Given that coffee is such a common drink worldwide, many questions have arisen on the topic of maximizing its benefits. This study provided some clarification that a small amount of cream and sugar did not substantially affect the associations between coffee and reduced mortality risks.

What do other studies say about coffee additives and mortality risks?

Three other studies have explored coffee additives. Overall, the associations between coffee with additives and mortality were inconsistent, and when these associations were present, the mortality risk reductions were often smaller than those for black coffee.^[3]^[4]^[5]

For example, in one study, coffee drinkers who had 2 to 3 cups per day (there were no associations for smaller amounts of coffee) had a 16% lower risk of all-cause mortality when the coffee was black and a 12% to 22% lower risk when the coffee contained low-fat milk or other milks (e.g., rice or soy), but not when the coffee contained cream/whole milk, nondairy creamer, sugar/honey, or sugar-free sweetener.^[5] This study had the advantage of examining more varieties of coffee additives.

However, unlike the summarized study, the 3 coffee additive studies did not analyze whether higher or lower amounts of additives changed the mortality associations.

The root of the problem?

The root of the problem could be the type of calories in the additives because added sugar and saturated fat can adversely affect CVD risk factors. As covered in a previous study summary, added sugar can promote insulin resistance and saturated fat can increase LDL.

The summarized study also contributed evidence for other common questions regarding coffee.

How much coffee?

Similar to what was observed in this study, mortality risk reductions have generally been the largest in other studies of coffee drinkers who consumed moderate-to-high amounts (2 to 4 cups per day) of coffee.^[1]^[6]^[7]^[2]^[8]^[9]^[10]^[11]^[12]

What is the typical size of the mortality risk reductions with coffee? Compared to the summarized study, the sizes of the mortality risk reductions have been similar or smaller; a 2017 umbrella review of meta-analyses found that drinking 3 cups of coffee per day was associated with a 17% lower risk of all-cause mortality and a 19% lower risk of CVD mortality.^[12]

Is coffee associated with a lower risk of cancer?

The summarized study did not find any association between coffee drinking and cancer mortality risk; however, cancer mortality risk was associated with a reduction in cancer mortality risk in 3 of 6 other similar studies.^[6]^[2]^[8]^[9]^[10]^[11]

Decaffeinated coffee and mortality risk

The finding in the summarized study that decaffeinated coffee was not associated with reduced mortality risk is not consistent with the findings of other studies; for example, there were reductions in mortality risk in 9 of 10 other studies,^[6]^[7]^[10]^[2]^[11]^[1]^[4]^[3]^[5] including a study covered in a previous Editor’s Pick.

Coffee, but hold the cream and sugar? Additives reduce coffee’s positive associations with mortality risk Original paper