Coffee

Have a Healthy Coffee Break

By Heather Mackie, MS, RD, LD

 

Many people love coffee and start their day with a cup of joe.  In fact, 54% of Americans over the age of 18 drink coffee daily.  Average consumption in the United States is 3.1 coffee drinks per day.  But what about bariatric surgery patients?  Is it safe for post-operative bariatric surgery patients to consume a cup of joe?

Serving Size - It is important to note that one cup of coffee is equivalent to 8 ounces (oz)!  Portion distortion has hit our country’s coffee craze.  Many people report, “I only drink one cup of coffee per day.”  The question is, “How big is that one cup of coffee?”  Is it the big bubba mug that you fill up at the convenience store or is a trenti (even bigger than a venti [large]) from Starbucks? 

Bariatric Surgery Patients and Coffee - Regular coffee contains caffeine, which is a diuretic (i.e., flushes fluid out of the body).  Dehydration is one of, if not the most, common reason post-operative bariatric surgery patients are readmitted to the hospital following their surgery.  Coffee is also acidic, which could increase a bariatric surgery patient’s risk of ulcers post-operatively.  Depending upon the coffee beverage of your choice, it may also be high in calories, sugar, and/or fat.  Most importantly, talk to your bariatric surgery healthcare team about consuming caffeine and/or coffee after your bariatric surgery.  Some programs/practices recommend that patients avoid it following bariatric surgery, while other programs/practices recommend that patients avoid it only for the first few weeks following bariatric surgery.

Hold the Caffeine? - First and foremost, follow the instructions from your bariatric surgeon.  While coffee may have some beneficial properties that does not necessarily mean that it is good for you.  There is no evidence demonstrating that coffee consumption leads to an increased level of antioxidants in the bloodstream even though we know that freshly brewed coffee is high in antioxidants.  Caffeine may raise blood pressure and epinephrine (i.e., the fight or flight hormone also known as adrenaline).  High consumption of caffeine (4-7 cups per day) has been reported to cause problems such as restlessness, anxiety, irritability, and sleeplessness, especially in those individuals that are more susceptible to caffeine.  Ultimately, you have to decide what is right for you based on your individual medical history, current state of health, current health goals, and what your bariatric surgeon recommends.  Remember, if you love the taste of coffee and your bariatric surgeon asks you to forgo the cup of joe, then consider substituting decaf coffee. 

Caffeine Content - Caffeine amounts in your beverage will vary according to a couple of factors including the variety of the coffee bean and the brewing method.  Usually, the longer the grounds are in contact with the water and the finer the grind, the higher the caffeine content.  Generally, espresso contains higher levels of caffeine compared to drip coffee and instant coffee has the least amount of caffeine.  Even though it is true that espresso contains more caffeine (milligrams [mg] of caffeine per ounce, lattes and cappuccinos do not have as much caffeine (in general) than an 8-oz cup of drip coffee since lattes and cappuccinos are made with only 1-3 oz of espresso (often referred to as shots).  The chart below reviews common caffeine amounts in various beverages.

Type of Coffee

Serving Size

Caffeine Content (mg)

Brewed coffee (generic)

8 oz

133 mg

Brewed coffee (Starbucks)

12 oz (tall)

240 mg

Instant coffee

8 oz

93 mg

Espresso (generic)

1 oz

40 mg

Espresso (Starbucks)

1 oz

75 mg

 

Calorie and Fat Content - Calories and grams (g) of fat can vary widely among coffee beverages.  There are many examples, but as you can see from the chart below it is important to choose non-fat milk (or soy or almond milk) and ask about sugar-free options (including non-nutritive sweeteners and/or sugar-free syrups) when choosing your cup of joe.  The other item to consider is the proportion of milk, coffee, and water.  

