Association of Coffee and Tea Intake with Bone Mineral Density and Hip Fracture: A Meta-Analysis

Causal relationship between tea intake and bone mineral density at different ages ̶ A Mendelian randomization study

INTRODUCTION

bone mineral density (BMD) is strongly associated with the risk of osteoporosis and fractures. Furthermore, dietary tea consumption also has a great impact on the variation in BMD. The pathway mechanisms from tea consumption to BMD are not well known. Therefore, we applied a two-sample Mendelian randomization (MR) approach in an attempt to explore the causality between tea consumption and BMD. And then examine whether the effects of tea intake on BMD are specific across different age groups.

METHODS

we investigated the relationship between tea consumption and BMD using a two-sample Mendelian randomization analysis, utilizing 31 single nucleotide polymorphisms (SNPs) related to tea intake from pooled data from a gene-wide association study (GWAS) of 447,485 British Biobank of European Origin participants, with BMD derived from a meta-analysis of total body BMD and age-specific effects in the Lifelong Genetic Cohort Study (n = 66,628). Causal analysis between tea intake and BMD was performed using MR-Egger, inverse variance weighting (IVW), weighted median, and weighted mode.

RESULTS

in IVW, tea consumption has a positive causal effect on total body BMD. However, in different age groups, BMD has a positive effect only within the 45-60-year group. There is no genetic pleiotropy effect of tea intake can have an effect on systemic BMD or among the five different age groups. The Cochran Q statistic and MR-Egger regression were applied to calculate heterogeneity in the IVW method, and no significant heterogeneity was indicated.

CONCLUSIONS

the results of the MR analysis showed a positive causal effect of tea intake on total body BMD, whereas among the different age groups, tea intake positively affected BMD only in the 45-60 age group, which implies that tea is beneficial in maintaining or increasing BMD in this age group and may reduce osteoporosis and fracture risk.

Coffee and tea consumption on the risk of osteoporosis: a meta-analysis

Objectives

This meta-analysis aims to quantify the relationship between coffee and tea consumption and the risk of osteoporosis and explore whether such consumption positively or negatively impacts this risk, thereby providing a scientific basis for understanding the effects of coffee and tea on bone health.

Methods

We systematically searched PubMed, the Cochrane Library, and Embase for observational studies published up to November 5, 2024, using medical subject headings (MeSH) and keywords related to "osteoporosis, tea, and coffee." Statistical analyses were conducted using Stata software version 14.0. A fixed-effects model was used when heterogeneity was low (I 2 ≤ 50% and p > 0.1). A random-effects model was used for greater heterogeneity (I 2 > 50%). Publication bias was assessed using funnel plots and Egger's regression tests.

Results

This meta-analysis included 14 observational studies comprising 562,838 participants published between 2008 and 2024. The pooled analysis showed that coffee consumption is significantly associated with a reduced risk of osteoporosis (odds ratio [OR] = 0.79, 95% confidence interval [CI]: 0.73-0.84, I 2 = 28.9%, p < 0.05). Tea consumption also demonstrated a protective effect, with a lower risk of osteoporosis (OR = 0.75, 95% CI: 0.62-0.91, I 2 = 80.4%, p < 0.05). Subgroup analysis revealed that high-frequency coffee consumption (more than one cup per day) was associated with a greater reduction in osteoporosis risk (OR = 0.83, 95% CI: 0.74-0.93, p = 0.001) compared to low-frequency consumption (less than one cup per day), which showed no statistically significant reduction (OR = 0.86, 95% CI: 0.68-1.07, p = 0.171). Similarly, high-frequency tea consumption (more than four times per week) exhibited a slightly stronger protective effect against osteoporosis compared to low-frequency consumption (OR = 0.82, 95% CI: 0.70-0.97, p = 0.02).

Conclusion

This meta-analysis suggests that long-term coffee and tea consumption is associated with a reduced risk of osteoporosis. Moreover, a higher frequency of consumption within a moderate range appeared to enhance the protective effect against osteoporosis.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024612101, PROSPERO CRD42024612101.

