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Antonio J, Newmire DE, Stout JR, Antonio B, Gibbons M, Lowery LM, Harper J, Willoughby D, Evans C, Anderson D, Goldstein E, Rojas J, Monsalves-Álvarez M, Forbes SC, Gomez Lopez J, Ziegenfuss T, Moulding BD, Candow D, Sagner M, Arent SM. Common questions and misconceptions about caffeine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr 2024; 21:2323919. [PMID: 38466174 DOI: 10.1080/15502783.2024.2323919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/17/2024] [Indexed: 03/12/2024] Open
Abstract
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.
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Affiliation(s)
- Jose Antonio
- Nova Southeastern University, Department of Health and Human Performance, Davie, FL, USA
| | - Daniel E Newmire
- Texas Woman's University, Exercise Physiology and Biochemistry Laboratory, School of Health Promotion and Kinesiology, Denton, TX, USA
| | - Jeffrey R Stout
- University of Central Florida, College of Health Professions and Sciences, Orlando, FL, USA
| | - Brandi Antonio
- University of Central Florida, College of Health Professions and Sciences, Orlando, FL, USA
| | | | - Lonnie M Lowery
- Nutrition, Exercise and Wellness Associates, Cuyahoga Falls, OH, USA
- Walsh University, Department of Exercise Science, North Canton, OH, USA
| | - Joseph Harper
- Walsh University, Department of Exercise Science, North Canton, OH, USA
| | - Darryn Willoughby
- School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, TX, USA
| | - Cassandra Evans
- Nova Southeastern University, Department of Health and Human Performance, Davie, FL, USA
| | - Dawn Anderson
- Indiana Tech, Exercise and Sport Performance Laboratory, Fort Wayne, IN, USA
| | - Erica Goldstein
- Stetson University, Department of Health Sciences, Deland, FL, USA
| | - Jose Rojas
- Keiser University, Fort Lauderdale, FL, USA
- Rocky Mountain University of Health Professions, Provo, UT, USA
| | - Matías Monsalves-Álvarez
- Universidad de O´Higgins, Exercise Metabolism and Nutrition Laboratory. Instituto de Ciencias de la Salud, Rancagua, Chile
- Motion Human Performance Laboratory, Lo Barnechea, Chile
| | - Scott C Forbes
- Brandon University, Department of Physical Education Studies, CBrandon, MB, Canada
| | | | - Tim Ziegenfuss
- The Center for Applied Health Sciences, Canfield, OH, USA
| | - Blake D Moulding
- University of Regina, Faculty of Kinesiology and Health Studies, Regina, SK, Canada
| | - Darren Candow
- University of Regina, Faculty of Kinesiology and Health Studies, Regina, SK, Canada
| | | | - Shawn M Arent
- University of South Carolina, Arnold School of Public Health, Columbia, SC, USA
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Xing C, Tan Y, Ni W. Tea intake and total body bone mineral density of all ages: a Mendelian randomization analysis. Front Nutr 2024; 11:1289730. [PMID: 38450242 PMCID: PMC10915007 DOI: 10.3389/fnut.2024.1289730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/01/2024] [Indexed: 03/08/2024] Open
Abstract
Background There is increasing evidence indicating that tea intake affects bone mineral density levels; however, the causality between tea intake and bone mineral density is inconclusive. This study aimed to assess the causal relationship between tea intake and total body bone mineral density (TB-BMD) through two-sample Mendelian randomization (MR) analysis. Methods We conducted a two-sample MR approach to estimate the potential causal effects of tea intake on TB-BMD at all ages in a European population. The analyses were performed using summary statistics obtained for single-nucleotide polymorphisms (SNPs), identified from a genome-wide association meta-analysis of tea intake (N = up to 447,485 individuals) and from the GEnetic Factors for OSteoporosis (GEFOS) Consortium's genome-wide association meta-analysis (N = up to 56,284 individuals), with baseline data collected in 2018 and populations derived from the European ancestry. The association between each SNP and TB-BMD was weighted by its association with tea intake, and estimates were combined mainly using an inverse-variance weighted meta-analysis. In addition, we explored the potential causal effects between green tea intake, herbal tea intake, and TB-BMD. Results The MR analysis revealed that genetically determined tea intake exerts a causal impact on TB-BMD, with an odds ratio (OR) of 1.204 (95% CI: 1.062-1.366, p = 0.004), especially in the age group of 45-60 years (OR = 1.360, 95% CI: 1.088-1.700, p = 0.007). No horizontal pleiotropy and heterogeneity were observed. However, there was no causal effect of tea intake on TB-BMD in the age groups of 0-15, 15-30, 30-45, and over 60 years. In the subgroup analysis, when green tea intake was regarded as the exposure factor, no salient associations were found between green tea consumption and TB-BMD (IVW p = 0.368). Similarly, there was also no causal association between herbal tea intake and TB-BMD (IVW p = 0.264). Conclusion The findings of this study support the evidence that tea consumption increases bone density and reduces the risk of osteoporosis in the age group of 45-60 years within the European population.
