Tuesday, May 31, 2022

Coffee drinkers may be at lower risk of early death, study suggests

Even people who take sugar seem at lower risk, say experts, but results may be due to coffee drinkers being more affluent

People who drink coffee – whether with or without sugar – appear to have a lower risk of an early death, although experts caution the finding may not be down to the brew itself.

About 98m cups of coffee are drunk every day in the UK, according to the British Coffee Association, with the National Coffee Association revealing that in the US the figure is about 517m cups.

Previous studies have suggested the beverage may be beneficial to health, with coffee drinking associated with a lower risk of conditions ranging from chronic liver disease to certain cancers and even dementia.

Now researchers in China have found people who consumed a moderate amount of coffee every day, whether sweetened with sugar or not, had a lower risk of death over a seven-year period than those who did not.

Similar results were found for instant, ground and decaffeinated coffee.

The study, published in the Annals of Internal Medicine, is based on data from more than 171,000 participants of the UK BioBank – which has collected genetic, lifestyle and health information from more than 500,000 people since it began in 2006, including details of participants’ coffee-drinking habits.

The team used data from death certificates to track the participants for a median period of seven years from 2009, during which 3,177 people died.

After taking into account factors including age, sex, ethnicity, educational level, smoking status, amount of physical activity, body mass index and diet, the team found that, compared with those who did not drink the brew, people who consumed unsweetened coffee had the lowest risk of death.

The greatest reduction, a 29% lower risk of death, was seen for those drinking between 2.5 and 4.5 cups a day.

Reductions in the risk of death were also seen for coffee sweetened with sugar, at least for those drinking between 1.5 and 3.5 cups a day. The trend was less clear for people who used artificial sweeteners.

However, the study questioned participants about coffee drinking and other habits only once, and relied on self-reporting. Most of those who used sugar added only a spoonful to their drink – meaning it is unclear if the results would hold for speciality coffees with a high sugar content.

Naveed Sattar, a professor of metabolic medicine at the University of Glasgow who was not involved in the work, cautioned that the findings – while intriguing – were not clear-cut.

“The observational nature of this new study means these conclusions are far from definitive,” he said.

“This is because coffee drinkers are in general more affluent and have healthier lives than non-drinkers and I remain unconvinced whether these factors can be overcome in observational studies.” Prof Sattar added that genetic evidence did not link coffee to any important health benefits.

“I would suggest people stick to coffee or tea, preferably without sugar, which most people can adapt to, and try to do all the other things we know keep you healthy – move more, eat and sleep better.”

In an accompanying editorial, Dr Christina Wee, deputy editor of the journal, agreed the findings were not conclusive. But, she added, it did appear that drinking coffee, whether unsweetened or with modest amount of sugar, was probably not harmful for most people.

“So drink up – but it would be prudent to avoid too many caramel macchiatos while more evidence brews,” she wrote.

Psychological distress in pregnant women during the COVID-19 pandemic and measures of the structure of the foetal brain

Psychological distress in pregnant women

A study published in Communications Medicine looks at maternal psychological distress during the COVID-19 pandemic and structural changes of the human foetal brain.

Prof Ciara McCabe, Professor of Neuroscience, Psychopharmacology and Mental Health, University of Reading, said:

“This small preliminary study is an extension of the authors’ previous work linking fetal brain development and maternal stress.  The study shows brain differences between pre-pandemic and pandemic fetal development.  However the authors acknowledge that the developmental differences related to stress did not remain after multiple correction, suggesting other pandemic factors may be at play, for e.g., unknown exposure to covid-19.  However the long term implications of this type of work is yet unknown.  Follow up longer term studies are needed for this.  As the human brain develops rapidly in early childhood with many further changes in adolescence it will be interesting to see how pandemic fetal development affects these later developmental processes going forward.

Does the press release accurately reflect the science?


Is this good quality research?  Are the conclusions backed up by solid data?


How does this work fit with the existing evidence?

“Yes, this is an extension of work by the same group looking at stress and fetal brain development.

Maternal stress and fetal brain development.

Have the authors accounted for confounders?  Are there important limitations to be aware of?

“The brain developmental differences related to stress did not remain after multiple correction, suggesting other pandemic factors may be at play.  Plus any brain changes between groups may have been due unknown exposure to covid-19.

What are the implications in the real world?  Is there any overspeculation?

