Caffeine and health(3) - Family Health

This is probably the first study to show any relationship between coffee consumption and stroke. It is well done, and long-term, and discusses elegantly the methodological issues, especially the difficulty of disentangling coffee and cigarette smoking, as both are highly positively related one to the other.

Overall comment

These three studies show us how careful we need to be in giving advice about lifestyle. It's a bit like Heisenberg's uncertainty principle - if you see it, it's not there any more. With lifestyle advice, any change for the good in one direction may be a change for the bad in another.

For coffee and men with hypertension, stopping drinking it may reduce the chance of a stroke, but increase the risk of colorectal cancer. Difficult, isn't it? But for pregnant women the evidence seems strong - limiting caffeine consumption will reduce the chance of a spontaneous abortion and a low birthweight infant.

References:

O Fernandes, M Sabharwal, T Smiley et al. Moderate to heavy caffeine consumption during pregnancy and relationship to spontaneous abortion and abnormal fetal growth: a meta-analysis. Reproductive Toxicology 1998 12: 435-44.
E Giovannucci. Meta-analysis of coffee consumption and risk of colorectal cancer. American Journal of Epidemiology 1998 147: 1043-52.
AA Hakim, GW Ross, JD Curb et al. Coffee consumption in hypertensive men in older middle-age and the risk of stroke: the Honolulu heart program. Journal of Clinical Epidemiology 1998 51: 487-94.

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