Association of Coffee Consumption with Total and Cause-Specific Mortality in Three Large Prospective Cohorts

CIRCULATIONAHA.115.017341 Published online before print November 16, 2015,
doi: 10.1161/CIRCULATIONAHA.115.017341

http://circ.ahajournals.org/content/early/2015/11/10/CIRCULATIONAHA.115.017341.abstract

Background—The association between consumption of caffeinated and decaffeinated coffee and risk of mortality remains inconclusive.

Methods and Results—We examined the associations of consumption of total, caffeinated, and decaffeinated coffee with risk of subsequent total and cause-specific mortality among 74,890 women in the Nurses' Health Study (NHS), 93,054 women in the NHS 2, and 40,557 men in the Health Professionals Follow-up Study. Coffee consumption was assessed at baseline using a semi-quantitative food frequency questionnaire. During 4,690,072 person-years of follow-up, 19,524 women and 12,432 men died. Consumption of total, caffeinated, and decaffeinated coffee were non-linearly associated with mortality. Compared to non-drinkers, coffee consumption one to five cups/d was associated with lower risk of mortality, while coffee consumption more than five cups/d was not associated with risk of mortality. However, when restricting to never smokers, compared to non-drinkers, the HRs of mortality were 0.94 (0.89 to 0.99) for ≤ 1 cup/d, 0.92 (0.87 to 0.97) for 1.1-3 cups/d, 0.85 (0.79 to 0.92) for 3.1-5 cups/d, and 0.88 (0.78 to 0.99) for > 5 cups/d (p for non-linearity = 0.32; p for trend < 0.001). Significant inverse associations were observed for caffeinated (p for trend < 0.001) and decaffeinated coffee (p for trend = 0.022). Significant inverse associations were observed between coffee consumption and deaths due to cardiovascular disease, neurological diseases, and suicide. No significant association between coffee consumption and total cancer mortality was found.

Conclusions—Higher consumption of total coffee, caffeinated coffee, and decaffeinated coffee was associated with lower risk of total mortality.

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reports the effect is clear only among those who drink coffee and “never smoked.” Among those, there was a 6% to 8% lower death rate connected to drinking up to 3 cups daily, and a 15% lower rate among those who drank 3 to 5 cups, and a 12% lower rate among those who drank over 5 cups daily. One possibility suggested is that coffee drinkers “drink less soda,” while it is also suggested that the lignans and chlorogenic acid in coffee “could reduce inflammation and help control blood sugar,” and so “reduce the risk of heart disease,” which was 10% lower among coffee drinkers. In addition, coffee drinkers had a 9% to 37% lower rate of death from “neurological diseases such as Parkinson’s and dementia.” They also had “between 20% and 36% lower rates of suicide.”

Vivaha Bhojanambu-My attempt

Slow Advancement of Enteral Feeds in VLBW Infants-Is It Harmful?

Cochrane Database Syst Rev. 2015 Oct 15;10:CD001241

Morgan J, Young L, McGuire W.

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001241.pub6/abstract

MAIN RESULTS:

We identified nine randomised controlled trials in which 949 infants participated. Most participants were stable preterm infants with birth weights between 1000 and 1500 g. Fewer participants were extremely preterm, extremely low birth weight, or growth-restricted. The trials typically defined slow advancement as daily increments of 15 to 24 mL/kg and faster advancement as 30 to 40 mL/kg. Meta-analyses did not show statistically significant effects on the risk of NEC (typical RR 1.02, 95% CI 0.64 to 1.62; typical RD -0.00, 95% CI -0.03 to 0.03) or all-cause mortality (typical RR 1.18, 95% CI 0.90 to 1.53; typical RD 0.03, 95% CI -0.02 to 0.08). Slow feeds advancement delayed the establishment of full enteral nutrition by one to five days and increased the risk of invasive infection (typical RR 1.46, 95% CI 1.03 to 2.06; typical RD 0.07, 95% CI 0.01 to 0.13; number needed to treat for an additional harmful outcome 14, 95% CI 8 to 100).

AUTHORS' CONCLUSIONS:

The available trial data suggest that advancing enteral feed volumes at daily increments of 30 to 40 mL/kg (compared to 15 to 24 mL/kg) does not increase the risk of NEC or death in VLBW infants. Advancing the volume of enteral feeds at slow rates results in several days of delay in establishing full enteral feeds and increases the risk of invasive infection. The applicability of these findings to extremely preterm, extremely low birth weight, or growth-restricted infants is limited. Further randomised controlled trials in these populations may be warranted to resolve this uncertainty.