The Relationship of Coffee Consumption with Mortality

17 June 2008 | Volume 148 Issue 12 | Pages 904-914

Background: Coffee consumption has been linked to various beneficial and detrimental health effects, but data on its relation with mortality are sparse.

Objective: To assess the association between coffee consumption and mortality from cardiovascular disease (CVD), cancer, and all causes during 18 years of follow-up in men and 24 years of follow-up in women.

Design: Sex-specific Cox proportional hazard models were used to investigate the association between coffee consumption and incidence of all-cause and disease-specific mortality in a prospective cohort study.

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

Participants: 41 736 men and 86 214 women with no history of CVD or cancer at baseline.

Measurements: Coffee consumption was assessed first in 1986 for men and in 1980 for women and then every 2 to 4 years through 2004. Investigators documented 6888 deaths (2049 due to CVD and 2491 due to cancer) among men and 11 095 deaths (2368 due to CVD and 5011 due to cancer) among women.

Results: After adjustment for age, smoking, and other CVD and cancer risk factors, the relative risks for all-cause mortality in men across categories of coffee consumption (<1 cup per month, 1 cup per month to 4 cups per week, 5 to 7 cups per week, 2 to 3 cups per day, 4 to 5 cups per day, and 6 cups per day) were 1.0, 1.07 (95% CI, 0.99 to 1.16), 1.02 (CI, 0.95 to 1.11), 0.97 (CI, 0.89 to 1.05), 0.93 (CI, 0.81 to 1.07), and 0.80 (CI, 0.62 to 1.04), respectively (P for trend = 0.008). For women, the relative risks were 1.0, 0.98 (CI, 0.91 to 1.05), 0.93 (CI, 0.87 to 0.98), 0.82 (CI, 0.77 to 0.87), 0.74 (CI, 0.68 to 0.81), and 0.83 (CI, 0.73 to 0.95), respectively (P for trend < 0.001). This inverse association was mainly due to a moderately reduced risk for CVD mortality and was independent of caffeine intake. By contrast, coffee consumption was not statistically significantly associated with risk for cancer death after adjustment for potential confounders. Decaffeinated coffee consumption was associated with a small reduction in all-cause and CVD mortality.

Limitation: Coffee consumption was estimated from self-report; thus, some measurement error is inevitable.

Conclusion: Regular coffee consumption was not associated with an increased mortality rate in either men or women. The possibility of a modest benefit of coffee consumption on all-cause and CVD mortality needs to be further investigated.

Editors' Notes Context Previous studies have examined the association between coffee consumption and a variety of specific diseases, such as type 2 diabetes, different types of cancer, and cardiovascular disease. However, the relationship between coffee consumption and all-cause mortality remains unclear. Contribution This study followed 2 large cohorts of men and women who provided data on coffee consumption, other behaviors, and health outcomes every 2 to 4 years over 2 decades. High coffee consumption was not related to increased mortality and may even be associated with lower total and cardiovascular mortality. Caution Misclassification of coffee consumption or confounding by other behavioral factors may account for these observations. —The Editors

 

Author and Article Information

From Harvard School of Public Health, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachussetts; Universidad Autónoma de Madrid, Madrid, Spain; and CIBERESP (CIBER of Epidemiology and Public Health), Spain.

Grant Support: Supported by National Institutes of Health research grants CA87969, CA55075, HL34594, and HL60712. Dr. Lopez-Garcia is supported by a contract from the Ramón y Cajal Programme. Dr. Hu is partly supported by an American Heart Association Established Investigator Award.

Potential Financial Conflicts of Interest: None disclosed.

Reproducible Research Statement: Study protocol: Available at http://www.hsph.harvard.edu/hpfs and http://www.channing.harvard.edu/nhs. Statistical code: Not available. Data set: Available subject to approval by the NHS and HPFS committees.

Requests for Single Reprints: Esther Lopez-Garcia, PhD, Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Avenida Arzobispo Morcillo 4, 28029 Madrid, Spain; e-mail, esther.lopez{at}uam.es.

Current Author Addresses: Drs. Lopez-Garcia and Rodriguez-Artalejo: Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Avenida Arzobispo Morcillo 4, 28029 Madrid, Spain.

Drs. van Dam, Li, and Hu: Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115.

Author Contributions: Conception and design: E. Lopez-Garcia, R.M. van Dam, T.Y. Li, F. Rodriguez-Artalejo, F.B. Hu.

Analysis and interpretation of the data: E. Lopez-Garcia, R.M. van Dam, T.Y. Li, F. Rodriguez-Artalejo, F.B. Hu.

Drafting of the article: E. Lopez-Garcia.

Critical revision of the article for important intellectual content: E. Lopez-Garcia, R.M. van Dam, F. Rodriguez-Artalejo, F.B. Hu.

Final approval of the article: E. Lopez-Garcia, R.M. van Dam, F. Rodriguez-Artalejo, F.B. Hu.

Statistical expertise: E. Lopez-Garcia, T.Y. Li.

Obtaining of funding: F.B. Hu.

Administrative, technical, or logistic support: F. Rodriguez-Artalejo, F.B. Hu.

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