Lower Risk of Cardiovascular Disease Mortality Associated With Morning Coffee

The risks of overall mortality and mortality related to cardiovascular disease were both lower in Americans who drank coffee in the morning compared with those who drank coffee later in the day, according to a study published in the European Heart Journal.¹

Coffee has been associated with lower risks of mortality, as well as type 2 diabetes and cardiovascular disease, which has made the consumption of coffee generally accepted as not harmful by cardiology experts.² However, the timing of coffee consumption has not been looked into as it relates to circadian rhythm and metabolism. This study aimed to identify the association between the timing and amount of coffee intake with the risk of all-cause mortality and cardiovascular-specific mortality.

Consuming coffee in the morning can help reduce the risk of overall and cardiovascular mortality | Image credit: dimakp - stock.adobe.com

All participants were recruited from a prospective cohort in the National Health and Nutrition Examination Survey (NHANES). The Women’s and Men’s Lifestyle Validation Study (WLVS and MLVS, respectively) substudies were also included in this study for external validation. Participants who provided dietary recall data and mortality data from 1999 to 2018 and were also 18 years or older were included in this study. The WLVS included 796 women aged 45 to 80 years and the MLVS included 914 men aged 46 to 82 years.

Dietary recalls were collected over 24 hours. All participants reported the time, types, and amount of food that they consumed between midnight and midnight. A second dietary interview was added in 2003. Both caffeinated and decaffeinated coffee were evaluated for consumption. Morning was considered 4 AM to 11:59 AM, afternoon was from 12 PM to 4:59 PM, and evening was 5 PM to 3:59 AM. The frequency of coffee was also calculated. The National Death Index was used to collect information on death and cause of death.

There were 40,725 participants in NHANES who were included in this study. There were 2 groups of participants who had different patterns of coffee consumption: cluster 1 consisted of morning consumers, whereas cluster 2 had all-day consumers. A total of 36% of the participants consumed coffee in the morning compared with 16% who consumed coffee all day and 48% who did not drink coffee. Participants from the WLVS and MLVS were morning consumers in 61% and 62% of cases, respectively, with 20% of each cohort not drinking coffee. Participants who drank coffee were more often White and older, had a higher prevalence of diabetes, and had a higher family income.

There were 4295 deaths reported during a median (IQR) follow-up of 9.8 (9.1) years, of which 1298 were due to cardiovascular disease and 934 were caused by cancer. A lower risk of all-cause mortality was found in people who drank coffee in the morning compared with those who did not drink coffee (HR, 0.88; 95% CI, 0.81-0.96). Participants who consumed coffee all day did not have a higher risk of all-cause mortality (HR, 0.99; 95% CI, 0.90-1.10). A lower risk of mortality related to cardiovascular disease was associated with consuming coffee in the morning (HR, 0.69; 95% CI, 0.55-0.87). A lower risk of all-cause mortality was also found in participants who drank 1 to 3 cups per day of coffee compared with those who did not consume coffee.

There were also limitations to this study. Causality cannot be established due to the observational design of the study. Recall bias and measurement errors are possible in the dietary recall from the participants. It is possible that there were confounding factors not measured, and coffee consumption could not be linked to a healthy lifestyle. External validation would be needed in the future, and genetic information was not used for this analysis. Finally, the study may not be generalizable outside of the US.

The researchers concluded that the timing of drinking coffee was associated with lowering risk of all-cause mortality and mortality related to cardiovascular disease. “Our findings highlight the importance of considering drinking timing in the association between the amounts of coffee intake and health outcomes,” the authors concluded.

References

1. Wang X, Ma H, Sun Q, et al. Coffee drinking timing and mortality in US adults. Eur Heart J. Published online January 8, 2025. doi:10.1093/eurheartj/ehae871
2. Williamson L. Is caffeine a friend or foe? American Heart Association. August 8, 2022. Accessed January 8, 2025. https://www.heart.org/en/news/2022/08/08/is-caffeine-a-friend-or-foe