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Coffee consumption and all-cause and cause-specific mortality: a meta-analysis by potential modifiers

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Youngyo Kim at Gyeongsang National University
Youngyo Kim
Youjin Je at Kyung Hee University
Youjin Je
Edward Giovannucci
Edward Giovannucci
Edward Giovannucci
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Coffee consumption has been associated with decreased mortality in previous studies. As aging, obesity, and lifestyle factors affect the risk of mortality, the association between coffee and mortality needs to be examined in various subpopulations by characteristics of subjects. To quantitatively assess this association, we conducted an updated meta-analysis including stratified analyses by potential modifiers. We searched in the PubMed and Web of Science databases through March 8, 2019, and conducted meta-analysis including linear and non-linear dose–response analyses. We identified 40 studies including 3,852,651 subjects and 450,256 all-cause and cause-specific deaths. Non-linear inverse associations between coffee consumption and mortality from all-causes, cardiovascular disease (CVD), and cancers were found. The lowest relative risk (RR) was at intakes of 3.5 cups/day for all-cause mortality (RR = 0.85, 95% CI 0.82–0.89), 2.5 cups/day for CVD mortality (RR = 0.83, 95% CI 0.80–0.87), and 2 cups/day for cancer mortality (RR = 0.96, 95% CI 0.94–0.99), while additional intakes were not associated with further lower mortality. An inverse association between coffee consumption and all-cause mortality was maintained irrespective of age, overweight status, alcohol drinking, smoking status, and caffeine content of coffee. By region, Europe and Asia showed stronger inverse associations than US. A non-linear inverse association was found for mortality from respiratory disease and diabetes, while linear inverse association was found for mortality from non-CVD, non-cancer causes. Moderate coffee consumption (e.g. 2–4 cups/day) was associated with reduced all-cause and cause-specific mortality, compared to no coffee consumption. The inverse association between coffee and all-cause mortality was consistent by potential modifiers except region.
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Vol.:(0123456789)
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European Journal of Epidemiology (2019) 34:731–752
https://doi.org/10.1007/s10654-019-00524-3
META-ANALYSIS
Coee consumption andall‑cause andcause‑specic mortality:
ameta‑analysis bypotential modiers
YoungyoKim1· YoujinJe1· EdwardGiovannucci2
Received: 7 November 2018 / Accepted: 24 April 2019 / Published online: 4 May 2019
© Springer Nature B.V. 2019
Abstract
Coffee consumption has been associated with decreased mortality in previous studies. As aging, obesity, and lifestyle factors
affect the risk of mortality, the association between coffee and mortality needs to be examined in various subpopulations
by characteristics of subjects. To quantitatively assess this association, we conducted an updated meta-analysis including
stratified analyses by potential modifiers. We searched in the PubMed and Web of Science databases through March 8, 2019,
and conducted meta-analysis including linear and non-linear dose–response analyses. We identified 40 studies including
3,852,651 subjects and 450,256 all-cause and cause-specific deaths. Non-linear inverse associations between coffee con-
sumption and mortality from all-causes, cardiovascular disease (CVD), and cancers were found. The lowest relative risk
(RR) was at intakes of 3.5cups/day for all-cause mortality (RR = 0.85, 95% CI 0.82–0.89), 2.5cups/day for CVD mortality
(RR = 0.83, 95% CI 0.80–0.87), and 2cups/day for cancer mortality (RR = 0.96, 95% CI 0.94–0.99), while additional intakes
were not associated with further lower mortality. An inverse association between coffee consumption and all-cause mortal-
ity was maintained irrespective of age, overweight status, alcohol drinking, smoking status, and caffeine content of coffee.
By region, Europe and Asia showed stronger inverse associations than US. A non-linear inverse association was found for
mortality from respiratory disease and diabetes, while linear inverse association was found for mortality from non-CVD,
non-cancer causes. Moderate coffee consumption (e.g. 2–4cups/day) was associated with reduced all-cause and cause-
specific mortality, compared to no coffee consumption. The inverse association between coffee and all-cause mortality was
consistent by potential modifiers except region.
