A large-scale analysis showed that drinking unsweetened coffee was associated with a lower risk of developing cardiovascular disease (CVD). The same protective association was not observed among people who took their coffee with sugar or artificial sweeteners.
According to a new paper from researchers at four Chinese universities published in Nutrition, Metabolism and Cardiovascular Diseases, the strongest protective effects were observed among people who drank 2-3 cups of unsweetened coffee per day. That group was 15% less likely to develop cardiovascular disease than the zero-coffee group.
The association was U-shaped, with higher and lower intakes showing smaller risk reductions or no clear benefit.
Additionally, there was no significant association among people who drank coffee with sugar or artificial sweeteners.
“Most existing studies have focused on the general relationship between coffee consumption and CVD without distinguishing between coffee with added sugars or sweeteners,” the authors wrote. “In real life, coffee is often sweetened with sugars or artificial sweeteners for flavor enhancement, which may reduce its health effects.”
The authors said the protective effect of unsweetened coffee extended across multiple CVD subtypes, including coronary artery disease, stroke, heart failure and atrial fibrillation (a-fib). On the latter, one major recent study found that coffee may also have a protective effect against a-fib.
The authors of the new study drew from UK Biobank data, involving a sample of 173,614 participants. About three-quarters (131,247) reported drinking coffee, and among the overall group, unsweetened coffee was the most common pattern (55.6%), followed by sugar-sweetened (14.1%) and artificially sweetened coffee (5.9%). Among sugar-sweetened coffee drinkers, participants added an average of 1.1 teaspoons of sugar.
The study reinforces the notion that additives matter in coffee’s relationship to health. In one example, a 2023 Harvard-led analysis found that increases in unsweetened coffee intake were linked with slightly less weight gain over time, while adding sugar was associated with more weight gain.
A major 2025 study found that coffee’s potential protective effects against type 2 diabetes were weaker when sugar or sweeteners were added.
In a U.S. NHANES-based study last year, researchers found that coffee’s ability to fend off death from any cause was weakened by heavily added sugar and saturated fat.
The paper, “Association of unsweetened and sweetened coffee consumption with risk of cardiovascular disease: a prospective cohort study,” involved funding from the Shenzhen Foundation for Basic and General Research. The authors did not disclose any conflicts of interest.
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