Coffee Drinking and Mortality in 10 European Countries: A Multinational Cohort Study

Published: Ann Intern Med. 2017;167(4):236-247. DOI: 10.7326/M16-2945 Published at www.annals.org on 11 July 2017 © 2017 American College of Physicians 14,065 Views since 1/1/2013 0 Citations Article has an altmetric score of 3028 ORIGINAL RESEARCH |15 AUGUST 2017 Marc J. Gunter, PhD (*); Neil Murphy, PhD (*); Amanda J. Cross, PhD; Laure Dossus, PhD; Laureen Dartois, PhD; Guy Fagherazzi, PhD; Rudolf Kaaks, PhD; Tilman Kühn, PhD; Heiner Boeing, PhD; Krasimira Aleksandrova, PhD; Anne Tjønneland, MD, PhD; Anja Olsen, PhD; Kim Overvad, MD, PhD; Sofus Christian Larsen, PhD; Maria Luisa Redondo Cornejo, PhD; Antonio Agudo, PhD; María José Sánchez Pérez, MD, PhD; Jone M. Altzibar, PhD; Carmen Navarro, MD, PhD; Eva Ardanaz, MD, PhD; Kay-Tee Khaw, MB BChir; Adam Butterworth, PhD; Kathryn E. Bradbury, PhD; Antonia Trichopoulou, MD, PhD; Pagona Lagiou, MD, PhD; Dimitrios Trichopoulos, MD, PhD (†); Domenico Palli, MD; Sara Grioni, BSc; Paolo Vineis, MD, MPH; Salvatore Panico, MD, MSc; Rosario Tumino, MD; Bas Bueno-de-Mesquita, MD, PhD; Peter Siersema, MD, PhD; Max Leenders, PhD; Joline W.J. Beulens, PhD; Cuno U. Uiterwaal, MD, PhD; Peter Wallström, MD, PhD; Lena Maria Nilsson, PhD; Rikard Landberg, PhD; Elisabete Weiderpass, MD, PhD; Guri Skeie, PhD; Tonje Braaten, PhD; Paul Brennan, PhD; Idlir Licaj, PhD; David C. Muller, PhD; Rashmi Sinha, PhD; Nick Wareham, PhD, MBBS; Elio Riboli, MD, ScM Article, Author, and Disclosure Information Full Article Figures Tables Audio/Video Summary for Patients Comments MORE The full content of Annals is available to subscribersSUBSCRIBE/LEARN MORE Abstract Background: The relationship between coffee consumption and mortality in diverse European populations with variable coffee preparation methods is unclear. Objective: To examine whether coffee consumption is associated with all-cause and cause-specific mortality. Design: Prospective cohort study. Setting: 10 European countries. Participants: 521 330 persons enrolled in EPIC (European Prospective Investigation into Cancer and Nutrition). Measurements: Hazard ratios (HRs) and 95% CIs estimated using multivariable Cox proportional hazards models. The association of coffee consumption with serum biomarkers of liver function, inflammation, and metabolic health was evaluated in the EPIC Biomarkers subcohort (n = 14 800). Results: During a mean follow-up of 16.4 years, 41 693 deaths occurred. Compared with nonconsumers, participants in the highest quartile of coffee consumption had statistically significantly lower all-cause mortality (men: HR, 0.88 [95% CI, 0.82 to 0.95]; P for trend < 0.001; women: HR, 0.93 [CI, 0.87 to 0.98]; P for trend = 0.009). Inverse associations were also observed for digestive disease mortality for men (HR, 0.41 [CI, 0.32 to 0.54]; P for trend < 0.001) and women (HR, 0.60 [CI, 0.46 to 0.78]; P for trend < 0.001). Among women, there was a statistically significant inverse association of coffee drinking with circulatory disease mortality (HR, 0.78 [CI, 0.68 to 0.90]; P for trend < 0.001) and cerebrovascular disease mortality (HR, 0.70 [CI, 0.55 to 0.90]; P for trend = 0.002) and a positive association with ovarian cancer mortality (HR, 1.31 [CI, 1.07 to 1.61]; P for trend = 0.015). In the EPIC Biomarkers subcohort, higher coffee consumption was associated with lower serum alkaline phosphatase; alanine aminotransferase; aspartate aminotransferase; γ-glutamyltransferase; and, in women, C-reactive protein, lipoprotein(a), and glycated hemoglobin levels. Limitations: Reverse causality may have biased the findings; however, results did not differ after exclusion of participants who died within 8 years of baseline. Coffee-drinking habits were assessed only once. Conclusion: Coffee drinking was associated with reduced risk for death from various causes. This relationship did not vary by country. Primary Funding Source: European Commission Directorate-General for Health and Consumers and International Agency for Research on Cancer.