Heavy Coffee Drinkers Research Articles

An umbrella review of meta-analysis to understand the effect of coffee consumption and the relationship between stroke, cardiovascular heart disease, and dementia among its global users

ABSTRACT Coffee has long been popular worldwide. The rise in lifestyle-related diseases such as cardiovascular disease, diabetes, stroke, dementia, and others has motivated coffee usage and illness prevalence studies. Some studies show coffee consumers are at risk for such diseases, whereas others show its active components protect them. Policymakers and the public need a comprehensive umbrella review to make healthy choices and enjoy coffee. Coffee consumption and stroke, CHD, and dementia outcomes have been distinguished using the PICO search strategy in PubMed with a filter for meta-analysis. We included 10 years of investigations until October 2023. MeSH terms “coffee intake,” “stroke, dementia,” and “transient ischemic attack,” comparing stroke risk with coffee consumption were used. The study excluded case reports and non-human, non-English observational research. The stroke risk of coffee was examined using RevMan software. Coffee consumption’s stroke risk ratio (RR), 95% CI, and I2 were estimated. Forest plots with P values ≤ 0.05 are significant. The umbrella review includes 11 meta-analyses from 457052 papers, totalling 11.96 million individuals. Drinking up to 4 cups of coffee daily reduced stroke risk by 12% compared with not drinking any coffee (0.88 (CI of 0.84-0.92, I2 of 13%, P < 0.00001)). Coffee drinkers had a 1.19 risk ratio for cardiovascular diseases compared to non-coffee drinkers (CI: 0.99–1.38, I2 = 84%, P < 0.00001). The dementia risk ratio for caffeine users was 0.90 (95% CI: 0.82-0.97, I2 = 46%, P < 0.00001) compared with non-consumers. Our analysis covering 5.42 million individuals found that 4 cups of coffee consumed a day reduced stroke risk by 12%. Coffee may reduce ischemic and haemorrhagic strokes by preserving endothelium and antioxidants. Coffee may lessen dementia risk, according to our study’s 0.94 pooled risk ratio after sensitivity analysis. Heavy coffee drinkers had a greater CHD risk, as per our findings. Heavy coffee drinkers were more at risk.

Impact of Physical and Psychological Rehabilitation on Quality of Life among Ischemic Heart Disease Patients: A Current Perspective

Cardiovascular diseases cause approximately one-third of deaths worldwide [1]. Among cardiovascular illnesses, ischemic heart disease (IHD) ranks as the most prevalent [2]. Indeed, IHD is acknowledged as an important threat to sustainable development in the 21st century [3] In 2020, around 19.1 million deaths were ascribed to IHD universally. Accessible epidemiologic proof showed that the presence of hypertension, hypercholesterolemia, and excessive cigarette smoking, either separately or in blend, are unequivocal gamble factors in the general population. Factors, for example, obesity, heavy coffee drinking, diabetes mellitus, and a positive family background of ischemic coronary illness are likewise significant, even though the extra explanation of their general significance is as yet required. In later years, two different regions of the existence design had been emphatically embroiled as risk factors; in particular, conduct qualities and propensities for active work, either occupation-related or relaxation time. Tragically, these two regions were not investigated in the absolute earliest epidemiologic examinations, and further documentation of their impact on the normal history of ischemic coronary illness is as yet required.[4]The evidence accessible at present emphatically proposes that people can be ordered tentatively as indicated by their behavioral trait and propensities for movement. As a general rule, the people with exuberant, ineffectively coordinated drive, expanded Hypochondriasis (MMPI) and expanded Movement Drive (TTS) have a higher frequency of myocardial localized necrosis than those subjects who miss the mark on qualities. Rosenman and Friedman marked such people as having character design Type A. The pace of myocardial localized necrosis seems, by all accounts, to be roughly one around 50% of that of the stationary population in men who are either routinely truly dynamic over the course of life or who partake in an occupation that requests customary actual work; i.e., transport guides, postal carriers, and so on [5].

