Coffee and tea drinking in relation to risk of hip fracture in the Singapore Chinese Health Study

Meta-analyses of studies conducted among Western populations suggest that coffee consumption does not affect osteoporotic fracture risk. However, experimental studies have shown that the effect of caffeine on bone health may depend on dosage. We examined the associations between consumption of coffe...

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Published in:Bone (New York, N.Y.) N.Y.), 2018-07, Vol.112, p.51-57
Main Authors: Dai, Zhaoli, Jin, Aizhen, Soh, Avril Zixin, Ang, Li-Wei, Yuan, Jian-Min, Koh, Woon-Puay
Format: Article
Language:English
Subjects:
Aged
Asian Continental Ancestry Group
Beverages - adverse effects
Caffeine
Chinese
Coffee
Coffee - adverse effects
Female
Health
Hip fracture
Hip Fractures - epidemiology
Humans
Male
Middle Aged
Postmenopause
Risk Factors
Singapore
Tea
Tea - adverse effects
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container_title Bone (New York, N.Y.)
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creator Dai, Zhaoli
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description Meta-analyses of studies conducted among Western populations suggest that coffee consumption does not affect osteoporotic fracture risk. However, experimental studies have shown that the effect of caffeine on bone health may depend on dosage. We examined the associations between consumption of coffee, tea and caffeine and risk of hip fracture in an Asian cohort. In a population-based prospective cohort of 63,257 Chinese men and women aged 45–74 years in Singapore, a validated semi-quantitative food frequency questionnaire was used to assess habitual consumption of coffee and tea at baseline. Cox proportional hazards regression models were used to estimate hazard ratio (HR) and 95% confidence interval (CI) for risk of hip fracture with adjustment for potential confounders. During a mean follow-up of 16.7 years, 2502 incident hip fracture cases were identified. Compared to coffee drinkers
doi_str_mv 10.1016/j.bone.2018.04.010
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However, experimental studies have shown that the effect of caffeine on bone health may depend on dosage. We examined the associations between consumption of coffee, tea and caffeine and risk of hip fracture in an Asian cohort. In a population-based prospective cohort of 63,257 Chinese men and women aged 45–74 years in Singapore, a validated semi-quantitative food frequency questionnaire was used to assess habitual consumption of coffee and tea at baseline. Cox proportional hazards regression models were used to estimate hazard ratio (HR) and 95% confidence interval (CI) for risk of hip fracture with adjustment for potential confounders. During a mean follow-up of 16.7 years, 2502 incident hip fracture cases were identified. Compared to coffee drinkers &lt;1 cup/week, those who drank ≥4 cups/day had a statistically significant higher risk to develop hip fractures, the HR (95% CI) was 1.32 (1.07, 1.63) in the whole cohort analysis, 1.46 (1.01, 2.10) for men and 1.33 (1.02, 1.72) for women. Among postmenopausal women, compared to those who drank coffee &lt;1 cup/week, drinking 2–3 cups/day was associated with the lowest risk [HR: 0.88 (0.76, 1.01)] and drinking ≥4 cups/day was associated with the highest risk [HR: 1.31 (1.00, 1.71)]. Similar associations with caffeine intake were found among postmenopausal women. Restricted spline analyses suggested a non-linear association between coffee/caffeine consumption and hip fracture risk in postmenopausal women (p for non-linearity ≤ 0.05). No association was found with tea consumption in either sex. These data suggest that drinking coffee ≥4 cups/day is associated with a higher hip fracture risk, while a moderate intake may alleviate risk in postmenopausal women. Future studies should corroborate these results to determine levels of optimal coffee consumption in relation to bone health. •Drinking coffee ≥4 cups/d may increase risk of hip fracture in men and women.•Drinking coffee 2–3 cups/d may lower risk of hip fracture in postmenopausal women.•Possible J-shaped relation of caffeine to fracture risk in postmenopausal women.</description><identifier>ISSN: 8756-3282</identifier><identifier>EISSN: 1873-2763</identifier><identifier>DOI: 10.1016/j.bone.2018.04.010</identifier><identifier>PMID: 29660426</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Asian Continental Ancestry Group ; Beverages - adverse effects ; Caffeine ; Chinese ; Coffee ; Coffee - adverse effects ; Female ; Health ; Hip fracture ; Hip Fractures - epidemiology ; Humans ; Male ; Middle Aged ; Postmenopause ; Risk Factors ; Singapore ; Tea ; Tea - adverse effects</subject><ispartof>Bone (New York, N.Y.), 2018-07, Vol.112, p.51-57</ispartof><rights>2018 Elsevier Inc.