Keywords Coffee· Mortality· Meta-analysis· Age· BMI· Alcohol consumption
Introduction
Coffee is a complex mixture of over a thousand bioactive
compounds including caffeine, chlorogenic acids, and dit-
erpenes [1]. As coffee is one of the most commonly con-
sumed beverages around the world, its potential effects on
human health could be large on a population scale. Coffee
was considered as potentially harmful to human health
because of caffeine which may raise blood pressure [2], and
the possible carcinogenicity of coffee had been suggested
regarding certain cancers such as urinary bladder cancer [3,
4]. However, recent summary results from cumulative evi-
dence show that moderate coffee consumption is associated
with decreased risk of type 2 diabetes, cardiovascular dis-
ease (CVD), mortality, and several types of cancers, includ-
ing liver and endometrial cancers, and possibly colorectal,
breast, and prostate cancers [5, 6]. These findings suggest
that coffee may be included as part of healthy diet.
Many observational studies have investigated the asso-
ciation between coffee consumption and mortality from all-
causes, CVD, and cancers in the general population [7–45].
Some of the studies have also reported the estimates strati-
fied by various factors including age, BMI, alcohol drinking
or smoking status [8, 9, 12, 13, 22, 25, 27, 31, 33–35, 37,
43–45]. Several clinical studies suggested that the effect of
Electronic supplementary material The online version of this
article (https ://doi.org/10.1007/s1065 4-019-00524 -3) contains
supplementary material, which is available to authorized users.
* Youjin Je
youjinje@khu.ac.kr
1 Department ofFood andNutrition, Kyung Hee University,
26 Kyunghee-daero, Dongdaemun-gu, Seoul02447,
SouthKorea
2 Departments ofNutrition andEpidemiology, Harvard TH
Chan School ofPublic Health, Boston, MA, USA
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
... Additionally, moderate coffee consumption seems to have a protective effect on the occurrence of stroke [9,10], the development of heart failure [11], and coronary artery disease [10]. Furthermore, different studies and metaanalyses in general populations have shown that moderate coffee consumption is associated with reduced risk of all-cause mortality [12,13] and cardiovascular mortality [14,15]. The role of coffee consumption in myocardial infarction is not yet fully understood. ...
... To the best of our knowledge, there is no evidence in the current literature of an association between coffee consumption and adverse cardiovascular events in AF patients. In contrast, there is much evidence in the general population in favor of coffee consumption [9][10][11][12][13][14][15]27]. In our study with elderly AF patients, we found comparable results as in patients from the general population. ...
... However, only patients who consumed 2-3 cups/day had a significantly reduced risk compared to patients who did not consume on a daily basis (HR (95% CI) 0.77 (0.63; 0.94). Another analysis of the general population showed a favorable effect of coffee consumption on cardiac death [14,15]. However, our study was not able to show a significant difference between patients with daily versus not-daily coffee consumption, even though the hazard ratio showed a trend toward a favorable effect of daily coffee consumption (HR (95% CI) 0.89 (0.70; 1.27)). ...
Coffee consumption and adverse cardiovascular events in patients with atrial fibrillation
Article
Full-text available
  • Dec 2024
  • BMC MED
Background There is some evidence of reduced major cardiovascular event (MACE) rates associated with moderate coffee consumption in the general population. However, there is concern about the potential risks of coffee consumption in patients with atrial fibrillation (AF). Therefore, we aimed to investigate the association between coffee consumption and MACE in AF patients. Methods Data of patients with documented AF enrolled in two large prospective observational multicenter cohort studies (Swiss-AF and Beat-AF) were analyzed. Follow-up information was obtained on a yearly basis. Coffee consumption was categorized into two main groups: “daily” and “not-daily” coffee consumers as well as additional subcategories. The primary endpoint was MACE, defined as a composite of stroke or systemic embolism, myocardial infarction, hospitalization for acute heart failure, and cardiovascular mortality. Secondary endpoints were the individual components of MACE and all-cause mortality. We performed time-updated multivariable adjusted Cox regression analyses to investigate the association between coffee consumption and MACE. Results The incidence rate for MACE was 5.09 per 100 person-years (py) in daily and 7.49 per 100 py in not-daily consumers (median follow-up duration: 4.7 years). After adjustment for pre-selected confounding variables, daily coffee consumption was associated with a 23% lower hazard for MACE compared to not-daily consumption (hazard ratio (HR) (95% confidence interval (CI)) 0.77 (0.66; 0.89)). Patients with moderate coffee consumption (2–3 cups/day) had the lowest hazard for MACE compared to patients with not-daily coffee consumption (HR (95% CI) 0.74 (0.63; 0.87)). Conclusions In a population of AF patients, daily coffee consumption was associated with a reduced risk for MACE, hospitalization for acute heart failure, and all-cause mortality. The results were inconclusive for stroke or systemic embolism, myocardial infarction, and cardiovascular death. In this analysis, we found no evidence of an unfavourable association of daily coffee consumption in AF Patients with adverse outcome events. Trial registration ClinicalTrials.gov Identifier: NCT02105844.
