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Relative associations of coffee, tea and plain water with all-cause and cause-specific mortality: a prospective cohort study

Published online by Cambridge University Press:  22 September 2025

Chen Shi
Affiliation:
State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China
Yu-Kun Wang
Affiliation:
Guangdong University of Foreign Studies South China Business College, Guangzhou, People’s Republic of China
Min-Qian Yan
Affiliation:
State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China
Zhen Peng
Affiliation:
State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China
Jin-Lun Zhang
Affiliation:
State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China
Yi-Ming Tao
Affiliation:
State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China
Lin Yang
Affiliation:
School of Nursing, Hong Kong Polytechnic University, Hong Kong, People’s Republic of China
Li Li*
Affiliation:
State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China
Chun-Quan Ou*
Affiliation:
State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People’s Republic of China
*
Corresponding authors: Li Li; Email: lylygdsg@163.com, Chun-Quan Ou; Email: ouchunquan@hotmail.com
Corresponding authors: Li Li; Email: lylygdsg@163.com, Chun-Quan Ou; Email: ouchunquan@hotmail.com

Abstract

Previous studies highlighted the health benefits of coffee and tea, but they only focused on the comparisons between different consumptions. Consequently, the association estimate lacked a clear interpretation, as the substitution of beverages and distribution of doses were not explicitly prescribed. We focused on the ‘relative association’ to ascertain the optimal consumption strategy (including total intake and optimal allocation strategy) for coffee, tea and plain water associated with decreased mortality. Self-reported coffee, tea and plain water intake were used from the UK Biobank. Within a compositional data analysis framework, a multivariate Cox model was used to assess the relative associations after adjusting for a range of potential confounders. The lower mortality risk was observed with at least approximately 7–8 drinks/d of total consumption. When the total intake > 4 drinks/d, substituting plain water with coffee or tea was linked to reduced mortality; nevertheless, the benefit was not seen for ≤ 4 drinks/d. Besides, a balanced consumption of coffee and tea (roughly a ratio of 2:3) associated with the lowest hazard ratios of 0·55 (95 % CI 0·47, 0·64) for all-cause mortality, 0·59 (95 % CI 0·48, 0·72) for cancer mortality, 0·69 (95 % CI 0·49, 0·99) for CVD mortality, 0·28 (95 % CI 0·15, 0·52) for respiratory disease mortality and 0·35 (95 % CI 0·15, 0·82) for digestive disease mortality than other combinations. These results highlight the importance of the rational combination of coffee, tea and plain water, with particular emphasis on ensuring adequate total intake, offering more comprehensive and explicit guidance for individuals.

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Type
Research Article
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society

