Dear Mark: New Coffee Study, Letting a Fever Run its Course, Collagen Dosage

For today’s edition of Dear Mark, I’m answering three questions from readers. First, I give my take on a new, big coffee study, which analyzed several meta-analyses of existing coffee and health data. Second, should you let a fever run its course or try to defeat it at all costs? The body obviously “wants” to get hotter in these situations. Is there a good reason? And finally, how much glycine do people need per day?

Let’s go:

Rudy asked:

Hey Mark,

Did you get a chance to see the latest study on coffee? There are a lot of connections, both good and bad. What were your biggest takeaways?

Here’s the full study.

On the whole, coffee seems to help, not hurt. While there are some associations between coffee consumption and poor health outcomes, they’re outweighed by the beneficial associations.

What’s a bigger scourge our society—type 2 diabetes or childhood cleft malformations? No disease or disorder should be taken lightly, however rare it may be, but if we’re just crunching numbers, the diseases coffee consumption seems to reduce are a bigger threat than the diseases it seems to promote.

The studies that found health benefits for coffee were more numerous and had more participants than those finding negative effects. For instance, there were 27 studies including over a million participants showing benefits against type 2 diabetes but only 6 studies with just under 5000 participants showing links between coffee and acute child leukemia.

What I found most interesting (and telling) was the apparent coffee/LDL/heart disease paradox. One of the strongest protective associations coffee had was with cardiovascular disease. People with high intakes had a much lower rate of death from cardiovascular disease than people with low intakes. It hasn’t been causally linked, of course, as the authors drew primarily on observational studies, but we can at least surmise that it’s not bad for your heart. Yet, despite those protective associations, coffee consumption was also linked to higher LDL levels—and in a dose response manner, meaning the more coffee one drank, the higher their LDL levels.

How could this be? Isn’t LDL supposed to ravage our bodies, clog our arteries, and doom us to cardiovascular disease?

Maybe LDL increases that result from diet are qualitatively different than LDL increases with non-dietary causes (like genetics). I don’t know, but it sure is interesting.

In the end, most of the associations with negative health effects were weak, inconsistent, and they often disappeared when you controlled for other health variables like smoking. There were some standout categories where coffee really did seem to be problematic, like in pregnancy or fracture risk. Even those are easy to solve—don’t drink caffeinated coffee during pregnancy, and be sure to keep an eye on your bone health if you’re a woman who drinks a lot of coffee.

Sara asked:

Hi Mark,

It’s cold and flu season and with three kids, it seems like someone’s always got something. Should I treat the fever or let it do its thing? Sara

I’m a firm believer in letting the fever run its course. That fever is happening for a reason.

And that’s without “hard evidence.” It’s my bias talking, but I tend to assume that if the body responds the same way every time, you shouldn’t just get in the way.

Luckily, you don’t have to take my personal gut instinct as evidence. Actual empirical evidence exists, and the bulk of it supports my bias. Higher body temperatures tend to enhance immune function, while lowering body temperature in the event of fever degrades it:

When mice are injected with an antigen, increasing their body temperature by 2 degrees increases production of CD-8 T-cells, which can attack infected or cancerous cells.

In kids with salmonella infections, those with higher body temperatures expel the bacteria more quickly.

I still don’t quite get why so many people, even many doctors, insist on “getting that fever down.” It wasn’t always this way. Ancient doctors used heat therapy—hot stones, hot baths, hot steam, hot sand, hot mud—to raise the patient’s body temperature. In the 19th and early 20th centuries, doctors induced fevers by injecting malaria to treat syphilis. And it worked.

Okay, maybe I do understand why people treat the fever. Fevers feel bad. You get hot, then cold, then hot again. You wake up soaked, if you can even sleep. It’s manageable when you only have to worry about yourself. It’s downright exhausting when you’re dealing with sick kids.

Unless other troubling symptoms exist (e.g. severe malaise, dehydration, seizures, a stiff neck—suggesting the possibility of meningitis), fevers below 104ºF generally aren’t an emergency. Very young babies (under 3 months) are another story and should be seen and treated for lower fevers.

But in non-acute scenarios, I’d still try to hold out and let the fever run its course.

Caitlin wondered:

Great post! Wondering, if you’re supplementing with a powdered collagen, what’s the recommended dosage? I’ve always just added a heaping tablespoon of the Great Lakes Collagen to my AM fat coffee, but would I benefit from adding more into my daily routine?

The average person requires at least 10 grams of glycine a day for basic physiological repair and various metabolic processes. We can make about 3 grams in house, leaving 7 grams for us to get from diet.

Collagen is roughly 33% glycine, so you’ll need at least 20 grams of collagen protein to hit 7 grams of glycine.

Now, that’s for your basic human being. Other human beings will need more or less glycine than 7 grams/day. Athletes, weight lifters, martial artists, runners, dancers, skiers, snowboarders, and anyone else engaging in intense and demanding physical toll that stresses the connective tissue will need more than 7 extra grams of glycine to rebuild and restrengthen.

If you fit into the above categories, or you’re just overall more active than average, grab some extra collagen—maybe another 5-10 grams.

A heaping tablespoon of Great Lakes collagen hydrolysate contains 6 grams of collagen, or about 2 grams of glycine. A good start, to be sure.

Hope these all helped! Thanks for reading!

Let’s hear from you guys below. Anyone have anything to add (or subtract)?

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