Coffee consumption and risk of cardiovascular events and all-cause mortality among women with type 2 diabetes

Association of caffeine intake with all-cause and cardiovascular mortality in diabetes and prediabetes

BACKGROUD

The association between caffeine intake and mortality in prediabetes and diabetes is not well defined. This study was designed to investigate the association between caffeine intake and all-cause mortality and cardiovascular disease (CVD) mortality in adults with prediabetes and diabetes in the United States.

METHODS

This analysis included 18,914 adult patients with diabetes and prediabetes from the National Health and Nutrition Examination Survey (NHANES) 2003-2018. Follow-up extended to December 31, 2019. Weighted Cox proportional hazards regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI) for all-cause mortality and CVD mortality.

RESULTS

During 142,460 person-years of follow-up, there were 3,166 cases of all-cause mortality and 1,031 cases of CVD mortality recorded. In the fully adjusted models, caffeine intake showed a significant dose-response association with the risk of all-cause mortality and CVD mortality in individuals with diabetes and prediabetes. When comparing extreme quartiles of caffeine intake, the multivariable-adjusted hazard ratio for all-cause mortality was 0.78 (0.67-0.91) (P for trend = 0.007); however, there was no significant association with the risk of CVD mortality. Results remained consistent in stratified analyses by sex, age, race/ethnicity, education level, family income-poverty ratio, BMI, hypertension, smoking status, alcohol intake, and HEI-2015.

CONCLUSIONS

This study suggests that caffeine intake is significantly inversely associated with the risk of all-cause mortality in individuals with diabetes and prediabetes. In individuals with prediabetes, there is also a significant inverse association between caffeine intake and CVD events, but this association is not present in those with diabetes.

Evaluation of trace metallic element levels in coffee by icp-ms: a comparative study among different origins, forms, and packaging types and consumer risk assessment

Trace elements (TE) contamination of foods and beverages constitutes a public health issue. In this context, the main objective of this study was to determine metals and metalloids content in coffee and to assess the health risks associated with contaminated coffee consumption. To this end, 44 samples of coffee from different origins, forms, and packaging types were analyzed. TE analysis was performed by ICP-MS after digestion. The data analysis was based on principal components analysis (PCA) and analysis of variance (ANOVA). Health risk assessment was determined by the estimated daily intake (EDI), target hazard quotient (THQ), and hazard index (HI). The findings showed that TE levels in coffee varied widely. The highest levels were related to aluminum (Al) (59.88 ± 54.86 mg/kg), manganese (Mn) (16.26 ± 24.59 mg/kg), copper (Cu) (11.60 ± 11.55 mg/kg), and cadmium (Cd) (9.92 ± 10.32 mg/kg). In terms of coffee form and packaging type, a significant difference (P < 0.0001) was observed in nickel (Ni), chromium (Cr), zinc (Zn), cobalt (Co), Cu, Mn, and Al content. The highest EDI was found in Al (0.0109 mg/kg BW/day) in ground coffee packaged in capsules. In terms of chronic daily intake (CDI), Cd and Al were above the reference dose (RfD). THQ of these elements were greater than 1.0, and HI was above the value of 1.0 in different forms of coffee. More interdisciplinary research on the relationships between the metal concentrations in coffee samples and those in feed, water, and soil would be quite interesting.

Coffee consumption and abdominal aortic calcification among adults with and without hypertension, diabetes, and cardiovascular diseases

BACKGROUND AND AIMS

This study was performed to investigate the effect of coffee consumption on abdominal aortic calcification (AAC) among adults with and without hypertension, diabetes, and cardiovascular diseases (CVD).

METHODS AND RESULTS

A total of 2548 participants from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 were included. Coffee consumption was obtained from 24-h dietary recalls. Dual-energy X-ray absorptiometry (DXA) was used to measure the severity of AAC. In the fully adjusted model, compared with non-drinkers, high coffee consumption (≥390 g/d) was associated with higher AAC scores among participants with hypertension (β = 0.72, 95% CI: 0.21-1.22), diabetes (β = 1.20, 95% CI: 0.35-2.05), and CVD (β = 2.03, 95% CI: 0.71-3.36). We did not observe such an association among participants without hypertension, diabetes, and CVD. Furthermore, decaffeinated coffee was not associated with AAC.

CONCLUSION

In conclusion, patients with hypertension, diabetes, and CVD should focus on coffee consumption, especially caffeinated coffee, to reduce the burden of AAC.

Dietary Factors and All-Cause Mortality in Individuals With Type 2 Diabetes: A Systematic Review and Meta-analysis of Prospective Observational Studies

BACKGROUND

Type 2 diabetes is a major health concern associated with mortality. Diet may influence the progression of diabetes; however, systematic reviews are lacking.

PURPOSE

This study systematically summarized the evidence on diet and all-cause mortality in individuals with type 2 diabetes.

DATA SOURCES

PubMed and Web of Science were searched until June 2022.

STUDY SELECTION

Prospective observational studies investigating dietary factors in association with all-cause mortality in individuals with type 2 diabetes were selected.

DATA SYNTHESIS

We identified 107 studies. Moderate certainty of evidence was found for inverse associations of higher intakes of fish (summary risk ratios per serving/week: 0.95; 95% CI 0.92, 0.99; n = 6 studies), whole grain (per 20 g/day: 0.84; 95% CI 0.71, 0.99; n = 2), fiber (per 5 g/day: 0.86; 95% CI 0.81, 0.91; n = 3), and n-3 polyunsaturated fatty acids (per 0.1 g/day: 0.87; 95% CI 0.82, 0.92; n = 2) and mortality. There was low certainty of evidence for inverse associations of vegetable consumption (per 100 g/day: 0.88; 95% CI 0.82, 0.94; n = 2), plant protein (per 10 g/day: 0.91; 95% CI 0.87, 0.96; n = 3), and for positive associations of egg consumption (per 10 g/day: 1.05; 95% CI 1.03, 1.08; n = 7) and cholesterol intake (per 300 mg/day: 1.19; 95% CI 1.13, 1.26; n = 2). For other dietary factors, evidence was uncertain or no association was observed.

CONCLUSIONS

Higher intake of fish, whole grain, fiber, and n-3 polyunsaturated fatty acids were inversely associated with all-cause mortality in individuals with type 2 diabetes. There is limited evidence for other dietary factors, and, thus, more research is needed.