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References

Simon, J, Fung, K, Raisi-Estabragh, Z, et al. (2022) Light to moderate coffee consumption is associated with lower risk of death: a UK Biobank study. Eur J Prev Cardiol 29, 982991.CrossRefGoogle Scholar
Xiang, Y, Xu, H, Chen, H, et al. (2024) Tea consumption and attenuation of biological aging: a longitudinal analysis from two cohort studies. Lancet Reg Health West Pac 42, 100955.Google ScholarPubMed
Ye, Z, Liu, M, Yang, S, et al. (2024) Coffee consumption with different additives and types, genetic variation in caffeine metabolism and new-onset acute kidney injury. Br J Nutr 132, 16451653.CrossRefGoogle ScholarPubMed
Freedman, ND, Park, Y, Abnet, CC, et al. (2012) Association of coffee drinking with total and cause-specific mortality. N Engl J Med 366, 18911904.CrossRefGoogle ScholarPubMed
Poole, R, Kennedy, OJ & Roderick, P (2017) Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes. BMJ 359, j5024.CrossRefGoogle ScholarPubMed
Inoue-Choi, M, Ramirez, Y, Cornelis, MC, et al. (2022) Tea consumption and all-cause and cause-specific mortality in the UK Biobank: a prospective cohort study. Ann Intern Med 175, 12011211.CrossRefGoogle ScholarPubMed
Loomis, D, Guyton, KZ, Grosse, Y, et al. (2016) Carcinogenicity of drinking coffee, mate, and very hot beverages. Lancet Oncol 17, 877878.CrossRefGoogle ScholarPubMed
Grosso, G, Godos, J, Galvano, F, et al. (2017) Coffee, caffeine, and health outcomes: an umbrella review. Annu Rev Nutr 37, 131156.CrossRefGoogle ScholarPubMed
Chung, M, Zhao, N, Wang, D, et al. (2020) Dose-response relation between tea consumption and risk of cardiovascular disease and all-cause mortality: a systematic review and meta-analysis of population-based studies. Adv Nutr 11, 790814.CrossRefGoogle ScholarPubMed
Kim, TL, Jeong, GH, Yang, JW, et al. (2020) Tea consumption and risk of cancer: an umbrella review and meta-analysis of observational studies. Adv Nutr 11, 14371452.CrossRefGoogle ScholarPubMed
Chen, Y, Zhang, Y, Zhang, M, et al. (2022) Consumption of coffee and tea with all-cause and cause-specific mortality: a prospective cohort study. BMC Med 20, 449.CrossRefGoogle ScholarPubMed
Loftfield, E, Cornelis, MC, Caporaso, N, et al. (2018) Association of coffee drinking with mortality by genetic variation in caffeine metabolism: findings from the UK Biobank. JAMA Intern Med 178, 10861097.CrossRefGoogle ScholarPubMed
Liu, D, Li, ZH, Shen, D, et al. (2022) Association of sugar-sweetened, artificially sweetened, and unsweetened coffee consumption with all-cause and cause-specific mortality: a large prospective cohort study. Ann Intern Med 175, 909917.CrossRefGoogle ScholarPubMed
Zhang, Y, Yang, H, Li, S, et al. (2021) Consumption of coffee and tea and risk of developing stroke, dementia, and poststroke dementia: a cohort study in the UK Biobank. PLoS Med 18, e1003830.CrossRefGoogle ScholarPubMed
Stern, D, Ibsen, DB, MacDonald, CJ, et al. (2024) Improving nutrition science begins with asking better questions. Am J Epidemiol 193, 15071510.CrossRefGoogle ScholarPubMed
Valtin, H (2002) ‘Drink at least eight glasses of water a day.’ Really? Is there scientific evidence for ‘8 × 8’? Am J Physiol Regul Integr Comp Physiol 283, R993R1004.CrossRefGoogle Scholar
Zhou, HL, Wei, MH, Cui, Y, et al. (2022) Association between water intake and mortality risk-evidence from a national prospective study. Front Nutr 9, 822119.CrossRefGoogle ScholarPubMed
Majdi, M, Hosseini, F, Naghshi, S, et al. (2021) Total and drinking water intake and risk of all-cause and cardiovascular mortality: a systematic review and dose-response meta-analysis of prospective cohort studies. Int J Clin Pract 75, e14878.CrossRefGoogle ScholarPubMed
Karcz-Kubicha, M, Antoniou, K, Terasmaa, A, et al. (2003) Involvement of adenosine A1 and A2A receptors in the motor effects of caffeine after its acute and chronic administration. Neuropsychopharmacol 28, 12811291.CrossRefGoogle ScholarPubMed
Sontrop, JM, Dixon, SN, Garg, AX, et al. (2013) Association between water intake, chronic kidney disease, and cardiovascular disease: a cross-sectional analysis of NHANES data. Am J Nephrol 37, 434442.CrossRefGoogle ScholarPubMed
Wu, LW, Chen, WL, Liaw, FY, et al. (2016) Association between fluid intake and kidney function, and survival outcomes analysis: a nationwide population-based study. BMJ Open 6, e010708.CrossRefGoogle ScholarPubMed
Zhao, L, Zhang, X, Coday, M, et al. (2023) Sugar-sweetened and artificially sweetened beverages and risk of liver cancer and chronic liver disease mortality. JAMA 330, 537546.CrossRefGoogle ScholarPubMed
Ma, L, Hu, Y, Alperet, DJ, et al. (2023) Beverage consumption and mortality among adults with type 2 diabetes: prospective cohort study. BMJ 381, e073406.CrossRefGoogle ScholarPubMed
Inoue-Choi, M, Ramirez, Y, Freedman, ND, et al. (2023) Tea consumption and all-cause and cause-specific mortality in the UK Biobank. Ann Intern Med 176, eL220478.CrossRefGoogle ScholarPubMed
Breskin, A & Murray, EJ (2020) Commentary: compositional data call for complex interventions. Int J Epidemiol 49, 13141315.CrossRefGoogle ScholarPubMed
McGregor, DE, Palarea-Albaladejo, J, Dall, PM, et al. (2020) Cox regression survival analysis with compositional covariates: application to modelling mortality risk from 24-h physical activity patterns. Stat Methods Med Res 29, 14471465.CrossRefGoogle ScholarPubMed
