Misclassification of coffee consumption data and the development of a standardised coffee unit measure

BackgroundAssociations of coffee consumption with multiple health outcomes have been researched extensively. Coffee consumption, usually reported in cups a day, is a heterogeneous measure due to numerous preparation methods and cup sizes, leading to misclassification. This paper develops a new ‘unit’ measure of coffee and uses coffee consumption data from a representative sample of the UK population to assess misclassification when cup volume and preparation type are not taken into account.MethodsA coffee unit measure was created using published estimates of caffeine and chlorogenic acid concentrations, and applied across volumes and preparation types. Four-day food diary data in adults from the UK National Diet and Nutrition Survey (NDNS; 2012–2016) were used to quantify coffee intake. Participant self-reported cups a day were compared with cups a day standardised by (a) 227 mL volume and (b) 227 mL instant coffee equivalents (unit measure), and the degree of misclassification was derived. Sensitivity analyses were conducted to model coffee drinking preferences of different populations and caffeine:chlorogenic acid weighting assumptions of the unit measure.ResultsThe NDNS sample consisted of 2832 adult participants. Coffee was consumed by 62% of participants. Types varied, with 75% of caffeinated coffee cups being instant, 17% filter, 3% latte, 2% cappuccino, 2% espresso and <1% other types. Comparing reported cups to volume-standardised cups, 84% of participants had correct classification, and 73% when using the coffee unit measure, 22% underestimated and 5% overestimated, largely by one cup. Misclassification varied by gender, age and income. Sensitivity analysis highlighted the benefits of using the unit measure over volume alone to cater for different populations, and stability of the unit composition assumption.ConclusionCup volume and preparation type should be taken into account, through the application of a standardised coffee unit measure, when coffee consumption is classified in future research studies.

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Abstract 021: C-reactive Protein Partially Mediates The Inverse Association Between Coffee Consumption And Risk Of Type 2 Diabetes: Findings From The UK Biobank And The Rotterdam Studies

Circulation ◽

10.1161/circ.143.suppl_1.021 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Carolina Ochoa-Rosales ◽

Niels van der Schaft ◽

Kim V Braun ◽

Frederick Ho ◽

Fanny Petermann ◽

...

Keyword(s):

Type 2 Diabetes ◽

Coffee Consumption ◽

Inverse Association ◽

Statistical Regression ◽

Uk Biobank ◽

C Reactive Protein ◽

Coffee Intake ◽

Reactive Protein ◽

The Uk

Background: Coffee intake has been linked to lower type 2 diabetes (T2D) risk. We hypothesized this may be mediated by coffee’s effects on inflammation. Methods: Using participants from the UK Biobank (UKB n=145370) and Rotterdam Study (RS n=7172) cohorts, we studied associations of coffee intake with incident T2D; longitudinally measured insulin resistance (HOMA IR); serum levels of inflammation markers; and the mediating role of inflammation. Statistical regression models were adjusted for sociodemographic, lifestyle and health factors. Results: The median follow up was 7 (UKB) and 9 (RS) years. An increase of one coffee cup/day was associated with 4-6% lower T2D risk (RS HR=0.94 [95% CI 0.90; 0.98]; UKB HR=0.96 [0.94; 0.98]); lower HOMA IR (RS β=-0.017 [-0.024; -0.010]); with lower C reactive protein (CRP) and higher adiponectin (Figure1). Consumers of filtered coffee had the lowest T2D risk (UKB HR=0.88 [0.83; 0.93]). CRP levels mediated 9.6% (UKB) and 3.4% (RS) of the total effect of coffee on T2D (Figure 1). Conclusions: We suggest that coffee’s beneficial effects on lower T2D risk are partially mediated by improvements in systemic inflammation.Figure 1. a CRP and a adiponectin refer to the effect of coffee intake on CRP and adiponectin levels. a CRP RS : β=-0.014 (-0.022; -0.005); UKBB a CRP UKB : β=-0.011 (-0.012; -0.009) and RS a adiponectin : β=0.025 (0.007; 0.042). b CRP and b adiponectin refer to the effect of coffee related levels in CRP and adiponectin on incident T2D, independent of coffee. RS b CRP : HR=1.17 (1.04; 1.31); UKB b CRP : HR=1.45 (1.37; 1.54); and b adiponectin : HR=0.58 (0.32; 0.83). c′ refers to coffee’ effect on T2D going directly or via others mediators. UKB c′ independent of CRP : HR=0.96 (0.94; 0.99); RS c′ independent of CRP : HR=0.94 (0.90; 0.99); and RS c′ independent of CRP+adiponectin : HR=0.90 (0.80; 1.01). Coffee related changes in CRP may partially explain the beneficial link between coffee and T2D, mediating a 3.4% (0.6; 4.8, RS) and 9.6% (5.7; 24.4, UKB). Evidence of mediation was also found for adiponectin.