Co-medication with disulfiram markedly increased serum clozapine levels: Two case reports.

Alcohol use disorder (AUD) is a significant co-morbidity in patients with schizophrenia. Clozapine offers some benefits in treating patients with refractory schizophrenia and AUD, but co-medicating with disulfiram is also common. We report two cases where co-medicating with disulfiram led to a significant increase in clozapine serum levels. Clozapine serum levels decreased to one-third in Patient 1 when disulfiram was discontinued and started to increase again when disulfiram was reintroduced. Patient 2 developed toxic serum levels of clozapine during disulfiram treatment combined with heavy coffee drinking and symptoms reminiscent of neuroleptic malignant syndrome. Clozapine and disulfiram are both metabolized by cytochrome P450 CYP1A2 and clinically relevant interaction through this shared pathway is possible.

Reduction in caffeine withdrawal after open-label decaffeinated coffee.

Withdrawal from addictive drugs can be reduced by administering placebo deceptively, but in the clinic it is unethical to deceive the patient. Open-label placebo effects have been observed across a range of psychophysiological phenomena, and may also apply to drug withdrawal. 24-hour abstinent heavy coffee drinkers (N = 61) rated their caffeine withdrawal symptoms before being allocated to one of three groups. The Deceptive group was given decaffeinated coffee (decaf) and told it was caffeinated, the Open-Label group given decaf and told it was decaf and the Control group given water and told it was water. After 45 min, caffeine withdrawal was measured again. All participants rated their expectancies of withdrawal reduction from caffeinated coffee, decaf and water prior to being randomised and the end of the study. There was a significant 9.5-point reduction in caffeine withdrawal in the Open-Label group (95% confidence interval (CI): 4.7, 14.3; p = 0.002), which was 8.6 points less than the Deceptive group (95%CI: 0.4, 16.8; p = 0.014) but 8.9 points greater than the Control group (95%CI: 0.6, 17.2; p = 0.012). Pre-randomisation, participants expected caffeinated coffee to reduce their withdrawal symptoms the most, followed by water and decaf, Pre-randomisation expectancy of withdrawal was only associated with amount of withdrawal reduction in the Deceptive group. It appears as if open-label placebo caffeine (i.e. decaf) can reduce caffeine withdrawal symptoms, even when people do not hold a conscious expectancy it will do so. There may be ways to integrate open-label placebo procedures into clinical interventions for drug dependence without violating informed consent.

Impact of Physical Activity on the Characteristics and Metabolic Consequences of Alcohol Consumption: A Cross-Sectional Population-Based Study.

Sedentary lifestyle and excessive alcohol drinking are major modifiable risk factors of health. In order to shed further light on the relationships between physical activity and health consequences of alcohol intake, we measured biomarkers of liver function, inflammation, lipid status and fatty liver index tests in a large population-based sample of individuals with different levels of physical activity, alcohol drinking and other lifestyle risk factors. The study included 21,050 adult participants (9940 men, 11,110 women) (mean age 48.2 ± 13.3 years) of the National FINRISK Study. Data on physical activity, alcohol drinking, smoking and body weight were recorded. The participants were classified to subgroups according to gender, levels of physical activity (sedentary, low, moderate, vigorous, extreme), alcohol drinking levels (abstainers, moderate drinkers, heavy drinkers) and patterns (regular or binge, types of beverages preferred in consumption). Serum liver enzymes (GGT, ALT), C-reactive protein (CRP) and lipid profiles were measured using standard laboratory techniques. Physical activity was linearly and inversely related with the amount of alcohol consumption, with the lowest alcohol drinking levels being observed in those with vigorous or extreme activity (p < 0.0005). Physically active individuals were less frequently binge-type drinkers, cigarette smokers or heavy coffee drinkers than those with sedentary activity (p < 0.0005 for linear trend in all comparisons). In the General Linear Model to assess the main and interaction effects of physical activity and alcohol consumption on biomarker status, as adjusted for anthropometric measures, smoking and coffee consumption, increasing levels of physical activity were found to be associated with more favorable findings on serum GGT (p < 0.0005), ALT (p < 0.0005 for men), cholesterol (p = 0.025 for men; p < 0.0005 for women), HDL-cholesterol (p < 0.0005 for men, p = 0.001 for women), LDL-cholesterol (p < 0.03 for men), triglycerides (p < 0.0005 for men, p < 0.03 for women), CRP (p < 0.0005 for men, p = 0.006 for women) and fatty liver index (p < 0.0005). The data support the view that regular moderate to vigorous physical activity may counteract adverse metabolic consequences of alcohol consumption on liver function, inflammation and lipid status. The role of physical activity should be further emphasized in interventions aimed at reducing health problems related to unfavorable risk factors of lifestyle.

