Coffee, tea and caffeine consumption in relation to osteoporotic fracture risk in a cohort of Swedish women

Department of Toxicology, National Food Administration, P. O. Box 622, 75126 Uppsala, Sweden.
Osteoporosis International (Impact Factor: 4.17). 06/2006; 17(7):1055-64. DOI: 10.1007/s00198-006-0109-y
Source: PubMed


Consumption of coffee and tea, and total intake of caffeine has been claimed to be associated with osteoporotic fracture risk. However, results of earlier studies lack consistency.
We examined this relation in a cohort of 31,527 Swedish women aged 40-76 years at baseline in 1988. The consumption of coffee, caffeinated tea and the intake of caffeine were estimated from a self-administered food frequency questionnaire (FFQ). Multivariate-adjusted hazards ratios (HRs) of fractures with 95% confidence intervals (95% CIs) were estimated by Cox proportional hazards models.
During a mean follow-up of 10.3 years, we observed 3,279 cases with osteoporotic fractures. The highest (>330 mg/day) compared with the lowest (<200 mg/day) quintile of caffeine intake was associated with a modestly increased risk of fracture: HR 1.20 (95% CI: 1.07-1.35). A high coffee consumption significantly increased the risk of fracture (p for trend 0.002), whereas tea drinking was not associated with risk. The increased risk of fracture with both a high caffeine intake and coffee consumption was confined to women with a low calcium intake (<700 mg/day): HR 1.33 (95% CI: 1.07-1.65) with > or =4 cups (600 ml)/day of coffee compared to <1 cup (150 ml)/day. The same comparison but risk estimated for women with a high propensity for fractures (> or =2 fracture types) revealed a HR of 1.88 (95% CI: 1.17-3.00).
In conclusion, our results indicate that a daily intake of 330 mg of caffeine, equivalent to 4 cups (600 ml) of coffee, or more may be associated with a modestly increased risk of osteoporotic fractures, especially in women with a low intake of calcium.

