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Studies of genetic polymorphisms for coffee metabolism were excluded.Results The umbrella review identified 201 meta-analyses of observational research with 67 unique health outcomes and 17 meta-analyses of interventional research with nine unique outcomes.

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Conclusion Coffee consumption seems generally safe within usual levels of intake, with summary estimates indicating largest risk reduction for various health outcomes at three to four cups a day, and more likely to benefit health than harm.

Robust randomised controlled trials are needed to understand whether the observed associations are causal.

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Coffee is one of the most commonly consumed beverages worldwide.1 As such, even small individual health effects could be important on a population scale.

There have been mixed conclusions as to whether coffee consumption is beneficial or harmful to health, and this varies between outcomes.2 Roasted coffee is a complex mixture of over 1000 bioactive compounds,3 some with potentially therapeutic antioxidant, anti-inflammatory, antifibrotic, or anticancer effects that provide biological plausibility for recent epidemiological associations.

Data sources Pub Med, Embase, CINAHL, Cochrane Database of Systematic Reviews, and screening of references.

Eligibility criteria for selecting studies Meta-analyses of both observational and interventional studies that examined the associations between coffee consumption and any health outcome in any adult population in all countries and all settings.

Objectives To evaluate the existing evidence for associations between coffee consumption and multiple health outcomes.

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