title: Coffee, tea, and the risk of hip fracture: a meta-analysis.
abstract: The present meta-analysis shows no clear association between coffee consumption and the risk of hip fractures. There was a nonlinear association between tea consumption and the risk of hip fracture. Compared to no tea consumption, drinking 1-4 cups of tea daily was associated with a lower risk of hip fracture.
  
  
  BACKGROUND
  Prospective cohort and case-control studies have suggested that coffee and tea consumption may be associated with the risk of hip fracture; the results have, however, been inconsistent. We conducted a meta-analysis to assess the association between coffee and tea consumption and the risk of hip fracture.
  
  
  METHODS
  We performed systematic searches using MEDLINE, EMBASE, and OVID until February 20, 2013, without limits of language or publication year. Relative risks (RRs) with 95% confidence intervals (CI) were derived using random-effects models throughout all analyses. We conducted categorical, dose-response, heterogeneity, publication bias, and subgroup analyses.
  
  
  RESULTS
  Our study was based on 195,992 individuals with 9,958 cases of hip fractures from 14 studies, including six cohort and eight case-control studies. The pooled RRs of hip fractures for the highest vs. the lowest categories of coffee and tea consumption were 0.94 (95% CI 0.71-1.17) and 0.84 (95% CI 0.66-1.02), respectively. For the dose-response analysis, we found evidence of a nonlinear association between tea consumption and the risk of hip fracture (p(nonlinearity) < 0.01). Compared to no tea consumption, 1-4 cups of tea per day may reduce the risk of hip fracture by 28% (0.72; 95% CI 0.56-0.88 for 1-2 cups/day), 37% (0.63; 95% CI 0.32-0.94 for 2-3 cups/day), and 21% (0.79; 95% CI 0.62-0.96 for 3-4 cups/day).
  
  
  CONCLUSIONS
  We found no significant association between coffee consumption and the risk of hip fracture. A nonlinear association emerged between tea consumption and the risk of hip fracture; individuals drinking 1-4 cups of tea per day exhibited a lower risk of hip fractures than those who drank no tea. The association between 5 daily cups of tea, or more, and hip fracture risk should be investigated.
authors.affiliation: Department of Geriatrics, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: J
authors.initials: J
authors.lastname: Sheng
authors.forename: X
authors.initials: X
authors.lastname: Qu
authors.forename: X
authors.initials: X
authors.lastname: Zhang
authors.forename: Z
authors.initials: Z
authors.lastname: Zhai
authors.forename: H
authors.initials: H
authors.lastname: Li
authors.forename: X
authors.initials: X
authors.lastname: Liu
authors.forename: H
authors.initials: H
authors.lastname: Li
authors.forename: G
authors.initials: G
authors.lastname: Liu
authors.forename: Z
authors.initials: Z
authors.lastname: Zhu
authors.forename: Y
authors.initials: Y
authors.lastname: Hao
authors.forename: A
authors.initials: A
authors.lastname: Qin
authors.forename: K
authors.initials: K
authors.lastname: Dai
mesh_terms: D003069:Coffee / Q000009:adverse effects*; D006620:Hip Fractures / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D058866:Osteoporotic Fractures / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors; D013662:Tea / Q000009:adverse effects*
chemical_list: D003069:Coffee; D013662:Tea