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#Grand Rounds

Can We Lay the Coffee and Mortality Debate to Rest?

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BACKGROUND AND PURPOSE: 

  • There have been previous studies that would indicate coffee consumption is associated with reduced mortality  
  • Gunter et al. (Annals of Internal Medicine, 2017) examined whether coffee consumption is associated with all-cause and cause-specific mortality in diverse European populations  

METHODS: 

  • Prospective cohort study of 521,330 people in 10 European countries  
  • A subcohort was further assessed for association of coffee consumption with serum biomarkers of liver function, inflammation, and metabolic health  
  • Mean follow-up of 16.4 years 

RESULTS: 

All-cause mortality 

  • Similar inverse associations (more coffee/lower mortality) and trends when comparing caffeinated to decaffeinated coffee 
    • Less pronounced association for caffeinated coffee in men  
  • When comparing ≥ 3 cups of coffee per day vs nonconsumers  
    • Men: hazard ratio (HR) 0.82 (95% CI 0.76 to 0.89; P < 0.001) 
    • Women: HR 0.92 (95% CI 0.87 to 0.98; P < 0.001) 

Specific-cause mortality 

  • Inversely associated with death due to digestive disease  
    • Comparing highest quartile coffee drinkers against nonconsumers and first quartile drinkers  
      • Men: HR 0.41 (95% CI 0.32 to 0.54; P < 0.001) 
      • Women: HR 0.60 (95% CI 0.46-0.78; P < 0.001) 
      • This strong inverse association was especially marked in digestive disease deaths due to liver disease such as cirrhosis
  • Inversely associated with circulatory disease, such as stroke   
    • Especially in women comparing highest quartile vs. nonconsumers 
      • HR 0.70 (95% CI 0.55 to 0.90; P = 0.002) 
      • Association might be driven by sex-specific beneficial effects of coffee on lipid, inflammatory, and metabolic profiles 
  • A positive association was found in ovarian cancer mortality  
    • Comparing highest quartile vs. nonconsumers 
      • HR 1.31 (CI, 1.07 to 1.61; P = 0.015) 
      • Requires follow up studies as other prospective studies did not find this association  
  • Coffee consumption was inversely associated with liver cancer mortality in both men and women  
  • Coffee drinking was associated with variation in serum biomarkers of liver function, inflammation, insulin sensitization, and blood lipids consistent with biological plausibility 

CONCLUSION:

  • Coffee drinking was associated with reduced risk for death in various cases 
  • The relationship does not appear to vary by country, and studies involving a larger geographical range of subjects obtained similar findings (Freedman et al., NEJM 2012) 
  • A companion paper in the same journal (Park et al., Annals of Internal Medicine, 2017) found that higher consumption of coffee was associated with a lower risk of death in African Americans, Japanese Americans, Latinos and whites, crossing racial and ethnic populations  
  • A recent paper by Grosso et al. (Public Health Nutrition, 2017) also found coffee consumption to be associated with decreased risk of mortality that was especially pronounced when stratified by smoking and alcohol intake  
  • Coffee intake may confer health benefits 

Learn More – Primary Sources:  

Coffee Drinking and Mortality in 10 European Countries: A Multinational Cohort Study 

Association of Coffee Consumption With Total and Cause-Specific Mortality Among Nonwhite Populations 

Coffee consumption and mortality in three Eastern European countries: results from the HAPIEE (Health, Alcohol and Psychosocial factors In Eastern Europe) study

Association of Coffee Drinking with Total and Cause-Specific Mortality

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Does Drinking Coffee Speed Gut Recovery Post GYN Surgery?

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