Coffee consumption and mortality in three Eastern European countries: results from the HAPIEE (Health, Alcohol and Psychosocial factors In Eastern Europe) study

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Research Papers

Nutritional epidemiology

Coffee is among the most consumed non-alcoholic beverages worldwide⁽¹⁾. Besides the gastronomic aspects, coffee has been suggested to affect human health and disease⁽²⁾. Although in the past it has been considered unhealthful due to its association with some negative outcomes following acute ingestion (i.e. rise in blood pressure and plasma lipids, inhibition of insulin activity), adverse health outcomes of long-term coffee consumption have not been found. Indeed, several epidemiological studies have explored the relationship between coffee intake and cardiovascular risk factors^(3,4), CVD⁽⁵⁾and certain types of cancer⁽⁶⁾, suggesting that a protective effect may exist. From an epidemiological point of view, long-term coffee drinking exerts different effects from acute intake typically examined under experimental conditions. Long-term experimental studies have demonstrated that habitual coffee drinkers develop tolerance to the acute effects of caffeine and may experience the effects of other coffee compounds that are related with its beneficial role on human health⁽⁷⁾. Coffee is a complex mixture of several biochemically active components, including caffeine, phenolic compounds and minerals (magnesium and potassium). Many of these compounds may act as antioxidants, thus preventing the state of subclinical inflammation involved in the pathogenesis of diseases such as cancer and CVD⁽⁸⁾. Among them, chlorogenic acids are responsible for ameliorating hypertension, glucose and lipid metabolism, whereas diterpenes demonstrate anti-carcinogenic properties⁽⁹⁾.

Recently published prospective studies evaluating the association between coffee consumption and mortality in large European cohorts have been mostly conducted in Northern^(10-12)and Western European countries⁽¹³⁾. Findings obtained are puzzling and inconsistent, suggesting that significant differences between countries and methods of coffee consumption may be relevant for the outcome explored. We recently reported an inverse association between coffee consumption and metabolic impairment and decreased risk of developing hypertension in Polish individuals free of diseases at baseline^(14,15). However, whether these associations may be translated into a decreased risk of mortality following a prospective evaluation is unknown. To date, no further data...