Association of Coffee Drinking With Total and Cause-Specific Mortality

Study Questions:

Is coffee consumption associated with total and cause-specific mortality?

Methods:

Data from the National Institutes of Health–AARP Diet and Health Study were used for the present analysis. The NIH–AARP Diet and Health Study enrolled AARP members (n = 617,119) between 1995 and 1996, who then completed a comprehensive questionnaire, assessing diet and lifestyle. Participants resided in six states (California, Florida, Louisiana, New Jersey, North Carolina, and Pennsylvania), and two metropolitan areas (Atlanta and Detroit). Participants were excluded if they had not personally completed the questionnaire; had a diagnosis of cancer, heart disease, or stroke at entry; or did not provide information on coffee consumption. Also excluded were those subjects who did not provide information on smoking or had extremely low or high caloric consumption. Coffee consumption was assessed through the baseline questionnaire. Specific causes of death were obtained through the National Death Index Plus.

Results:

A total of 229,119 men and 173,141 women (ages 50-71 years at baseline) contributed 5,148,760 person-years of follow-up between 1995 and 2008. During 14 years of follow-up (median 13.6 years), 33,731 men and 18,784 women died. In age-adjusted models, the risk of death was increased among coffee drinkers. However, coffee drinkers were also more likely to smoke. After adjustment for tobacco-smoking status and other potential confounders, a significant inverse association between coffee consumption and mortality was observed. Adjusted hazard ratios for death among men who drank coffee as compared with those who did not were as follows: 0.99 (95% confidence interval [CI], 0.95-1.04) for drinking less than 1 cup per day, 0.94 (95% CI, 0.90-0.99) for 1 cup, 0.90 (95% CI, 0.86-0.93) for 2 or 3 cups, 0.88 (95% CI, 0.84-0.93) for 4 or 5 cups, and 0.90 (95% CI, 0.85-0.96) for 6 or more cups of coffee per day (p < 0.001 for trend). For women, the respective hazard ratios were 1.01 (95% CI, 0.96-1.07) for drinking less than 1 cup per day, 0.95 (95% CI, 0.90-1.01) for 1 cup, 0.87 (95% CI, 0.83-0.92) for 2 or 3 cups, 0.84 (95% CI, 0.79-0.90) for 4 or 5 cups, and 0.85 (95% CI, 0.78-0.93) for 6 or more cups of coffee per day (p < 0.001 for trend). Inverse associations were observed for deaths due to heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections, but not for deaths due to cancer. Results were similar in subgroups, including persons who had never smoked and persons who reported very good to excellent health at baseline.

Conclusions:

The investigators concluded that coffee consumption was inversely associated with total and cause-specific mortality.

Perspective:

This study includes a large prospective cohort in which coffee does not appear to increase risk of cardiovascular death. Prior studies which have observed an association between coffee and mortality may have not completely adjusted for associated factors such as smoking.

Clinical Topics: Prevention, Diet, Smoking

Keywords: Stroke, Neoplasms, Follow-Up Studies, Risk Factors, Smoking, Drinking, Cause of Death, Tobacco, Cardiovascular Diseases, Diet, Confidence Intervals, United States, Diabetes Mellitus, Coffee


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