Drinking coffee is "more likely to benefit health than to harm it" for a range of health outcomes, say researchers. They bring together evidence from over 200 studies and find that drinking three to four cups of coffee a day is associated with a lower risk of death and getting heart disease compared with drinking no coffee. Coffee drinking is also associated with lower risk of some cancers, diabetes, liver disease and dementia.

However, they say drinking coffee in pregnancy may be associated with harms, and may be linked to a very small increased risk of fracture in women.

The included studies used mainly observational data, providing lower quality evidence, so no firm conclusions can be drawn about cause and effect, but their findings back up other recent reviews and studies of coffee intake. As such, they say, excluding pregnancy and women at risk of fracture, "coffee drinking appears safe within usual patterns of consumption" and they suggest that coffee could be safely tested in randomised trials.

Coffee is one of the most commonly consumed beverages worldwide and could have positive health benefits. But existing evidence is of lower quality from observational research and randomised controlled trials are needed to strengthen the evidence of benefits.

To better understand the effects of coffee consumption on health, a team led by Dr Robin Poole, Specialist Registrar in Public Health at the University of Southampton, with collaborators from the University of Edinburgh, carried out an umbrella review of 201 studies that had aggregated data from observational research and 17 studies that had aggregated data from clinical trials across all countries and all settings.

Drinking coffee was consistently associated with a lower risk of death from all causes and from heart disease, with the largest reduction in relative risk of death at three cups a day, compared with non-coffee drinkers. Increasing consumption to above three cups a day was not associated with harm, but the beneficial effect was less pronounced.

Coffee was also associated with a lower risk of several cancers, including prostate, endometrial, skin and liver cancer, as well as type 2 diabetes, gallstones and gout. The greatest benefit was seen for liver conditions, such as cirrhosis of the liver.

Finally, there seemed to be beneficial associations between coffee consumption and Parkinson's disease, depression and Alzheimer's disease.

Source:  BMJ