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Objectives. The association between carbonated beverage consumption and bone mineral density was examined in a community-based cohort of older White women.
Methods. One thousand women 44 to 98 years of age had bone mineral density measured at four sites and provided medical and behavioral histories, including type and quantity of carbonated beverages consumed.
Results. Bone mineral density levels were not associated with intake of any type of carbonated beverage after adjustment for age, obesity, calcium intake, exercise, and current use of tobacco and alcohol, thiazides, estrogen, or thyroid hormone.
Conclusions. Modest intake of carbonated beverages does not appear to have adverse effects on bone mineral density in older women. (Am J Public Health. 1997;87:276-279)
Introduction
The per capita consumption of soft drinks in the United States has been increasing for the last 30 years, from 51.7 L (13.6 gal) per year in 1960 to 167.2 L (44.0 gal) in 1990.i2 Currently, US consumption of soft drinks surpasses all other beverages, including milk, beer, coffee, and water.4 Therefore, any health risk of soft drinks would have broad public health implications.
Only two studies have directly investigated the relationship between soft drink consumption and osteoporosis. Both found that current consumption of nonalcoholic carbonated beverages, especially colas, was significantly associated with increased fracture risk s6 These authors postulated that the phosphorus (phosphoric acid) content of cola drinks may limit calcium absorption and contribute to bone loss. However, bone density was not measured.
Two other characteristics of carbonated beverages could also affect bone. First, caffeinated carbonated beverages may contribute to bone loss as a result of their caffeine content, which has been associated with reduced bone mineral density7 and increased fracture risk.8 Second, high carbonated beverage intake may replace milk consumption and indirectly influence bone mineral density.9,10 Because milk is a primary source of calcium,ll this switch from milk to carbonated beverages may lower dietary calcium intake and lead to lower bone mineral density.12,13
Considering the factors just discussed, we examined the relation of lifetime and current intake of carbonated beverages to bone mineral density in a community-based cohort of older White women.
Methods
Between February 1988 and February 1992, 1000 women 44 to 98 years of age residing in a middle- to upper-middleclass southern California community, Rancho...