“The long term implications are unknown.

Should new mothers or pregnant women be worried?

“No, as the long term implications are unknown plus the human brain continues to develop a lot in childhoods early years and right through to adulthood.  Then more slowly from then on.

Is this study able to show what effects there might be of any observed brain structural differences, or don’t we know that from this

“No as they are fetal – you can see brain differences but this study can’t directly tell you how this might affect behaviour later on.

Does this study have long-term data or is it preliminary?

“No – it is preliminary.” 

Dr Nadja Reissland, Senior Lecturer in Psychology, Durham University, said:

“The study was well conducted with a good sample of pregnant women during COVID compared with a Pre-Covid sample.  In the literature however there are now also quite a few studies which show that the pandemic itself was perhaps not the main factor, rather social support plays a big role in how pregnant women fared during the pandemic.  Women who were supported coped well whereas women who were left on their own (e.g. to decide whether or not to take the vaccine, with reduced care, worries about partner being allowed to be present at the birth) fared worse.  One study published in Pregnancy and Childbirth (2022) reported a negative experience when they had to give birth during the pandemic especially during the first lockdown.  Given that COVID was present in the second lockdown the difference between first and second lockdown are of interest.  These results emphasise that the context of being pregnant and giving birth is of prime importance.  It is something the authors mention themselves in the limitations to their study.

“Another limitation is that maternal COVID status was not assessed independently.  Hence it is unclear if at least some of the women were COVID positive which might have influenced the results.  Nevertheless, this is an important study showing that stress and depression seem to play a role in brain formation.

Maternal COVID status

“These findings makes sense and could explain what we have found in many of our fetal studies showing that maternal stress, depression and anxiety affect fetal behaviour.  For example in our paper on fetal vision (Reissland et al 2020) we found that In contrast to other studies examining fetal reactions to prenatal light stimulation, without controlling for maternal factors (importantly maternal stress, depression and anxiety) that in fetuses at 33 weeks gestation, maternal anxiety and depression, and fetal growth factors (femur length) all had a significant effect on fetal reactivity to face-like compared to a non-face-like control light stimulus.  This calls into question some previously published results.

“In another study (Reissland et al 2018) we found that fetuses in the third trimester reacted differentially to sound and light stimulation depending on maternal mental health status with a 20% increase in fetal eyeblink for each unit increase in anxiety score and a 21% decrease in fetal eyeblink for each unit increase in depression score indicating that fetuses are affected differentially by maternal anxiety and depression.

“The current study makes clear that in fact maternal stress measured using PSS and depression measured using EPDS, two measures used in many of our studies, have an effect on fetal brain development and this goes someway to explaining our findings of differential behaviours by the fetus depending on maternal mental health status.”


Reissland, N., Froggatt, S., Reames, E., & Girkin, J. (2018). Effects of maternal anxiety and depression on fetal neuro-development. Journal of Affective Disorders. 241, 460-474.

Reissland, N., Wood, R., Einbeck, J. & Lane, A. (2020). The effects of maternal mental health and prenatal attachment on fetal reactions to face-like light stimulation. EarlyHumanDevelopment151:105227 https://doi.org/10.1016/j.earlhumdev.2020.105227

Prof Carmine Pariante, Professor of Biological Psychiatry, Institute of Psychiatry Psychology & Neuroscience, King’s College London (IoPPN), said:

“The paper by Lu et al. presents some interesting findings of changes in the size of brain structures of developing foetus during the COVID pandemic, compared with a historical cohort the previous year. The sample size is relatively small, but these studies are difficult to complete and thus the authors should be commended for such an effort. Although the paper includes a multitude of statistical analyses, thus risking the occurrence of chance findings, in reality the findings are to be considered robust: the neuroimaging analyses uses advanced methods, and the described brain changes are consistent with what we already know about the effects of stress and mental disorders on the brain, including the effects of maternal stress or depression on the infant brains (although interestingly they cannot replicate well-known differences in the male and female infant brains).

“There are two main limitations that are worth considering. First, studies across historical cohorts are very difficult to interpret, especially when major social events occur, like in this study. The authors acknowledge that they do not measure “social isolation, financial insecurity, and nutritional changes”, which were massive factors during the pandemic. My opinion is that these factors will have had a more direct role in explaining these brain changes than just the subjective levels of mothers’ anxiety, and indeed some of the association between brain changes and maternal anxiety are statistically weak.

