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Coffee consumption and bladder cancer in nonsmokers: a pooled analysis of case-control studies in European countries.

BACKGROUND: Coffee consumption has been associated with an excess bladder cancer risk, but results from epidemiological studies are inconsistent. This association has been long debated, in part due to the potential confounding by smoking. We examined the risk associated with coffee consumption in nonsmokers in a pooled analysis of ten European bladder cancer case-control studies. METHODS: The pooled data set comprises 564 cases and 2929 hospital or population controls who had never smoked. They were enrolled in ten studies conducted in Denmark, Germany, Greece, France, Italy and Spain. Information on coffee consumption and occupation was re-coded following standard criteria. Unconditional logistic regression was applied adjusting for age, study center, occupation and gender. RESULTS: Seventy-nine percent of the study population reported having drunk coffee, and 2.4% were heavy drinkers, reporting having drunk on average ten or more cups per day. There was no excess risk in ever coffee drinkers (OR = 1.0, 95% CI 0.8-1.3) compared to never drinkers. The risk did not increase monotonically with dose but a statistically significant excess risk was seen for subjects having drunk ten or more cups per day (OR = 1.8, 95% CI 1.0-3.3). This excess was seen in both men and women. There was no evidence of an association of the risk with duration or type of coffee consumption. The pooled results were not dependent on the findings of any specific study, but they depended on the type of controls with an overall excess risk observed only for studies using hospital controls. CONCLUSION: Nonsmokers who are heavy coffee drinkers may have a small excess risk of bladder cancer. Although these results cannot be attributed to confounding by smoking, the possibility of bias in control selection cannot be discarded. On the basis of these results, only a very small proportion of cancers of the bladder among nonsmokers could be attributed to coffee drinking.

Bias↗

Coffee-mediated protective effects against directly acting genotoxins and gamma-radiation in mouse lymphoma cells.

The cytokinesis-block micronucleus test was performed using L5178Y mouse lymphoma cells to ascertain whether or not standard (caffeinated) instant coffee, the commonly consumed polyphenolic beverage with antioxidant activity can protect against chromosomal damage induced by the directly acting agents N-methyl-N-nitro-N-nitrosoguanidine (MNNG), mitomycin C (MMC), methyl methanesulfonate (MMS) and gamma radiation. Our results demonstrated significant reductions in the in vitro genotoxic effects of MNNG, MMC, and MMS following co-treatment of mouse lymphoma cells with standard instant coffee. Subsequently, the comet assay was carried out to assess the effect of coffee co-treatment on the level of DNA damage induced by MMS in mouse lymphoma cells. The results demonstrated a significant reduction in MMS-induced DNA damage following co-treatment with standard instant coffee. Protective effects were observed in mouse lymphoma cells which were treated with coffee immediately after exposure to gamma radiation (1 and 2 Gy). Another experiment showed protection when the mammalian cells were irradiated (0.5 and 1 Gy) midway (at 2 h) during a 4 h coffee treatment. However, the protective effect against the lower dose (0.5 Gy) was not significant. In addition we assessed the modulatory effect of coffee on MNNG-induced apoptotic frequency by flow cytometry. The results revealed only a minor influence of coffee on the frequency of apoptotic cells induced by the test compounds, rendering an increase in sensitivity for apoptosis as a reason for the reduced genomic damage an unlikely or at least incomplete explanation.

Animals↗

Coffee consumption and the risk of breast cancer. A prospective study of 14,593 Norwegian women.