</rights><rights>Copyright © 2018 Elsevier Inc. 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However, experimental studies have shown that the effect of caffeine on bone health may depend on dosage. We examined the associations between consumption of coffee, tea and caffeine and risk of hip fracture in an Asian cohort. In a population-based prospective cohort of 63,257 Chinese men and women aged 45–74 years in Singapore, a validated semi-quantitative food frequency questionnaire was used to assess habitual consumption of coffee and tea at baseline. Cox proportional hazards regression models were used to estimate hazard ratio (HR) and 95% confidence interval (CI) for risk of hip fracture with adjustment for potential confounders. During a mean follow-up of 16.7 years, 2502 incident hip fracture cases were identified. Compared to coffee drinkers &lt;1 cup/week, those who drank ≥4 cups/day had a statistically significant higher risk to develop hip fractures, the HR (95% CI) was 1.32 (1.07, 1.63) in the whole cohort analysis, 1.46 (1.01, 2.10) for men and 1.33 (1.02, 1.72) for women. Among postmenopausal women, compared to those who drank coffee &lt;1 cup/week, drinking 2–3 cups/day was associated with the lowest risk [HR: 0.88 (0.76, 1.01)] and drinking ≥4 cups/day was associated with the highest risk [HR: 1.31 (1.00, 1.71)]. Similar associations with caffeine intake were found among postmenopausal women. Restricted spline analyses suggested a non-linear association between coffee/caffeine consumption and hip fracture risk in postmenopausal women (p for non-linearity ≤ 0.05). No association was found with tea consumption in either sex. These data suggest that drinking coffee ≥4 cups/day is associated with a higher hip fracture risk, while a moderate intake may alleviate risk in postmenopausal women. 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However, experimental studies have shown that the effect of caffeine on bone health may depend on dosage. We examined the associations between consumption of coffee, tea and caffeine and risk of hip fracture in an Asian cohort. In a population-based prospective cohort of 63,257 Chinese men and women aged 45–74 years in Singapore, a validated semi-quantitative food frequency questionnaire was used to assess habitual consumption of coffee and tea at baseline. Cox proportional hazards regression models were used to estimate hazard ratio (HR) and 95% confidence interval (CI) for risk of hip fracture with adjustment for potential confounders. During a mean follow-up of 16.7 years, 2502 incident hip fracture cases were identified. Compared to coffee drinkers &lt;1 cup/week, those who drank ≥4 cups/day had a statistically significant higher risk to develop hip fractures, the HR (95% CI) was 1.32 (1.07, 1.63) in the whole cohort analysis, 1.46 (1.01, 2.10) for men and 1.33 (1.02, 1.72) for women. Among postmenopausal women, compared to those who drank coffee &lt;1 cup/week, drinking 2–3 cups/day was associated with the lowest risk [HR: 0.88 (0.76, 1.01)] and drinking ≥4 cups/day was associated with the highest risk [HR: 1.31 (1.00, 1.71)]. Similar associations with caffeine intake were found among postmenopausal women. Restricted spline analyses suggested a non-linear association between coffee/caffeine consumption and hip fracture risk in postmenopausal women (p for non-linearity ≤ 0.05). No association was found with tea consumption in either sex. These data suggest that drinking coffee ≥4 cups/day is associated with a higher hip fracture risk, while a moderate intake may alleviate risk in postmenopausal women. Future studies should corroborate these results to determine levels of optimal coffee consumption in relation to bone health. •Drinking coffee ≥4 cups/d may increase risk of hip fracture in men and women.•Drinking coffee 2–3 cups/d may lower risk of hip fracture in postmenopausal women.•Possible J-shaped relation of caffeine to fracture risk in postmenopausal women.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29660426</pmid><doi>10.1016/j.bone.2018.04.010</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Aged
Asian Continental Ancestry Group
Beverages - adverse effects
Caffeine
Chinese
Coffee
Coffee - adverse effects
Female
Health
Hip fracture
Hip Fractures - epidemiology
Humans
Male
Middle Aged
Postmenopause
Risk Factors
Singapore
Tea
Tea - adverse effects
title Coffee and tea drinking in relation to risk of hip fracture in the Singapore Chinese Health Study
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