title: Coffee consumption and risk of all-cause, cardiovascular, and cancer mortality in smokers and non-smokers: a dose-response meta-analysis.
abstract: Coffee consumption has been associated with several benefits toward human health. However, its association with mortality risk has yielded contrasting results, including a non-linear relation to all-cause and cardiovascular disease (CVD) mortality and no association with cancer mortality. As smoking habits may affect the association between coffee and health outcomes, the aim of the present study was to update the latest dose-response meta-analysis of prospective cohort studies on the association between coffee consumption and mortality risk and conduct stratified analyses by smoking status and other potential confounders. A systematic search was conducted in electronic databases to identify relevant studies, risk estimates were retrieved from the studies, and dose-response analysis was modeled by using restricted cubic splines. A total of 31 studies comprising 1610,543 individuals and 183,991 cases of all-cause, 34,574 of CVD, and 40,991 of cancer deaths were selected. Analysis showed decreased all-cause [relative risk (RR) = 0.86, 95 % confidence interval (CI) = 0.82, 0.89)] and CVD mortality risk (RR = 0.85, 95 % CI = 0.77, 0.93) for consumption of up to 4 cups/day of coffee, while higher intakes were associated with no further lower risk. When analyses were restricted only to non-smokers, a linear decreased risk of all-cause (RR = 0.94, 95 % CI = 0.93, 0.96), CVD (RR = 0.94, 95 % CI = 0.91, 0.97), and cancer mortality (RR = 0.98, 95 % CI = 0.96, 1.00) for 1 cup/day increase was found. The search for other potential confounders, including dose-response analyses in subgroups by gender, geographical area, year of publication, and type of coffee, showed no relevant differences between strata. In conclusion, coffee consumption is associated with decreased risk of mortality from all-cause, CVD, and cancer; however, smoking modifies the observed risk when studying the role of coffee on human health.
authors.affiliation: Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Policlinico Universitaria "Vittorio Emanuele", Via S. Sofia 85, 95123, Catania, Italy. giuseppe.grosso@studium.unict.it.
authors.forename: Giuseppe
authors.identifier: 0000-0003-3930-5285
authors.initials: G
authors.lastname: Grosso
authors.affiliation: Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Micek
authors.affiliation: Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Policlinico Universitaria "Vittorio Emanuele", Via S. Sofia 85, 95123, Catania, Italy.
authors.forename: Justyna
authors.initials: J
authors.lastname: Godos
authors.affiliation: Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Policlinico Universitaria "Vittorio Emanuele", Via S. Sofia 85, 95123, Catania, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Sciacca
authors.affiliation: Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Pajak
authors.affiliation: Department of Preventive Medicine & Public Health, School of Medicine, University of Navarra-IDISNA, Pamplona, Spain.|CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Martínez-González
authors.affiliation: Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.|Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.|Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Giovannucci
authors.affiliation: Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Galvano
mesh_terms: D002318:Cardiovascular Diseases / Q000401:mortality*; D003069:Coffee; D004327:Drinking Behavior; D006801:Humans; D009369:Neoplasms / Q000401:mortality*; D012306:Risk; D012307:Risk Factors; D000074285:Smokers / Q000706:statistics & numerical data*
chemical_list: D003069:Coffee
keywords: Cancer; Cardiovascular disease; Coffee; Meta-analysis; Mortality; Prospective cohorts; Smoking