Patterns and Correlates of Bone Mineral Density Parameters Measured Using Calcaneus Quantitative Ultrasound in Chinese Adults

Background: Monitoring bone mineral density (BMD) in adults is critical for early detection of osteoporosis and prevention of fracture, for which quantitative ultrasound (QUS) is a good non-invasive tool. We examined the associations of QUS measures, including stiffness index (SI) and T-score, with socio-demographic, lifestyle, and anthropometric correlates and risk of subsequent fracture. Methods: Calcaneal QUS was performed using GE's Lunar Achilles EXPII among 24,651 adults (mean age 59.5 years, 61.7% women) from the China Kadoorie Biobank study. Socio-demographic and lifestyle information was collected using an interviewer-administered electronic questionnaire, and anthropometrics were measured following standard protocols. Incidence of fracture and osteoporosis was recorded via linkage with nationwide health insurance database. Linear and Cox regression analyses were conducted, adjusting for potential confounders. Results: On average, men had higher SI (92.8 vs. 86.0) but lower T-score (-0.85 vs. -0.64) than women. In both men and women, advanced age and smoking were inversely associated with SI and T-score, while physical activity and tea drinking were positively so (p < 0.0001 for all). Except for height, all other anthropometric measures were significantly and positively associated with both BMD measures. With each SD lower SI, the risk of subsequent fracture was 26% (95% confidence interval: 10-44%) and 40% (25-57%) higher in men and women, and the corresponding associations of T-score were identical. Conclusions: Among Chinese adults, the SI and T-score provided by Achilles EXPII had similar patterns and predictive values for subsequent fracture, despite the T-score for men and women not being directly comparable because of gender-specific references used. Future studies are needed to confirm or refute the causality of relationship between lifestyle and anthropometric factors and BMD.

Association of caffeine intake and sleep duration with bone mineral density: a cross-sectional study from National Health and Nutrition Examination Survey between 2011 and 2018

OBJECTIVE

The association between sleep duration, caffeine intake, and bone mineral density (BMD) is not well understood, with previous studies providing controversial results. This study explores the associations among caffeine intake, sleep duration, and BMD.

METHODS

Data were sourced from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018, including 13,457 participants who self-reported sleep duration and caffeine intake, with BMD measured via dual X-ray absorptiometry. Multivariable linear regression models, adjusted for confounders, were used alongside restricted cubic splines to examine dose-response association.

RESULTS

Of all participants, 6821 (50.7%) were males and 6636 were females (49.3%). The mean caffeine intake and sleep duration were 93.4 mg/day and 7.19 h, respectively. RCS results showed that BMD increased with the increase in caffeine intake, especially in the low dose range of 0-200 mg/day. The dose-response association between sleep duration and BMD showed that sleep durations of 0-6 h may promote the increase of BMD, but after sleep durations greater than 6 h, BMD decreases. After adjustment for potential confounders, compared to the lowest referent quartile, individuals with caffeine intake in quartiles 2, 3, and 4 had a positive correlation with BMD (0.62 95% CI: 0.24-1.37; 0.51 95% CI: 0.22-1.13; 0.75 95% CI: 0.41-1.46; P for trend < 0.05). In covariate-adjusted linear regression models, compared with those sleeping 6 h or less per night, the difference in BMD among those sleeping 6-7 h, 7-8 h, and 8-14.5 h per night were 1.81 (95% CI: 0.4122.71), 1.25 (95% CI: 0.55-2.93), and 0.87 (95% CI: 0.38-1.69). Associations of caffeine intake, sleep duration, and BMD stratified by sex and age failed to reach statistical significance.

CONCLUSIONS

Association might exist between the consumption of caffeine, sleep duration, and BMD; however, when stratified by sex and age, the association did not reach statistical significance.

