Effects of Habitual Coffee Consumption on Cardiometabolic Disease, Cardiovascular Health, and All-Cause Mortality

James H. O'Keefe, MD; Salman K. Bhatti, MD; Harshal R. Patil, MD; James J. DiNicolantonio, PHARMD; Sean C. Lucan, MD, MPH, MS; Carl J. Lavie, MD


J Am Coll Cardiol. 2013;62(12):1043-1051. 

In This Article

Coffee and Other Health Effects

Coffee consumption is also associated with various other health effects. For instance, coffee may reduce the risk of depression, a known risk factor for the development of CV disease, as well as an independent predictor of poor prognosis.[49] In a recent longitudinal study of 50,739 women, ingesting ≥4 cups of coffee daily significantly decreased the RR of depression (Fig. 7). The effect may be due largely to the caffeine content because women consuming decaffeinated coffee did not show a reduced risk.[50] Coffee consumption may also benefit efforts at weight control, increasing the thermic effect of food and fat oxidation in normal-weight subjects.[51]

Figure 7.

Coffee and Depression
Multivariate-adjusted relative risk (RR) of clinical depression according to caffeine consumption (p for trend = 0.02). Error bars indicate 95% confidence interval. Reproduced with permission from Lucas et al.50

Other beneficial health effects of coffee may include reduced risks of Alzheimer's dementia[52,53] and other diseases of the central nervous system including Parkinson's disease.[54–56] Additionally, coffee may improve asthma symptoms, probably through caffeine, which is a methylxanthine bronchodilator, and enhance performance in sustained high-intensity exercise.[57,58] Coffee may prevent symptomatic gallstones[59] and be associated with protection against some infectious and malignant diseases, particularly of the liver.[60–62]

All of this is not to say that coffee is without its own risks. Many individuals experience palpitations, anxiety, tremulousness, and trouble sleeping after drinking coffee, particularly when it contains higher doses of caffeine.[63] The polycyclic aromatic hydrocarbon-inducible cytochrome P450 1A2 participates in the metabolism of caffeine and a number of drugs, including certain selective serotonin reuptake inhibitors (particularly fluvoxamine), antiarrhythmics (mexiletine), antipsychotics (clozapine), psoralens, idrocilamide and phenylpropanolamine, bronchodilators (furafylline and theophylline), and quinolones (enoxacin), can aggravate the unwanted secondary effects of coffee by inhibiting this isoenzyme.[64] Decaffeinated coffee may be a good option, particularly because many of coffee's potential benefits likely derive from sources other than its caffeine. Moreover, high levels of caffeine (>750 mg/day) may increase urine output and urinary calcium and magnesium excretion, which has implications for bone health .[65] Caffeinated coffee increases the risk of bone loss[66,67] and fractures.[68] Still, it has been estimated that the amount of calcium lost from consuming 1 cup of coffee can be offset by mixing in just 2 tablespoons of milk.[66] Moreover, a daily glass of milk might offset the calcium loss and reductions in bone mineral density due to coffee consumption.[67] Additionally, the human body develops tolerance to caffeine usually after 3 to 5 days of regular use and kidneys ensure that proper homeostatic conditions are maintained, which attenuate the already limited diuretic effects of kidney.[69]