Key Practice Point
#1
Recommendation
Coffee consumption (particularly boiled coffee at intakes >3 cups/day) probably contributes to a small increase in blood lipid levels (total cholesterol, LDL-C, triglyceride levels). Consuming <3 cups/day of filtered, instant or decaffeinated coffee is recommended for individuals with dyslipidemia.
The effects of coffee consumption on cardiovascular disease (CVD) mortality are uncertain and may differ according to sex, genetic variations, smoking, adiposity, and presence of other comorbidities including hypertension.
Evidence Summary
A 2020 systematic review and meta-analysis of RCTs reported that daily coffee consumption modestly increased total cholesterol (weighted mean difference (WMD), 0.21 mmol/L), LDL-C (WMD, 0.14 mmol/L) and triglyceride levels (WMD, 0.12 mmol/L) but had no effect on HDL-C. Subgroup analysis suggested greater effects on blood lipids for boiled coffee (versus filtered, instant or decaffeinated). Dose-response analysis showed greater effects on blood lipids at intakes of 3-5 cups/ day and >6 cups/ day.
A 2023 narrative review of observational studies reported that although some evidence suggests decreased risk of CVD mortality association with moderate coffee intake (e.g. 200 to <300 mg/day), overall evidence on the efficacy and safety of caffeine intake was conflicting which may be partially attributed to demographic and clinical characteristics of individuals (including sex, genetic variations, smoking, obesity, comorbidities, and other confounding factors).
Remarks
Cafestol and kahweol are natural diterpenes extracted from coffee beans with unfiltered coffee (e.g. Turkish coffee) contributing 3-6mg/ 250 mL. In addition to potential adverse lipidemic effects, these substances have been shown to regulate inflammatory mediators to reduce inflammation thus providing potential anti-inflammatory and anti-cancer effects.
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