Association between Central Nervous System Drugs and Femoral Fracture Risk in Japanese Individuals ≥80 Years Old: A Case-crossover Study

Objective To assess the association between concomitant use of central nervous system drugs and femoral fracture risk in individuals ≥80 years old in Japan. Methods A case-crossover design was used, defining the case period as 3 days before the fracture diagnosis and the control period as 31-33, 34-36, and 37-39 days prior. The association between the daily intake of central nervous system drugs (Anatomical Therapeutic Chemical codes) and fracture risk was analyzed using conditional logistic regression. Patients Using the Japanese administrative claims database, we examined elderly patients diagnosed with femoral neck fractures between January 1, 2009, and December 31, 2020. Results In 255,875 patients, the concomitant use of central nervous system drugs increased the odds ratios of femoral fracture [3.41 (95% confidence interval: 3.27-3.55), 3.69 (3.46-3.91), 3.76 (3.42-4.13), and 4.34 (3.86-4.86) for an intake of >0-1, >1-2, >2-3, and >3 central nervous system drugs, respectively]. Conclusion The concomitant use of central nervous system drugs is associated with an increased risk of femoral fractures in individuals ≥80 years old in Japan.

Coffee consumption and cardiometabolic health: a comprehensive review of the evidence

This review provides a comprehensive synthesis of longitudinal observational and interventional studies on the cardiometabolic effects of coffee consumption. It explores biological mechanisms, and clinical and policy implications, and highlights gaps in the evidence while suggesting future research directions. It also reviews evidence on the causal relationships between coffee consumption and cardiometabolic outcomes from Mendelian randomization (MR) studies. Findings indicate that while coffee may cause short-term increases in blood pressure, it does not contribute to long-term hypertension risk. There is limited evidence indicating that coffee intake might reduce the risk of metabolic syndrome and non-alcoholic fatty liver disease. Furthermore, coffee consumption is consistently linked with reduced risks of type 2 diabetes (T2D) and chronic kidney disease (CKD), showing dose-response relationships. The relationship between coffee and cardiovascular disease is complex, showing potential stroke prevention benefits but ambiguous effects on coronary heart disease. Moderate coffee consumption, typically ranging from 1 to 5 cups per day, is linked to a reduced risk of heart failure, while its impact on atrial fibrillation remains inconclusive. Furthermore, coffee consumption is associated with a lower risk of all-cause mortality, following a U-shaped pattern, with the largest risk reduction observed at moderate consumption levels. Except for T2D and CKD, MR studies do not robustly support a causal link between coffee consumption and adverse cardiometabolic outcomes. The potential beneficial effects of coffee on cardiometabolic health are consistent across age, sex, geographical regions, and coffee subtypes and are multi-dimensional, involving antioxidative, anti-inflammatory, lipid-modulating, insulin-sensitizing, and thermogenic effects. Based on its beneficial effects on cardiometabolic health and fundamental biological processes involved in aging, moderate coffee consumption has the potential to contribute to extending the healthspan and increasing longevity. The findings underscore the need for future research to understand the underlying mechanisms and refine health recommendations regarding coffee consumption.

Impact of coffee intake on human aging: Epidemiology and cellular mechanisms

The conception of coffee consumption has undergone a profound modification, evolving from a noxious habit into a safe lifestyle actually preserving human health. The last 20 years also provided strikingly consistent epidemiological evidence showing that the regular consumption of moderate doses of coffee attenuates all-cause mortality, an effect observed in over 50 studies in different geographic regions and different ethnicities. Coffee intake attenuates the major causes of mortality, dampening cardiovascular-, cerebrovascular-, cancer- and respiratory diseases-associated mortality, as well as some of the major causes of functional deterioration in the elderly such as loss of memory, depression and frailty. The amplitude of the benefit seems discrete (17 % reduction) but nonetheless corresponds to an average increase in healthspan of 1.8 years of lifetime. This review explores evidence from studies in humans and human tissues supporting an ability of coffee and of its main components (caffeine and chlorogenic acids) to preserve the main biological mechanisms responsible for the aging process, namely genomic instability, macromolecular damage, metabolic and proteostatic impairments with particularly robust effects on the control of stress adaptation and inflammation and unclear effects on stem cells and regeneration. Further studies are required to detail these mechanistic benefits in aged individuals, which may offer new insights into understanding of the biology of aging and the development of new senostatic strategies. Additionally, the safety of this lifestyle factor in the elderly prompts a renewed attention to recommending the maintenance of coffee consumption throughout life as a healthy lifestyle and to further exploring who gets the greater benefit with what schedules of which particular types and doses of coffee.

