Long-term coffee consumption in relation to fracture risk and bone mineral density in women

Am J Epidemiol. 2013 Sep 15;178(6):898-909. doi: 10.1093/aje/kwt062. Epub 2013 Jul 23.

Abstract

High consumption of coffee has been suggested to reduce the risk of some late-onset diseases and death but also to contribute to the development of osteoporotic fractures. Results of previous fracture studies have been inconsistent, and a comprehensive study is needed. The longitudinal population-based Swedish Mammography Cohort, including 61,433 women born in 1914-1948, was followed up from 1987 through 2008. Coffee consumption was assessed with repeated food frequency questionnaires. During follow-up, 14,738 women experienced fracture of any type, and 3,871 had a hip fracture. In a subcohort (n = 5,022), bone density was measured and osteoporosis determined (n = 1,012). After multivariable adjustment, there was no evidence of a higher rate of any fracture (hazard ratio per 200 mL coffee = 0.99; 95% confidence interval: 0.98, 1.00) or hip fracture (hazard ratio per 200 mL coffee = 0.97, 95% confidence interval: 0.95, 1.00) with increasing coffee consumption. A high coffee intake (≥4 cups daily) versus a low intake (<1 cup daily) was associated with a 2%-4% lower bone density, depending on site (P < 0.001), but the odds ratio for osteoporosis was only 1.28 (95% confidence interval: 0.88, 1.87). Thus, high coffee consumption was associated with a small reduction in bone density that did not translate into an increased risk of fracture.

Keywords: bone mineral density; coffee; cohort study; fracture; osteoporosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bone Density / drug effects*
  • Caffeine / adverse effects*
  • Coffee / adverse effects*
  • Female
  • Fractures, Bone / epidemiology
  • Fractures, Bone / etiology*
  • Humans
  • Longitudinal Studies
  • Middle Aged
  • Multivariate Analysis
  • Osteoporosis / complications*
  • Osteoporosis / epidemiology
  • Proportional Hazards Models
  • Risk Factors
  • Sweden / epidemiology
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood

Substances

  • Coffee
  • Vitamin D
  • Caffeine
  • 25-hydroxyvitamin D