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Tea or Coffee?
One of the most-repeated pieces of health advice we give is about what to drink: water, tea, or coffee as opposed to fruit juices, sodas, or "energy drinks".

Coffee, Italian-style
In today's latest edition of Yes, Coffee is Good for You, we have the results from an analysis of the coffee intake habits of Italians, who are known (stereotypically, that is) as one of the world's foremost coffee drinking populations.

Should you stop drinking coffee as you get older?
Today's research is a bit of a reversal: what happens if you are a habitual coffee drinker, and you stop drinking coffee? Researchers in Spain noted that as some people get older, they decide to drink less coffee, or even stop drinking it altogether. Might this have an effect on their health?

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Details on coffee and heart disease

coffee being poured into a china coffee cup

Over the years we've written easily a dozen Health & Nutrition Bites about coffee - and that's barely touching the surface of the amount of research that's been done on what has been called the single largest source of antioxidants in the Western diet.

Recently a team of European researchers analyzed data gathered for the UK Biobank Study to assess any link between coffee consumption, the type of coffee consumed, and risk of death from heart disease (Eur J Prev Cardiol 2022 Jan 20;zwac008. doi:10.1093/eurjpc/zwac008).

The UK Biobank study is another long-term, large-scale study that recruited the participation of over 500,000 men and women between 40 and 69 years of age between 2006 and 2010. As with other prospective studies, the participants responded to demographic, medical history, lifestyle and dietary questionnaires and underwent a physical exam along with providing blood samples.

For their analysis the authors chose to exclude those who reported having heart failure or having experience a heart attack or stroke. They also excluded those who reported consuming over 25 cups of coffee per day (!!) and those who left the dietary questions about coffee consumption blank. This left over 460,000 participants, of whom 77.9% reported drinking coffee daily.

What's unusual about this study is that the dietary questionnaire asked participants to identify the kind of coffee they consumed most frequently: caffeinated versus decaffeinated as well as ground, instant, or other. Often studies involving coffee don't differentiate more than caffeinated versus decaffeinated.

How much coffee (whether caffeinated or decaffeinated) the participants consumed was grouped into three levels: none, light-to-moderate (1/2 to 3 cups per day), and high (over 3 cups per day).

In 2020 the authors compared the coffee consumption of not only those who passed away over the course of the study with those who did not. In addition they compared those who experienced (and survived) a stroke or heart attack with those who did not have a stroke or heart attack.

Compared to those who did not drink coffee, those who kept their coffee intake at 3 cups per day or less were 12% less likely to die of any cause. That said, those drinking more than 3 cups per day were no less - or more - likely to die than those who didn't drink coffee.

When it came to dying of cardiovascular disease, the benefit of drinking a moderate amount of coffee every day was even greater - those coffee drinkers were 17% less likely to die of heart disease.

They were also 21% less likely to experience a stroke and just slightly (4%) less likely to have a heart attack.

Those who drank more than 3 cups of coffee per day, however, were 10% more likely to experience a heart attack.

About 100,000 of the participants in this study also underwent comprehensive imaging of their hearts as well as procedures to measure arterial stiffness - which is an indicator of arterial health (thnk "hardening of the arteries"). Those who drank moderate amounts of coffee had significantly decreased arterial stiffness and increased measures of cardiac health such as stroke volume and ventricular mass.

What about coffee type? The Biobank participants overwhelmingly drank either ground or instant coffee, if they drank it at all. The authors note that "we did not find statistically significant association between regular instant coffee consumption and health outcomes." Decaffeinated ground coffee, on the other hand, conferred similar health benefits to caffeinated ground coffee, at least with respect to overall risk of death from any cause.

What this means for you

The take-home message here is that if you drink a moderate amount of coffee regularly, it's almost certainly good for your health in general and your heart in particular. Instant coffee? Not so much, likely because it is far more processed than simply grinding the beans.

First posted: April 20, 2022