1. Journal Club Meena Meka MD

2. Topic Association of Coffee Drinking with Total and Cause-Specific Mortality

3. Background Coffee is one of the most widely consumed beverages, but the association between coffee consumption and the risk of death remains unclear.

4. PICO Question Patient Intervention Control Outcome

5. PICO Patient:

6. PICO Question Intervention

7. PICO Question Control:

8. PICO Question Outcome

9. The Article Association of Coffee Drinking with Total and Cause Specific Mortality. New England Journal of Medicine 2012;366:1891-1904

10. The Article Original Research Prospective, multicenter Journal – peer reviewed, general internal medicine Sites: multicenter Patients: 229,118 men and 173,141 women

11. Patient Criteria Inclusion – 50-71years Exclusion – Persons whose questionnaires were completed by others – Cancer – Heart disease – Previous stroke

12. Other exclusions Persons who did not provide information on coffee use Extremely low or high caloric consumption Those who died before completed questionnaire was received

13. Study Population 617,119 AARP members 50-71 years of age returned a comprehensive questionnaire assessing diet and lifestyle Participants resided in 6 states, CA, FL, LO, NJ, NC, PN, and 2 metropolitan areas, Atlanta and Detroit 566,401 completed the questionnaire satisfactorily

14. Methods Participants completed the baseline questionnaire that assessed demographic and lifestyle characteristics and 124 dietary items Consumption of fruits, vegetables, red meat, white meat, unsaturated fat were adjusted for total energy intake with the use of the nutrient density approach Coffee consumption was assessed according to 10 frequency categories ranging from 0-6 or more cups a day

15. Methods 96.5% of coffee drinkers provided information on whether they drank caffeinated or decaffeinated coffee more than half the time Participants were followed from baseline (95-96) until the date of death or 12/31/08. Coffee consumption was tabulated according to a number of dietary and lifestyle factors Hazard rations and 95% confidence intervals for mortality associated with coffee consumption were estimated with Cox proportional hazards regression models, with person-years as the underlying time metric

16. Methods Risk estimates were presented seperately for men and women Multivariate models were adjusted for: – Age, BMI, race/ethnicity, level of education, alcohol consumption, number of cigarettes smoked daily, use or nonuse of pipes or cigars, time of smoking cessation, health status, presence or absence of diabetes, marital status, level of physical activity, total energy intake, dietary consumption, vitamin supplementation, history of cancer in first degree relative and for women you of postmenopausal hormone therapy

17. Results Coffee consumption at baseline was associated with several other dietary and lifestyle factors As compared with persons who did not drink coffee, coffee drinkers were more likely to smoke cigarettes and consume more then 3 alcoholic drinks per day … and they consumed more red meat

18. Results Coffee drinkers also tended to have a lower level of education; were less likely to engage in vigorous activity and reported lower levels of consumption of fruits, vegetables and white meat However, coffee drinkers, especially women who drank coffee, were less likely to report having diabetes. About 2/3 of coffee drinkers reported drinking predominantly caffeinated coffee

19. Results

27. Author’s Conclusion

28. Evaluation

29. Statistics Discussion

30. Questions?