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Predictors of vegetable consumption in children and adolescents: analyses of the UK National Diet and Nutrition Survey (2008–2017)

British Journal Of Nutrition ◽

10.1017/s0007114520004109 ◽

2020 ◽

pp. 1-12

Author(s):

Liam R. Chawner ◽

Pam Blundell-Birtill ◽

Marion M. Hetherington

Keyword(s):

Multilevel Models ◽

Vegetable Intake ◽

Vegetable Consumption ◽

Daily Intake ◽

Average Energy ◽

Future Research ◽

Food Groups ◽

Nutrition Survey ◽

Portion Sizes ◽

The Uk

Abstract Children’s vegetable consumption is generally below national recommendations in the UK. This study examined predictors of vegetable intake by children aged 1·5–18 years using counts and portion sizes derived from 4-d UK National Diet and Nutrition Survey food diaries. Data from 6548 children were examined using linear and logit multilevel models. Specifically, we examined whether demographic variables predicted vegetable consumption, whether environmental context influenced portion sizes of vegetables consumed and which food groups predicted the presence (or absence) of vegetables at an eating occasion (EO). Larger average daily intake of vegetables (g) was predicted by age, ethnicity, equivalised income, variety of vegetables eaten and average energy intake per d (R2 0·549). At a single EO, vegetables were consumed in larger portion sizes at home, with family members and at evening mealtimes (Conditional R2 0·308). Within EO, certain configurations of food groups such as carbohydrates and protein predicted higher odds of vegetables being present (OR 12·85, 95 % CI 9·42, 17·54), whereas foods high in fats, sugars and salt predicted a lower likelihood of vegetable presence (OR 0·03, 95 % CI 0·02, 0·04). Vegetables were rarely eaten alone without other food groups. These findings demonstrate that only one portion of vegetables was eaten per d (median) and this was consumed at a single EO, therefore falling below recommendations. Future research should investigate ways to encourage vegetable intake at times when vegetables are not regularly eaten, such as for breakfast and as snacks, whilst considering which other, potentially competing, foods are presented alongside vegetables.

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861Mendelian randomization on habitual coffee intake and plasma lipid profile: evidence from UK Biobank

International Journal of Epidemiology ◽

10.1093/ije/dyab168.759 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Ang Zhou ◽

Elina Hyppönen

Keyword(s):

Lipid Profile ◽

Plasma Lipid ◽

Coffee Consumption ◽

Plasma Lipid Profile ◽

Robust Methods ◽

Uk Biobank ◽

Cvd Risk ◽

Coffee Intake ◽

The Uk

Abstract Background Long-term heavy coffee consumption may adversely affect individuals’ cardiovascular disease (CVD) risk. As hyperlipidemia is a well-established contributor to CVD, we investigated the association between habitual coffee intake and plasma lipid profile. Methods We used data from up to 362,571 UK Biobank participants to examine associations between coffee intake and plasma lipid profiles, including LDL-C, HDL-C, total-C, triglycerides, ApoA1 and ApoB. Inverse variance weighted mendelian randomization (MR) was used to interrogate the causal nature of coffee-lipid associations, complemented by pleiotropy-robust methods, including MR-median, MR-Mode, MR-PRESSO and MR-Egger. Results We observed positive dose-dependent associations between self-reported coffee intake and plasma concentration of LDL-C, ApoB and total-C, with the highest lipid levels seen among participants drinking >6 cups/day (Plinear trend≤1.97E-57 for all). Genetic instrument for coffee intake was robustly associated with self-reported intake in the UK Biobank (F-statistic = 416). One cup increase in genetically instrumented intake was associated with 0.07 mmol/L (95%CI 0.03 to 0.12), 0.02 g/L (95%CI 0.01 to 0.03), and 0.09 mmol/L (95%CI 0.04 to 0.14) increase in LDL-C, ApoB, and total-C, respectively. Pleiotropy-robust methods provided largely consistent results albeit with greater imprecision when using MR-Egger. Conclusions Our phenotypic and genetic analysis consistently suggests that long-term heavy coffee consumption can lead to unfavourable lipid profile, which could potentially increase individuals’ risk for CVD. Individuals with elevated cholesterol may need to reduce their daily coffee intake. Key messages Our study provides evidence that long-term heavy coffee consumption can lead to unfavourable lipid profile.