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Available from: Helena Hallström,
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    • "Estimated average Korean coffee consumption is about 1.28 cups per day, which is the equivalent of approximately 180 mg of caffeine daily.3) Recently, several investigators have reported that the consumption of coffee is associated with low bone density and osteoporotic fracture.4) Osteoporotic fractures are associated with morbidity and mortality, increasing health costs, and decreased quality of life. "
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    ABSTRACT: Although Asian people are known to have lower bone mass than that of Caucasians, little is known about coffee-associated bone health in Asian. This study aimed to assess the relationship between coffee consumption and bone mineral density (BMD) in Korean premenopausal women. Data were obtained from the Fourth Korea National Health and Nutrition Examination Survey 2008-2009. The study population consisted of 1,761 Korean premenopausal women (mean age 36 years) who were measured for lumbar spine and femoral neck BMD and who completed a standardized questionnaire about coffee intake frequency. We excluded the participants who took hormone replacement therapy or medication for osteoporosis. The cross-sectional relationship between coffee consumption and impaired bone health (osteopenia or osteoporosis) was investigated by bone densitometry. Coffee consumption showed no significant association with BMD of either femoral neck or lumbar spine, independent of other factors. The adjusted odds ratios for BMD for those who consumed once in a day, twice a day and three times a day were 0.94 (0.70-1.26), 0.93 (0.67-1.28), and 1.02 (0.69-1.50), respectively (P for trend = 0.927). This study does not support the idea that coffee is a risk factor for impaired bone health in Korean premenopausal women.
    Korean Journal of Family Medicine 01/2014; 35(1):11-8. DOI:10.4082/kjfm.2014.35.1.11
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    • "It has been hypothesised that coffee consumption could increase individual susceptibility to fracture by decreasing bone mineral density and bone mechanical strength, but results from earlier research have been conflicting. A total of eight case–control studies( 5 , 10 – 16 ) and twelve prospective cohort studies( 6 , 17 – 27 ) have explored associations between coffee consumption and hip fracture risk, among which eight studies showed positive association( 6 , 11 , 18 , 21 – 24 , 27 ) and one study in Sweden found that coffee consumption could increase hip fracture risk for non-drinkers( 19 ). Another study in Norway showed that women with an intake of at least nine cups of coffee daily tended to have an increased risk of hip fracture, but only 6·8 % of women consumed so much coffee per d( 20 ). "
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    ABSTRACT: To investigate the effect of coffee consumption on hip fracture risk, a meta-analysis was conducted. The PubMed database was screened for all published studies about coffee consumption and hip fracture through to November 2011. Reviews, PubMed option ‘related articles’ and references of retrieved papers were also searched for potentially relevant papers. Only studies that contained OR with 95 % CI for the association between coffee consumption and hip fracture risk were included. The summary risk estimates were calculated by fixed- and random-effects models. Subgroup analyses were carried out stratified by study designs and participant characteristics, respectively. A total of six prospective cohort studies and six case–control studies were included in the final analysis. The pooled OR displayed increased risk of hip fracture by 29·7 % (95 % CI 0·960, 1·751; P = 0·09) for the highest compared with the lowest coffee consumption by the random-effects model (P for heterogeneity = 0·000; I 2 = 84·0 %), but the result had no statistical significance. Subgroup analyses showed that coffee consumption significantly increased hip fracture risk by 54·7 % (95 % CI 1·152, 2·077; P = 0·004) among women, by 40·1 % (95 % CI 1·015, 1·935; P = 0·040) for elderly participants aged over 70 years, and by 68·3 % for Northern Americans (95 % CI 1·492, 1·899; P = 0·000). Other subgroup analyses according to data published before the year 2000 showed a positive association between coffee and hip fracture risk, and follow-up duration also positively affected hip fracture risk, especially when the follow-up length was less than 13 years. Although our meta-analysis has provided insufficient evidence that coffee consumption significantly increases hip fracture risk, coffee intake may increase hip fracture risk among women, elderly participants and Northern Americans. No dose–response pattern was observed.
    07/2013; 2. DOI:10.1017/jns.2013.13
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    • "Hallstrom et al. (2006) proves that heavy coffee consumption of 600 ml or more can modestly increase the risk of osteoporosis, especially in women with low calcium intake. Hallstrom et al. (2006) also show a link between drinking coffee and urinary calcium excretion. Therefore, coffee drinking should be heavily avoided by people at risk or who have osteoporosis. "
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    ABSTRACT: Coffee is the second most universally consumed liquid substances, second to water (Linskog et al., 2002). There are many studies with positive findings that shows coffee is beneficial to human health. Coffee affects the body in many different ways and the most obvious affect is that being an energy boost, which became the main reason why people drink it. Coffee is rich in antioxidants, such as 'chlorogenic acid' and 'melanoidins'. Antioxidants help prevent oxidation, a process that causes damage to cells and contributes to aging. Regular coffee drinking also reduces the risk of Parkinson's disease. Saaksjarvi et al. (2008) and Hu et al. (2007) have demonstrated that people who drink coffee on a regular basis are significantly less likely to develop Parkinson's disease. Meanwhile, Shino et al. (2010) revealed that coffee consumption exerted a protective effect against type 2 diabetes. vanDam et al. (2006) also found that moderate consumption of both caffeinated and decaffeinated coffee may lower the risk of type 2 diabetes in younger and middle aged women. Coffee drinking may also protect against liver diseases, especially liver cirrhosis. A Japanese study (Inoue et al., 2005) found that those who drank coffee daily, or close to it, had about half the risk of hepatocellular carcinoma (HCC), a type of liver cancer. There is some evidence from Leitzmann et al. (2002) that coffee drinking may be protective against gallstone formation (known as 'cholelithiasis') in both men and women. In addition, coffee consumption lowers the risk of kidney stone formation where coffee increases the urine volume, preventing the crystallization of calcium oxalate, which is the most common component of kidney stones. Coffee consumption may also associate with decreased risk of kidney cancer (Lee et al., 2007a). Coffee can also improve mental performance. Caffeine in coffee is a well-known stimulant where it can promotes alertness, attention and wakefulness. Regular coffee drinking may help to protect against Alzheimer's disease. A study by Cao et al. (2011) revealed that a yet unidentified mystery ingredient in coffee interacts with the caffeine to help protection from Alzheimer's disease. A study by Arendash et al. (2006) in mice showed that caffeine equivalent to 5 cups of coffee per day reduced the build-up of destructive plaques in the brain. For people with asthma, caffeine can also open airways and improve asthma symptoms due the relationship between caffeine and theophylline, an old asthmatic medication. Furthermore, a large study by Wilson et al. (2011) of nearly 50,000 men found that men who drank 6 cups of coffee per day had 60% lower risk of lethal prostate cancer and those who drank 3 cups per day had 30% lower risk. Lee et al. (2007b) also suggested that coffee consumption may lower colon cancer risk among women and a study by Nettleton et al. (2010) revealed a beneficial effect of coffee on the pulmonary function of non-smokers. Women who drank more than 1 cup of coffee per day also had about 25% lower risk of stroke than women who drank less (Larrson et al., 2010). Meanwhile, a study by Garcia et al. (2009) found that women who drank 4 or more cups of coffee per day reduced their stroke risk by 20%. From a study by Jaquet et al. (2009) showed that coffee produced an increase in the metabolic activity and numbers of Bifidobacterium, which are beneficial bacteria in the gut.
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