“The second limitation is that the paper does not present any neurological or behavioural assessment of the babies, which could have been easily carried out in the first few days or weeks after birth. These would have offered a clear interpretation of the true relevance of these brain size changes for babies’ mental life. So we don’t know from this study what impact, if any, these brain size changes might have on babies.”

‘Maternal psychological distress during the COVID-19 pandemic and structural changes of the human fetal brain’ by Yuan-Chiao Lu et al. was published in Communications Medicine at 16:00 UK time on Thursday 26 May 2022.

DOI: 10.1038/s43856-022-00111-w

Stress and Child Abuse: The Past Hurts

Child abuse casts a long shadow. A long-term study published in the Journal of Child Abuse and Neglect found that by age 21, up to 80 percent of child abuse survivors had developed a psychiatric illness, including depression and anxiety disorders.

In recent years, experts have discovered another disturbing consequence of childhood trauma: People who were abused or neglected as children also appear to be more vulnerable to a variety of serious physical illnesses. Drs. Vincent Felitti and Robert Anda of Kaiser Permanente led a study with the CDC as early as 1998 that showed children who were verbally or physically abused, were separated from their parents or had other severe adverse childhood experiences (ACEs) were more likely to suffer physical and mental ills across the lifespan, including cancer, heart disease, and depression.

As the National Clearinghouse on Child Abuse and Neglect later reported, abuse and neglect may also result in psychological problems that show up in high-risk behaviors, such as smoking, abusing alcohol, and overeating. This, in turn, may set the stage for diseases such as cancer and obesity, according to the report.

"The field [of mental health] is starting to realize that child abuse can have physical effects that last far beyond bumps and bruises," says Linda Luecken, PhD, an assistant professor of psychology at Arizona State University who has co-authored many studies. on childhood trauma and stress.

Destructive in any form

Child abuse comes in many different forms: some parents regularly hit or verbally abuse their children, some sexually abuse them, some withhold affection, and some neglect to provide basic care.

Whatever form it takes, mistreatment can actually change the hardwiring of a child's brain, Luecken says. Starting in infancy, children who don't get enough affection tend to produce large amounts of cortisol - a hormone that indicates high levels of stress. Physical discipline can turn on this hormone, too, even in infants.

A little cortisol now and then is harmless, but too much over too many years may damage the heart, weaken the immune system, and generally wreak havoc on a child's physical and mental well-being. In the most severe cases, abused children may exhibit many of the signs of post traumatic stress disorder (PTSD).

As Luecken reported in Clinical Psychology Review, there's also growing evidence that people who were abused or neglected as children may be particularly sensitive to stress. The stress of chronic abuse may change the hardwiring of certain parts of the brain so that even small amounts of stress trigger a "hyperarousal" response, which can result in hyperactivity, sleep disturbances, and anxiety, as well as increased susceptibility to hyperactivity, conduct. disorders, and memory and learning problems. Its not unusual for adults abused as children to overreact to threats (both real and perceived), and to be especially slow to calm down.

This sensitivity to stress may increase the risk of a whole roster of stress-related diseases, including heart disease, cancer, and infectious diseases. In the Clinical Journal of Pain, Luecken and colleagues reported that people with a history of child abuse are also especially likely to suffer from chronic pain, another problem that may be related to stress.

For teens and adults who were abused as children, physical problems and emotional problems are closely interwoven, Luecken says. Survivors of abuse may suffer from depression and low self-esteem, two conditions that can encourage risky behavior. A study of men in the Philadelphia area published in the Annals of Internal Medicine found that those who were abused as children were five times more likely to have injected illegal drugs. As teenagers, they became sexually active a full year earlier than other boys. Such behaviors may in turn lead to problems such as sexually transmitted diseases or addiction.

Mitigating the trauma

The good news is that children can be incredibly resilient. Intelligence, optimism, creativity, humor, self-esteem, and independence can all help abuse victims survive and even thrive as they recover. Even children who get the worst possible start in life may develop a healthy outlook if they eventually receive support and affection later on. "There are children who have been horribly abused in foreign orphanages who made remarkable recoveries after being adopted," Luecken says.

