Chapter 4: Coffee & Brazilian Public Health
Abstract
According to the International Coffee Organization's December 2023 report, Brazil is the fifth largest consumer of coffee worldwide by sheer volume. And yet, when consumption is measured per capita, Brazil doesn’t even crack the top thirty.[1] Why is that?
To answer this question, we need to shift focus. So far, we have explored the history of Brazilian coffee production, the industry’s ecological impacts, and the web of politics the industry is entangled in. Now, we turn our attention away from the institutions behind coffee and towards the people who drink it.
Along the way we'll answer other questions: is coffee good or bad for a person's health? Who is drinking all this coffee? Why do they drink it? And crucially, how does the general public perceive coffee's health effects, and why does that perception matter?
First Things First, is Coffee Healthy or Not?
The answer to this question is less clear than it might seem. To this day there is active scholarly debate over what researchers call 'the coffee paradox'. Research on coffee's health benefits and detriments substantially predates the Anthropocene, and has produced contradictory results. Some research points to a frankly staggering variety of potential health benefits; other research points to the presence of dangerous chemicals, chemicals that vary in concentration depending on both how the bean was produced and how the coffee has been prepared.
When we talk about what coffee does, besides taste good, what first comes to mind is its benefits as a stimulant. A cup wakes you up in the morning, fills you with energy, and helps you focus. Those are the benefits of caffeine. But coffee also contains hundreds of biologically active phytochemicals.[2] Many of these chemicals are linked with a wide variety of health benefits. Though, it is worth noting that the strength of those links varies. Some are well founded, others merely suspected.
Coffee’s healthier bioactive contents are thought to help regulate the gut microbiome, the system of bacteria in the digestive tract that has become increasingly relevant to medical research in recent years. They also provide a variety of neuroprotective, anti-inflammatory, and antidiabetic benefits. Some studies indicate that coffee may reduce risk of liver cancer and Parkinson's disease, but the evidence for these particular benefits is less definitive.[3]
Coffee is not toxic. But its contents also include trace quantities of toxic substances. Depending on the strain of plant, the conditions in which it is grown, and the way the coffee is prepared, the concentration of these toxins can vary significantly. These include neurotoxins (which damage the brain), genotoxins (which damage chromosomes), nephrotoxins (which damage kidneys), and various hormone-antagonistic ligands (chemicals similar enough to hormones to trick their receptors).[2] This host of chemicals is thought to contribute to the observed negative effects of over-consumption. Important to emphasize is that individual chemicals do not appear in sufficient quantities to do serious harm in a single drink. Rather, excessive consumption may cause cumulative damage. For the moderate drinker these negative effects are negligible at most.[2]
Coffee is the subject of intensive ongoing research. But with an extensive library of experimental data to work from, there is something resembling a consensus. If prepared well, consumed in small quantities, and having no more than a cup each day, coffee is more healthy than unhealthy.
Brazilian Coffee Consumption:
Who, Where, & Why ?
Having established that coffee is healthy, let us move on to the subject of consumption rates and return to our first question. How can Brazil’s sheer consumption and per capita consumption differ so much? To an extent, this can be explained by relative population size. The countries with the highest per capita rates tend to be those countries with minuscule populations, like Luxembourg and the Maldives.[1] But this explanation alone is inadequate.
A massive dietary study conducted by the Brazilian government between 2008 and 2009 found that large swaths of Brazil’s population simply do not drink coffee. [4] Those that do drink a lower volume of coffee per day compared to people in import-heavy regions like North America and Europe.[1] The study also broke down coffee drinkers by demographic. The populations that drank the least were mainly those in more rural areas. Meanwhile, the most coffee was drunk by lower education, low- to middle-income people in more urbanized districts. In other words: Brazil’s working class.[4]
A subsequent survey sought to expand on these findings. Researchers conducted a series of interviews in Brazil’s Federal District, a largely urbanized region home to the nation’s capital of Brasília. Their data indicated that around 81% of the district’s residents were coffee drinkers. Of those, 48% drank coffee primarily out of established habit. Only 4% of drinkers surveyed reported health or even energy benefits as their motive.[5]
The 2008-2009 study indicated that coffee intake specifically—and caffeine intake more broadly—fall well below the recommended daily maximum. This means that over-consumption and its associated risks are not significant problems for Brazilian public health.[4] Increase in Brazilian consumption has been roughly proportionate to population growth, though sales declined significantly due to the pandemic and the associated cost of living crisis. According to more recent data, while sheer volume is down, per capita consumption is on something of an upswing. Overall, data indicates that the consumer/coffee relationship in Brazil remains generally positive.[1]
However, one bit of this demographic information raises concerns. Coffee is primarily consumed out of habit and not for any specific benefit. What might this mean for how coffee is perceived, and how might changing perceptions of coffee’s health benefits change people’s consumption?
