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18/08/2013
To evaluate the association between coffee consumption and mortality from all causes and from cardiovascular disease.

Patients and Methods: Data from the Aerobics Center Longitudinal Study representing 43,727 participants with 699,632 person-years of follow-up were included. Baseline data were collected by an in-person interview on the basis of standardized questionnaires and a medical examination, including fasting blood
chemistry analysis, anthropometry, blood pressure, electrocardiography, and a maximal graded exercise test, between February 3, 1971, and December 30, 2002. Cox regression analysis was used to quantify the association between coffee consumption and all-cause and cause-specific mortality.
Results: During the 17-year median follow-up, 2512 deaths occurred (804 [32%] due to cardiovascular disease). In multivariate analyses, coffee intake was positively associated with all-cause mortality in men.
Men who drank more than 28 cups of coffee per week had higher all-cause mortality (hazard ratio [HR], 1.21; 95% CI, 1.04-1.40). However, after stratification based on age, younger (<55 years old) men and women showed a significant association between high coffee consumption (>28 cups per week) and allcause mortality after adjusting for potential confounders and fitness level (HR, 1.56; 95% CI, 1.30-1.87 for men; and HR, 2.13; 95% CI, 1.26-3.59 for women).
Conclusion: In this large cohort, a positive association between coffee consumption and all-cause mortality was observed in men and in men and women younger than 55 years. On the basis of these findings, it seems appropriate to suggest that younger people avoid heavy coffee consumption (ie, averaging >4
cups per day). However, this finding should be assessed in future studies of other populations.
ª 2013 Mayo Foundation for Medical Education and Research n Mayo Clin Proc. 2013;nn(n):1-9 Drinking coffee has become a normal daily routine for more than half of Americans and large numbers of people worldwide. According to the latest National Coffee Drinking Study from theNational CoffeeAssociation, approximately 64% of American adults drink coffee each day, and among coffee drinkers, the average coffee consumption
in the United States is 3.1 cups per day.1 Nevertheless, coffee has long been suspected to contribute to a variety of chronic health conditions. During the past 4 decades, the association between coffee consumption and chronic health outcomes has been investigated in relation to conditions such as obesity,2-6 hypertension,7,8 and coronary heart disease.9,10However, studies on coffee consumption in relation to all-causen and cause-specific mortality are limited, and
the results are often controversial. Several studies have found a positive association between higher levels of coffee consumption and all-cause and
cardiovascular disease (CVD) mortality,11-13 whereas others have found an inverse association with all-cause mortality in men and women,14-16 in women only,17,18 or in men only,19-21 with some evidence suggesting that there may be a U- or J-shaped relationship between coffee drinking and health outcomes. Still, other researchers suggest that the association may not exist at all.22-24The objective of the present study was to investigate the effect of coffee consumption on all-cause and CVD mortality in the Aerobics Center Longitudinal Study (ACLS) cohort, with average follow-up of 16 years and a relatively large sample of men and women.
PATIENTS AND METHODS
Study Population
The ACLS is a prospective observational study and has been described in detail previously.24,25 Between February 3, 1971, and December 30, From the Department of Biostatistics and Epidemiology (J.L., J.R.H., J.Z., S.N.B.) and Department of Exercise Science (X.S., S.N.B.), Arnold School of Public Health, University of South Carolina, Columbia; Department of Cardiovascular Diseases, Ochsner Medical Center, New Orleans, LA (C.J.L.); and Department for
Health Sport, Health, and Exercise Science, University of Bath, Bath, United Kingdom (C.P.E.).
Mayo Clin Proc. n XXX 2013;nn(n):1-9 n http://dx.doi.org/10.1016/j.mayocp.2013.06.020 www.mayoclinicproceedings.org nª 2013 Mayo Foundation for Medical Education and Research 1 FLA 5.2.0 DTD  JMCP503_proof  9 August 2013  5:56 pm
ORIGINAL ARTICLE