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... Coffee, known for its diverse bioactive compounds, has significant effects on long-term human health [4]. Numerous studies have focused on the health outcomes associated with coffee intake, revealing links to various benefits, including reduced overall mortality rates [5] and decreased risks of cardiovascular death [5,6], liver disease [7,8], type 2 diabetes [9], and Parkinson's disease [4,10]. Intervention trials show that coffee, primarily caffeine, enhances short-term glucose metabolism and insulin sensitivity [11,12]. ...
... Coffee, known for its diverse bioactive compounds, has significant effects on long-term human health [4]. Numerous studies have focused on the health outcomes associated with coffee intake, revealing links to various benefits, including reduced overall mortality rates [5] and decreased risks of cardiovascular death [5,6], liver disease [7,8], type 2 diabetes [9], and Parkinson's disease [4,10]. Intervention trials show that coffee, primarily caffeine, enhances short-term glucose metabolism and insulin sensitivity [11,12]. ...
Investigating causal relationships between coffee consumption and gynecological diseases: a Mendelian randomization study
Article
Full-text available
Introduction Gynecological diseases, including infections, endocrine disorders, and tumors, significantly impact women’s quality of life. Emerging evidence suggests that metabolic factors, nutrition, and dietary habits, such as coffee consumption, may influence these conditions. This study employed two-sample Mendelian randomization (2SMR) to investigate the relationship between coffee intake and gynecological diseases. Material and methods Publicly available genome-wide association study (GWAS) data from the Integrative Epidemiology Unit (IEU) GWAS database were analyzed using the TwoSampleMR R package. Data on coffee consumption were extracted from the UK Biobank. Instrumental variables were selected based on p < 5 × 10–8 and F-statistic > 10, and causal relationships were assessed using inverse variance weighting (IVW) and the Wald ratio (WR) method. Heterogeneity and pleiotropy were tested using MR-Egger regression. A negative control analysis using skin color was performed to address confounding by population stratification. Results The 2SMR analysis identified significant associations between coffee intake and reduced risks of ovarian cancer (OR = 0.07, 95% CI: 0.01–0.84), ovarian cyst (OR = 0.68, 95% CI: 0.49–0.95), and endometriosis (OR = 0.99, 95% CI: 0.99–1.00). Conversely, increased risks were noted for endometrioid ovarian cancer (OR = 7.88, 95% CI: 1.05–59.22). Analysis of different coffee types revealed that ground coffee was associated with decreased risks of ovarian cancer and endometriosis, while decaffeinated coffee showed positive associations with ovarian cancer and endometriosis. Conclusions Coffee intake, especially ground coffee, may lower the risk of certain gynecological diseases. However, decaffeinated coffee may increase these risks. Further research is needed to understand the mechanisms behind these findings.
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... Numerous studies showed that moderate intake of caffeine has a protective effect against diabetes, coronary heart disease, stroke, neurodegenerative diseases, cancer, and inflammatory diseases [6]. A recent meta-analysis by Kim Y et al. also found that consuming moderate doses of caffeine (e.g., 2-4 cups/day) reduces the risk of all-cause and causespecific mortality [7]. ...
