Acute Effects of Coffee Consumption on Health among Ambulatory Adults

Abstract

Background: Coffee is one of the most commonly consumed beverages in the world, but the acute health effects of coffee consumption remain uncertain.

Methods: We conducted a prospective, randomized, case-crossover trial to examine the effects of caffeinated coffee on cardiac ectopy and arrhythmias, daily step counts, sleep minutes, and serum glucose levels. A total of 100 adults were fitted with a continuously recording electrocardiogram device, a wrist-worn accelerometer, and a continuous glucose monitor. Participants downloaded a smartphone application to collect geolocation data. We used daily text messages, sent over a period of 14 days, to randomly instruct participants to consume caffeinated coffee or avoid caffeine. The primary outcome was the mean number of daily premature atrial contractions. Adherence to the randomization assignment was assessed with the use of real-time indicators recorded by the participants, daily surveys, reimbursements for date-stamped receipts for coffee purchases, and virtual monitoring (geofencing) of coffee-shop visits.

Results: The mean (±SD) age of the participants was 39±13 years; 51% were women, and 51% were non-Hispanic White. Adherence to the random assignments was assessed to be high. The consumption of caffeinated coffee was associated with 58 daily premature atrial contractions as compared with 53 daily events on days when caffeine was avoided (rate ratio, 1.09; 95% confidence interval [CI], 0.98 to 1.20; P = 0.10). The consumption of caffeinated coffee as compared with no caffeine consumption was associated with 154 and 102 daily premature ventricular contractions, respectively (rate ratio, 1.51; 95% CI, 1.18 to 1.94); 10,646 and 9665 daily steps (mean difference, 1058; 95% CI, 441 to 1675); 397 and 432 minutes of nightly sleep (mean difference, 36; 95% CI, 25 to 47); and serum glucose levels of 95 mg per deciliter and 96 mg per deciliter (mean difference, -0.41; 95% CI, -5.42 to 4.60).

Conclusions: In this randomized trial, the consumption of caffeinated coffee did not result in significantly more daily premature atrial contractions than the avoidance of caffeine. (Funded by the University of California, San Francisco, and the National Institutes of Health; CRAVE ClinicalTrials.gov number, NCT03671759.).

Figure 1.. Daily Step Count for Each Participant on Days of Coffee Consumption and Days of Caffeine Avoidance.

The x axis shows the mean daily step count for each participant for all days on which the participant was randomly assigned to avoid caffeine (blue) or to consume coffee (orange). Data for each participant are grouped in pairs and ordered according to the magnitude of the participants’ step counts on days they were randomly assigned to avoid caffeine. The vertical black bars indicate standard deviations. Step-count data were available for 86 of the 100 participants.

Figure 2.. Minutes Asleep for Each Participant after Coffee Consumption and Caffeine Avoidance.

The x axis shows the mean number of minutes of sleep for each participant after all days on which the participant was randomly assigned to avoid caffeine (blue) and to consume coffee (orange). Data for each participant are grouped in pairs and ordered according to the magnitude of the time participants were asleep on days on which they were randomly assigned to consume coffee. The vertical black bars indicate standard deviations. Sleep data were available for 81 of the 100 participants.