title: Long-term coffee consumption in relation to fracture risk and bone mineral density in women.
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.
authors.forename: Helena
authors.initials: H
authors.lastname: Hallström
authors.forename: Liisa
authors.initials: L
authors.lastname: Byberg
authors.forename: Anders
authors.initials: A
authors.lastname: Glynn
authors.forename: Eva Warensjö
authors.initials: EW
authors.lastname: Lemming
authors.forename: Alicja
authors.initials: A
authors.lastname: Wolk
authors.forename: Karl
authors.initials: K
authors.lastname: Michaëlsson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000187:drug effects*; D002110:Caffeine / Q000009:adverse effects*; D003069:Coffee / Q000009:adverse effects*; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000150:complications* / Q000453:epidemiology; D016016:Proportional Hazards Models; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D003069:Coffee; D014807:Vitamin D; D002110:Caffeine; C104450:25-hydroxyvitamin D
keywords: bone mineral density; coffee; cohort study; fracture; osteoporosis