Java lovers, take heart. A large prospective study suggests that – far from being bad for your health – that steaming cuppa is actually associated with a lower risk of death. Analysis of a large prospective study of more than 400,000 people found that men who drank four to five cups of coffee daily reduced their risk of death over a 13-year period by 12%, while women's risk dropped by 16%, according to Neal Freedman, PhD, of the National Cancer Institute, and colleagues. The inverse associations were seen for deaths due to heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections, but not for deaths due to cancer, the researchers found. On the other hand, a suite of other behaviors that often go hand-in-hand with coffee drinking – smoking, lack of exercise, and poor diet – usually combine to mask the benefit, the researchers noted in the May 17 issue of The New England Journal of Medicine. Freedman and colleagues cautioned that the study could not prove that coffee is good for you. "It may be that there's something that goes along with coffee-drinking that's affecting our results that we couldn't take into account in our analysis," Freedman told MedPage Today. But, together with previous research, he said, the findings provide "some reassurance that coffee drinkers don't have a higher risk of death (and suggest) that there might be some benefit from drinking coffee." Indeed, the findings are not surprising, according to Frank Hu, MD, PhD, of the Harvard School of Public Health, who was senior author on a 2008 study that also found an apparent benefit for coffee drinking. "All the evidence is coming together to indicate a potential health benefit of regular coffee consumption," Hu told MedPage Today. The only way to prove the benefit exists, Hu said, would be to conduct a large randomized trial, but such a study "may not be feasible" because it would need too many participants. In the meantime, a large prospective cohort, such as the National Institutes of Health–AARP Diet and Health Study analyzed by Freedman and colleagues, provides the "best available evidence." The NIH-AARP cohort has been running since 1995 and includes 229,119 men and 173,141 women who were 50 to 71 when the study started. Over the period from 1995 through 2008, Freedman and colleagues reported, 33,731 men and 18,784 women died. In an analysis that only took age into account, coffee consumption was associated with an increased risk of death, they reported. But coffee drinkers were also more likely to smoke, to eat more red meat and fewer fruits and vegetables, to drink alcohol, and to have less vigorous physical activity. When those factors were taken into account, Freedman and colleagues found, coffee emerged as being inversely associated with all-cause mortality, as well as a range of major causes of death. Compared with non-drinkers, there was little effect for those who drank some coffee, but less than a cup a day. But for more coffee, the odds of death dropped significantly. Specifically: For those who drank one cup a day, the odds ratios for death were 0.94 for men and 0.95 for women (95% CI 0.90 to 0.99 and 0.90 to 1.01, respectively). For two or three cups a day, the odds ratios for death were 0.90 for men and 0.87 for women (95% CI 0.86 to 0.93 and 0.83 to 0.92, respectively). For four or five cups a day, the odds ratios for death were 0.88 for men and 0.84 for women (95% CI 0.84 to 0.93 and 0.79 to 0.90, respectively). And for six or more cups a day, the odds ratio for death were 0.90 for men and 0.85 for women (95% CI 0.85 to 0.96 and 0.78 to 0.93, respectively). For both men and women the trend was significant at P
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