Kids don't need to have an idyllic childhood or perfect parents to have a healthy future, but they do need enough emotional support to keep them from feeling scared and alone. "I'm convinced that one strong bond with a caring adult is enough. That single bond --whether it's with a parent, grandparent, or a foster care provider -- can protect a child from stress by making him feel safe and valued," Luecken says.

Research from Tufts University and elsewhere has also found that other positive childhood experiences (PCEs) -- from being on a sports team and having the support of close friends and family to being involved in the community -- can help mitigate and even reverse the impact of ACEs.

Adults who were abused as children can also take steps to protect themselves from the effects of stress. Professional counseling can help change their attitudes about themselves and the world around them. A balanced diet, regular exercise, and quality medical care can help make up for all sorts of stress-related harm, Luecken says.

Luecken and other researchers are working to understand why child abuse takes such a heavy toll on physical health. The answers could help adult survivors find a way to stay healthy and strong despite the suffering in their past. And for all those children who suffer abuse or neglect every year, such research could lead to a better future.


Interview with Linda Luecken, PhD, assistant professor of psychology at Arizona State University and lead author of recent medical study on child abuse and stress.

Silverman, AB, et al The long-term sequelae of child and adult abuse: A longitudinal community study. Child Abuse and Neglect, 20 (8), 709-723.

U.S. Department of Health and Human Services. National Clearinghouse on Child Abuse and Neglect Information. Long-term consequences of child abuse and neglect. . http://nccanch.acf.hhs.gov/pubs/factsheets/long_te....

Luecken LJ and KS Lemery. Early caregiving and physiological stress response. Clinical Psychology Review. 24: 171-191.

Holmes WC and MD Sammel. Physical abuse of boys and possible associations with poor adult outcomes. Annals of Internal Medicine.143(8): 581-586.

Harvard Mental Health Letter. The biology of child maltreatment.

Saturday, March 19, 2022

Video Shows Cop Punching Woman In The Face, But She's The One Arrested For 'Assault'

Flagstaff, Arizona police: "Our agency is very concerned."

A uniformed Arizona police officer who was filmed punching a woman has been placed on administrative leave while the incident is investigated.

“Our agency is very concerned by what is depicted in this video,” police in Flagstaff, Arizona, said in a Wednesday evening press release.

The footage, shot and posted to youtube on Wednesday, shows a woman struggling with two officers who apparently believe there is an outstanding warrant for her arrest. She can be heard on video saying the issue has already been resolved.

“You cannot arrest me until I know I have a warrant,” she tells the officers as she struggles with them.

Suddenly, one of them strikes her in the face with a closed fist.

Authorities have identified that officer as Jeff Bonar. They haven’t released the name of the woman, but she identifies herself in the video as Marissa Morris.

“You just fucking punched me in the face,” Morris can be heard yelling after Bonar hits her.

A number of people appear to be watching the scene from a porch. The man who filmed the confrontation — identified by The Arizona Republic as Danny Paredes — can be also heard shouting, “Hey, you can’t hit a girl like that.”

Bonar cuffs Morris and the two other officers lead her away and place her in the back of a patrol car while a man ― presumably Paredes ― can be heard saying, “I got it on video, Marissa.”

Morris’ boyfriend, Jimmy Sedillo, told The Arizona Republic he and his children, ages 3 and 9, witnessed the incident.

“She had a warrant a few weeks ago,” Sedillo said. “He still assumed she had a warrant.”

Sedillo told Phoenix’s KTVK his girlfriend was ultimately charged with assaulting an officer and resisting arrest.

Morris, who reportedly remains behind bars, could not be reached for comment.

“An internal affairs investigation is being initiated,” Flagstaff police said. “Further details will be released as the investigation progresses.”

Thursday, December 16, 2021

Research finds that drinking even small amounts of alcohol while pregnant can cause harm

During pregnancy, women are told to avoid alcohol because there is no safe level of use.

New research has found that even very small amounts of exposure can lead to a baby growing up to experiment with alcohol at a very young age.

This behaviour is known as 'sipping', when a child has small sips from their mum or dad's drink, and while it might seem harmless, it increases their risk of problem drinking later in life.
For expectant parents, few issues have the ability to cause controversy like consuming alcohol while pregnant.

While women in the United States have been warned to avoid all alcohol during pregnancy, some research has found that small amounts of alcohol during pregnancy may be safe.