Factors associated with caffeine intake among undergraduates: a cross-sectional study from Palestine
Article
Full-text available
  • Feb 2025
  • J HEALTH POPUL NUTR
Background Caffeine is one of the world’s most frequently consumed central nervous system stimulants. Moderate caffeine intake has beneficial health effects, while increased caffeine intake may have harmful effects in the human body. Existing literature indicated that undergraduates consume caffeine excessively. Till this date, little is known about the consumption pattern of caffeine among Palestinian undergraduates. Therefore, the current study aimed to estimate the percentage of caffeine consumption among Palestinian undergraduates, to assess their caffeine daily intake, and to identify factors associated with unsafe caffeine consumption. Methods A cross-sectional study was conducted in Palestine between March and May 2022. Undergraduates were recruited by random sampling after a personal invitation. Undergraduates aged between 18 and 25 were included in the study, while those who were taking medications, had medical conditions affecting the data collection process, and had incomplete responses were excluded from the study. Caffeine consumption was assessed using a semi-quantitative food frequency questionnaire (FFQ) developed by the research team. The content validity of the FFQ was done by three reviewers. Also, a questionnaire was used to collect data related to sociodemographic characteristics, medical history, lifestyle habits, sleeping quality, physical activity, and psychological status. Data were analyzed through the descriptive statistics and inferential statistics (Chi-square test, Mann-Whitney test, and Kruskal-Wallis H test). Results The final analysis included 486 undergraduates with a mean age of 20.1 ± 1.48 years. The majority of the undergraduates were female (65.0%) and single (89.5%). The sample was distributed almost equally between the first (26.3%), second (23.0%), third (22.8%), and fourth (18.7%) academic years, and only 44 undergraduates (9.1%) were in their fifth year. The vast majority of university students (96.5%) consumed caffeinated products, with coffee ranking first place. Nearly half of the participants (32.7%) exceeded the safe levels of caffeine consumption. Males, smokers, poor physical activity, higher Sleep Hygiene Index (SHI) scores, and greater anxiety, stress, and depression scores had significantly higher rates of unsafe caffeine intake than their peers (p < 0.05). The total caffeine consumption was significantly associated with gender, low household income, smoking status, physical activity level, SHI score, as well as anxiety (p < 0.05). Conclusion Caffeine consumption in the studied sample was significantly high and exceeded the safe levels. The current study revealed that unsafe caffeine consumption was more common among males, smokers, and physically active individuals. Caffeine intake was also linked to poor-quality sleep and higher psychological concerns. Therefore, educational programs are recommended to increase awareness of the adverse effects of high caffeine intake.
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Do the hormetic effects of chlorogenic acid mediate some of the beneficial effects of coffee?
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  • Jan 2025
  • CHEM-BIOL INTERACT
The present paper provides the first documentation and assessment of the capacity of chlorogenic acid to induce hormetic dose-response relationships. The findings suggest that chlorogenic acid may induce anabolic (i.e., growth) and catabolic (i.e., protective) hormetic dose responses in several cell types via a range of complementary and cross-talking pathways, affecting a spectrum of endpoints of biomedical and therapeutic importance. This paper also addresses the issue of whether the widely recognized beneficial effects of coffee consumption, as reported in multiple epidemiological studies, may be related to the hormetic effects of chlorogenic acid and its metabolites and their interactions. The present analysis suggests that some beneficial effects of coffee consumption may be due to the effects of chlorogenic acid and/or its metabolites on the gastrointestinal tract via their capacity to impact gastrointestinal integrity, structure, and functionality. These effects collectively contribute to the attenuation of the gastrointestinal tract and concurrent systemic oxidative stress, positively affecting a range of organ-specific effects.
