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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    • "In prior studies showing a positive association, risk of osteoporosis (osteoporosis-induced fracture) was significantly increased when more than 4 cups/day of coffee (330 mg of caffeine, equivalent to 600 ml of coffee) was consumed (relative risk [RR], 1.2–1.9) [11, 14, 30]. This is quite a significant amount of coffee considering that the average amount of coffee consumption is merely 0.7 cup/day in the Korean population [29]. "
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    ABSTRACT: Purpose: Although the concern about coffee-associated health problems is increasing, the effect of coffee on osteoporosis is still conflicting. This study aimed to determine the relationship between coffee consumption and bone health in Korean postmenopausal women. Methods: A population-based, cross-sectional study was performed using a nationally representative sample of the Korean general population. All 4,066 postmenopausal women (mean age 62.6 years) from the fourth and fifth Korean National Health and Nutrition Examination Survey (2008-2011), who completed the questionnaire about coffee consumption and had data of dual-energy X-ray absorptiometry (DXA) examination. Bone mineral density (BMD) was measured using DXA at the femoral neck and lumbar spine and osteoporosis was defined by World Health Organization T-score criteria in addition to self-report of current anti-osteoporotic medication use. Results: After adjusting for various demographic and lifestyle confounders (including hormonal factors), subjects in the highest quartile of coffee intake had 36% lower odds for osteoporosis compared to those in the lowest quartile (Adjusted odds ratio [aOR] = 0.64; 95% confidence interval [CI], 0.43-0.95; P for trend = 0.015). This trend was consistent in osteoporosis of lumbar spine and femoral neck (aOR = 0.65 and 0.55; P for trend = 0.026 and 0.003, respectively). In addition, age- and body mass index (BMI)-adjusted BMD of the femoral neck and lumbar spine increased with higher coffee intake (P for trend = 0.019 and 0.051, respectively). Conclusions: Coffee consumption may have protective benefits on bone health in Korean postmenopausal women in moderate amount. Further, prospective studies are required to confirm this association.
    Full-text · Article · Jan 2016 · PLoS ONE
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    • "Recently, studies revealed possible associations between coffee consumption and OP in postmenopausal women [8] [9]. However, no associations between coffee consumption and outcome in postmenopausal women have been reported [10] [11] [12] [13]. No consistent conclusion has been drawn from studies that investigated the associations. "
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    ABSTRACT: Background: This study was aimed at estimating the associations between coffee intake and osteoporosis (OP) in Chinese postmenopausal women. Methods: We conducted a large-scale, community-based, cross-sectional study to investigate the associations by using self-report questionnaire to access frequency of coffee intake. The total of 1817 participants was available to data analysis in this study. Multiple regression models controlling for confounding factors to include frequency of coffee intake variable were performed to investigate the relationships for OP. Results: Positive correlations between frequency of meat food intake and T-score were reported (β = 0.216, P value < 0.001). Multiple regression analysis indicated that the frequency of meat food intake was significantly associated with OP (P < 0.05 for model 1 and model 2). The postmenopausal women with high frequency of meat food intake had a lower prevalence of OP. Conclusion: The findings indicated that frequency of coffee intake was independently and significantly associated with OP. The prevalence of OP was more frequent in Chinese postmenopausal women not preferring coffee habits.
    Full-text · Article · Sep 2015 · International Journal of Clinical and Experimental Medicine
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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.
    Full-text · Article · Jan 2014 · Korean Journal of Family Medicine
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