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#Grand Rounds

The Intersection of Coffee and Genetics: Is There an Impact on Mortality?

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BACKGROUND AND PURPOSE: 

  • Studies seem to confirm an association between coffee and reduced rates of chronic disease and cancer 
    • Prospective studies also indicate reduced all-cause and cause-specific mortality 
  • Limited data  
    • Research suggests that individuals with particular genetic background related to caffeine metabolism may be at increased risk of cardiovascular disease  
    • Few studies analyze heavy coffee drinking (≥6 cups/d)  
  • Loftfield et al. (JAMA Internal Medicine, 2018) sought to determine whether the association between coffee drinking and mortality is altered by genetic caffeine metabolism score

METHODS: 

  • Population-based study utilizing the UK Biobank cohort for baseline demographic, lifestyle, and genetic data 
  • Follow up questionnaires conducted over 10 years 
  • Genetic scores were defined based on expression of SNPs  
    • Known to be associated with blood caffeine metabolite levels  
    • Map near genes that are thought to play a role in caffeine metabolism 
  • Primary outcome was all-cause and cause-specific mortality

RESULTS: 

  • 498,134 subjects were included in the study 
    • Mean age: 57 years (range, 38-73 years) 
    • 271,019 (54%) were female 
    • 387,494 (78%) were coffee drinkers 
    • 14,225 deaths occurred 
  • Coffee drinking was inversely associated with all-cause mortality 
  • Using non–coffee drinkers as the reference group 
    • Less than 1 cup: Hazard ratio (HR) 0.94; 95% CI, 0.88-1.01 
    • 1 cup/d: HR 0.92; 95% CI, 0.87-0.97 
    • 2 to 3 cups/d: HR 0.88; 95% CI, 0.84-0.93 
    • 4 to 5 cups/d: HR 0.88; 95% CI, 0.83-0.93 
    • 6 to 7 cups/d: HR 0.84; 95% CI, 0.77-0.92 
    • 8 or more cups/d: HR 0.86; 95% CI, 0.77-0.95 
  • Results similar for  
    • Instant, ground, and decaffeinated coffee 
    • Across common causes of death 
    • Regardless of genetic caffeine metabolism score

CONCLUSION: 

  • Genetic caffeine metabolism score did not impact the inverse association between coffee and mortality 
  • Coffee drinking is inversely associated with all-cause mortality, even for heavy drinkers, regardless of whether or not someone is a slow or fast caffeine metabolizer  
  • Authors caution that while data is observational and does not imply or prove causation:

Nevertheless, these results provide further evidence that coffee drinking can be part of a healthy diet and may provide reassurance to those who drink coffee and enjoy it.

Learn More – Primary Sources: 

Association of Coffee Drinking With Mortality by Genetic Variation in Caffeine Metabolism – Findings From the UK Biobank 

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Can We Lay the Coffee and Mortality Debate to Rest?
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