The association between coffee consumption and the incidence rate of breast cancer has been analysed in 152 incident cases of breast cancer that developed among 14,593 Norwegian women during a mean follow-up of 12 years. At the time of inquiry they were between 35 and 51 years of age, and at the end of follow-up between 46 and 63. There was an overall weak negative association between daily intake of coffee and risk of breast cancer, which was not statistically significant. However, the association with coffee varied, depending on the body mass index (BMI) of the women. In the lean (Quetelet less than 24; population mean) there was an inverse relation between coffee intake and risk of breast cancer (chi 2 trend = 5.07, P = 0.02). In this group, women who reported drinking 5 cups or more per day had an age-adjusted IRR of 0.5 (95% confidence intervals, 0.3 and 0.9) compared to women who had 2 cups or less. In women with Quetelet's index equal to or greater than 24 there was a positive relation between coffee intake and breast cancer risk (chi 2 trend = 2.33, P = 0.13), where the corresponding age-adjusted IRR was 2.1 (95% confidence intervals, 0.8 and 5.2). This interaction effect between coffee intake and BMI was statistically significant (chi 2 interaction = 10.2, 3 d.f., P = 0.02). In summary, the results of this study suggest that coffee consumption reduces the risk of breast cancer in lean women, whereas coffee might have the opposite effect in relatively obese women.

Adult↗

Coffee, caffeine and blood pressure: a critical review.

OBJECTIVE: We review the published data relating to intake of coffee and caffeine on blood pressure in man. We also refer to studies on the possible mechanisms of actions of these effects of caffeine. DESIGN: The MEDLINE and Current Contents databases were searched from 1966 to April 1999 using the text words 'coffee or caffeine' and 'blood pressure or hypertension'. Controlled clinical and epidemiologic studies on the blood pressure effects of coffee or caffeine are reviewed. We also refer to studies on the possible mechanisms of action of these effects of caffeine. RESULTS: Acute intake of coffee and caffeine increases blood pressure. Caffeine is probably the main active component in coffee. The pressor response is strongest in hypertensive subjects. Some studies with repeated administration of caffeine showed a persistent pressor effect, whereas in others chronic caffeine ingestion did not increase blood pressure. Epidemiologic studies have produced contradictory findings regarding the association between blood pressure and coffee consumption. During regular use tolerance to the cardiovascular responses develops in some people, and therefore no systematic elevation of blood pressure in long-term and in population studies can be shown. CONCLUSIONS: We conclude that regular coffee may be harmful to some hypertension-prone subjects. The hemodynamic effects of chronic coffee and caffeine consumption have not been sufficiently studied. The possible mechanisms of the cardiovascular effects of caffeine include the blocking of adenosine receptors and the inhibition of phosphodiesterases.

Adolescent↗

Filtered coffee raises serum cholesterol: results from a controlled study.

OBJECTIVE: Earlier studies and trials have shown a serum cholesterol raising effect of unfiltered coffee, which is reduced by about 80% in filtered coffee. Recent cross-sectional studies and trials, however, have indicated that filtered coffee may have a more pronounced serum cholesterol raising effect than previously anticipated. The objective of this controlled study was to assess the effects of the intake and abstention of filtered brewed coffee on blood lipids. DESIGN: A prospective, controlled study with four consecutive trial periods. The first and third periods were 3 weeks of total coffee abstention. The second and fourth periods consisted of 4 weeks with the subjects consuming 600 ml filter brewed coffee/day. SETTING: Free-living population. Volunteers. SUBJECTS: A total of 121 healthy, nonsmoking men and women aged 29-65 y. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Serum total cholesterol, serum HDL cholesterol, serum triglycerides, serum lipoprotein (a) (Lp(a)), blood pressure and heart rate. RESULTS: The two coffee abstention periods were associated with a decline in serum cholesterol of 0.22 mmol/l (95% CI -0.31, -0.13) and 0.36 mmol/l (95% CI -0.46, -0.26), respectively. Filtered coffee/day 600 ml increased serum cholesterol by 0.25 mmol/l (95% CI 0.15, 0.36) and 0.15 mmol/l (95% CI 0.04, 0.26) during the two coffee drinking periods. CONCLUSIONS: Coffee abstention for 3 weeks decreased total serum cholesterol by 0.22-0.36 mmol/l. A volume of 600 ml (about four cups) of filtered coffee/day during 4 weeks raised total serum cholesterol by 0.15-0.25 mmol/l.