Coffee consumption and the risk of cerebrovascular disease: a meta-analysis of prospective cohort studies

Background

Stroke is a crucial health threat to adults worldwide. Despite extensive knowledge of risk-factor mitigation, no primary prevention exists for healthy people. Coffee is a widely consumed beverage globally. Health benefit of coffee for several neurological diseases has been identified; however, the association between stroke risk and coffee consumption in healthy people has not been determined. We investigated the effect of coffee on stroke risk by conducting a meta-analysis of prospective cohort studies.

Methods

Electronic databases, namely PubMed, BioMed Central, Medline, and Google Scholar, were searched using terms related to stroke and coffee. Articles that described clear diagnostic criteria for stroke and details on coffee consumption were included. The reference lists of relevant articles were reviewed to identify eligible studies not shortlisted using these terms. Enrolled studies were grouped into three outcome categories: overall stroke, hemorrhagic stroke, and ischemic stroke.

Results

Seven studies were included and all of them were large-scale, long-term, follow-up cohort studies of a healthy population. Upon comparing the least-coffee-consuming groups from each study, the meta-analysis revealed a reduction in the risk of overall stroke during follow-up (hazard ratio [HR] for overall stroke = 0.922, 95% confidence interval [CI] = 0.855–0.994, P = 0.035). In studies with a clear definition of hemorrhagic and ischemic stroke, coffee consumption reduced the risk of ischemic stroke more robustly than that of hemorrhagic stroke (hemorrhagic, HR = 0.895, 95% CI = 0.824–0.972, P = .008; ischemic, HR = 0.834, 95% CI = 0.739–0.876, P < .001). No obvious dose-dependent or U-shaped effect was observed.

Conclusions

Coffee consumption reduces the risk of overall stroke, especially ischemic stroke. Further investigation is required to identify beneficial components in coffee, including caffeine and phenolic acids, to develop preventive medication for stroke.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12883-021-02411-5.

Caffeine as a Factor Influencing the Functioning of the Human Body-Friend or Foe?

Nowadays, caffeine is one of the most commonly consumed substances, which presents in many plants and products. It has both positive and negative effects on the human body, and its activity concerns a variety of systems including the central nervous system, immune system, digestive system, respiratory system, urinary tract, etc. These effects are dependent on quantity, the type of product in which caffeine is contained, and also on the individual differences among people (sex, age, diet etc.). The main aim of this review was to collect, present, and analyze the available information including the latest discoveries on the impact of caffeine on human health and the functioning of human body systems, taking into account the role of caffeine in individual disease entities. We present both the positive and negative sides of caffeine consumption and the healing properties of this purine alkaloid in diseases such as asthma, Parkinson's disease, and others, not forgetting about the negative effects of excess caffeine (e.g., in people with hypertension, children, adolescents, and the elderly). In summary, we can conclude, however, that caffeine has a multi-directional influence on various organs of the human body, and because of its anti-oxidative properties, it was, and still is, an interesting topic for research studies including those aimed at developing new therapeutic strategies.

Coffee consumption and cardiovascular diseases and mortality in patients with type 2 diabetes: A systematic review and dose-response meta-analysis of cohort studies

AIMS

To evaluate the long-term consequences of coffee drinking in patients with type 2 diabetes.

DATA SYNTHESIS

PubMed, Scopus, and Web of Sciences were searched to November 2020 for prospective cohort studies evaluating the association of coffee drinking with risk of cardiovascular disease (CVD) and mortality in patients with type 2 diabetes. Two reviewers extracted data and rated the certainty of evidence using GRADE approach. Random-effects models were used to estimate the hazard ratios (HRs) and 95% CIs. Dose-response associations were modeled by a one-stage mixed-effects meta-analysis. Ten prospective cohort studies with 82,270 cases were included. Compared to those with no coffee consumption, the HRs for consumption of 4 cups/d were 0.79 (95%CI: 0.72, 0.87; n = 10 studies) for all-cause mortality, 0.60 (95%CI: 0.46, 0.79; n = 4) for CVD mortality, 0.68 (95%CI: 0.51, 0.91; n = 3) for coronary heart disease (CHD) mortality, 0.72 (95%CI: 0.54, 0.98; n = 2) for CHD, and 0.77 (95%CI: 0.61, 0.98; n = 2) for total CVD events. There was no significant association for cancer mortality and stroke. There was an inverse monotonic association between coffee drinking and all-cause and CVD mortality, and inverse linear association for CHD and total CVD events. The certainty of evidence was graded moderate for all-cause mortality, and low or very low for other outcomes.

CONCLUSIONS

Drinking coffee may be inversely associated with the risk of mortality in patients with type 2 diabetes. However, more research is needed considering type of coffee, sugar and cream added to coffee, and history of CVD to present more confident results.

REGISTRY AND REGISTRY NUMBER

The protocol of this systematic review was registered at Open Science Framework (https://osf.io/8uaf3, registered form: osf.io/xur76, registration DOI: 10.17605/OSF.IO/8UAF3).

Additive effects of green tea and coffee on all-cause mortality in patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry

INTRODUCTION

The impact of consuming green tea or coffee on mortality in patients with diabetes is controversial. We prospectively investigated the impact of each beverage and their combination on mortality among Japanese patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS

In all, 4923 patients (2790 men, 2133 women) with type 2 diabetes (mean age, 66 years) were followed prospectively (median, 5.3 years; follow-up rate, 99.5%). We evaluated the amount of green tea and coffee consumed using self-administered questionnaires.

RESULTS

During the follow-up period, 309 participants died. The consumption of green tea, coffee, and a combination of the beverages was associated with reduced all-cause mortality. Multivariable-adjusted hazard ratios (95% CIs) for green tea were as follows: none 1.0 (referent); 0.85 (0.60-1.22) for ≤1 cup/day; 0.73 (0.51-1.03) for 2-3 cups/day; 0.60 (0.42-0.85) for ≥4 cups/day; and P for trend, 0.002. For coffee, they were: none 1.0 (referent); 0.88 (0.66-1.18) for <1 cup/day; 0.81 (0.58-1.13) for 1 cup/day; 0.59 (0.42-0.82) for ≥2 cups/day; P for trend, 0.002. With the combination they were 1.0 (referent) for no consumption of green tea and coffee; 0.49 (0.24-0.99) for 2-3 cups/day of green tea with ≥2 cups/day of coffee; 0.42 (0.20-0.88) for ≥4 cups/day of green tea with 1 cup/day of coffee; and 0.37 (0.18-0.77) for ≥4 cups/day of green tea with ≥2 cups/day of coffee.