Coffee consumption and gastric cancer: a pooled analysis from the Stomach cancer Pooling Project consortium.

This study aimed to evaluate and quantify the relationship between coffee and gastric cancer using a uniquely large dataset from an international consortium of observational studies on gastric cancer, including data from 18 studies, for a total of 8198 cases and 21 419 controls. A two-stage approach was used to obtain the pooled odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) for coffee drinkers versus never or rare drinkers. A one-stage logistic mixed-effects model with a random intercept for each study was used to estimate the dose-response relationship. Estimates were adjusted for sex, age and the main recognized risk factors for gastric cancer. Compared to never or rare coffee drinkers, the estimated pooled OR for coffee drinkers was 1.03 (95% CI, 0.94-1.13). When the amount of coffee intake was considered, the pooled ORs were 0.91 (95% CI, 0.81-1.03) for drinkers of 1-2 cups per day, 0.95 (95% CI, 0.82-1.10) for 3-4 cups, and 0.95 (95% CI, 0.79-1.15) for five or more cups. An OR of 1.20 (95% CI, 0.91-1.58) was found for heavy coffee drinkers (seven or more cups of caffeinated coffee per day). A positive association emerged for high coffee intake (five or more cups per day) for gastric cardia cancer only. These findings better quantify the previously available evidence of the absence of a relevant association between coffee consumption and gastric cancer.

Association of coffee and genetic risk with incident dementia in middle-aged and elderly adults

ABSTRACT Background: Prior evidence suggests that coffee might be related to dementia, however, little is known about coffee and dementia in individuals with elevated genetic susceptibility for dementia. Additionally, most previous studies have focused on total coffee instead of examining coffee types separately. Methods This study included 203,776 participants (60–73 years old) from the UK Biobank who were initially free of dementia. Polygenic risk scores for dementia were divided into quintile to stratify individuals into low (lowest quintile), intermediate (quintile 2–4), and high (highest quintile) genetic risk categories. Coffee intake was assessed at baseline and included total, instant, ground, and decaffeinated coffee. Results During a median follow-up of 11.4 years, 4405 cases of dementia occurred (1856 Alzheimer’s disease [AD], 1105 vascular dementia). Compared to non-coffee drinking, heavy instant coffee drinking (> 6 cups/day) and moderate decaffeinated coffee drinking (1–3 cups/day) were associated with a higher risk of dementia (hazard ratio [HR] 1.19–1.34) and AD (HR 1.41–1.51), while moderate ground coffee drinking was associated with a lower risk of dementia (HR, 0.78; P = 0.001) and vascular dementia (HR, 0.58; P < 0.001). Among participants at high genetic risk, heavy coffee drinking was associated with a 95% (HR; 1.95, 95% CI, 1.21–3.16) higher risk of AD than non-coffee drinking. We found an interaction between coffee and genetic risk in relation to AD (P = 0.038). Conclusion The association of dementia and coffee varied by coffee types. Heavy coffee consumption was associated with a higher risk of AD in individuals with high genetic risk for dementia.

