Coffee Consumption and Risk of Type 2 Diabetes Mellitus Among Middle-aged Finnish Men and Women

Tuomilehto, Jaakko; Hu, Gang; Bidel, Siamak; Lindström, Jaana; Jousilahti, Pekka

doi:10.1001/jama.291.10.1213

Cited by 242 publications

(205 citation statements)

References 41 publications

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“…The main limitation of the interpretation of the results is the small number of subjects, especially in the analyses including only those who had NGT in the baseline OGTTs in 1991-1992. Still, the results obtained in both analyses showed a similar trend, and they were also parallel to those of some recent studies with larger populations of middle-aged subjects (Van Dam and Feskens, 2002;Agardh et al, 2004;Salazar-Martinez et al, 2004;Tuomilehto et al, 2004). There were no data available on the duration of coffee drinking in the present study, but in view of the fact that the subjects were already aged 70-92 years at baseline, by which age individual health behaviour habits have been quite firmly established for decades, it can be assumed that their coffee consumption had also been long term and constant for many years.…”

Section: Discussionsupporting

confidence: 88%

“…In addition, especially in Finland, coffee has been a very widely used beverage among all age groups for tens of decades. The follow-up period between the two OGTT examinations was clearly shorter in the present study than in some of the recent studies (Salazar-Martinez et al, 2004;Tuomilehto et al, 2004), which was due to practical reasons, particularly the high age of the participants already at baseline The possibility of memory bias is very small as to the immediate months and years before the examination, but may be bigger for earlier years and decades. Thus, although there are some limitations in the present study, it offers, instead of mere cross-sectional associations (Agardh et al, 2004), also a possibility for risk factor evaluation among the oldest old age groups, who have usually not been included in the recent large studies on this topic (Van Dam and Feskens, 2002;Agardh et al, 2004).…”

Section: Discussioncontrasting

confidence: 66%

“…Thus, although there are some limitations in the present study, it offers, instead of mere cross-sectional associations (Agardh et al, 2004), also a possibility for risk factor evaluation among the oldest old age groups, who have usually not been included in the recent large studies on this topic (Van Dam and Feskens, 2002;Agardh et al, 2004). In addition to the Dutch study in 2002 (Van Dam and Feskens, 2002), both the recent large Swedish cross-sectional population-based study among 7949 subjects aged 35-56 years and the prospective Nurses' Health Study and Health Professionals' Health Study as well as the Finnish study by Tuomilehto et al (2004) showed associations between low coffee consumption and AGT (Agardh et al, 2004;Salazar-Martinez et al, 2004). After adjustment for age, BMI and other risk factors, there was an independent association between high coffee consumption and AGT in all of the above-mentioned large studies.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have shown a high level of coffee consumption to be associated with or to predict a decreased incidence of impaired glucose tolerance (IGT) and type II DM among middle-aged and early old-aged populations (Van Dam and Feskens, 2002;Agardh et al, 2004;Salazar-Martinez et al, 2004;Tuomilehto et al, 2004). There are no similar studies focusing exclusively on people who are already elderly at the beginning of the follow-up.…”

Section: Introductionmentioning

confidence: 99%

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Are there associations between coffee consumption and glucose tolerance in elderly subjects?

Hiltunen

2006

Eur J Clin Nutr

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Objective: To describe the associations between coffee consumption and glucose tolerance among elderly subjects. Design: A survey among an unselected non-institutionalized elderly population. Diabetes was assessed on the basis of selfreports and 2-h oral glucose tolerance test for the subjects on diet treatment or with normal glucose tolerance (NGT). Coffee consumption was assessed by a questionnaire. Setting: Three municipalities in Northern Finland Subjects: All non-institutionalized subjects with baseline normal glucose tolerance or impaired glucose tolerance (IGT) aged 70 years or over. Main outcome measures: Incidence, persistence or impairment of abnormal glucose tolerance (AGT). Results: Forty-two percent of those with NGT and 0-5 cups of coffee daily developed AGT, whereas the corresponding figure was 25% for those who drank more than five cups coffee daily. Fifty-five percent of the subjects with IGT or NGT who drank 0-5 cups coffee daily either persisted in IGT or developed AGT. The corresponding figure was 30% for those drinking more than five cups coffee daily. After adjustment for age, body mass index, cardiovascular disease, smoking, alcohol consumption and physical exercise, among those with NGT, the odds ratio (OR) for developing AGT was 2.3 for those drinking 0-5 cups compared to those drinking more than five cups of coffee daily (95% confidence interval (CI) 0.7-7.2). Correspondingly, low coffee consumption was the most powerful predictor associated with the persistence of IGT or the development of AGT (OR 2.9; 95% CI 1.2-6.9). Conclusions: Low coffee consumption predicts impairment of AGT or persistence of IGT among elderly subjects.

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Section: Discussionsupporting

confidence: 88%

Section: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Are there associations between coffee consumption and glucose tolerance in elderly subjects?

Hiltunen

2006

Eur J Clin Nutr

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“…Some, [4][5][6][7][8] but not all 9,10 previous studies have found a protective effect from coffee or tea. However, the causal mechanism has not been identified.…”

Section: Introductionmentioning

confidence: 88%

Coffee, tea and diabetes: the role of weight loss and caffeine

et al. 2005

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OBJECTIVE:To assess the effect of weight change on the relationship between coffee and tea consumption and diabetes risk. DESIGN: Prospective cohort study, using data from the First National Health and Nutrition Examination Survey Epidemiologic Follow Up Study. Survival analyses were conducted using 301 selfreported cases of diabetes and eight documented diabetes deaths during an 8.4-y follow-up. SUBJECTS: A total of 7006 subjects aged 32-88 y with no reported history of diabetes were included in the study. RESULTS: For all subjects combined, increases in consumption of ground-caffeinated coffee and caffeine at baseline were followed by decreases in diabetes risk during follow-up. There were significant statistical interactions between age and consumption of caffeine (P ¼ 0.02) and ground-caffeinated coffee (P ¼ 0.03). Age-stratified analysis showed that the decrease in diabetes risk only applied to r60-y-old subjects, for whom the decrease in diabetes risk also obtained for ground-decaffeinated coffee and regular tea. The multivariate hazard ratio (HR) and 95% confidence interval for a 2 cups/day increment in the intake of ground-caffeinated coffee, ground-decaffeinated coffee and regular tea was 0.86 (0.75-0.99), 0.58 (0.34-0.99) and 0.77 (0.59-1.00), respectively. The diabetes risk was negatively related to the consumption in a dose-response manner. There were strong statistical interactions between prior weight change and beverage consumption for r60-y-old subjects. Further analysis revealed that the decrease in diabetes risk only applied to those who had lost weight, and that there was a positive doseresponse relationship between diabetes risk and weight change. For example, the multivariate HR and 95% confidence interval for 40 vs 0 cups/day of ground-decaffeinated coffee was 0.17 (0.04-0.74), 0.52 (0.19-1.42), 0.77 (0.30-1.96) and 0.91 (0.39-2.14) for subgroups with weight change of r0, 0-10, 10-20 and 420 lbs, respectively. There was no significant association between diabetes risk and consumption of instant-caffeinated coffee, instant-decaffeinated coffee or herbal tea. Caffeine intake appeared to explain some, but not all, of the diabetes-risk reduction and weight change. CONCLUSION: The negative relationship between diabetes risk and consumption of ground coffee and regular tea, observed for all NHEFS subjects, actually only applied to nonelderly adults who had previously lost weight.

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