Common questions and misconceptions about caffeine supplementation: what does the scientific evidence really show?

Caffeine is a popular ergogenic aid that has a plethora of evidence highlighting its positive effects. A Google Scholar search using the keywords "caffeine" and "exercise" yields over 200,000 results, emphasizing the extensive research on this topic. However, despite the vast amount of available data, it is intriguing that uncertainties persist regarding the effectiveness and safety of caffeine. These include but are not limited to: 1. Does caffeine dehydrate you at rest? 2. Does caffeine dehydrate you during exercise? 3. Does caffeine promote the loss of body fat? 4. Does habitual caffeine consumption influence the performance response to acute caffeine supplementation? 5. Does caffeine affect upper vs. lower body performance/strength differently? 6. Is there a relationship between caffeine and depression? 7. Can too much caffeine kill you? 8. Are there sex differences regarding caffeine's effects? 9. Does caffeine work for everyone? 10. Does caffeine cause heart problems? 11. Does caffeine promote the loss of bone mineral? 12. Should pregnant women avoid caffeine? 13. Is caffeine addictive? 14. Does waiting 1.5-2.0 hours after waking to consume caffeine help you avoid the afternoon "crash?" To answer these questions, we performed an evidence-based scientific evaluation of the literature regarding caffeine supplementation.

Association of coffee intake with bone mineral density: a Mendelian randomization study

Background

In observational studies, the relationship between coffee intake and bone mineral density (BMD) is contradictory. However, residual confounding tends to bias the results of these studies. Therefore, we used a two-sample Mendelian randomization (MR) approach to further investigate the potential causal relationship between the two.

Methods

Genetic instrumental variables (IVs) associated with coffee intake were derived from genome-wide association studies (GWAS) of the Food Frequency Questionnaire (FFQ) in 428,860 British individuals and matched using phenotypes in PhenoScanner. Summarized data on BMD were obtained from 537,750 participants, including total body BMD (TB-BMD), TB-BMD in five age brackets ≥60, 45-60, 30-45, 15-30, and 0-15 years, and BMD in four body sites: the lumbar spine, the femoral neck, the heel, and the ultradistal forearm. We used inverse variance weighting (IVW) methods as the primary analytical method for causal inference. In addition, several sensitivity analyses (MR-Egger, Weighted median, MR-PRESSO, Cochran's Q test, and Leave-one-out test) were used to test the robustness of the results.

Results

After Bonferroni correction, Coffee intake has a potential positive correlation with total body BMD (effect estimate [Beta]: 0.198, 95% confidence interval [Cl]: 0.05-0.35, P=0.008). In subgroup analyses, coffee intake was potentially positively associated with TB-BMD (45-60, 30-45 years) (Beta: 0.408, 95% Cl: 0.12-0.69, P=0.005; Beta: 0.486, 95% Cl: 0.12-0.85, P=0.010). In addition, a significant positive correlation with heel BMD was also observed (Beta: 0.173, 95% Cl: 0.08-0.27, P=0.002). The results of the sensitivity analysis were generally consistent.

Conclusion

The results of the present study provide genetic evidence for the idea that coffee intake is beneficial for bone density. Further studies are needed to reveal the biological mechanisms and offer solid support for clinical guidelines on osteoporosis prevention.