Dissociation between wanting and liking for coffee in heavy drinkers.

There is an ongoing discussion about the addictive strength of caffeine. According to the incentive-sensitization theory, the development and the maintenance of drug addiction is the result of a selective sensitization of brain regions that are relevant for wanting without a corresponding increase in liking. Dissociations of wanting and liking have been observed with a wide range of drugs in animals. For human subjects, results are inconclusive, which is possibly due to invalid operationalizations of wanting and liking. The present study examined dissociations of wanting and liking for coffee in heavy and low/non-consumers with newly developed and validated response time-based assessment procedures for wanting and liking. For this study 24 heavy and 32 low/non-consumers of coffee completed two versions of the Implicit-Association Test (IAT), one of which has been developed and validated recently to assess wanting for coffee, whereas the other reflects an indicator of liking for coffee. Results revealed a significant interaction between group (heavy vs. low/non-consumers) and IAT type (wanting vs. liking) indicating that heavy coffee drinkers differed from low/non-consumers by displaying increased wanting but not liking for coffee. These data confirm that heavy coffee consumption is associated with strong wanting despite low liking for coffee, indicating that wanting becomes independent from liking through repeated consumption of caffeine. This dissociation provides a possible explanation for the widespread and stable consumption of caffeine-containing beverages.

Coffee Consumption Reduces Mortality in Patients with Acute Myocardial Infarction

Aim: Acute myocardial infarction (AMI) is the number one cause of death in 2000. Usually, coffee restriction was advised to patients with cardiovascular diseases. Recent studies indicate coffee might have a cardioprotective effect.Method: Systematic search was done on Pubmed and Cochrane. Title and abstract screening were initiated on 12 articles, followed by selection with inclusion and exclusion criteria, and selected one meta-analysis study to be critically appraised. Result: The meta-analysis study appraised resulted with a good score. Reduction in mortality rate was found, and an inverse relationship was concluded between heavy coffee consumption versus no consumption and mortality in acute myocardial infarction patients. RR = 0.54 95% CI [0.45 – 0.65].Conclusion: Coffee consumption and mortality in myocardial infarction patients have an inverse relationship, with the highest risk reduction found in heavy coffee drinkers.

Maternal coffee intake and the risk of bleeding in early pregnancy: a cross-sectional analysis

BackgroundCaffeine can easily cross the placenta, and maternal caffeine intake, thus, has an effect on fetal growth. However, it is still unclear whether coffee consumption is an independent risk factor for bleeding in early pregnancy. The objective of this study was to examine the association between pre-pregnancy coffee consumption patterns and the risk of bleeding in early pregnancy.MethodsA cross-sectional analysis was conducted among 3510 pregnant women from the Korean Pregnancy Outcome Study who underwent baseline examination and for whom the results of the pregnancy were available. Coffee consumption patterns before pregnancy were examined using a questionnaire. The participants were classified according to the frequency of coffee consumption into seldom (< 1 cup/week), light (< 1 cup/day), moderate (1 cup/day), and heavy coffee drinker (≥2 cups/day) groups. Bleeding in early pregnancy was defined as the occurrence of vaginal bleeding in the first 20 weeks of pregnancy. Multiple logistic regression models were applied to examine the association between pre-pregnancy coffee consumption and the risk of bleeding in early pregnancy, after adjusting for age, body mass index (BMI), systolic blood pressure, cigarette smoking and alcohol consumption behavior, previous and current physical activity levels, stress levels, history of depression, antenatal depressive symptoms during the first trimester, type of emesis, parity, and the number of livebirths, stillbirths, miscarriages, and abortions.ResultsWomen who were light, moderate, and heavy coffee drinkers before pregnancy had adjusted ORs of 1.086, 1.225, and 1.358, respectively, for bleeding in early pregnancy. In a fully adjusted model, heavy coffee drinkers showed a significantly higher risk of bleeding in early pregnancy, even in women aged 35 years and younger (OR 1.680) and in those with a normal body mass index (OR 1.389), who were at relatively low risk for pregnancy-related complications.ConclusionsOur results showed that heavy coffee drinking was independently associated with a higher risk of bleeding in early pregnancy among pregnant Korean women, suggesting that caffeine intake before conception and during pregnancy should be reduced. Our study highlights the need for nutritional interventions for healthy coffee drinking among pregnant women in Korea.