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Current intakes of Interesterified fats in the UK diet and the dietary impact of their substitution with functionally equivalent alternatives

Proceedings of The Nutrition Society ◽

10.1017/s0029665120004000 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Johanna Bruce ◽

Wendy Hall ◽

Lucy Francis ◽

Charlotte Mills ◽

Sarah Berry

Keyword(s):

Low Income ◽

Research Work ◽

Palm Kernel ◽

Income Group ◽

Health Impact ◽

Future Research ◽

Fat Intake ◽

Nutrition Survey ◽

Baked Goods ◽

The Uk

AbstractInteresterified (IE) saturated-rich fats are widely used to replace partially-hydrogenated fats as hard fats with functional properties needed for spreads/margarines, baked goods, and confectionary, while avoiding the health hazards of trans fats. However, the amount of IE fat consumed and their predicted pubic health impact relative to other application-appropriate fats is unknown. We investigated current intakes of IE fats and the dietary impact of substitution of IE with functionally-equivalent replacement fats using observational data from the UK National Diet and Nutrition Survey (NDNS) (years 5–6 (2012–2014), n = 2546) and technical manufacturing data from a UK IE fat supplier. The major sources, types and quantities of IE fat intake were calculated for the total population and different age, ethnic and socioeconomic groups.IE fat contributes 3.4% of total fat and 1.1% of % total energy intake (TEI) (range 0–10.3%), with 19–64 yr old males consuming 1.1% and females 0.9% TEI from IE fats. 19–64 yr old quartiles of TEI intake were: 0.1%, 0.5%, 1.0% and 2.2%. The 65 yr + age category consumed the most IE fat (1.5% Energy), followed by 11–18 yr (1.2%) and 19–64 yr (1.0%). TEI from IE fats was 1% for high-income households, 1.1% for the middle-income group and 1.2% for the low-income group. White individuals consumed more energy from IE fat (1.2% TEI) than all other ethnic groups (0.7% TEI).The main sources of IE fats in the UK are from retail spreads (margarines); 54.2%, baked goods; 22.1%, biscuits; 7.7%, non-dairy creams; 5.9% and confectionery; 5.6%. Palmitic/lauric acid-rich IE fats, formulated from palm and palm kernel oils, account for 70% of IE fat consumed. Reformulation of the largest contributor to IE intakes (spreads) to remove IE fat, but retain the same functional characteristics, increased the saturated fatty acid (SFA) composition from 22% to 37%, 25% to 36%, 39% to 42% in three most commonly consumed spread formulations. Replacement of IE fats with non-IE alternative formulations would increase population SFA intake by 0.3% of TEI.IE fats contribute a small but important amount to the fat intake of the UK population. Removal of IE fat would result in an increase in SFA intake which may have public health implications. Previous research has not focused on the most commonly consumed IE fat blends identified (Palmitic/lauric rich), therefore a re-prioritisation of future research work is recommended to assess the potential impact of IE fats consumed by the UK population.

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Cigarette smoking increases coffee consumption: findings from a Mendelian randomisation analysis

10.1101/107037 ◽

2017 ◽

Author(s):

Johan H Bjørngaard ◽

Ask Tybjærg Nordestgaard ◽

Amy E Taylor ◽

Jorien L Treur ◽

Maiken E. Gabrielsen ◽

...

