In previous e-Alerts I've mentioned my love/hate relationship with coffee - that is: I love it, and I hate to think of going without it. I know it's probably not the best thing for me, but as health vices go (I rationalize) it's a small infraction. Especially because I usually drink only a cup or two each day. Okay - a couple of large mugs each day. But still, I lead an otherwise healthy lifestyle, and coffee doesn't seem to create any problems, so I let myself indulge.

But now I'm having second thoughts, because of a friend of mine named David who reminded me how important it may be for those at risk for type 2 diabetes to consider giving up the java.

Like a lot of us, David has been a daily coffee drinker for many years. He never drank a lot of coffee, but first thing every morning, he started his day with a cup or two. Over the years he noticed that if he missed his morning cup he would develop a dull headache that lasted most of the day. This is typical of regular coffee drinkers, of course, and a reminder that caffeine is a drug - and as with any drug, your body reacts with an unpleasant response when the usual dose is not administered.

A few weeks ago David went on a much-needed vacation. Knowing that there would be several days when he would not be able to get his wake-up cup of java, David slowly weaned himself off coffee by drinking less and less over a two week period. By the time his vacation started, he was able to pass on the morning cup without suffering the headache side effect.

When David returned from his trip, he decided to extend his coffee hiatus, just to see if it made any difference in the way he felt in the morning. After several days he noticed something that amazed him.

For the past 5 years, David has been dogged by two or three painful headaches almost every week. He attributed these to eye-strain (he spends his days working in front of a computer screen), and noticed that he seemed most vulnerable to the headaches when he wasn't getting enough sleep.

But now those headaches are mostly a thing of the past. David isn't very happy about living without his morning cup o' joe, but as you might imagine, he doesn't miss the headaches at all.

Coffee can have a dehydrating effect, which could very well have been the source of those chronic headaches. But beyond getting rid of the headaches, David may have done another very important favor for his health.

David is in his early 50s, and he has what he himself describes as "that expanding middle-aged gut." And while that "apple" shape is typical of many middle-aged people, it should be held in check as much as possible with diet and exercise regimens because studies have shown that people who carry excess weight predominantly in the abdomen are at greater risk for decreasing insulin sensitivity that leads to type 2 diabetes.

In an e-Alert I sent you last year ("One Small Change You Can Make Today To Improve Insulin Sensitivity" 2/26/02) I told you about a Dutch study that examined the effects of caffeine on insulin sensitivity. The research revealed that moderate caffeine intake may decrease insulin sensitivity by as much as 15 percent. Which is significant enough to evolve into a real problem for someone like David who shows at least one sign of a potential pre-diabetic condition.

A further concern is the growing number of young people who are overweight (another pre-diabetic condition). There was a time when coffee was considered strictly an adult's drink, but recently I've noticed more and more teenagers - and even younger kids - lining up at Starbucks for their café lattes and Grande Mochaccinos. Besides the fact that they're getting hooked on a stimulant, they're also consuming plenty of sugar with their brew-of-the-day. Throw in a carb-heavy scone or a muffin, and it's easy to imagine that the fight against obesity and type 2 diabetes (now a far greater problem in young people than ever before) is headed in the wrong direction.