Association between coffee drinking and telomere length in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial.

Mounting evidence indicates that coffee, a commonly consumed beverage worldwide, is inversely associated with various chronic diseases and overall mortality. Few studies have evaluated the effect of coffee drinking on telomere length, a biomarker of chromosomal integrity, and results have been inconsistent. Understanding this association may provide mechanistic insight into associations of coffee with health. The aim of our study was to test the hypothesis that heavier coffee intake is associated with greater likelihood of having above-median telomere length. We evaluated the cross-sectional association between coffee intake and relative telomere length using data from 1,638 controls from four previously conducted case-control studies nested in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Coffee intake was assessed using a food frequency questionnaire, and relative telomere length was measured from buffy-coat, blood, or buccal cells. We used unconditional logistic regression models to generate multivariable-adjusted, study-specific odds ratios for the association between coffee intake and relative telomere length. We then conducted a random-effects meta-analysis to determine summary odds ratios. We found that neither summary continuous (OR = 1.01, 95% CI = 0.99–1.03) nor categorical (OR <3 cups/day vs. none = 1.37, 95% CI = 0.71–2.65; OR ≥3 cups/day vs. none = 1.47, 95% CI = 0.81–2.66) odds ratio estimates of coffee drinking and relative telomere length were statistically significant. However, in the largest of the four contributing studies, moderate (<3 cups/day) and heavy coffee drinkers (≥3 cups/day) were 2.10 times (95% CI = 1.25, 3.54) and 1.93 times as likely (95% CI = 1.17, 3.18) as nondrinkers to have above-median telomere length, respectively. In conclusion, we found no evidence that coffee drinking is associated with telomere length. Thus, it is unlikely that telomere length plays a role in potential coffee-disease associations.

The effect of dose expectancies on caffeine withdrawal symptoms during tapered dose reduction.

Negative expectancies can exacerbate withdrawal symptoms via the nocebo effect. As such, information provided about dose reductions during attempts to taper a drug could contribute to withdrawal symptoms and increase the likelihood of relapse. The current study tested whether blinding participants to dose reductions during a supervised caffeine dose taper reduced these nocebo-induced withdrawal symptoms. Three groups of moderate to heavy coffee drinkers had their dose of caffeine reduced (tapered) from 300 mg per day to 0 mg over the course of five days and reported withdrawal symptoms twice daily. Groups were given differing information about how much caffeine they were receiving. An Open Reduction group was given accurate information about dose reductions. A Blind Reduction group was given no dose information whatsoever. A Deceptive Reduction group was misinformed about dose, with instructions suggesting that the dose remained on 300 mg for three days then dropped to 0 mg. The Open Reduction group reported more pronounced caffeine withdrawal symptoms than the Deceptive Reduction group on the days with the greatest discrepancy between actual dose and informed dose, indicating a nocebo effect of open versus deceptive reductions. In addition, the rate of increase in reported withdrawal symptoms in the Blind Reduction and Deceptive Reduction groups was less than that of the Open Reduction group. These results suggest that awareness of dose reductions during a dose taper can result in a nocebo withdrawal effect, and that removing this awareness can reduce withdrawal. This has important implications for standard supervised dose-tapering practice, where patients are aware of the timing and magnitude of dose reductions.

