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Coffee Linked to Lower Death Risk

Analysis of a large prospective study of more than 400,000 people found that men who drank four to five cups of coffee daily reduced their risk of death over a 13-year period by 12 percent, while women’s risk dropped by 16 percent, according to Neal Freedman, PhD, of the National Cancer Institute, and colleagues.

The inverse associations were seen for deaths due to heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections, but not for deaths due to cancer, the researchers found.

On the other hand, a suite of other behaviors that often go hand-in-hand with coffee drinking – smoking, lack of exercise, and poor diet – usually combine to mask the benefit, the researchers noted in the May 17 issue of The New England Journal of Medicine.

Freedman and colleagues cautioned that the study could not prove that coffee is good for you.

“It may be that there’s something that goes along with coffee-drinking that’s affecting our results that we couldn’t take into account in our analysis,” Freedman toldMedPage Today.

But, together with previous research, he said, the findings provide “some reassurance that coffee drinkers don’t have a higher risk of death (and suggest) that there might be some benefit from drinking coffee.”

Indeed, the findings are not surprising, according to Frank Hu, MD, PhD, of the Harvard School of Public Health, who was senior author on a 2008 study that also found an apparent benefit for coffee drinking.

“All the evidence is coming together to indicate a potential health benefit of regular coffee consumption,” Hu told MedPage Today.

The only way to prove the benefit exists, Hu said, would be to conduct a large randomized trial, but such a study “may not be feasible” because it would need too many participants.

In the meantime, a large prospective cohort, such as the National Institutes of Health–AARP Diet and Health Study analyzed by Freedman and colleagues, provides the “best available evidence.”

The NIH-AARP cohort has been running since 1995 and includes 229,119 men and 173,141 women who were 50 to 71 when the study started. Over the period from 1995 through 2008, Freedman and colleagues reported, 33,731 men and 18,784 women died.

In an analysis that only took age into account, coffee consumption was associated with an increased risk of death, they reported.

But coffee drinkers were also more likely to smoke, to eat more red meat and fewer fruits and vegetables, to drink alcohol, and to have less vigorous physical activity.

When those factors were taken into account, Freedman and colleagues found, coffee emerged as being inversely associated with all-cause mortality, as well as a range of major causes of death.

Compared with non-drinkers, there was little effect for those who drank some coffee, but less than a cup a day. But for more coffee, the odds of death dropped significantly.

While most of the outcomes showed a benefit for coffee, “the effect was modest,” Freedman said.

Indeed, other experts said other behavioral changes are likely to be more useful than drinking more coffee.

“Based on this study alone, I would not tell people to start drinking more coffee to lower their risk of death,” said Lona Sandon, RD, of UT Southwestern Medical Center in Dallas.

“There are other things with bigger impact on mortality that they probably should be doing,” Sandon said in an email to MedPage Today and ABC News.

Freedman told MedPage Today that people should consult their physicians before making a change – or not – in their diet.

Sandon also questioned one of the acknowledged limitations of the study — that the coffee consumption was measured only at the beginning. “It is possible that their coffee-drinking habits changed over the 12 years of the study,” she said.

Again Freedman agreed, but noted that other studies have shown that coffee drinking as a part of diet is relatively stable over time.

The bottom line, Sandon said, is to “stop smoking, be more physically active, eat your fruits, veggies, whole grains, and healthy fats, and a little coffee doesn’t appear to hurt.”

The study is well done and the conclusions are supported by the data, argued Peter McCullough, MD, of the St. John Providence Health System in Detroit.

In an email to MedPage Today and ABC News, McCullough noted that even decaffeinated coffee appeared to be beneficial – “good news” for people who like coffee but fear caffeine.

But he and others called for a deeper understanding of the complex mix of compounds found in coffee.

“If you are not a coffee drinker, this study is not a good enough reason to start,” commented Cheryl Williams, RD, of Emory Heart & Vascular Center in Atlanta.

Williams said in an email to MedPage Today and ABC News that she’s not confident coffee is truly beneficial, given that other factors might also play a role in the outcomes reported by Freedman and colleagues.

“Overall,” she said, “more research needs to be done to truly understand the compounds in coffee (including those unknown) and their biological activity and effect on health.”