CONCLUSIONS

Higher consumption of green tea and coffee was associated with reduced all-cause mortality: their combined effect appeared to be additive in patients with type 2 diabetes.

Health Decline Is Associated with Reports of No Coffee Consumption Years After Reporting Coffee Consumption Among Older Adults in Spain

BACKGROUND

Part of the health benefits of coffee reported in observational studies might be due to health status influencing coffee intake rather than the opposite.

OBJECTIVE

We examined whether changes in health influenced subsequent reports of no coffee consumption in older adults.

METHODS

Data came from 718 coffee drinkers aged ≥60 y recruited in the Seniors-Estudio de Nutrición y Salud Cardiovascular en España (ENRICA) cohort in 2008-2010 (wave 0) and followed-up in 2012 (wave 1), 2015 (wave 2), and 2017 (wave 3). Health status was measured with a 52-item deficit accumulation index (DAI) with 4 domains: functionality, self-rated health/vitality, mental health, and morbidity/health services use. Coffee intake was estimated with a validated diet history. We examined how changes in health status over a 3-y period (wave 0 to wave 1) influenced reports of no coffee consumption during the subsequent 5 y (wave 1 to wave 3) by using logistic regression models.

RESULTS

Health deterioration over 3 y was associated with a higher frequency of reports of no regular coffee consumption during the subsequent 5 y (fully adjusted OR: 1.48 per 1-SD increment in DAI; 95% CI: 1.17-1.87). Deteriorating function (OR: 1.38 per 1-SD increment; 95% CI: 1.06-1.81) and mental health (OR: 1.34 per 1-SD increment; 95% CI: 1.04-1.73) were the DAI domains associated with increased reports of no regular coffee consumption. Also, individuals with worsened perceived health or hypertension onset were more likely to report no regular coffee consumption. No associations were found for decaffeinated coffee.

CONCLUSIONS

Health deterioration was associated with reports of no regular coffee consumption years after reporting regular coffee consumption among older adults in Spain. A potential implication of this finding is that part of the beneficial effect of coffee consumption on health in observational studies might be due to reverse causation, which should be confirmed in future research.

Caffeine Consumption and Mortality in Diabetes: An Analysis of NHANES 1999-2010

Aim: An inverse relationship between coffee consumption and mortality has been reported in the general population. However, the effect of coffee consumption in diabetes remains unclear. We aimed to evaluate the association of caffeine consumption and caffeine source with mortality among patients with diabetes. Methods: We examined the association of caffeine consumption with mortality among 1974 women and 1974 men with diabetes, using the National Health and Nutrition Examination Survey (NHANES) 1999-2010. Caffeine consumption was assessed at baseline using 24 h dietary recalls. Cox proportional hazard models were fitted to estimate hazard ratios (HR) for all-cause, cardiovascular, and cancer-related mortality according to caffeine consumption and its source, adjusting for potential confounders. Results: A dose-dependent inverse association between caffeine and all-cause mortality was observed in women with diabetes. Adjusted HR for death among women who consumed caffeine, as compared with non-consumers, were: 0.57 (95% CI, 0.40-0.82) for <100 mg of caffeine/day, 0.50 (95% CI, 0.32-0.78) for 100 to <200 mg of caffeine/day, and 0.39 (95% CI, 0.23-0.64) for ≥200 mg of caffeine/day (p = 0.005 for trend). This association was not observed in men. There was a significant interaction between sex and caffeine consumption (p = 0.015). No significant association between total caffeine consumption and cardiovascular or cancer mortality was observed. Women who consumed more caffeine from coffee had reduced risk of all-cause mortality (p = 0.004 for trend). Conclusion: Our study showed a dose-dependent protective effect of caffeine consumption on mortality among women with diabetes.

Dietary phosphatidylcholine and risk of all-cause and cardiovascular-specific mortality among US women and men

BACKGROUND

The trimethylamine-containing nutrient phosphatidylcholine is the major dietary source for the gut microbiota metabolite trimethylamine-N-oxide (TMAO), which has been related to cardiovascular diseases (CVDs) and mortality. Previous research suggested that the relation of TMAO with CVD risk might be stronger in diabetic than in nondiabetic populations. However, the evidence for an association of dietary phosphatidylcholine with CVD and mortality is limited.

OBJECTIVES

We aimed to examine whether dietary consumption of phosphatidylcholine, which is mainly derived from eggs, red meat, and fish, is related to all-cause and CVD mortality in 2 cohorts of US women and men. In particular, we also tested if such an association was modified by diabetes status.

DESIGN

We followed 80,978 women from the Nurses' Health Study (1980-2012) and 39,434 men from the Health Professionals Follow-Up Study (1986-2012), who were free of cancer and CVD at baseline, for mortality. Dietary intakes and potential confounders were assessed with regularly administered questionnaires. We used Cox proportional hazards models to estimate HRs and 95% CIs.

RESULTS

We documented 17,829 all-cause and 4359 CVD deaths during follow-up. After multivariate adjustment for potential confounders, including demographic factors, disease status, lifestyle, and dietary intakes, higher phosphatidylcholine intakes were associated with an increased risk of all-cause and CVD mortality. HRs (95% CIs) comparing the top and bottom quintiles of phosphatidylcholine intake were 1.11 (1.06, 1.17; P-trend across quintiles < 0.0001) for all-cause mortality and 1.26 (1.15, 1.39; P-trend < 0.0001) for CVD mortality in the combined data of both cohorts. The associations of phosphatidylcholine with all-cause and CVD mortality were stronger in diabetic than in nondiabetic participants (P-interaction = 0.0002 and 0.001, respectively).

CONCLUSION

These data suggest that higher phosphatidylcholine consumption is associated with increased all-cause and CVD mortality in the US population, especially in patients with diabetes, independent of traditional risk factors.

Caffeine and cardiovascular diseases: critical review of current research

Caffeine is a most widely consumed physiological stimulant worldwide, which is consumed via natural sources, such as coffee and tea, and now marketed sources such as energy drinks and other dietary supplements. This wide use has led to concerns regarding the safety of caffeine and its proposed beneficial role in alertness, performance and energy expenditure and side effects in the cardiovascular system. The question remains "Which dose is safe?", as the population does not appear to adhere to the strict guidelines listed on caffeine consumption. Studies in humans and animal models yield controversial results, which can be explained by population, type and dose of caffeine and low statistical power. This review will focus on comprehensive and critical review of the current literature and provide an avenue for further study.