Understanding the role of bitter taste perception in coffee, tea and alcohol consumption through Mendelian randomization

Consumption of coffee, tea and alcohol might be shaped by individual differences in bitter taste perception but inconsistent observational findings provide little insight regarding causality. We conducted Mendelian randomization analyses using genetic variants associated with the perception of bitter substances (rs1726866 for propylthiouracil [PROP], rs10772420 for quinine and rs2597979 for caffeine) to evaluate the intake of coffee, tea and alcohol among up to 438,870 UK Biobank participants. A standard deviation (SD) higher in genetically predicted bitterness of caffeine was associated with increased coffee intake (0.146 [95%CI: 0.103, 0.189] cups/day), whereas a SD higher in those of PROP and quinine was associated with decreased coffee intake (−0.021 [−0.031, −0.011] and −0.081 [−0.108, −0.054] cups/day respectively). Higher caffeine perception was also associated with increased risk of being a heavy (>4 cups/day) coffee drinker (OR 1.207 [1.126, 1.294]). Opposite pattern of associations was observed for tea possibly due to the inverse relationship between both beverages. Alcohol intake was only negatively associated with PROP perception (−0.141 [−1.88, −0.94] times/month per SD increase in PROP bitterness). Our results reveal that bitter perception is causally associated with intake of coffee, tea and alcohol, suggesting a role of bitter taste in the development of bitter beverage consumption.

Impact of Coffee, Wine, and Chocolate Consumption on Cognitive Outcome and MRI Parameters in Old Age.

Coffee, wine and chocolate are three frequently consumed substances with a significant impact on cognition. In order to define the structural and cerebral blood flow correlates of self-reported consumption of coffee, wine and chocolate in old age, we assessed cognition and brain MRI measures in 145 community-based elderly individuals with preserved cognition (69 to 86 years). Based on two neuropsychological assessments during a 3-year follow-up, individuals were classified into stable-stable (52 sCON), intermediate (61 iCON) and deteriorating-deteriorating (32 dCON). MR imaging included voxel-based morphometry (VBM), tract-based spatial statistics (TBSS) and arterial spin labelling (ASL). Concerning behavior, moderate consumption of caffeine was related to better cognitive outcome. In contrast, increased consumption of wine was related to an unfavorable cognitive evolution. Concerning MRI, we observed a negative correlation of wine and VBM in bilateral deep white matter (WM) regions across all individuals, indicating less WM lesions. Only in sCON individuals, we observed a similar yet weaker association with caffeine. Moreover, again only in sCON individuals, we observed a significant positive correlation between ASL and wine in overlapping left parietal WM indicating better baseline brain perfusion. In conclusion, the present observations demonstrate an inverse association of wine and coffee consumption with cognitive performances. Moreover, low consumption of wine but also moderate to heavy coffee drinking was associated with better WM preservation and cerebral blood-flow notably in cognitively stable elders.

Heavy Coffee Consumption and Risk of Pancreatitis: A Systematic Review and Meta-Analysis.

Heavy consumption of coffee may have a protective effect against pancreatitis although results from previous studies were inconsistent. This meta-analysis was conducted with the aim to summarize all available data. This meta-analysis included observational studies that compared the risk of pancreatitis between heavy coffee-drinkers and individuals who were not heavy coffee-drinkers. Pooled risk ratios (RRs) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. Out of 219 retrieved articles, four studies with 351,137 participants met the eligibility criteria and were included in the analysis. The risk of pancreatitis among heavy coffee-drinkers was significantly lower than individuals who were not heavy coffee-drinkers with the pooled RR of 0.78 (95% CI 0.67-0.91). The statistical heterogeneity between the studies was insignificant (I2 = 0%). This meta-analysis demonstrated a significantly decreased risk of pancreatitis among heavy coffee-drinkers. However, further investigations are still required to determine causality and potential clinical application.

Coffee consumption and risk of esophageal cancer incidence: A meta-analysis of epidemiologic studies.

