Association of Coffee Consumption With Total and Cause-Specific Mortality in 3 Large Prospective Cohorts

Abstract

Background: The association between consumption of caffeinated and decaffeinated coffee and risk of mortality remains inconclusive.

Methods and results: We examined the associations of consumption of total, caffeinated, and decaffeinated coffee with risk of subsequent total and cause-specific mortality among 74,890 women in the Nurses' Health Study (NHS), 93,054 women in the Nurses' Health Study II, and 40,557 men in the Health Professionals Follow-up Study. Coffee consumption was assessed at baseline using a semiquantitative food frequency questionnaire. During 4,690,072 person-years of follow-up, 19,524 women and 12,432 men died. Consumption of total, caffeinated, and decaffeinated coffee were nonlinearly associated with mortality. Compared with nondrinkers, coffee consumption of 1 to 5 cups per day was associated with lower risk of mortality, whereas coffee consumption of more than 5 cups per day was not associated with risk of mortality. However, when restricting to never smokers compared with nondrinkers, the hazard ratios (and 95% confidence intervals) of mortality were 0.94 (0.89-0.99) for 1.0 or less cup per day, 0.92 (0.87-0.97) for 1.1 to 3.0 cups per day, 0.85 (0.79-0.92) for 3.1 to 5.0 cup per day, and 0.88 (0.78-0.99) for more than 5.0 cup per day (P value for nonlinearity = 0.32; P value for trend < 0.001). Significant inverse associations were observed for caffeinated (P value for trend < 0.001) and decaffeinated coffee (P value for trend = 0.022). Significant inverse associations were observed between coffee consumption and deaths attributed to cardiovascular disease, neurologic diseases, and suicide. No significant association between coffee consumption and total cancer mortality was found.

Conclusions: Higher consumption of total coffee, caffeinated coffee, and decaffeinated coffee was associated with lower risk of total mortality.

Keywords: coffee; mortality; smoking.

Figure 1

The association between coffee consumption and risk of mortality in the overall population and among never smokers pooled across the three cohorts. 1a. Total coffee consumption and risk of mortality 1b. Caffeinated coffee consumption and risk of mortality 1c. Decaffeinated coffee consumption and risk of mortality. Multivariate-adjusted models adjusted for age, baseline disease status (hypertension, hypercholesterolemia, diabetes), BMI (< 20.9, 21-22.9, 23-24.9, 25-29.9, 30-34.9, ≥ 35 kg/m²), physical activity (< 3, 3-8.9, 9-17.9, 18-26.9, ≥ 27 MET-h/wk), smoking status (never, former (1 - 4 cigarettes/d), former (5 - 14 cigarettes/d), former (15 - 24 cigarettes/d), former (25 - 34 cigarettes/d), former (35 - 44 cigarettes/d), former (≥ 45 cigarettes/d), former (unknown cigarettes/d), current (1 - 4 cigarettes/d), current (5 - 14 cigarettes/d), current (15 - 24 cigarettes/d), current (25 - 34 cigarettes/d), current (35 - 44 cigarettes/d), current (≥ 45 cigarettes/d), current (unknown cigarettes/d)), overall dietary pattern (AHEI score, in quintiles), total energy intake (quintiles), sugar-sweetened beverages consumption (quintiles) and alcohol consumption (0, 0-5, 5-10, 10-15, ≥ 15 g/d). We additionally adjusted for menopausal status (yes vs. no), and postmenopausal hormone use (yes vs. no) for women. Caffeinated and decaffeinated coffee adjusted for each other.

Figure 2

The association of a 1-cup per day increment in coffee consumption with risk of cause-specific mortality pooled across the three cohorts. The black squares stand for the overall population. The red squares stand for never smokers. * P value < 0.05. ** P value < 0.001. Multivariate-adjusted models adjusted for age, baseline disease status (hypertension, hypercholesterolemia, diabetes), BMI (< 20.9, 21-22.9, 23-24.9, 25-29.9, 30-34.9, ≥ 35 kg/m²), physical activity (< 3, 3-8.9, 9-17.9, 18-26.9, ≥ 27 MET-h/wk), smoking status (never, former (1 - 4 cigarettes/d), former (5 - 14 cigarettes/d), former (15 - 24 cigarettes/d), former (25 - 34 cigarettes/d), former (35 - 44 cigarettes/d), former (≥ 45 cigarettes/d), former (unknown cigarettes/d), current (1 - 4 cigarettes/d), current (5 - 14 cigarettes/d), current (15 - 24 cigarettes/d), current (25 - 34 cigarettes/d), current (35 - 44 cigarettes/d), current (≥ 45 cigarettes/d), current (unknown cigarettes/d)), overall dietary pattern (AHEI score, in quintiles), total energy intake (quintiles), sugar-sweetened beverages consumption (quintiles) and alcohol consumption (0, 0-5, 5-10, 10-15, ≥ 15 g/d). We additionally adjusted for menopausal status (yes vs. no), and postmenopausal hormone use (yes vs. no) for women. Caffeinated and decaffeinated coffee adjusted for each other.