Confounders contributing to the reported associations of coffee or caffeine with disease

Prev Med. 1988 May;17(3):295-309. doi: 10.1016/0091-7435(88)90005-9.


The role of caffeine or coffee in causing or promoting the incidence of serious disease is equivocal. Two design factors may account for the discrepancies in reported findings on the effects of coffee drinking: (a) imprecision of measurement and (b) confounding variables. A study of 2,714 white U.S. adults disclosed that, of 32 risk factors analyzed by linear and logistic regression, only sex and cigarette smoking were found to be important potential confounders of caffeine and coffee intake. Partial R2 values of the other 30 risk factors were relatively small and were inconsistent for each sex. It is unlikely that any of these factors could explain any of the reported associations between caffeine or coffee consumption and certain diseases. However, certain weak associations with caffeine or coffee intake should be included in the study design when they are known to be risk factors of a disease under investigation. These factors for men are dietary fat intake, vitamin C intake, and body mass index; and for women are vitamin use, alcohol intake, stress, and perceived health status.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Caffeine / adverse effects*
  • Coffee / adverse effects*
  • Coronary Disease / etiology
  • Disease Susceptibility / etiology*
  • Drinking Behavior*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / etiology
  • Random Allocation
  • Research Design / standards*
  • Risk Factors
  • Self Disclosure
  • Sex Factors


  • Coffee
  • Caffeine