Adult↗

Effect of chronic coffee consumption on aortic stiffness and wave reflections in hypertensive patients.

OBJECTIVE: Aortic stiffness and wave reflections are important markers and prognosticators of cardiovascular risk. Caffeine increases acutely aortic stiffness and wave reflections. Furthermore, chronic coffee consumption is associated with increased aortic stiffness and wave reflections in normotensive subjects. In the present study, we aimed to assess the association between chronic coffee consumption, and aortic stiffness and wave reflections in hypertensive patients. DESIGN: Epidemiological survey. SETTING: Hypertension Unit, University Hospital. SUBJECTS-METHODS: We examined 259 never-treated hypertensives (age 50+/-12 years, 165 males) without diabetes mellitus, who were asked to describe in detail the type and amount of coffee they consumed. Carotid-femoral pulse wave velocity (PWV) and augmentation index (AIx) were measured non-invasively as indices of aortic stiffness and wave reflections, respectively. RESULTS: When controlled for gender, age, height, smoking status, heart rate, mean pressure, HDL cholesterol and hsCRP, AIx was found to be higher with increasing daily coffee consumption. Post hoc analysis revealed that all groups of coffee consumption had higher AIx compared to no-consumption. PWV did not differ among groups of daily coffee consumption. Each participant had 35% higher relative risk of having high AIx for each cup (150 ml) of coffee per day, and 40% higher relative risk for each 10 cup-years. CONCLUSIONS: Coffee consumption is associated with increased wave reflections, but not aortic stiffness in never-treated hypertensive patients. This finding may have important clinical implications for cardiovascular health in hypertensive subjects.

Aorta↗

Coffee intake is associated with lower risk of symptomatic gallstone disease in women.

BACKGROUND & AIMS: Metabolic studies have shown that coffee affects several hepatobiliary processes that are involved in cholesterol lithogenesis. We previously showed that coffee drinking was associated with a lower risk of symptomatic gallstone disease in men. METHODS: We prospectively examined the association between coffee drinking and cholecystectomy, a surrogate of symptomatic gallstone disease, in a cohort of 80,898 women age 34-59 years in 1980 who had no history of gallstone disease. Coffee consumption and cholecystectomy were reported by participants on biennial mailed questionnaires. RESULTS: During 20 years of follow-up to the year 2000, 7,811 women reported a cholecystectomy. Compared with women who consistently reported consuming no caffeinated coffee, the multivariate relative risks (adjusting for risk factors for gallstone disease) of cholecystectomy comparing increasing categories of consistent intake of caffeinated coffee (0, 1, 2-3, and > or =4 cups/day) were 1.0, 0.91, 0.78, and 0.72 (95% confidence interval comparing extreme categories, 0.62-0.84; P value of test for trend < 0.0001). Caffeine intake from beverages and dietary sources was also inversely associated with risk of cholecystectomy. The multivariate relative risks comparing increasing categories of caffeine intake (< or =25, 26-100, 101-200, 201-400, 401-800, and >800 mg/day) were 1.0, 1.03, 1.01, 0.94, 0.85, and 0.85 (95% confidence interval comparing extreme categories, 0.74-0.96; P value of test for trend < 0.0001). In contrast, decaffeinated coffee was not associated with risk. CONCLUSIONS: These data suggest that consumption of caffeinated coffee may play a role in the prevention of symptomatic gallstone disease in women.

Adult↗

Coffee and tea consumption are associated with a lower incidence of chronic liver disease in the United States.

