Loftfield Erikka, Freedman Neal D, Graubard Barry I, Guertin Kristin A, Black Amanda, Huang Wen-Yi, Shebl Fatma M, Mayne Susan T, Sinha Rashmi
Am J Epidemiol. 2015 Dec 15;182(12):1010-22. doi: 10.1093/aje/kwv146. Epub 2015 Nov 27.
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.
对高咖啡因摄入量以及咖啡作为添加脂肪和糖载体的担忧引发了关于咖啡对健康的净影响的问题。尽管已观察到咖啡与总体死亡率呈负相关，但特定病因死亡率的数据却很稀少。此外，很少有研究专门考虑脱咖啡因咖啡的摄入量或咖啡添加剂的使用情况。在前列腺、肺、结肠直肠癌和卵巢癌筛查试验中，通过自我报告在基线时评估咖啡摄入量。使用Cox比例风险模型估计风险比。在研究基线（1998 - 2001年）时无癌症且在研究入组时（1993 - 2001年）无心血管疾病病史的90317名美国成年人中，从1998年到2009年的805644人年随访期间发生了8718例死亡。在对吸烟和其他潜在混杂因素进行调整后，与不喝咖啡的人相比，喝咖啡的人总体死亡率的风险比更低（每天饮用少于1杯：风险比（HR）= 0.99（95%置信区间（CI）：0.92，1.07）；每天饮用1杯：HR = 0.94（95% CI：0.87，1.02）；每天饮用2 - 3杯：HR = 0.82（95% CI：0.77，0.88）；每天饮用4 - 5杯：HR = 0.79（95% CI：0.72，0.86）；每天饮用≥6杯：HR = 0.84（95% CI：0.75，0.95））。脱咖啡因咖啡和咖啡添加剂也观察到了类似的结果。在心脏病、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方面观察到了负相关，但在癌症方面未观察到。咖啡可能通过对炎症、肺功能、胰岛素敏感性和抑郁产生有利影响来降低死亡风险。