Association of Coffee Consumption With Total and Cause-Specific Mortality in 3 Large Prospective Cohorts

BACKGROUND

The association between consumption of caffeinated and decaffeinated coffee and risk of mortality remains inconclusive.

METHODS AND RESULTS

We examined the associations of consumption of total, caffeinated, and decaffeinated coffee with risk of subsequent total and cause-specific mortality among 74,890 women in the Nurses' Health Study (NHS), 93,054 women in the Nurses' Health Study II, and 40,557 men in the Health Professionals Follow-up Study. Coffee consumption was assessed at baseline using a semiquantitative food frequency questionnaire. During 4,690,072 person-years of follow-up, 19,524 women and 12,432 men died. Consumption of total, caffeinated, and decaffeinated coffee were nonlinearly associated with mortality. Compared with nondrinkers, coffee consumption of 1 to 5 cups per day was associated with lower risk of mortality, whereas coffee consumption of more than 5 cups per day was not associated with risk of mortality. However, when restricting to never smokers compared with nondrinkers, the hazard ratios (and 95% confidence intervals) of mortality were 0.94 (0.89-0.99) for 1.0 or less cup per day, 0.92 (0.87-0.97) for 1.1 to 3.0 cups per day, 0.85 (0.79-0.92) for 3.1 to 5.0 cup per day, and 0.88 (0.78-0.99) for more than 5.0 cup per day (P value for nonlinearity = 0.32; P value for trend < 0.001). Significant inverse associations were observed for caffeinated (P value for trend < 0.001) and decaffeinated coffee (P value for trend = 0.022). Significant inverse associations were observed between coffee consumption and deaths attributed to cardiovascular disease, neurologic diseases, and suicide. No significant association between coffee consumption and total cancer mortality was found.

CONCLUSIONS

Higher consumption of total coffee, caffeinated coffee, and decaffeinated coffee was associated with lower risk of total mortality.

Development and Application of a Genetic Algorithm for Variable Optimization and Predictive Modeling of Five-Year Mortality Using Questionnaire Data

The problem of selecting important variables for predictive modeling of a specific outcome of interest using questionnaire data has rarely been addressed in clinical settings. In this study, we implemented a genetic algorithm (GA) technique to select optimal variables from questionnaire data for predicting a five-year mortality. We examined 123 questions (variables) answered by 5,444 individuals in the National Health and Nutrition Examination Survey. The GA iterations selected the top 24 variables, including questions related to stroke, emphysema, and general health problems requiring the use of special equipment, for use in predictive modeling by various parametric and nonparametric machine learning techniques. Using these top 24 variables, gradient boosting yielded the nominally highest performance (area under curve [AUC] = 0.7654), although there were other techniques with lower but not significantly different AUC. This study shows how GA in conjunction with various machine learning techniques could be used to examine questionnaire data to predict a binary outcome.

Coffee Intake, Recurrence, and Mortality in Stage III Colon Cancer: Results From CALGB 89803 (Alliance)

PURPOSE

Observational studies have demonstrated increased colon cancer recurrence in states of relative hyperinsulinemia, including sedentary lifestyle, obesity, and increased dietary glycemic load. Greater coffee consumption has been associated with decreased risk of type 2 diabetes and increased insulin sensitivity. The effect of coffee on colon cancer recurrence and survival is unknown.

PATIENTS AND METHODS

During and 6 months after adjuvant chemotherapy, 953 patients with stage III colon cancer prospectively reported dietary intake of caffeinated coffee, decaffeinated coffee, and nonherbal tea, as well as 128 other items. We examined the influence of coffee, nonherbal tea, and caffeine on cancer recurrence and mortality using Cox proportional hazards regression.

RESULTS

Patients consuming 4 cups/d or more of total coffee experienced an adjusted hazard ratio (HR) for colon cancer recurrence or mortality of 0.58 (95% CI, 0.34 to 0.99), compared with never drinkers (Ptrend = .002). Patients consuming 4 cups/d or more of caffeinated coffee experienced significantly reduced cancer recurrence or mortality risk compared with abstainers (HR, 0.48; 95% CI, 0.25 to 0.91; Ptrend = .002), and increasing caffeine intake also conferred a significant reduction in cancer recurrence or mortality (HR, 0.66 across extreme quintiles; 95% CI, 0.47 to 0.93; Ptrend = .006). Nonherbal tea and decaffeinated coffee were not associated with patient outcome. The association of total coffee intake with improved outcomes seemed consistent across other predictors of cancer recurrence and mortality.

CONCLUSION

Higher coffee intake may be associated with significantly reduced cancer recurrence and death in patients with stage III colon cancer.

Tea consumption and mortality of all cancers, CVD and all causes: a meta-analysis of eighteen prospective cohort studies

Epidemiological studies have demonstrated inconsistent associations between tea consumption and mortality of all cancers, CVD and all causes. To obtain quantitative overall estimates, we conducted a dose-response meta-analysis of prospective cohort studies. A literature search in PubMed and Embase up to April 2015 was conducted for all relevant papers published. Random-effects models were used to calculate pooled relative risks (RR) with 95 % CI. In eighteen prospective studies, there were 12 221, 11 306 and 55 528 deaths from all cancers, CVD and all causes, respectively. For all cancer mortality, the summary RR for the highest v. lowest category of green tea and black tea consumption were 1·06 (95 % CI 0·98, 1·15) and 0·79 (95 % CI 0·65, 0·97), respectively. For CVD mortality, the summary RR for the highest v. lowest category of green tea and black tea consumption were 0·67 (95 % CI 0·46, 0·96) and 0·88 (95 % CI 0·77, 1·01), respectively. For all-cause mortality, the summary RR for the highest v. lowest category of green tea and black tea consumption were 0·80 (95 % CI 0·68, 0·93) and 0·90 (95 % CI 0·83, 0·98), respectively. The dose-response analysis indicated that one cup per d increment of green tea consumption was associated with 5 % lower risk of CVD mortality and with 4 % lower risk of all-cause mortality. Green tea consumption was significantly inversely associated with CVD and all-cause mortality, whereas black tea consumption was significantly inversely associated with all cancer and all-cause mortality.

The coffee paradox in stroke: Increased consumption linked with fewer strokes

OBJECTIVE

To determine the association in amount of daily coffee consumption with incidence of stroke in a broad cohort, considering other vascular risk factors.