Beverage (12 oz/Tall)

Calories

Fat (g)

Brewed drip coffee with half & half cream (2 tbsp) + sugar (2 tbsp)

72

3.5

Brewed drip coffee with skim milk (2 tbsp)

23

0.2

Latte, regular (1 oz espresso + whole milk)

204

10.5

Latte, nonfat (1 oz espresso + skim milk)

100

0

Cappuccino, regular (1 oz espresso + equal parts whole milk/milk foam)

110

6

Cappuccino, nonfat (1 oz espresso + equal parts skim milk/milk foam)

60

0

Americano Misto, regular (1 oz espresso + equal parts water/whole milk)

102

5.6

Americano Misto, nonfat (1 oz espresso + equal parts water/skim milk)

62

0.5

Caramel Macchiato, regular (1 oz espresso, whole milk, vanilla syrup, caramel sauce)

204

7.8

Caramel Macchiato, nonfat (1 oz espresso, skim milk, vanilla syrup, caramel sauce)

140

1

 

Coffee Bottom Line - If caffeinated coffee is allowed, moderate consumption is most likely safe depending upon your individual medical history.  However, consumption may be dependent upon what stage you are in post-operatively.  Be aware of total caffeine consumption and caloric intake from coffee beverages.  Do not be afraid to ask questions and customize your drink order.  Some websites are wonderful in breaking down the nutritional content allowing you to make changes online to determine which beverage best matches your caloric, fat, sugar, and protein needs.   

Making Fancy Coffee Healthier -  Below are a few tips to help you have your froufrou cup of joe and not feel guilty about it (be sure to talk to your bariatric surgeon to see if you should choose caffeinated or decaf).  It is recommended to stay clear of 3-in-1 specialty coffee mixes, as these tend to be high in sugar and hydrogenated oils (which are categorized as unhealthy fats).

  • - Avoid Whipped Cream – While this may seem obvious, some individuals like to think that having specialty coffee is a treat.  However, the problem is that for most individuals this becomes a habit and is no longer on occasion.  Adding the whipped cream packs in 110-140 extra calories and 9-13 g of fat in a 16-oz beverage.
  • - Go Low – Choose low-fat and low-calorie versions.  Most coffee beverages are made with whole milk at coffee shops, but often skim milk can be substituted.  This may cut as much as 105 calories and more than 12 g of fat in a 16-oz beverage. 
  • - Cut the Syrup – Most coffee beverages are too sweet anyways.  Ask for half the syrup to save about 20 calories and 5 g of sugar for every pump.  Most bariatric surgery patients report foods and drinks taste sweeter after their bariatric surgery anyways, so you may find you do not require as much syrup as you did pre-operatively for the same taste sensation.  
  • - Consider Sugar-Free – Substituting sugar-free syrup can save about 80-120 calories and 20-25 g of sugar for a 16-oz beverage. 
  • - Practice Portion Distortion – If you normally order a large (or venti) coffee drink, consider cutting back to a medium (grande) or even a small (tall) to save on calories, fat, sugar, and caffeine intake. 
  • - Pump up the Protein – Consider increasing the protein count by adding milk (or soy milk) and decrease the amount of caffeine.  Ask for light soy milk or skim milk.  You can order a café au lait (half coffee and half steamed milk).  This increases the protein and calcium intake.  You can also add protein powder to coffee, but be sure the coffee temperature is less than 140oF or the protein will break down and possibly clump. 
  • - Tea Time – Opt for a cup of tea once per week instead of your normal cup of joe.  Generally tea does not contain as much caffeine as coffee and has many beneficial antioxidants. 

The aforementioned are a few modifications you can use to make your coffee healthier.  Be sure to check out the nutritional information online of many large coffee chains for more details.  Looking up your favorite coffee drink can be a real eye opener!  Also, keep in mind that while coffee may appear “safe” to consume, replacing coffee for other beverages, such as low-fat milk and juice, may cause you to miss out on other key nutrients (vitamin D, vitamin C, vitamin A, calcium, etc.).  Lastly, remember to follow the instructions of your bariatric surgery healthcare team, as they know you and your medical history the best.  

As an aside, a high consumption of coffee and/or tea (decaf or regular) will increase your tannin intake.  High tannin consumption makes it more difficult for the body to absorb iron and possibly other nutrients.  This occurs even if you take the iron separate from the coffee or tea.  This is important for bariatric surgery patients, since iron deficiency is one of the more common deficiencies following bariatric surgery.  Be sure to follow-up with your bariatric surgeon to ensure you are taking your bariatric surgery vitamins and minerals as directed and to get your labs checked as recommended.