BACKGROUND & AIMS: Coffee drinking has been suggested to protect against liver injury, but it is uncertain whether this is of clinical significance. We examined the relationship of coffee and tea consumption with the incidence of hospitalization or death from chronic liver disease (CLD). METHODS: Participants in the population-based, first National Health and Nutrition Examination Survey, 1971-1975, were asked about coffee and tea consumption, which was categorized as <1 cup (mean, 0.2 cups), 1 to 2 cups, and >2 cups per day (mean, 4.0 cups). A second analysis included persons who, in 1982-1984, were asked more detailed questions on coffee and tea drinking. Participants were followed through 1992-1993 for a hospital or death certificate diagnosis of CLD or cirrhosis (ICD-9-CM 571). Hazard rate ratios for CLD according to coffee and tea intake were calculated using Cox proportional hazards analysis. RESULTS: Among 9849 persons followed for a median of 19.0 years (range, 0.02-22.1), the cumulative incidence of CLD was 1.4%. In multivariate analysis, participants who drank >2 cups per day had less than half the rate of CLD as those who drank <1 cup per day (hazard ratio, 0.43, 95% confidence interval: 0.24-0.78). Protection by coffee and tea was limited to persons at higher risk for liver diseases from heavier alcohol intake, overweight, diabetes, or high iron saturation. Among 9650 participants who provided detailed drink information in 1982-1984, intake of regular ground coffee and of caffeine was associated with lower incidence of CLD. CONCLUSIONS: Coffee and tea drinking decreases the risk of clinically significant CLD.

Adult↗

Gastric acid secretion and lower-esophageal-sphincter pressure in response to coffee and caffeine.

Caffeine stimulates gastric acid secretion and reduces the competence of the lower esophageal sphincter in man. These effects of caffeine have been used as evidence that regular coffee should not be used by patients with peptic-ulcer disease or gastroesophageal reflux. We compared the dose-response relations of caffeine, regular coffee and decaffeinated coffee for gastric acid secretion and sphincter pressure in normal subjects. Decaffeinated coffee gave a maximal acid response of 16.5 +/- 2.6 mEq per hour (mean +/- S.E.M.), which was similar to that of regular coffee, 20.9 +/- 3.6 mEq per hour, both values being higher than that of caffeine, 8.4 +/- 1.3, on a cup-equivalent basis. Sphincter pressure showed minimal changes in response to caffeine, but was significantly increased by both regular and decaffeinated coffee (P less than 0.05). These data suggest that clinical recommendations based upon the known gastrointestinal effects of caffeine may bear little relation to the actual observed actions of coffee or decaffeinated coffee.

Adult↗

Coffee, caffeine, and cardiovascular disease in men.

BACKGROUND: For many years, an association between coffee consumption and the risk of coronary heart disease has been suspected. Although based on small numbers of end points, a prospective study has suggested a particularly strong association between recent coffee drinking and the incidence of cardiovascular disease. METHODS: We examined prospectively the relation of coffee consumption with the risk of myocardial infarction, need for coronary-artery bypass grafting or angioplasty, and risk of stroke in a cohort of 45,589 U.S. men who were 40 to 75 years old in 1986 and who had no history of cardiovascular disease. RESULTS: During two years of follow-up observation, 221 participants had a nonfatal myocardial infarction or died of coronary heart disease, 136 underwent coronary-artery surgery or angioplasty, and 54 had a stroke. Total coffee consumption was not associated with an increased risk of coronary heart disease or stroke. The age-adjusted relative risk for all cardiovascular disease among participants who drank four or more cups of coffee per day was 1.04 (95 percent confidence intervals, 0.74 to 1.46). Increasing levels of consumption of caffeinated coffee were not associated with higher risks of cardiovascular disease. Higher consumption of decaffeinated coffee, however, was associated with a marginally significant increase in the risk of coronary heart disease (relative risk, 1.63; 95 percent confidence interval, 1.02 to 2.60). Finally, we observed no pattern of increased risk across the subgroups of participants with increasing intakes of caffeine from all sources. Adjustment for major cardiovascular-risk indicators, dietary intake of fats, and cholesterol intake did not materially alter these associations. CONCLUSIONS: These findings do not support the hypothesis that coffee or caffeine consumption increases the risk of coronary heart disease or stroke.