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Drinking Coffee, Mate, and Very Hot Beverages
Article
Full-text available
  • Jan 2018
This volume of the IARC Monographs presents evaluations of the carcinogenic hazard to humans of drinking coffee and very hot beverages including, but not limited to, mate. An IARC Monographs Working Group reviewed epidemiological evidence, animal bioassays and co-carcinogenicity studies, and mechanistic and other relevant data to reach conclusions as to the carcinogenic hazard to humans of drinking coffee, mate, and very hot beverages. The Working Group assessed more than 1000 observational and experimental studies that investigated the association between cancer at more than 20 sites with drinking coffee, mate, and very hot beverages.
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Coffee Consumption and All-Cause and Cardiovascular Mortality ― Three-Prefecture Cohort in Japan ―
Article
Full-text available
  • Mar 2019
  • CIRC J
Background: Coffee, which contains various bioactive compounds, is one of the most popular beverages. Further accumulation of evidence is needed, however, to confirm whether coffee consumption would be effective in preventing cardiovascular disease in the general Japanese population. Methods and Results: We evaluated the association between coffee consumption frequency (never, sometimes, 1–2 cups/day, 3–4 cups/day and ≥5 cups/day) and mortality from all causes, heart disease, and cerebrovascular disease, in 39,685 men and 43,124 women aged 40–79 years at baseline, in a 3-prefecture cohort study. The coffee consumption frequency was assessed on questionnaire. Cox proportional hazards regression modeling was used to assess the association between coffee consumption frequency and all-cause and cardiovascular disease mortality with adjustment for potential confounders. During 411,341 and 472,433 person-years in men and women, respectively, a total of 7,955 men and 5,725 women died. Coffee consumption frequency was inversely associated with all-cause mortality in both genders (P for trend<0.001). In addition, the risks of mortality from cerebrovascular disease in men (P for trend<0.001), and heart disease in women (P for trend=0.031) were inversely associated with coffee consumption. Conclusions: In this Japanese population, coffee drinking has a preventive effect on all-cause and on cardiovascular mortality in men and/or women.
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Coffee consumption and mortality from all causes of death, cardiovascular disease and cancer in an elderly Spanish population
Article
Full-text available
  • Sep 2019
  • EUR J NUTR
Purpose: The effect of coffee consumption on mortality has been scarcely investigated in the elderly. We assessed the association between coffee consumption and mortality from all-cause, cardiovascular disease (CVD) and cancer, in an elderly population of Spain. Methods: We studied 903 individuals (511 women) aged 65 years and older from two population-based studies, the EUREYE-Spain study and the Valencia Nutritional Survey. Coffee consumption and diet were assessed using a validated food frequency questionnaire. Information on education, anthropometry, sleeping time, smoking, alcohol intake, physical activity and pre-existing disease was collected at baseline. Deaths were ascertained during a 12-year follow-up period, and Cox proportional hazards regression models were used to estimate adjusted hazard ratios (HR). Results: There were 403 deaths during the 12-year period (40% from CVD), 174 of which occurred during the first 6 years. We observed evidence of a lower CVD mortality among coffee drinkers in the first 6 years of follow-up. Drinkers of ≤1 cup of coffee/day and > 1 cup/day showed lower CVD mortality than non-drinkers of coffee, HR 0.82 (95% CI 0.46-1.44) and HR 0.38 (0.15-0.96), respectively (p trend = 0.04). This association of coffee with CVD mortality attenuated after 12 years of follow-up. No significant association was observed with all-cause or cancer mortality, neither for caffeinated and decaffeinated coffee. Conclusions: In this study, coffee consumption was associated with lower CVD mortality in elderly. Although this association should be further investigated, coffee consumption appears to be safe for the elderly since no increased mortality was observed in coffee drinkers.