Public Perception of Coffee's Health Effects
There is an extensive body of research concerning how healthy coffee is and in what ways. Research into how coffee is perceived by consumers, especially in regards to health, lags in comparison.
For most of its presence in human history, coffee has been viewed as beneficial. By some akin to a miracle cure. According to anthropologist Edward F. Fischer, the earliest story of coffee use by humans was as a stimulant for livestock. An Ethiopian goatherd named Kaldi is said to have fed the coffee plant to his flock before later tasting the plant’s berries for himself. Over the ensuing centuries, coffee developed a close relationship with both religious institutions and the intelligentsia. Coffee was first and foremost a means of sharpening the mind. With industrialization, coffee became more widely available at the very historical moment that there was a sudden demand for safe stimulants. By the late 19th century, widespread consumption gave rise to a moral panic called caffeinism, which warned that coffee was destroying minds and ruining lives.[6]
Coffee was not outright banned, of course, but this panic sparked public interest in new coffee research, especially research that was critical of coffee. Thus began the wave of experimentation and clashing opinions that gave rise to our modern ‘coffee paradox’.[6]
All the while, people continued to drink. With the 20th century’s many upheavals, caffeinism receded from public consciousness. What the public was left with was a sense of ambivalence. For most of its role in history, coffee was thought of as healthy. By the time of the Anthropocene, the narrative around coffee and health became so conflicted that health largely exited the conversation.
Returning to the Federal District survey: of the 19% of respondents who did not drink coffee, just 10% of them cited health concerns as their primary objection. Just under 2% of the full sample. Of the 81% who did drink coffee, recall that only 4% cited health benefits. This translates to a bit over 3% of the overall sample.[5] Therefore, assuming this sample is representative of the total population, only 5% of Brazilians' engagement with coffee prioritizes health concerns of any sort.
Studies conducted elsewhere in the world can add more nuance to this story. The Federal District survey asked respondents for their primary motivation, but does not address the perceptions of those for whom health was not the deciding factor. A 2017 analysis by the National Coffee Association of the USA (NCA for short) reported that 66% of American consumers limited their coffee intake due to health concerns.[7] A 2019 study conducted by market researchers in Italy found that only 25% of respondents, all coffee drinkers, even knew that coffee had any non-stimulant benefits.[8] What this suggests is that broad public perception believes coffee to be unhealthy, and many millions drink it anyway. In this way, coffee is positioned as a luxury good, and not as a health food. But that status quo is subject to change.
There are ongoing efforts by the coffee industry to shift public perception and develop the gourmet and health food coffee markets. Both the NCA[7] and the Italian study above[8] advocate increased awareness of coffee’s health benefits as an industry-wide goal.
One ethnographic study from 2021 explores one way in which this push can manifest. The article chronicles a growing interest in specialty coffees and how it has led to the growth of parallel markets. In some cases the same growers are producing different coffees: some mass market, some ‘artisanal’. Brands tie their coffees to specific regions, practices, and social groups. This has created an environment in which an increasing portion of coffee’s valuation is symbolic, leading to the emergence of more and more ‘specialized’ products.[9]
Coffee branding is diversifying. That diversification has coincided with the industry push to spread word regarding coffee’s health benefits. Likewise, this has coincided with the COVID-19 pandemic, which has contributed to increasing public interest in health products and brands in general. Like coffee’s impacts on the body, this is not limited to the plant itself. Preparation also plays a part. Per NCA research from 2024, 21% of American coffee drinkers believe that cold brew is healthier than hot coffee. This claim has not been substantiated by medical research, and its spread is a product of marketing, particularly on social media.[10] While more people recognizing that coffee is healthy might seem like a positive outcome, corporations are not interested in honest engagement with health. Marginal and context-dependent health benefits can be slapped on even cheap coffee, while still dodging advertisement regulations.[10] This approach of exploiting the consumer knowledge gap is liable to increase consumption, in a manner that increases the risk of some people's consumption rising above healthy levels.
For the moment, Brazil’s relationship with coffee is healthy. Failure to properly regulate brands and advertisements might well change that for the worse.
A Quick Aside: Is Coffee Addictive?
Coffee is often informally referred to as ‘addictive’, or even outright compared to other addictions like nicotine. But is there truth to that comparison? How addictive is coffee, and in what specific ways is it addictive? See the infographic below to learn more.
Click on the Mug to view the infographic
So What?
The state of public health in Brazil, at least as it relates to coffee, is largely positive. But there are a number of potential and emerging problems.
Current research shows that coffee's bioactive components are more helpful than harmful. For the moment, consumption levels are moderate among most drinkers, which can be partly credited to the muddled perception of coffee's health benefits. That latter point is subject to change. Change that may be for the worse thanks to under-regulated, health-based marketing practices. Besides better regulation the best solution to this is—oddly enough—to do as the marketers want. Increase awareness and accuracy about the relationship between coffee and human health. Doing so ought to keep consumption levels healthy and encourage better practices.