ABSTRACT
Purpose:
Previous studies have reported inconsistent associations of coffee and tea consumption with cardiovascular disease (CVD). The mixed findings may partly reflect differences in the habitual addition of sweeteners to coffee and tea, a factor not considered in most previous studies. We aimed to evaluate the dose-response associations of unsweetened and sweetened coffee and tea consumption with incident CVD.
Methods:
This prospective cohort study included 167,142 UK Biobank participants without prevalent CVD at baseline. Beverage intake and sweetener use were assessed using repeated web-based 24-h dietary recalls. Incident CVD was defined as the first recorded occurrence of coronary heart disease, stroke, or heart failure. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models.
Results:
During a median follow-up of 11.1 years, 14,395 participants developed incident CVD. Unsweetened coffee showed a U-shaped association with incident CVD (P-nonlinearity < 0.001), with the lowest risk observed at 2.5 units/day. Compared with non-consumers, participants who consumed > 0-5 units/day of unsweetened coffee had a lower CVD risk, with HRs (95% CIs) of 0.89 (0.84-0.94) for > 0-1 unit/day, 0.90 (0.85-0.95) for > 1-2 units/day, 0.81 (0.76-0.86) for > 2-3 units/day, and 0.86 (0.81-0.91) for > 3-5 units/day, respectively. However, no significant association was observed for > 5 units/day unsweetened coffee (HR: 1.00, 95% CI: 0.91-1.11). Sweetened coffee consumption was not associated with a lower CVD risk at any intake level. Similarly, unsweetened tea was associated with a lower CVD risk across intake categories, whereas high sweetened tea intake was associated with higher a CVD risk (HR: 1.13, 95% CI: 1.01-1.26 for > 5 units/day).
Conclusions:
Moderate intakes of unsweetened coffee and tea were each associated with a lower risk of incident CVD, whereas sweetened types did not show protective associations. These findings suggest that sweetener use should be considered when evaluating the cardiovascular relevance of coffee and tea consumption.
