ABSTRACT

Background and aims:
Global population aging has increased multimorbidity of non-communicable diseases (MNCDs). Coffee bioactive compounds may influence chronic disease pathways, yet their role in MNCDs progression is unclear. This study examines how habitual coffee intake affects transitions from first NCD to MNCDs and subsequent mortality.

Methods and results:
Based on the application of the Cox proportional hazards and multi-state models to the UK Biobank cohort data, this study found that among the 60,616 participants who developed at least one non-communicable disease (NCD), 9938 progressed to MNCDs. Compared with non-coffee drinkers, individuals consuming fewer than 3 cups of coffee daily had a reduced risk of transitioning from an NCD-free state to a first NCD [HR = 0.91, 95 %CI:0.89-0.93(0-1 cups/day); HR = 0.89, 95 %CI:0.87-0.91(1-3 cups/day)] and from a first NCD to MNCDs [HR = 0.85, 95 %CI:0.80-0.90(0-1cups/day); HR = 0.85,95 %CI:0.81-0.90(1-3cups/day)]. Conversely consuming exceeding 5 cups/day was associated with an increased risk of progression from a first NCD to MNCDs (HR = 1.26, 95 %CI:1.17-1.36) and from MNCDs to death (HR:1.19, 95 %CI:1.04-1.36). The association between high coffee intake (>5 cups/day) and increased risk of progression to MNCDs was more pronounced in participants with the slowest caffeine metabolism (HR = 1.54, 95 %CI: 1.32-1.80), but attuned in those with the fastest caffeine metabolism (HR = 1.17, 95 %CI: 1.03-1.32).

Conclusions:
Habitual coffee consumption of fewer 3 cups/day is associated with a lower risk of developing NCDs and MNCDs, whereas intake exceeding 5 cups/day increases the risk of MNCDs and mortality in those with MNCDs, particularly among individuals with slower caffeine metabolism.

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