From the Guidelines
Drinking coffee in moderation is not a significant risk factor for osteoporosis, as long as adequate calcium and vitamin D intake are maintained. The available evidence suggests that moderate coffee consumption, defined as three to five 8-oz servings per day or approximately 400 mg caffeine/d, can be incorporated into healthy eating patterns without negatively impacting bone health 1. While caffeine can slightly increase calcium excretion in urine, this effect is minimal when consuming reasonable amounts of coffee (1-3 cups daily) and maintaining adequate calcium intake. In fact, a recent systematic review found that consumption of ≤400 mg caffeine/d in healthy adults is not associated with adverse bone status 1. Additionally, coffee contains compounds that may have both positive and negative effects on bone metabolism, such as chlorogenic acid, which has been shown to inhibit protein glycation and dicarbonyl compound formation 1. Therefore, for most people, drinking coffee does not meaningfully impact bone health when part of an otherwise balanced diet that includes sufficient calcium (1000-1200mg daily) and vitamin D (600-800 IU daily). However, excessive coffee consumption (more than 4 cups daily) might have a small negative effect on calcium balance, particularly in people with already low calcium intake or those with other osteoporosis risk factors. If you're concerned about bone health, focus on established protective factors like weight-bearing exercise, adequate calcium and vitamin D intake, avoiding smoking, and limiting alcohol consumption rather than eliminating moderate coffee consumption.
From the Research
Association between Coffee Consumption and Osteoporosis
- The relationship between coffee consumption and osteoporosis is complex, with some studies suggesting a potential link between caffeine intake and reduced bone mineral density or increased fracture risk 2.
- However, other studies have found no significant association between coffee consumption and bone mineral density or fracture risk 3, 4.
- A systematic review and meta-analysis found that high versus low coffee consumption was associated with a lower risk of osteoporosis, but the association with fracture incidence was non-significant 5.
Effects of Caffeine on Bone Health
- Caffeine may promote bone loss by inhibiting bone formation and promoting bone resorption through its effects on adenosine receptors and calcium metabolism 2.
- However, some studies have found that moderate coffee consumption (≤ 2 cups per day) may have protective effects against osteoporosis and osteopenia in older adults 6.
Epidemiological Studies
- A cross-sectional study found that moderate coffee consumption was associated with a lower odds of having femoral neck osteopenia/osteoporosis and lumbar-spine osteopenia/osteoporosis in US adults over the age of 50 6.
- A systematic review and meta-analysis found that the association between coffee consumption and fracture incidence decreased in studies with larger sample sizes, higher quality, and more adjustments 5.
Limitations and Future Directions
- The evidence on the association between coffee consumption and osteoporosis is inconsistent, and further studies with dedicated designs are needed to confirm the independent effects of coffee consumption on bone health 5.
- More research is needed to understand the mechanisms by which caffeine affects bone health and to determine the optimal level of coffee consumption for maintaining strong bones 2, 5.