METHODS

We utilized the Third National Health and Nutrition Examination Survey (1988-1994; NHANES III) data on participants aged ≥17 years old to examine coffee consumption and stroke. Multivariate logistic regression models related the amount of coffee use reported in a food frequency questionnaire with stroke, controlling for other vascular risk factors.

RESULTS

Of 33 994 NHANES III subjects, coffee consumption and stroke data in adults ≥17 years old were available in 19 994. Daily coffee consumption ranged from 0 to 20 (median 1) cups and 644 (3.2%) participants had a stroke diagnosed by a physician. Coffee intake varied with age, gender, and ethnicity (P < 0.001). Interestingly, heart failure, diabetes, and hypertension were less frequent, and high cholesterol more frequent in those consuming ≥3 cups per day (P < 0.001). Smoking was more frequent in all coffee drinkers (P < 0.0001). Multivariate analyses revealed an independent effect of heavier coffee consumption (≥3 cups/day) on reduced stroke (OR 0.44, 95% CI 0.22-0.87, P < 0.02) in healthy subjects that was attenuated by vascular risk factors (OR 0.78, 95% CI 0.58-1.07, P ≈ 0.12).

CONCLUSION

Heavier daily coffee consumption is associated with decreased stroke prevalence, despite smoking tendency in heavy coffee drinkers.

Association of coffee intake with total and cause-specific mortality in a Japanese population: the Japan Public Health Center-based Prospective Study

BACKGROUND

Despite the rising consumption of coffee worldwide, few prospective cohort studies assessed the association of coffee intake with mortality including total and major causes of death.

OBJECTIVE

We aimed to investigate the association between habitual coffee drinking and mortality from all causes, cancer, heart disease, cerebrovascular disease, respiratory disease, injuries, and other causes of death in a large-scale, population-based cohort study in Japan.

DESIGN

We studied 90,914 Japanese persons aged between 40 and 69 y without a history of cancer, cerebrovascular disease, or ischemic heart disease at the time of the baseline study. Subjects were followed up for an average of 18.7 y, during which 12,874 total deaths were reported. The association between coffee intake and risk of total and cause-specific mortality was assessed by using a Cox proportional hazards regression model with adjustment for potential confounders.

RESULTS

We showed an inverse association between coffee intake and total mortality in both men and women. HRs (95% CIs) for total death in subjects who consumed coffee compared with those who never drank coffee were 0.91 (0.86-0.95) for <1 cup/d, 0.85 (0.81-0.90) for 1-2 cups/d, 0.76 (0.70-0.83) for 3-4 cups/d, and 0.85 (0.75-0.98) for >5 cups/d (P-trend < 0.001). Coffee was inversely associated with mortality from heart disease, cerebrovascular disease, and respiratory disease.

CONCLUSION

With this prospective study, we suggest that the habitual intake of coffee is associated with lower risk of total mortality and 3 leading causes of death in Japan.

Cardiovascular risk profiles in Type 2 diabetes and the impact of geographical setting

Cardiovascular (CV) disease is a leading morbidity and mortality in Type 2 diabetes (T2DM). Previous studies have shown geographic differences in the prevalence of CV and renal diseases. A literature review of longitudinal (≥5 years) studies including ≥1000 T2DM patients and reporting CV endpoints was performed to compare risk profiles. Key differences between geographies included a relatively higher prevalence of microalbuminuria in East Asian relative to North American and European patients, which in turn is an important CV risk factor. Patients from East Asia also have a relatively higher incidence of stroke and lower incidence of coronary heart disease. Overall, there are differences in CV risk in T2DM patients between different regions and that long-term studies from Africa, the Middle East and Latin America are lacking.

Circulating adiponectin and cardiovascular mortality in patients with type 2 diabetes mellitus: evidence of sexual dimorphism

BACKGROUND

The pathogenesis of cardiovascular (CV) mortality, whose rate is increased in type 2 diabetes, is poorly understood.

METHODS

Three prospective cohorts were analyzed: 1) Gargano Heart Study (GHS; 359 patients, 58 events/1,934 person-years; py); 2) Health Professional Follow-up Study (HPFS; 833 men, 146 events/10,024 py); 3) Nurses' Health Study (NHS; 902 women, 144 events/15,074 py).

RESULTS

In GHS serum adiponectin predicted CV mortality in men (hazard ratio, HR, and 95% CI per standard deviation, SD, increment = 1.54, 1.19-2.01), but not women (HR = 0.98, 0.48-2.01).

CONCLUSIONS

This is the first report showing that high circulating adiponectin predicts increased CV mortality in men, but not in women with type 2 diabetes. Further studies are necessary to unravel the mechanisms through which adiponectin influences CV mortality in a sex-specific manner.

A meta-analysis of prospective studies of coffee consumption and mortality for all causes, cancers and cardiovascular diseases

Several prospective studies considered the relation between coffee consumption and mortality. Most studies, however, were underpowered to detect an association, since they included relatively few deaths. To obtain quantitative overall estimates, we combined all published data from prospective studies on the relation of coffee with mortality for all causes, all cancers, cardiovascular disease (CVD), coronary/ischemic heart disease (CHD/IHD) and stroke. A bibliography search, updated to January 2013, was carried out in PubMed and Embase to identify prospective observational studies providing quantitative estimates on mortality from all causes, cancer, CVD, CHD/IHD or stroke in relation to coffee consumption. A systematic review and meta-analysis was conducted to estimate overall relative risks (RR) and 95 % confidence intervals (CI) using random-effects models. The pooled RRs of all cause mortality for the study-specific highest versus low (≤1 cup/day) coffee drinking categories were 0.88 (95 % CI 0.84-0.93) based on all the 23 studies, and 0.87 (95 % CI 0.82-0.93) for the 19 smoking adjusting studies. The combined RRs for CVD mortality were 0.89 (95 % CI 0.77-1.02, 17 smoking adjusting studies) for the highest versus low drinking and 0.98 (95 % CI 0.95-1.00, 16 studies) for the increment of 1 cup/day. Compared with low drinking, the RRs for the highest consumption of coffee were 0.95 (95 % CI 0.78-1.15, 12 smoking adjusting studies) for CHD/IHD, 0.95 (95 % CI 0.70-1.29, 6 studies) for stroke, and 1.03 (95 % CI 0.97-1.10, 10 studies) for all cancers. This meta-analysis provides quantitative evidence that coffee intake is inversely related to all cause and, probably, CVD mortality.

