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ARTICLE

Coffee Consumption and Risk for Type 2 Diabetes Mellitus

Eduardo Salazar-Martinez, MD, PhD; Walter C. Willett, MD, DrPH; Alberto Ascherio, MD, DrPH; JoAnn E. Manson, MD, DrPH; Michael F. Leitzmann, MD, DrPH; Meir J. Stampfer, MD, DrPH; and Frank B. Hu, MD, PhD

6 January 2004 | Volume 140 Issue 1 | Pages 1-8

Background: In small, short-term studies, acute administration of caffeine decreases insulin sensitivity and impairs glucose tolerance.

Objective: To examine the long-term relationship between consumption of coffee and other caffeinated beverages and incidence of type 2 diabetes mellitus.

Design: Prospective cohort study.

Setting: The Nurses' Health Study and Health Professionals' Follow-up Study.

Participants: The authors followed 41 934 men from 1986 to 1998 and 84 276 women from 1980 to 1998. These participants did not have diabetes, cancer, or cardiovascular disease at baseline.

Measurements: Coffee consumption was assessed every 2 to 4 years through validated questionnaires.

Results: The authors documented 1333 new cases of type 2 diabetes in men and 4085 new cases in women. The authors found an inverse association between coffee intake and type 2 diabetes after adjustment for age, body mass index, and other risk factors. The multivariate relative risks for diabetes according to regular coffee consumption categories (0, <1, 1 to 3, 4 to 5, or 6 cups per day) in men were 1.00, 0.98, 0.93, 0.71, and 0.46 (95% CI, 0.26 to 0.82; P = 0.007 for trend), respectively. The corresponding multivariate relative risks in women were 1.00, 1.16, 0.99, 0.70, and 0.71 (CI, 0.56 to 0.89; P < 0.001 for trend), respectively. For decaffeinated coffee, the multivariate relative risks comparing persons who drank 4 cups or more per day with nondrinkers were 0.74 (CI, 0.48 to 1.12) for men and 0.85 (CI, 0.61 to 1.17) for women. Total caffeine intake from coffee and other sources was associated with a statistically significantly lower risk for diabetes in both men and women.

Conclusions: These data suggest that long-term coffee consumption is associated with a statistically significantly lower risk for type 2 diabetes.

Editors' Notes Context A recently published study in a Dutch population identified an association between higher coffee consumption and lower risk for type 2 diabetes mellitus but did not distinguish between intake of regular and decaffeinated coffee. Contribution This large epidemiologic study in a U.S. sample confirmed the Dutch study findings. It also found a statistically significant protective association between total caffeine intake and type 2 diabetes mellitus and a modest inverse association with decaffeinated coffee consumption. Implications Consumption of caffeinated coffee is associated with a reduced risk for type 2 diabetes mellitus. Further studies should explore the long-term effects of caffeine on glucose metabolism. –The Editors

 

Author and Article Information

From Harvard School of Public Health, Channing Laboratory, Harvard Medical School, and Brigham and Women's Hospital, Boston, Massachusetts; and Mexican Institute of Social Security, Cuernavaca, Morelos, Mexico.

Acknowledgments: The authors thank Tricia Li for her expert assistance in data analysis.

Grant Support: By research grants DK58845, HL35464, AA11181, CA87969, and CA55075 from the National Institutes of Health.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Frank B. Hu, MD, PhD, Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115; e-mail, frank.hu{at}channing.harvard.edu.

Current Author Addresses: Dr. Salazar-Martinez: National Institute of Public Health, Av. Universidad 655, Col. Sta. Maria Ahuacatitlánin, 62508 Cuernavaca, Morelos, Mexico.

Drs. Willett, Ascherio, and Hu: Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115.

Dr. Manson: Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, 900 Commonwealth Avenue, 3rd Floor, Boston, MA 02215.

Dr. Leitzmann: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, MSC 7232, Bethesda, MD 20892.

Dr. Stampfer: Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115.

Author Contributions: Conception and design: E. Salazar-Martinez, W.C. Willett, A. Ascherio, J.E. Manson, M.F. Leitzmann, F.B. Hu.

Analysis and interpretation of the data: E. Salazar-Martinez, W.C. Willett, A. Ascherio, J.E. Manson, M.F. Leitzmann, M.J. Stampfer, F.B. Hu.

Drafting of the article: E. Salazar-Martinez, F.B. Hu.

Critical revision of the article for important intellectual content: E. Salazar-Martinez, W.C. Willett, A. Ascherio, J.E. Manson, M.F. Leitzmann, M.J. Stampfer, F.B. Hu.

Final approval of the article: E. Salazar-Martinez, A. Ascherio, J.E. Manson, M.F. Leitzmann, M.J. Stampfer, F.B. Hu.

Statistical expertise: M.F. Leitzmann, M.J. Stampfer, F.B. Hu.

Obtaining of funding: W.C. Willett, J.E. Manson, F.B. Hu.

Administrative, technical, or logistic support: J.E. Manson, F.B. Hu.

Collection and assembly of data: J.E. Manson, F.B. Hu.

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