Sudlow, C, Gallacher, J, Allen, N, et al. (2015) UK Biobank: an open access resource for identifying the causes of a wide range of complex diseases of middle and old age. PLoS Med 12, e1001779.CrossRefGoogle ScholarPubMed
Palmer, LJ (2007) UK Biobank: bank on it. Lancet 369, 19801982.CrossRefGoogle ScholarPubMed
Liu, B, Young, H, Crowe, FL, et al. (2011) Development and evaluation of the oxford WebQ, a low-cost, web-based method for assessment of previous 24 h dietary intakes in large-scale prospective studies. Public Health Nutr 14, 19982005.CrossRefGoogle ScholarPubMed
Biobank U (2024) Mortality Data: Linkage to Death Registries. https://biobank.ctsu.ox.ac.uk/crystal/crystal/docs/DeathLinkage (accessed March 2024).Google Scholar
Zhang, Y-B, Chen, C, Pan, X-F, et al. (2021) Associations of healthy lifestyle and socioeconomic status with mortality and incident cardiovascular disease: two prospective cohort studies. BMJ 373, n604.CrossRefGoogle ScholarPubMed
Kim, Y, Je, Y & Giovannucci, E (2019) Coffee consumption and all-cause and cause-specific mortality: a meta-analysis by potential modifiers. Eur J Epidemiol 34, 731752.CrossRefGoogle ScholarPubMed
Manz, F & Wentz, A (2005) The importance of good hydration for the prevention of chronic diseases. Nutr Rev 63, S2S5.CrossRefGoogle ScholarPubMed
Popkin, BM, D’Anci, KE & Rosenberg, IH (2010) Water, hydration, and health. Nutr Rev 68, 439458.CrossRefGoogle ScholarPubMed
Ding, M, Satija, A, Bhupathiraju, SN, et al. (2015) Association of coffee consumption with total and cause-specific mortality in three large prospective cohorts. Circulation 132, 23052315.CrossRefGoogle Scholar
Kim, Y & Je, Y (2024) Tea consumption and risk of all-cause, cardiovascular disease, and cancer mortality: a meta-analysis of thirty-eight prospective cohort data sets. Epidemiol Health 46, e2024056.CrossRefGoogle ScholarPubMed
Yan, Y, Sui, X, Yao, B, et al. (2017) Is there a dose-response relationship between tea consumption and all-cause, CVD, and cancer mortality? J Am Coll Nutr 36, 281286.CrossRefGoogle Scholar
van den Brandt, PA (2018) Coffee or tea? A prospective cohort study on the associations of coffee and tea intake with overall and cause-specific mortality in men v. women. Eur J Epidemiol 33, 183200.CrossRefGoogle ScholarPubMed
Park, S-Y, Freedman, ND, Haiman, CA, et al. (2017) Association of coffee consumption with total and cause-specific mortality among nonwhite populations. Ann Intern Med 167, 228235.CrossRefGoogle ScholarPubMed
Shin, S, Lee, JE, Loftfield, E, et al. (2022) Coffee and tea consumption and mortality from all causes, cardiovascular disease and cancer: a pooled analysis of prospective studies from the Asia Cohort Consortium. Int J Epidemiol 51, 626640.CrossRefGoogle Scholar
Yu, C, Tang, H, Guo, Y, et al. (2018) Hot tea consumption and its interactions with alcohol consumption and tobacco smoking on risk of esophageal cancer: a population-based cohort study. Ann Intern Med 168, 489497.CrossRefGoogle ScholarPubMed
Hang, D, Kværner, AS, Ma, W, et al. (2019) Coffee consumption and plasma biomarkers of metabolic and inflammatory pathways in US health professionals. Am J Clin Nutr 109, 635647.CrossRefGoogle ScholarPubMed
Bakuradze, T, Lang, R, Hofmann, T, et al. (2015) Consumption of a dark roast coffee decreases the level of spontaneous DNA strand breaks: a randomized controlled trial. Eur J Nutr 54, 149156.CrossRefGoogle ScholarPubMed
Martínez-López, S, Sarriá, B, Mateos, R, et al. (2019) Moderate consumption of a soluble green/roasted coffee rich in caffeoylquinic acids reduces cardiovascular risk markers: results from a randomized, cross-over, controlled trial in healthy and hypercholesterolemic subjects. Eur J Nutr 58, 865878.CrossRefGoogle Scholar
Bag, S, Mondal, A, Majumder, A, et al. (2022) Tea and its phytochemicals: hidden health benefits & modulation of signaling cascade by phytochemicals. Food Chem 371, 131098.CrossRefGoogle ScholarPubMed
Hayakawa, S, Ohishi, T, Miyoshi, N, et al. (2020) Anti-cancer effects of green tea epigallocatchin-3-gallate and coffee chlorogenic acid. Molecules 25, 4553.CrossRefGoogle ScholarPubMed
Kokubo, Y, Iso, H, Saito, I, et al. (2013) The impact of green tea and coffee consumption on the reduced risk of stroke incidence in Japanese population: the Japan public health center-based study cohort. Stroke 44, 13691374.CrossRefGoogle ScholarPubMed
Marventano, S, Salomone, F, Godos, J, et al. (2016) Coffee and tea consumption in relation with non-alcoholic fatty liver and metabolic syndrome: a systematic review and meta-analysis of observational studiesClin Nutr 35, 12691281.CrossRefGoogle ScholarPubMed
van Dam, RM, Hu, FB & Willett, WC (2020) Coffee, caffeine, and health. N Engl J Med 383, 369378.CrossRefGoogle ScholarPubMed
Ruggiero, E, Di Castelnuovo, A, Costanzo, S, et al. (2021) Daily coffee drinking is associated with lower risks of cardiovascular and total mortality in a general Italian population: results from the Moli-Sani study. J Nutr 151, 395404.CrossRefGoogle Scholar
Cai, L, Ma, D, Zhang, Y, et al. (2012) The effect of coffee consumption on serum lipids: a meta-analysis of randomized controlled trials. Eur J Clin Nutr 66, 872877.CrossRefGoogle ScholarPubMed
Satija, A, Yu, E, Willett, WC, et al. (2015) Understanding nutritional epidemiology and its role in policy. Adv Nutr 6, 518.CrossRefGoogle ScholarPubMed
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