Now, new research finds that the safest option for pregnant women is to avoid alcohol all together.

After analyzing 23 previously published studies, researchers confirmed that drinking alcohol during pregnancy leads to children with poorer cognitive functions and increases the risk of lower birth weight.

“We wanted to look at all of the evidence from different types of studies, in a comprehensive way,” Luisa Zuccolo, PhD, study lead and senior lecturer in epidemiology at Bristol Medical School: Population Health Sciences, told Healthline.

“We also found that for two outcomes, cognition and birth weight, there were enough studies of different type agreeing with each other, indicating a harmful effect of alcohol in pregnancy,” Zuccolo said. “This was not surprising, but it adds another piece to the jigsaw of evidence on this important public health question.”

The study was published Wednesday in the International Journal of Epidemiology.

First time different study designs were compared

Researchers say this is the first time results from a number of different study designs were compared relating to the effect of drinking alcohol during pregnancy.

“The trickiest thing in this field is to be able to have comparable groups of pregnant women, and children, who only differ by alcohol consumed during pregnancy — this is how we can tell if alcohol causes the outcomes, rather than just being correlated with them,” said Zuccolo.

The analysis looked at both traditional studies like randomized controlled trials (RCT) and alternative strategies that involved comparing children in the same family whose mothers reduced or increased alcohol consumption between pregnancies.

Zuccolo explained that they used study designs with different methods and assumptions to make these groups comparable, as would be done in an experiment, so “we can be more confident in our conclusions, provided the results point in the same direction.”

Previous research findings not as ‘robust’

Previous research on drinking during pregnancy was done using observational studies. This is when participants have been exposed to a risk factor and researchers don’t try to change who has or hasn’t been exposed.

“Our present study was the first to assess together the evidence from disparate sources, most of which included women drinking in moderation. The results are more robust than other reviews,” Zuccolo confirmed.

While the research was comprehensive, Zuccolo admits it was limited in its ability to establish the amount of alcohol that leads to a negative outcome.

Alcohol industry minimizes harmful effects of alcohol

A recent study finds that alcohol industry-funded websites routinely omit or misrepresent evidence on the risks of alcohol consumption during pregnancy. According to researchers, this may “nudge” women toward continuing to drink during pregnancy. The findings suggest that alcohol industry-funded bodies can increase risk to pregnant women by spreading misinformation.

“Alcohol is a teratogen, meaning it causes anomalies. Alcohol affects the developing fetal brain, heart, facial features, and impairs normal growth,” said Dr. Kecia Gaither, director of perinatal services at NYC Health + Hospitals/Lincoln.

Gaither explained that drinking during pregnancy increases the risk for fetal alcohol syndrome (FAS), a disorder characterized by symptoms that include:
neurological issues like cognitive delay
hearing issues
cardiac abnormalities
facial deformities

“These affects occur along a spectrum, and babies and children so affected grow up into adults so affected,” Gaither emphasized. “To my knowledge there is no threshold of drinking alcohol during pregnancy known so as to provide a guide as to how much will cause the syndrome or not. Therefore, women are advised not to imbibe at all during pregnancy.”

Monday, December 13, 2021

Probiotics found to improve nausea and vomiting in pregnancy

Researchers at the University of California, Davis have found that probiotics significantly improve the symptoms of pregnancy-related nausea, vomiting and constipation. Their findings were published in the journal Nutrients.

During pregnancy, hormones like oestrogen and progesterone increase, bringing about many physical changes. These increases can also change the gut microbiome, which likely affects the digestive system functions and causes unwanted symptoms like nausea, vomiting and constipation. The researchers set out to determine whether supplementing with a probiotic could be beneficial for gastrointestinal function during pregnancy.

A total of 32 participants took a probiotic capsule twice a day for six days and then took two days off; they then repeated the cycle. The probiotics were available over the counter and mainly contained Lactobacillus, a type of good bacteria. Each capsule contained approximately 10 billion live cultures at the time of manufacture.

The researchers found that taking the probiotic significantly reduced nausea and vomiting. Nausea hours (the number of hours participants felt nauseous) were reduced by 16%, and the number of times participants vomited was reduced by 33%. Probiotic intake also significantly improved symptoms related to quality of life, such as fatigue, poor appetite and difficulty maintaining normal social activities, as scored by questionnaires. Probiotics were also found to reduce constipation significantly.

