. It became legal in 1997 as a result of the ‘Death with Dignity Act’ which was passed in the state in 1994.

(b) Direct Direct euthanasia means the involvement of a clinician as agent in inducing a patient’s death, like administering a lethal drug by injection. Direct euthanasia is not currently legal anywhere in the US, but both direct and indirect euthanasia are legal in Belgium, Colombia, Japan and the Netherlands.

(c) Voluntary Voluntary euthanasia occurs with the fully-informed request of a decisionally-competent adult patient or that of their surrogate (proxy).

(d) Non-voluntary Non-voluntary euthanasia occurs without the fully-informed consent and fully-informed request of a decisionally-competent adult patient or that of their surrogate (proxy). An example of this might be if a patient has decisional capacity but is not told they will be euthanised; or, if a patient is not conscious or lacks decisionalcapacity and their surrogate is not told the patient will be euthanised.

(e) Involuntary Involuntary euthanasia occurs over the objection of a patient or someone who can speak on the patient’s behalf. An example of this might be if a patient who can decide for himself/herself is told what will happen. The patient refuses, yet the patient is euthanised anyway.

Where is it legal?
Euthanasia is currently legal in parts of America and the Netherlands.

The case of Terri Schiavo

• A woman hailing from Florida, USA, Terri Schiavo’s case fuelled intense media attention and debate. In 1990, at the age of 26, she collapsed in her home and experienced respiratory and cardiac arrest. She remained in a coma for ten weeks.
• Within three years, she was diagnosed as being in a persistent vegetative state (PVS). In 1998, when it became legal to do so, Terri’s husband and guardian Michael Schiavo petitioned the courts to remove her gastric feeding tube; Terri’s parents, Robert and Mary Schindler, opposed this.
• The courts found that Terri was in a PVS and that she did not wish to be kept alive.
• By March 2005, the legal history around the Schiavo case included a complex web of motions, petitions, appeals and lawsuits. Finally, her feeding tube was removed a third and final time on March 18, 2005.
• She died on March 31, 2005, at the age of 41.

Championing the cause...

• Jack Kevorkian is a controversial American pathologist.
• He is most noted for publicly championing a terminal patient’s ‘right to die’ and for assisting several patients to that end, and is currently serving out a prison sentence for his practices.
• On March 26, 1999, Kevorkian was charged with seconddegree homicide and also for the delivery of a controlled substance by administering a lethal injection to Thomas Youk, a man suffering from a terminal nerve disease.