Consumption of a boiled Greek type of coffee is associated with improved endothelial function: The Ikaria Study

Objective:

The association of coffee consumption with cardiovascular disease remains controversial. Endothelial function is associated with cardiovascular risk. We examined the association between chronic coffee consumption and endothelium function in elderly inhabitants of the island of Ikaria.

Methods:

The analysis was conducted on 142 elderly subjects (aged 66–91 years) of the Ikaria Study. Endothelial function was evaluated by ultrasound measurement of flow-mediated dilation (FMD). Coffee consumption was evaluated based on a food frequency questionnaire and was categorized as ‘low’ (< 200 ml/day), ‘moderate’ (200–450 ml/day), or ‘high’ (> 450 ml/day).

Results:

From the subjects included in the study, 87% consumed a boiled Greek type of coffee. Moreover, 40% had a ‘low’, 48% a ‘moderate’ and 13% a ‘high’ daily coffee consumption. There was a linear increase in FMD according to coffee consumption (‘low’: 4.33 ± 2.51% vs ‘moderate’: 5.39 ± 3.09% vs ‘high’: 6.47 ± 2.72%; p = 0.032). Moreover, subjects consuming mainly a boiled Greek type of coffee had a significantly higher FMD compared with those consuming other types of coffee beverages ( p = 0.035).

Conclusions:

Chronic coffee consumption is associated with improved endothelial function in elderly subjects, providing a new connection between nutrition and vascular health.

The impact of green tea and coffee consumption on the reduced risk of stroke incidence in Japanese population: the Japan public health center-based study cohort

BACKGROUND AND PURPOSE

Few prospective studies have examined the impact of both green tea and coffee consumption on strokes. We investigated the association of the combination of those consumption with stroke incidence in a general population.

METHODS

We studied 82 369 Japanese (aged 45-74 years; without cardiovascular disease [CVD] or cancer in 1995 and 1998 for Cohort I and II, respectively) who received 13 years of mean follow-up through the end of 2007. Green tea and coffee consumption was assessed by self-administered food frequency questionnaire at baseline.

RESULTS

In the 1 066 718 person-years of follow-up, we documented the incidence of strokes (n=3425) and coronary heart disease (n=910). Compared with seldom drinking green tea, the multivariable-adjusted hazard ratios (95% confidence intervals) of all strokes were 0.86 (0.78-0.95) and 0.80 (0.73-0.89) in green tea 2 to 3 and ≥ 4 cups/d, respectively. Higher green tea consumption was associated with inverse risks of CVD and strokes subtypes. Compared with seldom drinking coffee, the multivariable-adjusted hazard ratios (95% confidence intervals) of all strokes were 0.89 (0.80-0.99), 0.80 (0.72-0.90), and 0.81 (0.72-0.91) for coffee 3 to 6 times/week and 1 and ≥ 2 times/day, respectively. Coffee consumption was associated with an inverse risk of CVD and cerebral infarction. Higher green tea or coffee consumption reduced the risks of CVD and stroke subtypes (especially in intracerebral hemorrhage, P for interaction between green tea and coffee=0.04). None of the significant association was observed in coronary heart disease.

CONCLUSIONS

Higher green tea and coffee consumption were inversely associated with risk of CVD and stroke in general population.

Effect of smoking and caffeine consumption on polybrominated diphenyl ethers (PBDE) and polybrominated biphenyls (PBB)

Effect of smoking and caffeine consumption (CC) on the levels of polybrominated diphenyl ethers (PBDE) and polybrominated biphenyls (PBB) has not been adequately studied. Data from 2003-2004 National Health and Nutrition Examination Survey (n = 1013) to simultaneously evaluate the effect of smoking and CC on levels of serum 2,2',4,4'-tetrabromodiphenyl ether (PBDE-47), 2,2',4,4',5-pentabromodiphenyl ether (PBDE-99), 2,2',4,4',6-pentabromodiphenyl ether (PBDE-100), 2,2',4,4',5,5'-hexabromodiphenyl ether (PBDE-153), and their sum and 2,2',4,4',5,5'-hexabromobiphenyl (PBB-153) were used. Regression models were fitted with logs of PBDE and PBB as dependent variables and age, age(2), gender, body mass index (BMI), race/ethnicity, smoking status, fish/shellfish consumption status during the last 30 d, and CC as independent variables. For lipid-adjusted models, age was negatively associated while age(2) was positively associated with almost all PBDE models. The reverse was the case for PBB-153. Body mass index was found to be negatively associated with PBDE-153 and PBB-153. Levels of all whole weight PBDE increased with levels of total lipid. Smoking was not markedly associated with concentrations of either PBDE or PBB. Males displayed significantly higher levels of PBDE-153 and ΣPBDE. For the whole weight PBDE congeners 47, 99, and 100 and PBB-153, non-Hispanic black (NHB) males showed significantly higher levels than NHB females.

Coffee Consumption and Stroke Risk: A Meta-analysis of Epidemiologic Studies

Background

Coffee is one of the most widely consumed beverages in the world, and contains caffeine and phenolic compounds. Many studies on the association between coffee consumption and risk of stroke have been reported, however, more research is needed to further explore many studies' inconsistent results. Therefore, we conducted a meta-analysis to verify the relationship between coffee consumption and stroke.

Methods

We searched MEDLINE (PubMed), EMBASE, and the Cochrane Library, using the keywords "coffee" or "caffeine" for the exposure factors, and "transient ischemic attack" or "stroke" or "acute cerebral infarction" or "cardiovascular events" for the outcome factors. We included prospective cohort and case-control studies published between 2001 and July 2011 in this review. The search was limited to English language.

Results

Among 27 articles identified for this review, only 9 studies met the inclusion criteria, all of which were cohort studies. When using all cohort studies, the pooled relative risk (RR) of stroke for the highest vs. lowest category of coffee consumption was 0.83 (95% confidence interval [CI], 0.76 to 0.91). When subgroup analysis was performed, for Europeans, increased coffee drinking showed a preventive effect on stroke occurrence with RR 0.82 (95% CI, 0.74 to 0.92); RR for women 0.81 (95% CI, 0.70 to 0.93); for ischemic stroke 0.80 (95% CI, 0.71 to 0.90); and for those drinking 4 cups or more per day 0.83 (95% CI, 0.75 to 0.91).

Conclusion

We found that coffee consumption of 4 cups or more per day showed a preventive effect on stroke in this meta-analysis.

