Abstract
We assessed the association between usual coffee consumption and all-cause, cardiovascular (CV), and cancer mortality in an adult population in Spain, taking into account both the amount and type of coffee consumed. We used baseline data on coffee consumption and other personal variables, and the number of deaths during an 18-year follow-up period, for 1567 participants aged 20 years and older from the Valencia Nutrition Study in Spain. Total, caffeinated, and decaffeinated coffee consumption was assessed using a validated food frequency questionnaire. Cox regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). During the 18-year follow-up period, 317 died; 115 due to CV disease and 82 due to cancer. Compared with no-consumption, the consumption of ≤1 cup per day and >1 cup per day of coffee was associated with a lower risk of all-cause mortality, HR = 0.73 (95% CI: 0.56–0.97) and HR 0.56 (95% CI: 0.41–0.77), respectively. A lower cancer mortality was observed among drinkers of more than 1 cup per day compared with nondrinkers, HR 0.41 (95% CI 0.20–0.86). Regarding the type of coffee, only the overall consumption of caffeinated coffee was associated with lower all-cause mortality at 12 and 18 years of follow-up, HR = 0.66 (95% CI:0.46–0.94) and HR = 0.59 (95% CI: 0.44–0.79), respectively. In conclusion, this study suggests that the moderate consumption of coffee, particularly caffeinated coffee (range 1–6.5 cups per day), is associated with a lower all-cause and cancer mortality after a long follow-up period. No significant association was found between coffee consumption and CVD mortality.
Highlights
Coffee consumption is very prevalent worldwide and it has been associated with lower total mortality, the association is not fully consistent and the evidence from Mediterranean countries is still scarce [1]
The inverse association between coffee consumption and all-cause mortality observed in our study is consistent with the results from previous meta-analyses in adult populations [11,31,32,33,34], and with results observed in subsequent prospective studies carried out in the United States [12,35], Europe [36,37], and Asia [38]
Our results may not seem fully innovative with respect to other studies that have previously reported a protective effect of coffee consumption, the interest and the novelty of this study may still be sustained by the fact that it is the first study to evaluate the association between coffee consumption and all-cause, cardiovascular diseases (CVD), and cancer mortality in adults aged 20 years and older of a Mediterranean country, i.e., Spain
Summary
Coffee consumption is very prevalent worldwide and it has been associated with lower total mortality, the association is not fully consistent and the evidence from Mediterranean countries is still scarce [1]. Most of the recently published studies have reported inverse associations between habitual coffee consumption and the incidence of some diseases such as type 2 diabetes [6,7], mental illness [8,9], cardiovascular diseases [10,11,12], and cancer [10,13,14], all of which are major causes of mortality These findings are in agreement with the results obtained by Kim et al [1] in a recent meta-analysis that included 40 studies and 3,852,651 subjects from different countries. Some meta-analyses have shown that flavonoids and some non-flavonoids such as lignans with weak estrogen-like activity may have beneficial effects against cardiovascular disease and some cancers [15], more evidence on specific compounds is still needed
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