|Image credit: Mighty Optical Illusions (moillusions.com)|
Freedman et al., NEJM 2012
In this large, prospective U.S. cohort study, we observed a dose-dependent inverse association between coffee drinking and total mortality, after adjusting for potential confounders (smoking status in particular). As compared with men who did not drink coffee, men who drank 6 or more cups of coffee per day had a 10% lower risk of death, whereas women in this category of consumption had a 15% lower risk. Similar associations were observed whether participants drank predominantly caffeinated or decaffeinated coffee. Inverse associations persisted among many subgroups, including participants who had never smoked and those who were former smokers and participants with a normal BMI and those with a high BMI. Associations were also similar for deaths that occurred in the categories of follow-up time examined (0 to <4 years, 4 to <9 years, and 9 to 14 years).
Our study was larger than prior studies, and the number of deaths (>52,000) was more than twice that in the largest previous study. Whereas the results of previous small studies have been inconsistent, our results are similar to those of several larger, more recent studies, including the Health Professionals Follow-up Study and the Nurses' Health Study.
Given the observational nature of our study, it is not possible to conclude that the inverse relationship between coffee consumption and mortality reflects cause and effect. However, we can speculate about plausible mechanisms by which coffee consumption might have health benefits. Coffee contains more than 1000 compounds that might affect the risk of death. The most well-studied compound is caffeine, although similar associations for caffeinated and decaffeinated coffee in the current study and a previous study suggest that, if the relationship between coffee consumption and mortality were causal, other compounds in coffee (e.g., antioxidants, including polyphenols) might be important.
In summary, this large prospective cohort study showed significant inverse associations of coffee consumption with deaths from all causes and specifically with deaths due to heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections. Our results provide reassurance with respect to the concern that coffee drinking might adversely affect health.Please feel free to discuss feasible instruments for coffee consumption in the comments (or not). (via bb)