Light to moderate coffee drinking – less than 5 cups per day – is associated with decreased coronary artery calcium, and thus decreased risk of cardiovascular disease, according to an analysis of a large cohort published online March 2 in Heart.
Coffee consumption’s effect on cardiovascular health has been controversial, even though the bulk of the substantial evidence collected to date suggests that it is cardioprotective. To clarify the association between coffee drinking and CVD, researchers performed a cross-sectional analysis of data from a large cohort study of asymptomatic young and middle-age South Korean adults attending a comprehensive health screening during a 3-year period. Members of the cohort (mean age 41 years) completed a detailed food-frequency questionnaire and underwent cardiac CT to measure coronary artery calcium, a marker of subclinical coronary atherosclerosis that predicts future heart disease, said Dr. Yuni Choi of Sungkyunkwan University, Seoul, South Korea, and her associates.
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For this analysis, results for 25,138 participants who had no clinical evidence of CVD were assessed. The large sample size allowed for the data to be adjusted to account for numerous confounding factors such as medication use, personal and family medical history, physical activity level, alcohol consumption, smoking status, and sociodemographic factors.
Coffee consumption correlated with coronary artery calcium in a U-shaped pattern: Adults who drank up to 3 cups of coffee per day (light intake) had a decreased prevalence of subclinical coronary athersclerosis, those who drank 3-4 cups per day (moderate intake) had the lowest prevalence, and those who drank 5 or more cups per day had an increased prevalence, compared with people who didn’t drink coffee. Coronary artery calcium ratios that compared coffee drinkers with nondrinkers were 0.86 at less than 1 cup per day, 0.82 at 1-2 cups per day, 0.78 at 3-4 cups per day, and 1.77 at 5 or more cups per day. The association between coffee intake and coronary artery calcium scores remained consistent across all subgroup analyses and in sensitivity analyses, the investigators said (Heart 2015 March 2 [doi:10.1136/heartjnl-2014-306663]).
The cross-sectional design of this study means that it can establish only an association, not causality, between coffee intake and CVD risk. “Further research is needed to confirm our findings and establish the biological basis of coffee’s potential preventive effects on coronary artery disease,” Dr. Choi and her associates wrote.
But the evidence already is strong enough that for the first time this year, dietary guidelines will likely state that moderate coffee consumption appears to be cardioprotective and “can be incorporated into a healthy dietary pattern.” Coffee drinkers need only minimize the sugars and fats they add to their coffee, in the form of sweeteners and creamers, to benefit from the beverage, the 2015 Dietary Guidelines Advisory Committee recommended in a report submitted for review to the secretaries of the U.S. Department of Health & Human Services and the U.S. Department of Agriculture in February.