Adult↗

Induced changes in the consumption of coffee alter ad libitum dietary intake and physical activity level.

Dietary trials with subjects on a freely selected diet may be affected by unwanted behavioural changes. Few studies, if any, have examined changes in coffee consumption and possible concomitant changes in diet and health-related habits. The aim of the present study was to examine whether induced changes in coffee consumption lead to changes in food habits and leisure-time physical activity. Healthy, non-smoking coffee-drinkers (n 214) were asked to change their coffee habits in a controlled clinical trial on the metabolic effects of coffee. The participants were asked to maintain their usual dietary habits. Self-perceived changes in diet and physical activity during the 6-week intervention period were assessed at the end. In the analyses, the participants were rearranged into groups reflecting the difference in coffee intake during the trial as compared with habitual intake. Associations with changes in food intake or physical activity were analysed by Spearman rank correlation. Changes in intake of 'chocolate, sweets' (r 0.179, P<0.05), 'cakes, sweet biscuits, pastry' (r 0.306, P<0.001), and 'jam' r 0.198, P<0.05) showed positive associations with change in coffee intake during the trial. Negative associations were found for 'dishes with fish' (r -0.204, P<0.01) and many of the drinks as well as with physical activity (r -0.164, P<0.05). Induced changes in coffee intake seem to alter ad libitum intake of several foods. The recognized associations between health behaviours may have physiological explanations.

Adult↗

Modulation of metal-induced cytotoxicity by maillard reaction products isolated from coffee brew.

Nondialyzable Maillard reaction products (MRPs) were recovered from three different coffee brew extracts (i.e., brewed, boiled, instant) to evaluate the efficacy of MRPs in modulating in vitro metal-induced cytotoxicity in C3H/10T1/2 mouse embryo fibroblast cells, cultured in the presence of Fe2+, Fe3+, or Cu2+ ions. Preliminary experiments were performed in an vitro linoleic acid emulsion model system to characterize the anti- or pro-oxidant activity of coffee MRPs. Cytotoxicity experimental protocols involved both the direct application of metal ions and coffee MRPs to fibroblast cells, and the premixing of metal ions with coffee MRPs at room temperature prior to incubating with fibroblast cells. Fe2+ and Cu2+ significantly lowered the colonization efficiency (CE) of cells at all three concentrations (i.e., 0.1, 10, 50 microM) used. Similar Fe3+ activity was observed only at 50 microM concentration. None of the coffee MRPs alone or together with 0.1 and 10 microM of Fe2+ or Fe3+ produced cytotoxic effects during direct application. The premixing step, however, significantly enhanced the CE of cells compared to the control, denoting cytoprotection, only in the presence of Fe2+. In addition, the application of MRPs with 0.1 or 10 microM of Cu2+ significantly lowered the CE of cells than the control, but enhanced the CE of cells than the Cu2+ added control. These results corresponded directly with the results of model linoleic acid emulsion test, thereby demonstrating that lipid hydroperoxide generation is the source for fibroblast cell toxicity when MRPs are added to cells together with metal ions. These results further indicate that coffee MRPs can suppress in vitro metal-induced cytotoxicity to a certain extent when Fe2+, Cu2+, or Fe3+ ions are present below a concentration of 50 microM, possibly by chelating the metal ions. Ionic reducing capacity of coffee MRPs, albeit small, may explain the potential for increased cytotoxicity at higher coffee MRP concentrations.

Animals↗

Design of a sampling plan to detect ochratoxin A in green coffee.