Keyword(s):

Causal Effect ◽

Coffee Consumption ◽

Cigarette Consumption ◽

Mendelian Randomisation ◽

Caffeine Intake ◽

Tea Consumption ◽

Coffee Intake ◽

General Population Study ◽

Weak Evidence ◽

The Uk

AbstractBackgroundSmokers tend to consume more coffee than non-smokers and there is evidence for a positive relationship between cigarette and coffee consumption in smokers. Cigarette smoke increases the metabolism of caffeine, so this association may represent a causal effect of smoking on caffeine intake.MethodsWe performed a Mendelian randomisation analysis in 114,029 individuals from the UK Biobank, 56,664 from the Norwegian HUNT study and 78,650 from the Copenhagen General Population Study. We used a genetic variant in the CHRNA5 nicotinic receptor (rs16969968) as a proxy for smoking heaviness. Coffee and tea consumption were self-reported. Analyses were conducted using linear regression and meta-analysed across studies.ResultsEach additional cigarette per day consumed by current smokers was associated with higher coffee consumption (0.10 cups per day, 95% CI:0.03,0.17). There was weak evidence for an increase in tea consumption per additional cigarette smoked per day (0.04 cups per day, 95% CI:-0.002,0.07). There was strong evidence that each additional copy of the minor allele of rs16969968 (which increases daily cigarette consumption) in current smokers was associated with higher coffee consumption (0.15 cups per day, 95% CI:0.11,0.20), but only weak evidence for an association with tea consumption (0.04 cups per day, 95% CI:- 0.01,0.09). There was no clear evidence that rs16969968 was associated with coffee or tea consumption in never or former smokers.ConclusionThese findings suggest that higher cigarette consumption causally increases coffee intake. This is consistent with faster metabolism of caffeine by smokers, but may also reflect behavioural links between smoking and coffee.

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Free and Added Sugar Consumption and Adherence to Guidelines: The UK National Diet and Nutrition Survey (2014/15–2015/16)

Nutrients ◽

10.3390/nu12020393 ◽

2020 ◽

Vol 12 (2) ◽

pp. 393 ◽

Cited By ~ 6

Author(s):

Birdem Amoutzopoulos ◽

Toni Steer ◽

Caireen Roberts ◽

David Collins ◽

Polly Page

Keyword(s):

Public Health ◽

Dietary Intake ◽

Free Sugar ◽

Food Diary ◽

Nutrition Survey ◽

Added Sugar ◽

Free Sugars ◽

Sugar Intake ◽

The Uk ◽

The Impact

Monitoring dietary intake of sugars in the population’s diet has great importance in evaluating the efficiency of national sugar reduction programmes. The study objective was to provide a comprehensive assessment of dietary sources of added and free sugars to assess adherence to public health recommendations in the UK population and to consider the impact of different sugar definitions on monitoring. The terms “added sugar” and “free sugar” are different sugar definitions which include different sugar components and may result in different sugar intakes depending on the definition. Dietary intake of added sugars, free sugars and seven individual sugar components (sugar from table sugar; other sugars; honey; fruit juice; fruit puree; dried fruit; and stewed fruit) of 2138 males and females (1.5–64 years) from the National Diet and Nutrition Survey (NDNS) 2014–2016, collected using a 4 day estimated food diary, were studied. Added and free sugar intake accounted for 7% to 13% of total energy intake respectively. Major sources of free sugar intake were “cereals and cereal products”, “non-alcoholic beverages”, and “sugars, preserves, confectionery”. Differences between added and free sugar intake were significantly large, and thus use of free sugar versus added sugar definitions need careful consideration for standardised monitoring of sugar intake in relation to public health.

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Long-term coffee consumption, caffeine metabolism genetics, and risk of cardiovascular disease: a prospective analysis of up to 347,077 individuals and 8368 cases

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqy297 ◽

2019 ◽

Vol 109 (3) ◽

pp. 509-516 ◽

Cited By ~ 17

Author(s):

Ang Zhou ◽

Elina Hyppönen

Keyword(s):

