Association of Coffee Consumption With Overall and Cause-Specific Mortality in a Large US Prospective Cohort Study
Association of Coffee Consumption With Overall and Cause-Specific Mortality in a Large US Prospective Cohort Study
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DOI：
10.1093/aje/kwv146
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发表时间：
2015-12-15
影响因子：
5
通讯作者：
Sinha, Rashmi
中科院分区：
文献类型：
--
作者：
Loftfield, Erikka;Freedman, Neal D.;Sinha, Rashmi
对高咖啡因摄入量和咖啡作为添加脂肪和糖的载体的担忧引发了对咖啡对健康的净影响的质疑。虽然已经观察到总体死亡率的负相关，但原因特异性死亡率的数据很少。此外，很少有研究专门考虑摄入脱咖啡因咖啡或使用咖啡添加剂。在前列腺癌、肺癌、结直肠癌和卵巢癌筛查试验中，通过自我报告评估基线咖啡摄入量。使用考克斯比例风险模型估计风险比。在研究基线（1998-2001年）或研究入组时（1993-2001年）无心血管疾病史的90，317名美国成年人中，在1998年至2009年的805，644人-年随访期间发生了8，718例死亡。在对吸烟和其他潜在混杂因素进行校正后，与不喝咖啡的人相比，喝咖啡的人总体死亡率的风险比较低（< 1杯/天：风险比（HR）= 0.99（95%置信区间（CI）：0.92，1.07）; 1杯/天：HR = 0.94（95% CI：0.87，1.02）; 2-3杯/天：HR = 0.82（95% CI：0.77，0.88）; 4-5杯/天：HR = 0.79（95% CI：0.72，0.86）; >= 6杯/天：HR = 0.84（95% CI：0.75，0.95））。在脱咖啡因咖啡和咖啡添加剂中也观察到类似的发现。心脏病、慢性呼吸道疾病、糖尿病、肺炎和流感以及故意自残导致的死亡与癌症呈负相关，但与癌症无关。咖啡可以通过有利地影响炎症、肺功能、胰岛素敏感性和抑郁症来降低死亡风险。
Concerns about high caffeine intake and coffee as a vehicle for added fat and sugar have raised questions about the net impact of coffee on health. Although inverse associations have been observed for overall mortality, data for cause-specific mortality are sparse. Additionally, few studies have considered exclusively decaffeinated coffee intake or use of coffee additives. Coffee intake was assessed at baseline by self-report in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Hazard ratios were estimated using Cox proportional hazards models. Among 90,317 US adults without cancer at study baseline (1998-2001) or history of cardiovascular disease at study enrollment (1993-2001), 8,718 deaths occurred during 805,644 person-years of follow-up from 1998 through 2009. Following adjustment for smoking and other potential confounders, coffee drinkers, as compared with nondrinkers, had lower hazard ratios for overall mortality (< 1 cup/day: hazard ratio (HR) = 0.99 (95% confidence interval (CI): 0.92, 1.07); 1 cup/day: HR = 0.94 (95% CI: 0.87, 1.02); 2-3 cups/day: HR = 0.82 (95% CI: 0.77, 0.88); 4-5 cups/day: HR = 0.79 (95% CI: 0.72, 0.86); >= 6 cups/day: HR = 0.84 (95% CI: 0.75, 0.95)). Similar findings were observed for decaffeinated coffee and coffee additives. Inverse associations were observed for deaths from heart disease, chronic respiratory diseases, diabetes, pneumonia and influenza, and intentional self-harm, but not cancer. Coffee may reduce mortality risk by favorably affecting inflammation, lung function, insulin sensitivity, and depression.