“Over the years, I’ve observed that probiotics can reduce nausea and vomiting and ease constipation; it’s very encouraging that the study proved this to be true,” said Albert T Liu, lead author on the study and a professor of obstetrics and gynaecology. “Probiotics have also benefited many of my other patients who weren’t in the study.”

Participants also contributed faecal specimens before and during the study, which were analysed to identify the type and number of microbes and the different by-products of digestion. This allowed the researchers to examine whether biomarkers in the faecal specimens corresponded with more severe nausea and assess how the probiotics affected participants who began the study with different baseline biomarkers.

One finding was that a low amount of bacteria that carry an enzyme named bile salt hydrolase, which generates bile acid to absorb nutrients, was associated with more pregnancy-related vomiting. Probiotics increase bile salt hydrolase-producing bacteria, which may explain why the supplements decreased levels of nausea and vomiting.

Another finding was that high levels of the gut microbes Akkermansia and A. muciniphila at the beginning of the study were associated with more vomiting. The probiotic significantly reduced the amount of those particular microbes and also reduced vomiting. This suggests Akkermansia and A. muciniphila may be reliable biomarkers that can predict vomiting in pregnancy.

The researchers caution that due to the small sample size, further studies will be needed to confirm the effects of the probiotics. They are also keen to test the impact of probiotics in other areas, such as for the reduction of nausea and vomiting caused by chemotherapy in cancer patients.


Friday, November 19, 2021

Österreich wird die COVID-19-Impfung vorschreiben, wenn das Land vollständig gesperrt wird.


Österreich wird das erste Land in Westeuropa sein, das erneut eine vollständige COVID-19-Sperrung verhängt, sagte es am Freitag, als das benachbarte Deutschland warnte, es könnte diesem Beispiel folgen und Schauer durch die Finanzmärkte schicken, die über die wirtschaftlichen Auswirkungen besorgt sind.

Eine vierte Infektionswelle habe Deutschland, Europas größte Volkswirtschaft, in einen nationalen Notstand gestürzt, sagte Gesundheitsminister Jens Spahn. Er forderte die Menschen auf, ihre sozialen Kontakte zu reduzieren, und warnte davor, dass Impfungen allein die Fallzahlen nicht reduzieren würden.

Österreich sagte, es werde ab Februar die gesamte Bevölkerung impfen lassen.

Etwa zwei Drittel der österreichischen Bevölkerung sind vollständig gegen COVID-19 geimpft, eine der niedrigsten Raten in Westeuropa. Die Infektionen gehören mit einer Inzidenz von 991 pro 100.000 Menschen an sieben Tagen zu den höchsten auf dem Kontinent.

„Es ist uns nicht gelungen, genug Leute davon zu überzeugen, sich impfen zu lassen“, sagte Bundeskanzler Alexander Schallenberg auf einer Pressekonferenz und sagte, die Sperrung würde am Montag beginnen und die Impfpflicht am 1. Februar bestehen.

"Es tut weh, dass solche Maßnahmen noch getroffen werden müssen."

Auf die Frage, ob Deutschland eine vollständige Sperrung nach österreichischem Vorbild ausschließen könne, sagte Spahn: „Wir befinden uns jetzt in einer Situation – auch wenn dies eine Nachrichtenwarnung erzeugt –, in der wir nichts ausschließen können.

„Wir befinden uns in einem nationalen Notfall“, sagte er auf einer Pressekonferenz.

Europäische Aktien gaben von Rekordhochs nach, während Staatsanleiherenditen, Ölpreise und der Euro einbrachen, als das Gespenst einer erneuten COVID-bedingten Sperrung in Deutschland und anderen Teilen Europas einen neuen Schatten auf die Weltwirtschaft warf.

Da die Fälle in ganz Europa wieder zunehmen, haben eine Reihe von Regierungen begonnen, die Aktivitäten wieder einzuschränken, von der vollständigen Sperrung Österreichs über eine teilweise Sperrung in den Niederlanden bis hin zu Beschränkungen für Ungeimpfte in Teilen Deutschlands, der Tschechischen Republik und der Slowakei.

Quelle:- globalnews.ca

Coffee drinkers may be at lower risk of early death, study suggests

Even people who take sugar seem at lower risk, say experts, but results may be due to coffee drinkers being more affluent People who drink c...