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Reductions in bone mineral density are associated with an increased risk of osteoporosis and an increased risk of fractures.

Osteoporosis

Research suggests that factors such as low intakes of calcium and vitamin D, limited exposure to sunlight, low BMI, low mobility, impaired balance and low physical activity all contribute to reduced bone density and an increased fracture risk1.

The scale of the issue

European data from 2010 suggests that approximately 6% of men and 21% of women aged 5084 years had osteoporosis, affecting 27.6 million men and women2.

Approximately 3.5 million new fragility fractures occur annually in the EU. In 2010 alone, fragility fractures resulted in costs of €37 billion3.

bone-health---infographics

The number of osteoporotic fractures is rising in many countries, related in part to the ageing population3.

Coffee Consumption and Bone Health

A 2002 review4 suggested that there is no overall negative effect of caffeine on bone health, where calcium intakes are adequate. Potentially negative effects were seen in those with insufficient calcium intake or very high coffee consumption (over 9 cups daily).

Four more recent meta analyses5,6,7,8 show significant variability in their results.  Some results suggest no association between coffee consumption and fracture risk whilst others suggest a potential effect in women and elderly participants in particular.

Additional studies assessing the association between coffee consumption and bone mineral density and fracture risk have also provided inconclusive results. A Swedish study9 suggested that high coffee intake was associated with a small reduction in bone mineral density but not an increased risk of fracture.

Interactions between coffee components and bone health are unclear.  Animal models suggest that caffeine intake may result in negative calcium balance through increased calcium excretion, and this may affect bone mineral density10.  Human studies have suggested that caffeine may impair the efficiency of calcium absorption, increase calcium excretion in urine, and limit the role of vitamin D in bone too.  These effects could reduce bone mineral density and increase the risk of fractures and osteoporosis.

Currently, there are insufficient data to reach a convincing conclusion and further research needs to be conducted.

References

  1. International Osteoporosis Foundation Fact Sheet http://www.iofbonehealth.org/facts-statistics
  2. Osteoporosis in the European Union in 2008:Ten years of progress and ongoing challenges http://abrasso.org.br/boletins/relatorios_iof_2008.pdf
  3. Hernlund E. et al. (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA) Arch Osteoporos 8:136
  4. Heaney R.P. (2002) Effects of caffeine on bone and the calcium economy. Food Chem Toxicol, 40: 1263-70.
  5. Liu H. et al. (2012) Coffee consumption and risk of fractures: a meta-analysis Arch Med Sci. Nov 9, 2012; 8(5): 776–783.
  6. Li X.I. and Xu J.-H. (2013) Coffee consumption and hip fracture risk: a meta-analysis Journal of Nutritional Science, vol. 2, e23 doi:10.1017/jns.2013.13
  7. Sheng J. et al. (2013) Coffee, tea, and risk of hip fracture: a meta-analysis Osteoporos Int DOI 10.1007/s00198-013-2563-7
  8. Lee D.R. et al. (2014) Coffee Consumption and risk of fractures: A systematic review and dose-response meta-analysis. Bone published on line ahead of print
  9. Hallström et al. (2013) Long-term Coffee Consumption in Relation to Fracture Risk and Bone Mineral Density in Women Am J Epidemiol DOI: 10.1093/aje/kwt062
  10. Kara F.M. et al. (2010) Adenosine A1 Receptors Regulate Bone Resorption in Mice. Arthritis & Rheumatism 62, No. 2, pp 534–541

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