The Health Lowdown on Caffeine

Daily, approximately 90% of Americans consume caffeine in one form or another; coffee, tea, soft drinks, energy drinks and or chocolate. Besides its ability to provide increase wakefulness it has been touted to have many health benefits. Multiple studies show caffeine consumption provides cardiovascular protection and decreases the risk for developing type 2 diabetes mellitus, stroke in women, certain cancers and several neurological conditions. However, consumption in higher quantities does carry risk for adverse health condition.

Role of coffee in modulation of diabetes risk

Coffee consumption has been associated with a lower risk of type 2 diabetes. This association does not depend on race, gender, geographic distribution of the study populations, or the type of coffee consumed (i.e., caffeinated or decaffeinated). This review discusses the strength of this relationship, examines the possibility that the pattern of coffee consumption could influence the association, and evaluates the possible relationship between coffee consumption and other risk factors associated with diabetes. Particular attention is paid to the identification, on the basis of the scientific evidence, of the possible mechanisms by which coffee components might affect diabetes development, especially in light of the paradoxical effect of caffeine on glucose metabolism. In addition to the role of coffee in reducing the risk of developing type 2 diabetes, the possible role of coffee in the course of the illness is explored. Finally, the possibility that coffee can also affect the risk of other forms of diabetes (e.g., type 1 diabetes and gestational diabetes) is examined.

Coffee consumption and risk of stroke: a dose-response meta-analysis of prospective studies

Coffee consumption has been inconsistently associated with risk of stroke. The authors conducted a meta-analysis of prospective studies to quantitatively assess the association between coffee consumption and stroke risk. Pertinent studies were identified by searching PubMed and Embase from January 1966 through May 2011 and by reviewing the reference lists of retrieved articles. Prospective studies in which investigators reported relative risks of stroke for 3 or more categories of coffee consumption were eligible. Results from individual studies were pooled using a random-effects model. Eleven prospective studies, with 10,003 cases of stroke and 479,689 participants, met the inclusion criteria. There was some evidence of a nonlinear association between coffee consumption and risk of stroke (P for nonlinearity = 0.005). Compared with no coffee consumption, the relative risks of stroke were 0.86 (95% confidence interval (95% CI): 0.78, 0.94) for 2 cups of coffee per day, 0.83 (95% CI: 0.74, 0.92) for 3-4 cups/day, 0.87 (95% CI: 0.77, 0.97) for 6 cups/day, and 0.93 (95% CI: 0.79, 1.08) for 8 cups/day. There was marginal between-study heterogeneity among study-specific trends (I₂ = 12% and I₂ = 20% for the first and second spline transformations, respectively). Findings from this meta-analysis indicate that moderate coffee consumption may be weakly inversely associated with risk of stroke.

Coffee and its consumption: benefits and risks

Coffee is the leading worldwide beverage after water and its trade exceeds US $10 billion worldwide. Controversies regarding its benefits and risks still exist as reliable evidence is becoming available supporting its health promoting potential; however, some researchers have argued about the association of coffee consumption with cardiovascular complications and cancer insurgence. The health-promoting properties of coffee are often attributed to its rich phytochemistry, including caffeine, chlorogenic acid, caffeic acid, hydroxyhydroquinone (HHQ), etc. Many research investigations, epidemiological studies, and meta-analyses regarding coffee consumption revealed its inverse correlation with that of diabetes mellitus, various cancer lines, Parkinsonism, and Alzheimer's disease. Moreover, it ameliorates oxidative stress because of its ability to induce mRNA and protein expression, and mediates Nrf2-ARE pathway stimulation. Furthermore, caffeine and its metabolites help in proper cognitive functionality. Coffee lipid fraction containing cafestol and kahweol act as a safeguard against some malignant cells by modulating the detoxifying enzymes. On the other hand, their higher levels raise serum cholesterol, posing a possible threat to coronary health, for example, myocardial and cerebral infarction, insomnia, and cardiovascular complications. Caffeine also affects adenosine receptors and its withdrawal is accompanied with muscle fatigue and allied problems in those addicted to coffee. An array of evidence showed that pregnant women or those with postmenopausal problems should avoid excessive consumption of coffee because of its interference with oral contraceptives or postmenopausal hormones. This review article is an attempt to disseminate general information, health claims, and obviously the risk factors associated with coffee consumption to scientists, allied stakeholders, and certainly readers.

Caffeine and cardiac arrhythmias: a review of the evidence

Limited data exist on the safety and physiologic effects of caffeine in patients with known arrhythmias. The studies presented suggest that in most patients with known or suspected arrhythmia, caffeine in moderate doses is well tolerated and there is therefore no reason to restrict ingestion of caffeine. A review of the literature is presented.

Coffee consumption and risk of stroke in women

BACKGROUND AND PURPOSE

Coffee consumption has been inconsistently associated with stroke incidence and mortality in previous studies. We investigated the association between coffee consumption and stroke incidence in the Swedish Mammography Cohort.

METHODS

We prospectively followed of 34,670 women without a history of cardiovascular disease or cancer at baseline in 1997. Coffee consumption was assessed in 1997 using a self-administered questionnaire. Incident stroke cases were ascertained from the Swedish Hospital Discharge Registry.

RESULTS

During a mean follow-up of 10.4 years, we ascertained 1680 stroke events, including 1310 cerebral infarctions, 154 intracerebral hemorrhages, 79 subarachnoid hemorrhages, and 137 unspecified strokes. After adjustment for other risk factors, coffee consumption was associated with a statistically significant lower risk of total stroke, cerebral infarction, and subarachnoid hemorrhage but not intracerebral hemorrhage. The multivariable relative risks of total stroke across categories of coffee consumption (<1 cup/day, 1 to 2 cups/day, 3 to 4 cups/day, and ≥5 cups/day) were 1.00, 0.78 (95% CI, 0.66 to 0.91), 0.75 (95% CI, 0.64 to 0.88), and 0.77 (95% CI, 0.63 to 0.92, respectively; P for trend=0.02). The association between coffee consumption and cerebral infarction was not modified by smoking status, body mass index, history of diabetes or hypertension, or alcohol consumption.

CONCLUSIONS

These findings suggest that low or no coffee consumption is associated with an increased risk of stroke in women.