Background:In epidemiologic studies, association between coffee consumption and esophageal cancer risk is inconsistent.Objective:The aim of tjis study was to evaluate the effect of coffee on esophageal cancer by combining several similar studies.Methods:We conducted a meta-analysis for association of coffee intake and esophageal cancer incidence. Eleven studies, including 457,010 participants and 2628 incident cases, were identified. A relative risk (RR, for cohort study) or odds ratio (OR, for case–control study) of heavy coffee drinkers was calculated, compared with light coffee drinkers or non-drinkers. The analysis was also stratified by cancer types (esophageal squamous cell carcinoma and esophageal adenocarcinoma), sex, and geographic region.Results:The summarized OR of having esophageal cancer in heavy coffee drinkers was 0.93 (95% confidence interval [CI]: 0.73–1.12), compared with light coffee drinkers. When stratified by sex, pathologic type of esophageal cancer, and type of epidemiologic study, we did not find any association of coffee consumption and esophageal cancer incidence. However, an inverse association between coffee consumption and incidence of esophageal cancer was found in East Asia participants with OR of 0.64 (95% CI: 0.44–0.83), but not in Euro-America participants (OR = 1.05; 95% CI: 0.81–1.29).Conclusion:There is a protective role of coffee consumption against esophageal cancer in East Asians, but not in Euro-Americans.

Associations of Coffee, Diet Drinks, and Non-Nutritive Sweetener Use with Depression among Populations in Eastern Canada

Consumption of coffee and diet drinks and the use of non-nutritive sweeteners is commonplace worldwide. We conducted a cross-sectional analysis to investigate the associations between coffee consumption and non-nutritive sweetener use and depression among populations in Atlantic Canada. During 2009 to 2013, we recruited 18838 participants aged 35–69 years (5854 men and 12984 women) for the baseline survey of the Atlantic Partnership for Tomorrow’s Health cohort study. Coffee consumption, sweetener use, and major depression were assessed using a set of standardized questionnaires. We utilized multiple logistic regression models to assess the associations of coffee drinking and non-nutritive sweetener use with major depression. Compared with non-coffee drinkers, female participants who drank coffee ≥4 cups/day had an odds ratio of 1.38 (95% confidence interval, 1.15–1.64) for major depression with adjustment for sociodemographic and behavioral factors, chronic disease status, and body mass index. We found a significant association between depression and consumption of sweeteners and diet drinks, which was more apparent among women than men. We conclude that heavy coffee drinking and non-nutritive sweetener use were associated with depression among populations in Atlantic Canada. Further studies are warranted to investigate the underlying biological mechanisms.

Factors of adherence to treatment with trospium in employees

AimTo conduct a comprehensive study of adverse factors and decreasing patients’ adherence during treatment with trospium. Materials and methodsDuring 12 months, 977 patients receiving trospium were studied regarding demographic, socioeconomic, and medical parameters by studying employer’s records, extracts from income tax returns, questionnaires OABq-SF, MOS SF-36, ICIQ-SF, and questionnaires concerning demographic and social status, voiding diaries, and uroflowmetry. ResultsIn total, 54.4% and 35.5% of patients preserved adherence to treatment with trospium during 6 months and 12 months, respectively. The average time of reaching a 30-day break in trospium administration was 182 days. Patients diagnosed with urge urinary incontinence and overactive bladder OAB (56.1%; 40.7%), having severe incontinence symptoms (56.1%), showing objectively high treatment efficacy (25.3%), and individuals subjectively satisfied with treatment outcome (57.5%) prevail among adherent patients, a significant minority is heavy coffee drinkers (14.5%).Individuals who are healthcare and education employees having annual and monthly income significantly higher than the mean income of patients receiving trospium also prevail among adherent patients (25.0%; 32.5%). Adherent patients are significantly older (56.3) than patients less adherent to the treatment. ConclusionThis experiment allowed for the first time the determination of the complexity of heterogeneous medical, socioeconomic, and demographic factors affecting patients’ adherence in treatment with trospium.

Coffee reduces the risk of death after acute myocardial infarction: a meta-analysis.

