Coffee or Tea? A prospective cohort study on the associations of coffee and tea intake with overall and cause-specific mortality in men versus women

Abstract

Coffee and tea intake have been associated with reduced mortality, but no studies have investigated possible substitution effects. The relationship of mortality with coffee, tea, and substituting coffee with tea was investigated in the Netherlands Cohort Study. In 1986, 120,852 men and women aged 55-69 years provided information on dietary and lifestyle habits. Mortality follow-up until 1996 consisted of linkage to Statistics Netherlands. Multivariate case-cohort analyses were based on 8665 deaths and 3166 subcohort members with complete data on coffee, tea and confounders. Higher coffee intake was significantly, nonlinearly related to lower overall and cause-specific mortality in women. In men, coffee was significantly positively related to cancer and cardiovascular mortality, and inversely to respiratory and other causes of death. Tea intake was significantly, nonlinearly related to lower overall, cancer and cardiovascular mortality in men, but showed no association with mortality in women. In substitution analyses, increasing the proportion tea (replacing coffee with tea) was significantly and nonlinearly related to lower overall, cancer and cardiovascular mortality in men, but in women higher tea proportions were positively associated with overall mortality (and most causes of death). This study suggests that for men, compared to exclusive coffee drinkers, those drinking 30-50% tea showed the lowest mortality; any tea drinking seemed better than only coffee. For women, those who drank exclusively coffee or drinking up to 40% tea had the lowest mortality, but those drinking higher percentages of tea were at increased mortality risk [HR = 1.41 (95% CI 1.01-1.99) for 80-100% tea compared to exclusive coffee drinkers].

Keywords: Cardiovascular diseases; Coffee; Cohort studies; Mortality; Neoplasms; Tea.

Fig. 1

Spline regression curves for the association between coffee intake and total mortality. Red lines: men. Blue lines: women. Solid lines represents point estimates and dashed lines represent 95% CI. Multivariate HRs are calculated by restricted cubic spline regression (using 3 knots at 10th, 50th, and 90th percentiles) adjusting for: age at baseline (continuous, in years), cigarette smoking status (coded as never, former, current smoker), number of cigarettes smoked per day, and years of smoking (both continuous, centered), history of physician-diagnosed hypertension (no, yes) and diabetes (no, yes), body height (continuous, m), BMI (< 18.5, 18.5–< 25, 25–< 30, ≥ 30 kg/m²), non-occupational physical activity (< 30, 30–60, 61–90, ≥ 90 min/day), highest level of education (primary school or lower vocational, secondary or medium vocational, and higher vocational or university), intake of alcohol (0, 0.1–< 5, 5–< 15, 15–< 30, 30+ g/day), nuts (0, 0.1–< 5, 5–< 10, 10+ g/day), vegetables and fruit (both continuous, g/day), tea (continuous, cups/day), energy (continuous, kcal/day), use of nutritional supplements (no, yes), and, in women, postmenopausal HRT (never, ever). (Color figure online)

Fig. 2

Spline regression curves for the association between tea intake and total mortality. Red lines: men. Blue lines: women. Multivariate HRs are calculated by restricted cubic spline regression (using 3 knots at 10th, 50th, and 90th percentiles) adjusting for: age at baseline (continuous, in years), cigarette smoking status (coded as never, former, current smoker), number of cigarettes smoked per day, and years of smoking (both continuous, centered), history of physician-diagnosed hypertension (no, yes) and diabetes (no, yes), body height (continuous, m), BMI (< 18.5, 18.5–< 25, 25–< 30, ≥ 30 kg/m²), non-occupational physical activity (< 30, 30–60, 61–90, ≥ 90 min/day), highest level of education (primary school or lower vocational, secondary or medium vocational, and higher vocational or university), intake of alcohol (0, 0.1–< 5, 5–< 15, 15–< 30, 30+ g/day), nuts (0, 0.1–< 5, 5–< 10, 10+ g/day), vegetables and fruit (both continuous, g/day), coffee (continuous, cups/day), energy (continuous, kcal/day), use of nutritional supplements (no, yes), and, in women, postmenopausal HRT (never, ever). (Color figure online)

Fig. 3

Spline regression curves for the association between percentage tea of total coffee and tea and total mortality in substitution analyses. Red lines: men. Blue lines: women. Multivariate HRs are calculated by restricted cubic spline regression (using 3 knots at 10th, 50th, and 90th percentiles) adjusting for: age at baseline (continuous, in years), cigarette smoking status (coded as never, former, current smoker), number of cigarettes smoked per day, and years of smoking (both continuous, centered), history of physician-diagnosed hypertension (no, yes) and diabetes (no, yes), body height (continuous, m), BMI (< 18.5, 18.5–< 25, 25–< 30, ≥ 30 kg/m²), non-occupational physical activity (< 30, 30–60, 61–90, ≥ 90 min/day), highest level of education (primary school or lower vocational, secondary or medium vocational, and higher vocational or university), intake of alcohol (0, 0.1–< 5, 5–< 15, 15–< 30, 30+ g/day), nuts (0, 0.1–< 5, 5–< 10, 10+ g/day), vegetables and fruit (both continuous, g/day), coffee + tea (continuous, cups/day), energy (continuous, kcal/day), use of nutritional supplements (no, yes), and, in women, postmenopausal HRT (never, ever). (Color figure online)