Possible health effects of caffeinated coffee consumption on Alzheimer's disease and cardiovascular disease

Coffee has been known to have both beneficial and harmful effects upon health. Coffee is one of the most widely consumed beverages, worldwide. Dementia/Alzheimer's disease (AD) and cardiovascular disease (CVD) are public health problems that are rapidly increasing in the aging population. Due to the high consumption of coffee, even small effects on an individual's health could have a large effect on public health.The aim of this review article is to provide an overview of previously published studies of coffee consumption on health. Herein, we focus on epidemiological and experimental findings to investigate whether coffee-drinking habits, and/or the quantity of coffee consumption, have any relationship to CVD, dementia/AD, and other chronic diseases. Although the underlying mechanisms are not fully understood, when comparing coffee drinkers with non-drinkers, moderate doses of caffeine showed protective effects against CVD and AD. We hypothesized that caffeine may be a novel therapy to treat CVD and dementia/AD.

Methylxanthines and human health: epidemiological and experimental evidence

When considering methylxanthines and human health, it must be recognized that in many countries most caffeine is consumed as coffee. This is further confounded by the fact that coffee contains many bioactive substances in addition to caffeine; it is rich in phenols (quinides, chlorogenic acid, and lactones) and also has diterpenes (fatty acid esters), potassium, niacin, magnesium, and the vitamin B(3) precursor trigonelline. There is a paradox as consumption of either caffeine or caffeinated coffee results in a marked insulin resistance and yet habitual coffee consumption has repeatedly been reported to markedly reduce the risk for type 2 diabetes. There is strong evidence that caffeine reduces insulin sensitivity in skeletal muscle and this may be due to a combination of direct antagonism of A(1) receptors and indirectly β-adrenergic stimulation as a result of increased sympathetic activity. Caffeine may also induce reduced hepatic glucose output. With the exception of bone mineral, there is little evidence that caffeine impacts negatively on other health issues. Coffee does not increase the risk of cardiovascular diseases or cancers and there is some evidence suggesting a positive relationship for the former and for some cancers, particularly hepatic cancer.

Association of caffeine consumption and smoking status with the serum concentrations of polychlorinated biphenyls, dioxins, and furans in the general U.S. population: NHANES 2003-2004

Smoking appears to enhance the body's clearance of dioxins and dioxin-like polychlorinated biphenyls (PCB) by inducing CYP1A2 activity based on studies with a limited number of participants. This hypothesis was evaluated by using data from National Health and Nutrition Examination Survey. Specifically, adult participants were identified and the sums of their serum lipid-adjusted concentrations of 12 polychlorinated dibenzo-p-dioxins/polychlorinated dibenzofurans (PCDD/PCDF) congeners, 33 PCB (total), 26 non-dioxin-like PCB, and 6 mono-ortho (dioxin-like) PCB were determined. In addition to evaluating the association of smoking, the association of caffeine consumption and the interaction between them was evaluated. Data analysis included regression models that were fitted with age, gender, race/ethnicity, and body mass index (BMI). R(2) varied from 34.8 to 66%. Smokers had significantly lower concentrations of total PCDD/PCDF than nonsmokers. New to this study, a siginificant interaction between caffeine consumption and smoking for total PCB was found. When caffeine was consumed less than once a day, smokers had higher concentrations of total PCB than nonsmokers. However, when caffeine was consumed at least once a day, smokers had lower concentrations than nonsmokers. A significant interaction between age and caffeine consumption frequency for each of the PCB groups was also observed. The differences in concentration between younger and older age groups were greater when caffeine was consumed at least once a day than when caffeine was consumed less frequently. Smoking and caffeine consumption need to be considered in the interpretation of human biomonitoring data because they appear to affect the serum concentrations of these chemicals.

Whole-grain, cereal fiber, bran, and germ intake and the risks of all-cause and cardiovascular disease-specific mortality among women with type 2 diabetes mellitus

BACKGROUND

Although whole-grain consumption has been associated with a lower risk of cardiovascular diseases (CVD) and mortality in the general population, the association of whole grain with mortality in diabetic patients remains to be determined. This study investigated whole grain and its components cereal fiber, bran, and germ in relation to all-cause and CVD-specific mortality in patients with type 2 diabetes mellitus.

METHODS AND RESULTS

We followed 7822 US women with type 2 diabetes mellitus in the Nurses' Health Study. Dietary intakes and potential confounders were assessed with regularly administered questionnaires. We documented 852 all-cause deaths and 295 CVD deaths during up to 26 years of follow-up. After adjustment for age, the highest versus the lowest fifths of intakes of whole grain, cereal fiber, bran, and germ were associated with 16% to 31% lower all-cause mortality. After further adjustment for lifestyle and dietary risk factors, only the association for bran intake remained significant (P for trend=0.01). The multivariate relative risks across the fifths of bran intake were 1.0 (reference), 0.94 (0.75 to 1.18), 0.80 (0.64 to 1.01), 0.82 (0.65 to 1.04), and 0.72 (0.56 to 0.92). Similarly, bran intake was inversely associated with CVD-specific mortality (P for trend=0.04). The relative risks across the fifths of bran intake were 1.0 (reference), 0.95 (0.66 to 1.38), 0.80 (0.55 to 1.16), 0.76 (0.51 to 1.14), and 0.65 (0.43 to 0.99). Similar results were observed for added bran alone.

CONCLUSIONS

Whole-grain and bran intakes were associated with reduced all-cause and CVD-specific mortality in women with diabetes mellitus. These findings suggest a potential benefit of whole-grain intake in reducing mortality and cardiovascular risk in diabetic patients.

Randomized control trial investigating the influence of coffee on heart rate variability in patients with ST-segment elevation myocardial infarction

BACKGROUND

Cardiac autonomic dysfunction post ST-segment elevation myocardial infarction (STEMI) has been linked to an excess risk of premature cardiovascular morbidity and mortality above those with normal autonomic function post-STEMI.

AIM

The aim of this study was to evaluate the effect of acute ingestion of coffee on autonomic function and cardiovascular outcomes in patients with acute STEMI.

DESIGN

Randomized control trial.

METHODS

We randomized 103 patients with acute STEMI, admitted to our Coronary Care Unit, to receive regular coffee (caffeinated) or de-caffeinated coffee using a randomized controlled double-blinded design. Heart rate variability was assessed 5 days post-STEMI to assess the effect of caffeine on autonomic function.

RESULTS

In the group randomized to regular coffee, parasympathetic activity increased by up to 96% (P = 0.04) after 5 days. There was no detrimental effect of regular coffee on cardiac rhythm post-STEMI.

CONCLUSION

Coffee ingestion is associated with an increase in parasympathetic autonomic function immediately post-STEMI. Coffee was found to be safe and not associated with any adverse cardiovascular outcomes in the short term.