Drinking coffee in the morning is associated with lower mortality risk

In a large US observational cohort study, drinking coffee in the morning, but not throughout the day, was associated with lower risks of all-cause and CV death compared with non-coffee drinking.

This summary is based on the publication of Wang X, Ma H, Sun Q, et al. - Coffee drinking timing and mortality in US adults. Eur Heart J. 2025 Jan 8:ehae871 [Online ahead of print]. doi: 10.1093/eurheartj/ehae871

Introduction and methods

Background

Moderate coffee consumption is associated with lower risks of T2D, CVD, and mortality [1,2], and it is therefore recommended as part of a healthy dietary pattern by the 2015–2020 US Dietary Guidelines [3]. However, the association between heavy coffee consumption (i.e., more than 3–5 cups/day) and mortality risk and the possible effect modification by clinical and behavioral factors such as smoking or drinking decaffeinated coffee are still unclear [2,4-6]. In addition, the timing of coffee consumption may modify the association between the amount of coffee intake and health outcomes [7].

Aim of the study

The study aim was to identify patterns of coffee drinking timing and evaluate the joint association of these timing patterns and the amounts of coffee intake with the risks of all-cause and cause-specific mortality.

Methods

In this observational study, patterns of coffee drinking timing were identified using 2-step cluster analysis. For the association between coffee drinking timing and mortality risk, data from 40,725 individuals aged ≥18 years were collected from the prospective cohort study NHANES (National Health and Nutrition Examination Survey), a nationally representative study of health and nutritional status of adults and children in the US. Median follow-up time was 9.8 years (IQR: 9.1). The results on coffee drinking timing patterns were externally validated in 1463 adults with complete 7-day dietary record data from the Women’s and Men’s Lifestyle Validation Studies, two substudies to validate lifestyle assessment in the Nurses’ Health Study I and II and the Health Professionals Follow-up Study cohorts.

Main results

• In the NHANES cohort, 2 distinct patterns of coffee drinking timing were identified: morning-type (mainly 4:00–11:59 a.m.; n=14,643; 36%) and all-day-type (n=6489; 14%). The other participants (n=19,593; 48%) did not consume coffee.

• These results were validated in the Women’s and Men’s Lifestyle Validation Studies.

• After adjustment for baseline variables (including smoking status), intake of caffeinated and decaffeinated drinks, and sleeping hours, the morning-type pattern was associated with a lower risk of all-cause mortality compared with non-coffee drinking (HR: 0.84; 95%CI: 0.74–0.95).

• In contrast, the all-day-type pattern was not associated with risk of all-cause mortality (HR: 0.96; 95%CI: 0.83–1.12).

• The morning-type pattern was also associated with a lower risk of CV death compared with non-coffee drinking (HR: 0.69; 95%CI: 0.55–0.87) but not with cancer-specific mortality (HR: 0.97; 95%CI: 0.75–1.25). The all-day-type pattern was not associated with risk of CV death (HR: 0.82; 95%CI: 0.61–1.10) or cancer-specific mortality (HR: 1.14; 95%CI: 0.83–1.56) compared with non-coffee drinking.

• A joint analysis showed coffee drinking timing modified the association between coffee intake amounts and risk of all-cause mortality (P for interaction=0.031). Among individuals with the morning-type pattern, drinking >1 cup/day was associated with a decreased risk (HR for >1 to 2 cups/day: 0.84; 95%CI: 0.73–0.96; HR for >2 to 3 cups/day: 0.71; 95%CI: 0.60–0.86; HR for >3 cups/day: 0.79; 95%CI: 0.65–0.96; P for linear trend<0.001).

• A similar interaction pattern was found for CV death (P for linear trend<0.001), although the P value for interaction was not significant.

• In participants with the all-day pattern, coffee consumption was not associated with risk of all-cause mortality (P for linear trend=0.10) or CV death (P for linear trend=0.45).

Conclusion

In this observational study of a nationally representative cohort of US adults, drinking >1 cup of coffee in the morning was associated with lower risks of all-cause and CV death compared with non-coffee drinking, while there was no association between drinking coffee throughout the day and evening and mortality risk.

Find this article online at Eur Heart J.

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