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Coffee consumption and reduced risk of developing type 2 diabetes: A systematic review with meta-analysis
Article
Full-text available
  • Mar 2018
Context Type 2 diabetes (T2D) is a major health problem worldwide that is associated with increased morbidity and mortality. There is increased interest in the value of different nutrition-based strategies for preventing the development of T2D. Objective This review aims to cover current knowledge regarding the effects of coffee consumption on development of T2D or modulation of adverse complications. A meta-analysis on coffee consumption and the risk of T2D was conducted. Moreover, bioactive components in coffee, polymorphisms, and potential underlying mechanism(s) in relation to T2D and adverse complications are discussed. Data sources PubMed was searched up to December 1, 2017, and prospective cohort and nested case–control studies of the association between coffee consumption and T2D risk were selected. Data extraction Two investigators independently extracted data from included studies. Results A total of 30 prospective studies with 1 185 210 participants and 53 018 incident T2D cases were included in the meta-analysis. The pooled relative risk (RR) was 0.71 (95% confidence interval [CI], 0.67–0.76) for the highest category of coffee consumption (median consumption, 5 cups/d) vs the lowest category (median consumption, 0 cups/d). The risk of T2D decreased by 6% (RR = 0.94; 95%CI, 0.93–0.95) for each cup-per-day increase in coffee consumption. Results were similar for caffeinated coffee consumption (per additional cup of coffee per day: RR = 0.93; 95%CI, 0.90–0.96) and decaffeinated coffee consumption (corresponding RR = 0.94; 95%CI, 0.90–0.98). Conclusions Available evidence indicates that coffee consumption is inversely associated with risk of T2D. Possible mechanisms behind this association include thermogenic, antioxidative, and anti-inflammatory effects; modulation of adenosine receptor signaling; and microbiome content and diversity.
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Coffee consumption and plasma biomarkers of metabolic and inflammatory pathways in US health professionals
Article
  • Mar 2019
  • AM J CLIN NUTR
Background: Coffee consumption has been linked to lower risk of various health outcomes. However, the biological pathways mediating the associations remain poorly understood. Objectives: The aim of this study was to assess the association between coffee consumption and concentrations of plasma biomarkers in key metabolic and inflammatory pathways underlying common chronic diseases. Methods: We investigated the associations of total, caffeinated, and decaffeinated coffee consumption with 14 plasma biomarkers, including C-peptide, insulin-like growth factor 1 (IGF-1), IGF binding protein (IGFBP) 1, IGFBP-3, estrone, total and free estradiol, total and free testosterone, sex hormone-binding globulin (SHBG), total adiponectin, high-molecular-weight (HMW) adiponectin, leptin, C-reactive protein (CRP), interleukin 6 (IL-6), and soluble tumor necrosis factor receptor 2 (sTNFR-2). Data were derived from 2 cohorts of 15,551 women (Nurses' Health Study) and 7397 men (Health Professionals Follow-Up Study), who provided detailed dietary data before blood draw and were free of diabetes, cardiovascular disease, or cancer at the time of blood draw. Multivariable linear regression was used to calculate the percentage difference of biomarker concentrations comparing coffee drinkers with nondrinkers, after adjusting for a variety of demographic, clinical, and lifestyle factors. Results: Compared with nondrinkers, participants who drank ≥4 cups of total coffee/d had lower concentrations of C-peptide (-8.7%), IGFBP-3 (-2.2%), estrone (-6.4%), total estradiol (-5.7%), free estradiol (-8.1%), leptin (-6.4%), CRP (-16.6%), IL-6 (-8.1%), and sTNFR-2 (-5.8%) and higher concentrations of SHBG (5.0%), total testosterone (7.3% in women and 5.3% in men), total adiponectin (9.3%), and HMW adiponectin (17.2%). The results were largely similar for caffeinated and decaffeinated coffee. Conclusions: Our data indicate that coffee consumption is associated with favorable profiles of numerous biomarkers in key metabolic and inflammatory pathways. This trial was registered at clinicaltrials.gov as NCT03419455.
