A coffee habit is associated with longer life. That's according to a recent study of more than 400,000 middle-aged men and women.
Drinking either regular or decaf went hand in hand with lower death rates for heart disease, respiratory disease, stroke, injuries and accidents, diabetes and infections. And that was drinking even more than six cups a day.
So is coffee good for you?
Maybe. Observational studies like this one demonstrate connections. They do not show cause and effect.
What's the takeaway?
"For people that already drink coffee, it provides some reassurance that it's not worse than if you didn't drink coffee," says lead author Neal D. Freedman. Freedman is an investigator at the National Institutes of Health. The New England Journal of Medicine published the report in May 2012.
We don't know as much as we'd like about health and coffee.
Coffee is complicated. It consists of hundreds of mysterious compounds. This chemistry depends on the type of coffee and how it's roasted and brewed.
"There are many different compounds in coffee," Freedman says. "Most of them have not been characterized terrifically well, especially in terms of health. You would imagine that there may be some compounds that might be healthy, that might be beneficial. And some that may not be beneficial, that might be a risk or something."
Because coffee is complex, it "probably has a complicated effect on human health," Freedman says. "There may be some diseases where it's protective. And some diseases where it increases the risk."
Coffee drinkers also exhibit some confounding habits. Compared with the general population, they smoke more. They exercise less.They eat fewer fruits and vegetables. They drink more alcohol. Coffee drinkers appeared to die at a quicker pace until Freedman and colleagues compensated for these known risks. It's impossible to know if they accounted for all factors that distort the association between exposure and a health outcome.
"We did the best we could," Freedman says.
There are reasons to believe the results aren't as provisional as they sound. The huge sample included large numbers of nonsmokers. And the coffee drinkers among them lived longer.
Furthermore, other studies have supported coffee's benefits. What do these other studies say?
Coffee seems to have a paradoxical effect on blood pressure. A 2011 study in the American Journal of Clinical Nutrition found that caffeine boosted blood pressure for up to three hours in people with hypertension. But evidence did not point to a link between long-term coffee drinking and high blood pressure or higher risk of cardiovascular disease.
A 2012 study in Human Molecular Genetics associated coffee drinking with lower blood pressure and lower risk of hypertension. Some recent studies showed no relationship between coffee consumption and heart disease. Another suggested coffee lowered the risk of death from heart disease. (Tea seemed to cut the risk much more.) Yet another recent analysis showed that moderate coffee drinking -- four cups a day -- reduces the risk of heart disease. But as coffee drinking exceeded that amount, the risk of heart failure also rose.
Several studies indicate coffee drinking protects against type 2 diabetes. A 2009 analysis of 18 studies found that every additional cup of coffee consumed in a day was associated with a 7 percent reduction in the risk of diabetes. "High intakes of coffee, decaffeinated coffee and tea are associated with reduced risk of diabetes," the analysis says.
Most work to date has focused on coffee drinking among healthy people.
"I think more research remains to be done among populations with preexisting disease," Freedman says. "There may be different previous conditions that people have where coffee may be a risk factor."
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