Cardiovascular Disease ◽

Coffee Consumption ◽

Cvd Risk ◽

Coffee Intake ◽

Genetic Score ◽

Increased Risk ◽

Decaffeinated Coffee ◽

Caffeine Metabolism ◽

The Uk ◽

Cyp1a2 Genotype

ABSTRACT Background Coffee is one of the most widely consumed stimulants worldwide and is generally considered to be safe or even beneficial for health. However, increased risk of myocardial infarction and hypertension has been suggested for individuals who carry a functional variant at cytochrome P450 1A2 (CYP1A2), which makes them less effective at metabolizing caffeine. Objectives The aim of this study was to examine if the CYP1A2 genotype or a genetic score for caffeine metabolism (caffeine-GS) modifies the association between habitual coffee consumption and the risk of cardiovascular disease (CVD). Methods Genetic data and information on habitual coffee intake and relevant covariates were available for 347,077 individuals in the UK Biobank, including 8368 incident CVD cases. We used logistic regression to test for the association between coffee intake and CVD risk, and whether the association varies with CYP1A2 genotype or caffeine-GS. Results The association between habitual coffee intake and CVD risk was nonlinear, and, compared with participants drinking 1–2 cups/day, the risk of CVD was elevated for nondrinkers, drinkers of decaffeinated coffee, and those who reported drinking >6 cups/day (increase in odds by 11%, 7%, and 22%, respectively, P-curvature = 0.013). CYP1A2 genotype and caffeine-GS were not associated with CVD (P ≥ 0.22 for all comparisons). There was no evidence for an interaction between the CYP1A2 genotype or caffeine-GS and coffee intake with respect to risk of CVD (P ≥ 0.53). Conclusions Heavy coffee consumption was associated with a modest increase in CVD risk, but this association was unaffected by genetic variants influencing caffeine metabolism.

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Breakfast Consumption in the UK: Patterns, Nutrient Intake and Diet Quality. A Study from the International Breakfast Research Initiative Group

Nutrients ◽

10.3390/nu10080999 ◽

2018 ◽

Vol 10 (8) ◽

pp. 999 ◽

Cited By ~ 19

Author(s):

Szilvia Gaal ◽

Maeve A. Kerr ◽

Mary Ward ◽

Helene McNulty ◽

M. Barbara E. Livingstone

Keyword(s):

Diet Quality ◽

Age Groups ◽

Food Group ◽

Food Diary ◽

Nutrition Survey ◽

Breakfast Consumption ◽

Total Fat ◽

Daily Intakes ◽

Calcium Iron ◽

The Uk

Breakfast consumption is associated with higher overall dietary adequacy; however, there is a lack of quantitative guidelines for optimal nutrient intakes at breakfast in the UK. This study aimed to investigate nutrient and food group intakes at breakfast and examine their relationship to overall Diet Quality (DQ). Data from the most recent National Diet and Nutrition Survey (NDNS, 2008–2014) were accessed to provide a representative sample (n = 8174) of the UK population, aged 5–96 years, mean age of 33 years. Food intake was measured by a 4-day estimated food diary and DQ was assessed by the Nutrient Rich Food Index 9.3 method. Energy- and socio-economic-adjusted nutrient and food group intakes were compared across age groups and DQ tertiles by ANCOVA. Breakfast contributed 20–22% to total energy intake. Breakfast intakes of carbohydrate and non-milk extrinsic sugars (NMES) were higher, and intakes of protein, total fat and saturated fatty acid (SFA) were lower, than relative daily intakes. Breakfast was particularly rich in B vitamins, vitamin D, calcium, iron, iodine and magnesium. From the lowest to the highest DQ tertile decreasing intakes of NMES, SFA and total fat and increasing intakes of carbohydrate, protein, fibre and most micronutrients were found. These findings could help to inform the development of nutrient-based recommendations for a balanced breakfast for the first time in the UK.

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Association of daily coffee consumption with cardiovascular health – results from the UK Biobank

European Heart Journal ◽

10.1093/eurheartj/ehab724.2416 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

J Simon ◽

K Fung ◽

Z Raisi-Estabragh ◽

N Aung ◽

M Y Khanji ◽

...

Keyword(s):