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Caffeinated and decaffeinated coffee consumption and risk of all-cause mortality: a dose-response meta-analysis of cohort studies
Article
  • Feb 2019
Background Previous meta‐analysis showed an inverse association between coffee consumption and all‐cause mortality. However, the relationship between caffeinated and decaffeinated coffee consumption and all‐cause mortality is inconsistent. We aimed to identify and review the published evidence updating the association between coffee consumption and all‐cause mortality and, furthermore, to investigate the association of caffeinated and decaffeinated coffee consumption and all‐cause mortality. Methods We systematically searched PubMed and Web of Science for studies published up to 9 November 2017. Cohort studies in which authors reported relative risks (RRs) of all‐cause mortality for at least three levels of coffee consumption were eligible. Random‐effects models were used to estimate the pooled RR of all‐cause mortality with coffee consumption. Restricted cubic splines were used to model the dose–response association. Results We included 21 cohort study articles (10 103 115 study participants and 240 303 deaths). We found a nonlinear association between coffee consumption and all‐cause mortality (Pnonlinearity < 0.001). Compared with no or rare coffee consumption, with a consumption of 3 cups day–1, the risk of all‐cause mortality might reduce 13% (RR = 0.87; 95% confidence interval = 0.84–0.89). Conclusions The findings of the present study provide quantitative data suggesting that coffee consumption plays a role in reducing the risk of all‐cause mortality. Similar inverse associations are found for caffeinated coffee and decaffeinated coffee.
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The Effect of Daily Fluid Management and Beverages Consumption on the Risk of Bladder Cancer: A Meta-analysis of Observational Study
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  • Dec 2018
Epidemiological studies have evaluated the risk of bladder cancer (BCa) in relation to total fluid intake, as well as specific type of beverages consumption, with controversial results. The aim of this study was to further explore the potential relationship by conducting a meta-analysis. Fifty-four articles involving more than 43,000 BCa patients were included in this meta-analysis. A positive, though not statistically significant, association was found between total fluid intake and risk of BCa comparing the highest with lowest intake (SRRE: 1.16, 95%CI: 1.00–1.36). By conducting dose-response meta-analysis, we found that each 500 ml/day increase in total fluid intake was associated with 3.3% increased risk of BCa (RR: 1.03, 95%CI: 1.00–1.07). Pronounced increase in risk of BCa was detected when total fluid intake was more than 3000 ml/day. Meta-analyses of specific type of beverages showed increasing intake of coffee (RR: 1.03, 95%CI: 1.02–1.05) were risk factors for BCa. On the contrary, increasing intake of milk appeared to be a potential protective factor for BCa (RR: 0.90, 95%CI: 0.83–0.98). The risk of BCa was not significantly related to intake of water (RR: 1.01, 95%CI: 0.98–1.03), alcohol (RR: 1.01, 95%CI: 0.97–1.05), tea (RR: 1.01, 95%CI: 0.97–1.05) and soft drinks (RR: 1.04, 95%CI: 0.96–1.11).
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Coffee consumption and total mortality in a Mediterranean prospective cohort
Article
  • Nov 2018
  • AM J CLIN NUTR
Background: The relation of coffee consumption with total mortality is controversial, because the available evidence is still inconsistent. Objective: This study aimed to assess this association in a highly educated, middle-aged Mediterranean cohort. Design: We analyzed data from 201,055 person-years of follow-up arising from 19,888 participants. Coffee consumption was obtained at baseline with the use of a previously validated semiquantitative food-frequency questionnaire. Information on mortality was ascertained by permanent contact with the "Seguimiento Universidad de Navarra" (SUN) participants and their families, postal authorities, and consultation of the National Death Index. We used Cox regression models to estimate HRs and 95% CIs for mortality according to baseline total coffee consumption adjusted for potential confounders. Sex, age, and baseline adherence to the Mediterranean diet were considered as potential effect modifiers. Results: Among the 19,888 participants, 337 died. Overall, in the multivariable adjusted analysis, we found a 22% lower risk of all-cause mortality for each 2 additional cups of total coffee per day (HR: 0.78; 95% CI: 0.66, 0.93). This association was stronger for participants aged ≥55 y (HR: 0.67; 95% CI: 0.52, 0.86) than for younger participants, who showed no significant association (P-interaction = 0.002). Conclusion: In a Mediterranean cohort, we found an inverse linear association between total coffee consumption and the risk of all-cause mortality that was strongest among participants older than 54 y.
