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Prof. Maja-Lisa Løchen
Association of coffee consumption with total and cause-specific mortality in three large prospective cohorts.Ming Ding et al.Circulation DOI: 10.1161/CIRCULATIONAHA.115.017341
This is an important study concluding that coffee consumption with and without caffeine can be incorporated into advices for healthy lifestyle because it is not associated with increased mortality. Long-term heavy coffee drinking in never smokers is associated with lower risk of total mortality, and lower mortality from CVD, neurological diseases and suicide, but not for cancer.
The associations of coffee consumption measured by questionnaires were examined in a merged American cohort consisting of three large health personnel studies (Two Nurses’ Health studies and Health Professionals Follow-up Study). During 4,690,072 person years of follow up, 19,524 women and 12,432 men died.
The association between coffee and mortality was non-linear for the whole population. Compared to non-drinkers, one to five cups per day was related with lower mortality risk, and more than five cups was not associated with mortality risk. When restricting to never smokers, the associations were linear. Compared to non-drinkers, the hazard ratios of total mortality were 0.94 (0.89 to 0.99) for < 1 cup per day and 0.88 (0.78 to 0.99) for >5 cups. Given that the association became linear and inverse when the analyses were restricted to never smokers, the authors comment that this might have been due to residual confounding by smoking. The biological mechanism may be as for type 2 diabetes, where coffee reduces insulin resistance and systemic inflammation through effects of chlorogenic acid, lignans, quinides, trigonelline and magnesium. As both caffeinated and decaffeinated coffee drinking is associated with lower risk of death, it is plausible that other components in coffee in addition to caffeine are beneficial.
Strengths of the study are detailed measurements of coffee consumption, the large sample size and number of deaths as well as long follow-up time. The results may not be generalised to other populations than white.
In conclusion, coffee consumption can be recommended as part of a healthy lifestyle for those who love it.
The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology
Maja-Lisa Løchen, Department of Community Medicine, UIT The Arctic University of Norway, Tromsø, Norway