Regression Models ◽

Cox Regression ◽

Multivariable Analysis ◽

Coffee Consumption ◽

Uk Biobank ◽

Coffee Intake ◽

Stroke Incidence ◽

Age Related ◽

Lv Mass ◽

The Uk

Abstract Background There are conflicting reports on the association of coffee consumption with cardiovascular (CV) health. The UK Biobank is a prospective cohort study including data for half a million middle-aged individuals. Purpose We studied the association of daily coffee consumption with all-cause and CV mortality, and incidence of the major CV diseases in the UK Biobank. In a subgroup of participants who underwent cardiovascular magnetic resonance (CMR), we evaluated the association between regular coffee intake and cardiac structure and function parameters. Methods UK Biobank cohort of participants without clinically manifested heart disease at the time of recruitment were included. Regular coffee intake was categorized into 3 groups: zero, light-to-moderate (0.5–3 cups/day) and high (>3 cups/day) coffee drinkers. We estimated association of daily coffee consumption with incident outcomes using multivariable Cox-regression models (median follow-up of 11 years) and, in the subset with CMR data, with left and right ventricular (LV, RV) end-systolic and end-diastolic volumes, LV mass, and LV/RV stroke volume using multivariable linear regression. Models were adjusted for potential confounders and mediators, including: age, sex, non-European ethnicities, body mass index, smoking, physical activity, Townsend deprivation index, alcohol, meat, fruit and vegetable intake, hypertension, diabetes mellitus, and cholesterol level. Results We included 468,629 individuals (mean age 56.2±8.1 years, 44.2% male). Among them, 22.1% did not consume coffee on a regular basis, 58.4% had 0.5–3 cups per day and 19.5% had >3 cups per day. After adjustment for potential confounders and mediators, compared to non-coffee drinkers, light-to-moderate coffee drinking was associated with lower risk of all-cause mortality (HR=0.88, p<0.001), CV mortality (HR=0.83, p=0.006), and incident stroke (HR=0.79; p=0.037). CMR data were available in 30,650 participants. In multivariable analysis, compared to non-coffee drinkers, both the light-to-moderate and high coffee consuming categories, were associated with significantly increased LV and RV ventricular end-systolic (β=0.91 and 1.64 for LV and 1.10 and 1.72 for RV), end-diastolic (β=2.21 and 3.28 for LV and 2.24 and 3.35 for RV) and stroke volumes (β=1.31 and 1.64 for LV and 1.15 and 1.63 for RV), as well as greater LV mass (β=0.78 and 1.64; all p<0.001). Conclusion In this large study of the UK Biobank population, regular coffee consumption of up to 3 cups per day was associated with favorable cardiovascular outcomes, in particular, decreased all-cause and CV mortality and stroke incidence. Regular coffee consumption was also associated with a pattern of CMR metrics in keeping with the reverse of age-related cardiac alterations. FUNDunding Acknowledgement Type of funding sources: None.

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A Daily Cup of Tea or Coffee May Keep You Moving: Association between Tea and Coffee Consumption and Physical Activity

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15091812 ◽

2018 ◽

Vol 15 (9) ◽

pp. 1812 ◽

Cited By ~ 3

Author(s):

Luciana Torquati ◽

Geeske Peeters ◽

Wendy Brown ◽

Tina Skinner

Keyword(s):

Physical Activity ◽

Regression Models ◽

Coffee Consumption ◽

Future Research ◽

Caffeine Intake ◽

Middle Aged ◽

Coffee Intake ◽

Metabolic Equivalent ◽

Major Barrier ◽

Logistic Regression Models

Physical activity (PA) is an independent predictor of mortality and frailty in middle-aged women, but fatigue remains a major barrier in this group. While caffeine intake has been associated with reduced exertion and perceived fatigue, it is not well understood whether consumption of naturally caffeinated drinks is associated with physical activity. The aim of this study was to determine whether habitual consumption of coffee and tea is associated with participation in physical activity. Women (n = 7580) from the Australian Longitudinal Study on Women’s Health were included in this investigation. Participants reported average tea and coffee intake over the last 12 months and usual PA. Logistic regression models were adjusted for relevant health and lifestyle confounders, and Sobel test was used for mediation analysis. Participants who consumed 1–2 cups of coffee/day were 17% more likely to meet the recommended 500 metabolic equivalent (MET).min/week than women who had <1 cup/day (odds ratio (OR) 1.17, 95% confidence interval (CI) 1.04–1.32). Participants who reported drinking either 1–2 cups or >3 cups/day of tea were 13–26% more likely to meet 500 MET.min/week than those who had <1 cup/day (OR 1.26, 95% CI 1.08–1.46 and OR 1.13, 95% CI 1.01–1.26, respectively). Tiredness and energy mediated associations between intake of coffee (fully) and tea (partially) and PA. Middle-aged women who drink 1–2 cups of coffee or >1 cup of tea/day are more likely to meet the moderate-to-vigorous PA guidelines than those who drink <1 cup/day. Future research is warranted to investigate causality and effects of specific coffee and tea amounts.

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