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Michael F. Leitzmann, M.D., and colleagues from the Harvard School of Public Health in Boston, followed 46,008 men enrolled in the Health Professionals Follow-Up Study.

The study participants were dentists, veterinarians, optometrists, osteopathic physicians and podiatrists, who ranged in age from 40 to 75 and were without a history of gallstone disease. The researchers wanted to examine the association between coffee consumption and the risk of symptomatic gallstone disease.

Coffee has several metabolic effects that could reduce the risk of gallstone formation, but previous epidemiological studies have offered conflicting results.

The researchers found that men who drank regular coffee—filtered, instant or espresso—had a lower risk of gallstone disease.

“In this large prospective cohort study among men, we found a strong inverse association between consumption of regular coffee and risk of symptomatic gallstone disease,” they write. “All brewing methods showed a decreased risk.”

Men who drank two to three cups of regular coffee per day had a 40 percent lower risk of developing gallstone disease than men who did not drink regular coffee; men who drank four or more cups of regular coffee per day had a 45 percent lower risk.

The men were followed for 10 years. During the follow-up period, the researchers documented 1,081 cases of self-reported symptomatic gallstone disease. Surgery to remove the gall bladder was required in 885 cases. Higher intakes of caffeine were associated with a decreasing risk of gallstone disease, with the lowest risk found among men who drank four or more cups per day.

“The inverse association between coffee intake and gallstone disease may be due specifically to the effect of caffeine,” the authors write. There was no significant association between the consumption of tea, decaffeinated coffee, or low-calorie caffeinated soft drinks. “The lack of association we observed with decaffeinated coffee and tea may be due to the low amount of caffeine in these beverages in our study population,” the authors write. “Men drinking four or more cups of decaffeinated coffee per day consumed only 140 milligrams/day of caffeine from all sources (approximately equivalent to one cup of regular coffee), and tea usually contains less than half the caffeine of regular coffee.”

According to information cited by the authors, gallstone disease affects more than 20 million Americans. It causes 800,000 hospitalizations each year, at a direct cost of more than $2 billion.

“The fact that symptomatic gallstones are associated with considerable morbidity and are currently the most common digestive-related cause of hospitalization in the United States underscores the significant implications of these findings for health-related quality of life and the use of health care resources,” the authors write.

“Further studies are needed to evaluate the apparent benefits of coffee consumption for preventing gallstone disease and to assess the potential therapeutic effects of coffee and individual coffee components on gallstone disease,” they conclude. “Because the overall effect of coffee intake on health may vary considerably according to acute or chronic consumption, level of intake, source and type of coffee, methods of roasting and preparation of the brew, and the development of tolerance, clinical recommendations on coffee consumption should be based on the patients' individual health risks and benefits.”