#74 Coffee: Advice for our Vice?
CLINICAL QUESTION
Does drinking coffee impact mortality or other health outcomes in the general population?
BOTTOM LINE
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).
Reading Tools for Practice Article can earn you MainPro+ Credits
Join NowAlready a CFPCLearn Member? Log in
EVIDENCE
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.
- 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
#364 Facing the Evidence in Acne, Part II: Oral Antibiotics
How effective are oral antibiotics in treating acne of at least mild-moderate severity?
#363 Making a difference in indifference? Medications for apathy in dementia
In patients with dementia, how safe and effective are stimulants, antidepressants, and antipsychotics for treating apathy?
#362 Facing the Evidence in Acne, Part I: Oral contraceptives and spironolactone in females
How effective are combined oral contraceptives (COC) and spironolactone for treating acne of at least mild-moderate severity in females?