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Association of Coffee Drinking With Mortality by Genetic Variation in Caffeine Metabolism: Findings From the UK Biobank
Article
  • Jul 2018
Importance Prospective cohorts in North America, Europe, and Asia show consistent inverse associations between coffee drinking and mortality, including deaths from cardiovascular disease and some cancers. However, concerns about coffee, particularly among people with common genetic polymorphisms affecting caffeine metabolism and among those drinking more than 5 cups per day, remain. Objective To evaluate associations of coffee drinking with mortality by genetic caffeine metabolism score. Design, Setting, and Participants The UK Biobank is a population-based study that invited approximately 9.2 million individuals from across the United Kingdom to participate. We used baseline demographic, lifestyle, and genetic data form the UK Biobank cohort, with follow-up beginning in 2006 and ending in 2016, to estimate hazard ratios (HRs) for coffee intake and mortality, using multivariable-adjusted Cox proportional hazards models. We investigated potential effect modification by caffeine metabolism, defined by a genetic score of previously identified polymorphisms in AHR, CYP1A2, CYP2A6, and POR that have an effect on caffeine metabolism. Of the 502 641 participants who consented with baseline data, we included those who were not pregnant and had complete data on coffee intake and smoking status (n = 498 134). Exposures Total, ground, instant, and decaffeinated coffee intake. Main Outcomes and Measures All-cause and cause-specific mortality. Results The mean age of the participants was 57 years (range, 38-73 years); 271 019 (54%) were female, and 387 494 (78%) were coffee drinkers. Over 10 years of follow-up, 14 225 deaths occurred. Coffee drinking was inversely associated with all-cause mortality. Using non–coffee drinkers as the reference group, HRs for drinking less than 1, 1, 2 to 3, 4 to 5, 6 to 7, and 8 or more cups per day were 0.94 (95% CI, 0.88-1.01), 0.92 (95% CI, 0.87-0.97), 0.88 (95% CI, 0.84-0.93), 0.88 (95% CI, 0.83-0.93), 0.84 (95% CI, 0.77-0.92), and 0.86 (95% CI, 0.77-0.95), respectively. Similar associations were observed for instant, ground, and decaffeinated coffee, across common causes of death, and regardless of genetic caffeine metabolism score. For example, the HRs for 6 or more cups per day ranged from 0.70 (95% CI, 0.53-0.94) to 0.92 (95% CI, 0.78-1.10), with no evidence of effect modification across strata of caffeine metabolism score (P = .17 for heterogeneity). Conclusions and Relevance Coffee drinking was inversely associated with mortality, including among those drinking 8 or more cups per day and those with genetic polymorphisms indicating slower or faster caffeine metabolism. These findings suggest the importance of noncaffeine constituents in the coffee-mortality association and provide further reassurance that coffee drinking can be a part of a healthy diet.
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Associations of coffee consumption with circulating level of adiponectin and leptin. A meta-analysis of observational studies
Article
  • Mar 2018
The association between coffee consumption and the circulating level of adiponectin and leptin has been evaluated in several epidemiological studies with conflicting results. Therefore, the aim of this study was to examine the associations of coffee consumption with the circulating level of adiponectin and leptin. A comprehensive literature search up to January 2018, using PUBMED, EMBASE and Web of Science databases, was conducted to identify the relevant observational studies that examined the associations of coffee consumption with the circulating level of adiponectin and leptin. A total of twelve cross-sectional studies were included in this meta-analysis. According to the combined standard mean difference (SMD) between the highest and the lowest coffee intake category, coffee consumption was associated with a higher circulating adiponectin level (SMD = 0.11, 95%CI: 0.06–0.17; P < .001). Subgroup analysis confirmed such findings in females (SMD = 0.11, 95%CI: 0.02–0.20; P = .01), but not in males (SMD = 0.03, 95%CI: −0.08 to 0.14; P = .59). In addition, the combined SMD showed that coffee consumption was negatively associated with the circulating level of leptin (SMD = −0.19, 95%CI: −0.28 to −0.10; P < .001). The results of this meta-analysis suggested that coffee consumption was associated with a higher circulating level of adiponectin. Additionally, we showed that coffee consumption was inversely associated with the circulating level of leptin. More well-designed prospective cohort studies and randomised controlled trials are needed to further elaborate the concerned issues.
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