The establishment of maximum limits for ochratoxin A (OTA) in coffee by importing countries requires that coffee-producing countries develop scientifically based sampling plans to assess OTA contents in lots of green coffee before coffee enters the market thus reducing consumer exposure to OTA, minimizing the number of lots rejected, and reducing financial loss for producing countries. A study was carried out to design an official sampling plan to determine OTA in green coffee produced in Brazil. Twenty-five lots of green coffee (type 7 - approximately 160 defects) were sampled according to an experimental protocol where 16 test samples were taken from each lot (total of 16 kg) resulting in a total of 800 OTA analyses. The total, sampling, sample preparation, and analytical variances were 10.75 (CV = 65.6%), 7.80 (CV = 55.8%), 2.84 (CV = 33.7%), and 0.11 (CV = 6.6%), respectively, assuming a regulatory limit of 5 microg kg(-1) OTA and using a 1 kg sample, Romer RAS mill, 25 g sub-samples, and high performance liquid chromatography. The observed OTA distribution among the 16 OTA sample results was compared to several theoretical distributions. The 2 parameter-log normal distribution was selected to model OTA test results for green coffee as it gave the best fit across all 25 lot distributions. Specific computer software was developed using the variance and distribution information to predict the probability of accepting or rejecting coffee lots at specific OTA concentrations. The acceptation probability was used to compute an operating characteristic (OC) curve specific to a sampling plan design. The OC curve was used to predict the rejection of good lots (sellers' or exporters' risk) and the acceptance of bad lots (buyers' or importers' risk).

Coffee↗

Abstention from filtered coffee reduces the concentrations of plasma homocysteine and serum cholesterol--a randomized controlled trial.

BACKGROUND: Elevated concentrations of plasma total homocysteine (tHcy) and serum total cholesterol are risk factors for ischemic heart disease (IHD). Previous studies showed that the consumption of very high doses of unfiltered coffee increases tHcy and total cholesterol. OBJECTIVE: A prospective intervention study was performed to assess the effects of coffee consumption on the concentrations of tHcy and total cholesterol by using doses and brewing methods common in southeastern Norway. DESIGN: The study was an unblinded, controlled trial with 191 healthy, nonsmoking, coffee-drinking volunteers aged 24-69 y randomly assigned to 3 groups who were asked to consume for 6 consecutive weeks no coffee, 1-3 cups (approximately 175-525 mL)/d, or > or =4 cups (approximately 700 mL)/d prepared in the manner to which they were accustomed. Blood samples were drawn when the subjects were randomly assigned and at 3 and 6 wk of the trial. Dietary data were collected by questionnaire. RESULTS: Ninety-seven percent of the participants reported being regular consumers of caffeinated filtered coffee. Abstention from coffee for 6 wk was associated with a decrease in the tHcy concentration of 1.08 micromol/L and a decrease in the total cholesterol concentration of 0.28 mmol/L in participants who had been drinking on average 4 cups of filtered coffee daily for the past year. Adjustments for several possible confounders did not alter the results. CONCLUSION: Abstention from filtered coffee in doses that are commonly consumed was associated with lower concentrations of tHcy and total cholesterol.

Adult↗

Associations between coffee consumption and inflammatory markers in healthy persons: the ATTICA study.

BACKGROUND: The effect of coffee consumption on the cardiovascular system is conflicting. Inflammation is important to the development of cardiovascular disease (CVD), and several dietary factors are thought to exert significant effects on inflammation and thus on the risk of CVD. OBJECTIVE: We aimed to investigate the associations between coffee consumption and inflammatory markers. DESIGN: The cross-sectional survey enrolled 1514 men (x +/- SD age: 46 +/- 13 y; range: 18-87 y) and 1528 women (aged 45 +/- 13 y; range: 18-89 y). Five percent of men and 3% of women were excluded for history of CVD. Fasting blood samples were collected. Dietary habits (including consumption of various types of coffee) were evaluated by using a validated food-frequency questionnaire. RESULTS: Compared with coffee nondrinkers, men who consumed >200 mL coffee/d had 50% higher interleukin 6 (IL-6), 30% higher C-reactive protein (CRP), 12% higher serum amyloid-A (SAA), and 28% higher tumor necrosis factor alpha (TNF-alpha) concentrations and 3% higher white blood cell (WBC) counts (all: P < 0.05). Women who consumed >200 mL coffee/d had 54% higher IL-6, 38% higher CRP, 28% higher SAA, and 28% higher TNF-alpha concentrations and 4% higher WBC counts (all: P < 0.05) than did coffee nondrinkers. The findings were significant even after control for the interactions between coffee consumption and age, sex, smoking, body mass index, physical activity status, and other covariates. CONCLUSIONS: A relation exists between moderate-to-high coffee consumption and increased inflammation process. This relation could explain, in part, the effect of increased coffee intake on the cardiovascular system.

