Horizonte Médico · Aug 24, 2026

Coffee consumption and human health: a narrative review with implications for Latin American family medicine

By Leon JST

Coffee is the second most consumed beverage worldwide after water, with global production exceeding 170 million 60 kg bags annually. In Latin America, which accounts for more than 60% of global production, coffee is not only a strategic export product but also an element deeply rooted in everyday culture and primary care clinical practice. This reality makes coffee one of the most frequent topics in consultations with Latin American family physicians, who face daily questions about its safety in patients with arterial hypertension, diabetes mellitus, heart failure, osteoporosis, and polypharmacy, in many cases without an up-to-date and contextualized reference framework. The available scientific evidence on coffee has undergone a substantial transformation over the last two decades. Mendelian randomization studies, umbrella meta-analyses, and large-scale prospective cohorts have reversed the historical perception of coffee as a cardiovascular risk factor. Today, moderate coffee consumption―operationally defined as three to five cups daily, equivalent to approximately 400 mg of caffeine―is associated with statistically significant and clinically relevant reductions in all-cause mortality (RR: 0.85; IC 95%: 0.82-0.89), cardiovascular mortality (RR: 0.81; IC 95%: 0.74-0.89), and the risk of incident type 2 diabetes mellitus (RR: 0.67; IC 95%: 0.61-0.74 for the highest consumption relative to the lowest). These effects extend to neuroprotection against Parkinson's disease and Alzheimer-type dementia, reduced risk of liver cirrhosis (RR: 0.56) and hepatocellular carcinoma (RR: 0.50-0.60), and decreased risk of major depression and stroke. The biological mechanisms underlying these effects involve multiple bioactive compounds beyond caffeine: chlorogenic acids exert antioxidant activity and modulate hepatic gluconeogenesis, diterpenes―such as cafestol and kahweol―show anticarcinogenic properties, trigonelline has neuroprotective and antidiabetic effects, and melanoidins and total polyphenols modulate the gut microbiota and reduce systemic oxidative stress. From a pharmacological perspective, coffee has clinically relevant interactions with lithium, theophylline, fluoroquinolones, clozapine, oral anticoagulants, hormonal contraceptives, and iron supplements, and knowledge of these interactions is essential for family physicians caring for patients taking multiple medications. Polymorphism of the CYP1A2 gene, which determines the rate of caffeine metabolism, introduces individual variability that explains differences in the cardiovascular response to coffee and has specific implications for patients with arterial hypertension or a risk of arrhythmias. This narrative review aims to synthesize the most up-to-date scientific evidence on the effects of coffee on human health, with an emphasis on practical clinical implications for family physicians practicing in the Latin American context, where coffee is part of the cultural, social, and dietary patterns of the population they care for daily.

doi.org/10.24265/horizmed.2026.v26n3.12 Open access Interventions