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

Design

• Cohort: EPIC participants (n = 521,330) across 10 European centers
• Exposure: coffee intake (country-specific consumption quartiles; non-consumers referent)
• Follow-up: mean 16.4 y; 41,693 deaths

Mortality associations (multivariable Cox; abstract)

• All-cause (highest quartile vs non-consumers): men HR 0.88 (95% CI 0.82–0.95; P for trend < 0.001); women HR 0.93 (95% CI 0.87–0.98; P for trend = 0.009)
• Digestive disease mortality: strong inverse trends (men HR 0.41, 95% CI 0.32–0.54; women HR 0.60, 0.46–0.78)
• Women: inverse associations also for circulatory and cerebrovascular mortality; positive association for ovarian cancer mortality in highest consumers (HR 1.31, 95% CI 1.07–1.61)

Biomarker subcohort (EPIC Biomarkers; abstract narrative)

Higher coffee consumption associated with lower serum ALP, ALT, AST, GGT; in women also lower CRP, Lp(a), and HbA1c in adjusted models—interpret as observational patterns, not intervention effects.

Evidence hygiene

• Residual confounding possible; authors note sensitivity analyses excluding early deaths did not materially change results.
• Pair with umbrella re-synthesis (Poole et al. 2017, PMID 29167102) and US multiethnic cohort replication (Park et al. 2017, PMID 28693036).

Publication

Gunter MJ, Murphy N, Cross AJ, et al. Ann Intern Med. 2017 Aug 15;167(4):236-247. doi: 10.7326/M16-2945. PMID 28693038.