Adolescent↗

Misclassification of exposure: coffee as a surrogate for caffeine intake.

This study was conducted to assess the effect of exposure misclassification when coffee is used as a surrogate measure of caffeine exposure. Subjects were randomly selected from the telephone directories of four regional municipalities in southern Ontario, CANADA: Data on daily caffeine intake from foods, beverages, and medications were collected from June to November 1995 through self-administered, mailed questionnaires from 481 men and women aged 30-75 years. Although coffee was the main source of caffeine, cross-tabulations of exposure to coffee by total caffeine intake showed that assessment of coffee alone severely underestimated caffeine intake by at least one exposure level. A hypothetical 10-fold increase in risk was completely obscured when only coffee was used to estimate total caffeine intake. The results of this study suggest that measuring coffee instead of caffeine intake may contribute to a lack of positive findings in studies of coffee as a risk factor for disease occurrence, if in fact caffeine is the exposure of interest. On the other hand, measurement of coffee, tea, and cola soft drink intake in the present study appeared to approximate caffeine intake sufficiently and not affect risk estimates adversely.

Adult↗

Coffee and fetal death: a cohort study with prospective data.

The authors conducted a cohort study within the Danish National Birth Cohort to determine whether coffee consumption during pregnancy is associated with late fetal death (spontaneous abortion and stillbirth). A total of 88,482 pregnant women recruited from March 1996 to November 2002 participated in a comprehensive interview on coffee consumption and potentially confounding factors in pregnancy. Information on pregnancy outcome was obtained from the National Hospital Discharge Register and medical records. The authors detected 1,102 fetal deaths. High levels of coffee consumption were associated with an increased risk of fetal death. Relative to nonconsumers of coffee, the adjusted hazard ratios for fetal death associated with coffee consumption of 1/2-3, 4-7, and > or =8 cups of coffee per day were 1.03 (95% confidence interval (CI): 0.89, 1.19), 1.33 (95% CI: 1.08, 1.63), and 1.59 (95% CI: 1.19, 2.13), respectively. Reverse causation due to unrecognized fetal demise may explain the association between coffee intake and risk of fetal death prior to 20 completed weeks' gestation but not the association with fetal loss following 20 completed weeks' gestation. Consumption of coffee during pregnancy was associated with a higher risk of fetal death, especially losses occurring after 20 completed weeks of gestation.

Abortion, Spontaneous↗

Caffeine content of specialty coffees.

Caffeine is the world's most widely consumed drug with its main source found in coffee. We evaluated the caffeine content of caffeinated and decaffeinated specialty coffee samples obtained from coffee shops. Caffeine was isolated from the coffee by liquid-liquid extraction and analyzed by gas chromatography with nitrogen-phosphorus detection. In this study, the coffees sold as decaffeinated were found to have caffeine concentrations less than 17.7 mg/dose. There was a wide range in caffeine content present in caffeinated coffees ranging from 58 to 259 mg/dose. The mean (SD) caffeine content of the brewed specialty coffees was 188 (36) mg for a 16-oz cup. Another notable find is the wide range of caffeine concentrations (259-564 mg/dose) in the same coffee beverage obtained from the same outlet on six consecutive days.

Caffeine↗