Habitual coffee consumption is protective against coronary heart disease in women; however, it is not clear whether such cardioprotection is conferred on those who have already experienced an acute myocardial infarction (AMI). Our aim was to investigate whether coffee consumption affected mortality after AMI. We carried out a dose-response meta-analysis of prospective studies that examined the relationship between coffee intake and mortality after an AMI. Using a defined-search strategy, electronic databases (MEDLINE and Embase) were searched for papers published between 1946 and 2015. Two eligible studies investigating post-AMI mortality risk against coffee consumption were identified and assessed using set criteria. Combined, these studies recruited a total of 3271 patients and 604 died. The hazard ratios for the following experimental groups were defined: light coffee drinkers (1-2 cups/day) versus noncoffee drinkers, heavy coffee drinkers (>2 cups/day) versus noncoffee drinkers and heavy coffee drinkers versus light coffee drinkers. A statistically significant inverse correlation was observed between coffee drinking and mortality; all three groups showed a significant reduction in risk ratio. Light coffee drinkers versus noncoffee drinkers were associated with a risk ratio of 0.79 [95% confidence interval (CI): 0.66-0.94, P=0.008]; heavy coffee drinkers versus noncoffee drinkers were associated with a risk ratio of 0.54 (95% CI: 0.45-0.65, P<0.00001); and heavy coffee drinkers versus light coffee drinkers were associated with a risk ratio of 0.69 (95% CI: 0.58-0.83, P<0.0001). Drinking coffee habitually following AMI was associated with a reduced risk of mortality.

OP.8A.05] REGULAR PHYSICAL ACTIVITY ATTENUATES THE ASSOCIATION BETWEEN COFFEE CONSUMPTION AND CARDIOVASCULAR EVENTS IN HYPERTENSION. THE HARVEST

Objective: Coffee consumption has been found to predict the risk of cardiovascular events (CVE) in hypertension. Aim of the present study was to ascertain whether the strength of the coffee-CVE association is modulated by regular physical activity. Design and method: The analysis was made in 1204 participants from the HARVEST, a prospective cohort study of non-diabetic subjects aged 18–45 years, screened for stage 1 hypertension. Among the participants, 26.2% were abstainers, 62.8% were moderate coffee drinkers (1–3 cups/day) and 10.0% were heavy coffee drinkers (>3 cups/day). For physical activity level, 61.1% were categorized as sedentary (class 0), 14.9% as mild exercisers (class 1), 14.9% as amateurs (class 2), and 9.1% as competitive athletes (class 3). Results: The frequency of coffee drinkers was higher among the sedentary (77.4%) than the active (67.9%) subjects (p < 0.001). During a 12.6 year follow-up 70 participants developed a CVE. The rate of CVE was higher among the coffee drinkers (7.1%) than the abstainers (2.2%, p = 0.001) and was higher in the sedentary (7.2%) than the active (3.6%) subjects (p = 0.01). In a 2x2 sub-table the coffee-related difference in CVE was significant among the sedentary (p = 0.006) but not the active subjects (p = 0.22) with a Mantel-Haenszel Chi-Square = 8.3 (p = 0.004). In a multivariable Cox analysis, including age, sex, parental CVE, smoking, alcohol use, total cholesterol, follow-up hypertension, and a coffee-physical activity interaction term, coffee consumption was a significant predictor of CVE in heavy coffee drinkers (Hazard ratio, 95%CI; 3.3, 1.2–8.9) and was a borderline predictor in moderate drinkers (HR, 95%CI; 2.0, 0.9–4.5). In addition, a borderline negative interaction was found between coffee consumption and physical activity habits on risk of CVE (p = 0.05). Conclusions: These data confirm that coffee use is associated with increased risk of CVE in young-to-middle age subjects with stage 1 hypertension. However, the effects of coffee on risk of CVE is modulated by the individual level of physical activity. Regular physical activity seems to counteract the long-term deleterious effect of caffeinated coffee on the cardiovascular system.