title: Soda consumption and risk of hip fractures in postmenopausal women in the Nurses' Health Study.
abstract: BACKGROUND
  The frequency of soda consumption remains high in the United States. Soda consumption has been associated with poor bone health in children, but few studies have examined this relation in adults, and to our knowledge, no study has examined the relation of soda consumption with risk of hip fractures.
  
  
  OBJECTIVE
  We examined the association of soda, including specific types of soda, and risk of hip fracture in postmenopausal women.
  
  
  METHODS
  An analysis was conducted in postmenopausal women from the Nurses' Health Study cohort (n = 73,572). Diet was assessed at baseline by using a semiquantitative food-frequency questionnaire and updated approximately every 4 y. In ≤30 y of follow-up, we identified 1873 incident hip fractures. We computed RRs for hip fractures by the amount of soda consumption by using Cox proportional hazards models with adjustment for potential confounders.
  
  
  RESULTS
  In multivariable models, each additional serving of total soda per day was associated with a significant 14% increased risk of hip fracture (RR: 1.14; 95% CI: 1.06, 1.23). The attributable risk in our cohort for total soda consumption was 12.5%. Risk was significantly elevated in consumers of both regular soda (RR: 1.19; 95% CI: 1.02, 1.38) and diet soda (RR: 1.12; 95% CI: 1.03, 1.21) and also did not significantly differ between colas and noncolas or sodas with or without caffeine. The association between soda and hip fractures did not differ by body mass index or diagnosis of diabetes.
  
  
  CONCLUSIONS
  Increased soda consumption of all types may be associated with increased risk of hip fracture in postmenopausal women; however, a clear mechanism was not apparent on the basis of these observational data.
authors.affiliation: From the Departments of Epidemiology (FG, JNK, WCW, and MHA), Nutrition (WCW, TTF), and Biostatistics (BR), Harvard School of Public Health, Boston, MA; the Department of Nutrition, Simmons College, Boston, MA (TTF); the Channing Division of Network Medicine (DF, FG, BR, and WCW), the Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy (JNK), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and the Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC (MHA).
authors.forename: Teresa T
authors.initials: TT
authors.lastname: Fung
authors.affiliation: From the Departments of Epidemiology (FG, JNK, WCW, and MHA), Nutrition (WCW, TTF), and Biostatistics (BR), Harvard School of Public Health, Boston, MA; the Department of Nutrition, Simmons College, Boston, MA (TTF); the Channing Division of Network Medicine (DF, FG, BR, and WCW), the Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy (JNK), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and the Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC (MHA).
authors.forename: Meredith H
authors.initials: MH
authors.lastname: Arasaratnam
authors.affiliation: From the Departments of Epidemiology (FG, JNK, WCW, and MHA), Nutrition (WCW, TTF), and Biostatistics (BR), Harvard School of Public Health, Boston, MA; the Department of Nutrition, Simmons College, Boston, MA (TTF); the Channing Division of Network Medicine (DF, FG, BR, and WCW), the Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy (JNK), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and the Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC (MHA).
authors.forename: Francine
authors.initials: F
authors.lastname: Grodstein
authors.affiliation: From the Departments of Epidemiology (FG, JNK, WCW, and MHA), Nutrition (WCW, TTF), and Biostatistics (BR), Harvard School of Public Health, Boston, MA; the Department of Nutrition, Simmons College, Boston, MA (TTF); the Channing Division of Network Medicine (DF, FG, BR, and WCW), the Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy (JNK), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and the Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC (MHA).
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Katz
authors.affiliation: From the Departments of Epidemiology (FG, JNK, WCW, and MHA), Nutrition (WCW, TTF), and Biostatistics (BR), Harvard School of Public Health, Boston, MA; the Department of Nutrition, Simmons College, Boston, MA (TTF); the Channing Division of Network Medicine (DF, FG, BR, and WCW), the Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy (JNK), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and the Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC (MHA).
authors.forename: Bernard
authors.initials: B
authors.lastname: Rosner
authors.affiliation: From the Departments of Epidemiology (FG, JNK, WCW, and MHA), Nutrition (WCW, TTF), and Biostatistics (BR), Harvard School of Public Health, Boston, MA; the Department of Nutrition, Simmons College, Boston, MA (TTF); the Channing Division of Network Medicine (DF, FG, BR, and WCW), the Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy (JNK), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and the Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC (MHA).
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
authors.affiliation: From the Departments of Epidemiology (FG, JNK, WCW, and MHA), Nutrition (WCW, TTF), and Biostatistics (BR), Harvard School of Public Health, Boston, MA; the Department of Nutrition, Simmons College, Boston, MA (TTF); the Channing Division of Network Medicine (DF, FG, BR, and WCW), the Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy (JNK), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; and the Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC (MHA).
authors.forename: Diane
authors.initials: D
authors.lastname: Feskanich
mesh_terms: D000328:Adult; D002253:Carbonated Beverages / Q000009:adverse effects*; D015331:Cohort Studies; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D059012:Lost to Follow-Up; D008875:Middle Aged; D009726:Nurses; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000209:etiology*; D017698:Postmenopause; D016016:Proportional Hazards Models; D012307:Risk Factors; D057566:Self Report; D014481:United States / Q000453:epidemiology
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