Coffee drinking and mortality in ten European countries - the EPIC Study.

Background How coffee consumption relates to mortality in diverse European populations, with variable coffee preparation methods and customs, is unclear. Objectives To examine whether coffee consumption is associated with all-cause and cause-specific mortality. Design Prospective cohort study. Setting Ten European countries. Participants A total of 521,330 individuals enrolled in the European Prospective Investigation into Cancer and Nutrition (EPIC). Main outcome measures Hazard ratios (HRs) and 95% confidence intervals(CIs) estimated using multivariable Cox proportional hazards models. The association of coffee with serum biomarkers of liver function, inflammation, and metabolic health was evaluated in the EPIC Biomarkers sub-cohort (n=14,800). Results During a mean follow-up of 16.4 years, 41,693 deaths occurred. Compared with non-consumers, participants in the highest quartile of coffee consumption experienced statistically significant lower all-cause mortality (Men: HR=0.88, 95%CI: 0.82-0.95; P-trend<0.001; Women: HR=0.93, 95%CI: 0.87-0.98; P-trend=0.009). Inverse associations were also observed for digestive disease mortality for men (HR=0.41, 95%CI: 0.32-0.54; P-trend<0.0001) and women (HR=0.60, 95%CI: 0.46-0.78; P-trend<0.0001). Among women only, there was a statistically significant inverse association between coffee and circulatory disease mortality, (HR=0.78, 95%CI: 0.68-0.90; P-trend<0.001), cerebrovascular disease mortality (HR=0.70, 95%CI: 0.55-0.90; P-trend=0.002), and a positive association between coffee and ovarian cancer mortality (HR 1.31, 95% CI: 1.07-1.61; P-trend 0.02). In the EPIC-biomarkers sub-cohort, higher coffee consumption was associated with lower serum alkaline phosphatase, alanine transaminase, aspartate transaminase, and C-reactive protein. Limitation Reverse causality may have led to spurious findings; however, results did not differ following exclusion of participants who died within 8-years of baseline. The study is also limited by a single assessment of coffee drinking habits. Conclusions Overall, coffee drinking was associated with reduced risk of mortality from various causes. This relationship did not vary by country where coffee preparation and drinking habits may differ.