Tools for Practice

#74 Coffee: Advice for our Vice?

Does drinking coffee impact mortality or other health outcomes in the general population?

Coffee consumption is associated with a possible small reduction in mortality in cohort studies. While the evidence is not strong enough to recommend non-drinkers to start consuming coffee, coffee drinkers can be reassured that it does not result in harm (except in pregnancy).

CFPCLearn Logo

Reading Tools for Practice Article can earn you MainPro+ Credits

Join Now

Already a CFPCLearn Member? Log in

Meta-analysis1 of 21 cohort studies including 997,464 people in US, Europe or Japan 
  • Largest included cohort study2 followed 402,260 people in US (age 50-71 years) for 14 years 
    • Drinking coffee was associated with several confounders (more likely to smoke cigarettes, drink alcohol, be physically inactive, and have poor diet) 
  • After adjusting for confounders, coffee drinkers (compared to those that did not drink coffee), had a statistically significant lower risk of overall mortality: 
    • About 15% relative risk reduction for 2-3 cups/day 
    • No dose-response relationship; risk was similar whether individuals drank 1 or 8 cups/day 
  • Cardiovascular deaths decreased, deaths due to cancer were unchanged. 
Other meta-analyses3,4 (including one of 36 observational studies of 1,279,804 individuals3) found similar results for cardiovascular events and mortality. Context:  
  • Decaffeinated coffee seems to convey similar health benefits, so the benefit may not be due to caffeine.2 
  • Similar evidence for drinking tea.5 
  • Evidence is from cohort studies, and therefore can only show association (not causation) with reduced mortality 
    • Unfortunately, a large randomized controlled trial is unlikely 
    • However, this evidence seems to rule out clinically important harm. 
  • Cancer rates: Some research suggests coffee consumption is associated with reduced rates of some cancers,6,7 while other studies find no association.7-10 
  • Coffee intake is also associated with a reduced risk of diabetes11 and depression.12 
  • Coffee use in pregnancy (particularly >4 cups/day) increases the risk of fetal loss.13 Pregnant women should be advised of this potential risk. 

Latest Tools for Practice

#348 How to Slow the Flow III: Tranexamic acid for heavy menstrual bleeding (Free)

In premenopausal heavy menstrual bleeding due to benign etiology, does tranexamic acid (TXA) improve patient outcomes?
Read 0.25 credits available

#347 Chlorthali-D’OH!: What is the best thiazide diuretic for hypertension?

Which thiazide diuretic is best at reducing cardiovascular events in hypertension?
Read 0.25 credits available

#346 Stress Urinary Incontinence: Pelvic floor exercises or pessary? (Free)

How effective are pelvic floor exercises or pessaries for stress urinary incontinence?
Read 0.25 credits available

This content is certified for MainPro+ Credits, log in to access


  • G. Michael Allan MD CCFP
  • Marco Mannarino MD CCFP

1. Crippa A, Discacciati A, Larsson SC, Wolk A, Orsini N. Am J Epidemiol 2014;180:763-75.

2. Freedman ND, Park Y, Abnet CC, et al. N Engl J Med 2012;366:1891-904.

3. Ding M, Bhupathiraju SN, Satija A, van Dam RM, Hu FB. Circulation 2014;129:643-59.

4. Zhao Y, Wu K, Zheng J, Zuo R, Li D. Public Health Nutrition 2014;18:1282-91.

5. Zhang C, Qin Y-Y, Wei X, Yu F-F, Zhou Y-H, He J. Eur J Epidemiol 2015;30:103-13.

6. Yu X, Bao Z, Zou J, et al. BMC Cancer 2011;11:96.

7. Turati F, Galeone C, La Vecchia C, et al. Ann Oncol 2011;22:536-44.

8. Park C-H, Myung S-K, Kim T-Y, et al. BJU Int 2010;106:762-9.

9. Turati F, Galeone C, Edefonti V, et al. Ann Oncol 2012;23:311-8.

10. Zhang X, Albanes D, Beeson WL, et al. J Natl Cancer Inst 2010;102:771–83.

11. Huxley R, Lee CMY, Barzi F, et al. Arch Intern Med 2009;169:2053-63.

12. Grosso G, Micek A, Castellano S, Pajak A, Galvano F. Mol Nutr Res 2016;60:223-34.

13. Li J, Zhao H, Song JM, Zhang J, Tang YL, Xin CM. Int J Gynaecol Obstet 2015;130:116-22.

Authors do not have any conflicts of interest to declare.