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Affiliation(s)
- Chen Xing
- Department of Gastroenterology, Institute of Digestive Diseases of PLA, The First Affiliated Hospital (Southwest Hospital), Army Medical University (Third Military Medical University), Chongqing, China
| | - Yanrong Tan
- Department of Gastroenterology, Institute of Digestive Diseases of PLA, The First Affiliated Hospital (Southwest Hospital), Army Medical University (Third Military Medical University), Chongqing, China
| | - Wentao Ni
- Beijing Key Laboratory of Genome and Precision Medicine Technologies, Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China
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Zhou F, Wang T, Li L, Yu J, Liu Z, Zhang J, Wang G, Li J, Shao C, Wang P, Chen W. Tea consumption and risk of bone health: an updated systematic review and meta-analysis. J Bone Miner Metab 2024; 42:99-114. [PMID: 38057603 DOI: 10.1007/s00774-023-01479-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/27/2023] [Indexed: 12/08/2023]
Abstract
INTRODUCTION Current research evaluating the association between tea consumption and bone health still has inconsistent findings. MATERIALS AND METHODS The electronic databases of Embase, PubMed, Scopus, and Web of Science were systematically searched from inception until December 2022 to identify eligible studies. The calculation of summary relative risks (RRs) and 95% confidence intervals (CIs) was carried out using random-effects models. I2 statistics and Forest plots were used to assess the heterogeneity of RR values across studies. RESULTS The pooled relative risks for bone health-related outcomes of interest among tea drinkers, compared to non-drinkers, were 0.910 (95% confidence interval 0.845 to 0.980) for fractures, based on 20 studies, 0.332 (0.207-0.457) for BMD (13 studies), 0.800 (0.674-0.950) for osteoporosis (10 studies), and 1.006 (0.876-1.156) for osteopenia (5 studies). Subgroup analysis of locations showed that the pooled relative risks were 0.903 (0.844-0.966) for the hip, 0.735 (0.586-0.922) for the femur, 0.776 (0.610-0.988) for the lumbar, 0.980 (0.942-1.021) for the forearm and wrist, 0.804 (0.567-1.139) for the phalanges, and 0.612 (0.468-0.800) for Ward's triangle. One-stage dose-response analysis revealed that individuals who consumed less than 4.5 cups of tea per day had a lower risk of bone health-related outcomes than those who did not consume tea, with statistically significant results. CONCLUSION There is an association between tea consumption and a reduced risk of fractures, osteoporosis, hip, femur, and lumbar, as well as increased BMD.
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Affiliation(s)
- Fuding Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Ting Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Lexun Li
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Jinchuan Yu
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Zhengxiang Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Jianghui Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510000, China
| | - Guangjun Wang
- School of Public Health, Anhui Medical University, Hefei, China
| | - Jiujiu Li
- Hefei Center for Disease Control and Prevention, Hefei, 230041, Anhui, China
| | - Changsheng Shao
- Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, 230026, China
| | - Peng Wang
- Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, 230026, China.
| | - Wenjun Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei, 230032, China.
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Uragami M, Matsushita K, Shibata Y, Takata S, Karasugi T, Sueyoshi T, Masuda T, Nakamura T, Tokunaga T, Hisanaga S, Yugami M, Sugimoto K, Yonemitsu R, Ideo K, Fukuma Y, Takata K, Arima T, Kawakami J, Maeda K, Yoshimura N, Matsunaga H, Kai Y, Tanimura S, Shimada M, Tateyama M, Miyamoto K, Kubo R, Tajiri R, Tian X, Homma F, Morinaga J, Yamanouchi Y, Takebayashi M, Kajitani N, Uehara Y, Miyamoto T. A machine learning-based scoring system and ten factors associated with hip fracture occurrence in the elderly. Bone 2023; 176:116865. [PMID: 37562661 DOI: 10.1016/j.bone.2023.116865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/30/2023] [Accepted: 08/01/2023] [Indexed: 08/12/2023]
Abstract
Hip fractures are fragility fractures frequently seen in persons over 80-years-old. Although various factors, including decreased bone mineral density and a history of falls, are reported as hip fracture risks, few large-scale studies have confirmed their relevance to individuals older than 80, and tools to assess contributions of various risks to fracture development and the degree of risk are lacking. We recruited 1395 fresh hip fracture patients and 1075 controls without hip fractures and comprehensively evaluated various reported risk factors and their association with hip fracture development. We initially constructed a predictive model using Extreme Gradient Boosting (XGBoost), a machine learning algorithm, incorporating all 40 variables and evaluated the model's performance using the area under the receiver operating characteristic curve (AUC), yielding a value of 0.87. We also employed SHapley Additive exPlanation (SHAP) values to evaluate each feature importance and ranked the top 20. We then used a stepwise selection method to determine key factors sequentially until the AUC reached a plateau nearly equal to that of all variables and identified the top 10 sufficient to evaluate hip fracture risk. For each, we determined the cutoff value for hip fracture occurrence and calculated scores of each variable based on the respective feature importance. Individual scores were: serum 25(OH)D levels (<10 ng/ml, score 7), femoral neck T-score (<-3, score 5), Barthel index score (<100, score 3), maximal handgrip strength (<18 kg, score 3), GLFS-25 score (≥24, score 2), number of falls in previous 12 months (≥3, score 2), serum IGF-1 levels (<50 ng/ml, score 2), cups of tea/day (≥5, score -2), use of anti-osteoporosis drugs (yes, score -2), and BMI (<18.5 kg/m2, score 1). Using these scores, we performed receiver operating characteristic (ROC) analysis and the resultant optimal cutoff value was 7, with a specificity of 0.78, sensitivity of 0.75, and AUC of 0.85. These ten factors and the scoring system may represent tools useful to predict hip fracture.
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Affiliation(s)
- Masaru Uragami
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Kozo Matsushita
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Yuto Shibata
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Shu Takata
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Tatsuki Karasugi
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Takanao Sueyoshi
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Tetsuro Masuda
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Takayuki Nakamura
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Takuya Tokunaga
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Satoshi Hisanaga
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Masaki Yugami
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Kazuki Sugimoto
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Ryuji Yonemitsu
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Katsumasa Ideo
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Yuko Fukuma
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Kosei Takata
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Takahiro Arima
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Jyunki Kawakami
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Kazuya Maeda
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Naoto Yoshimura
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Hideto Matsunaga
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Yuki Kai
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Shuntaro Tanimura
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Masaki Shimada
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Makoto Tateyama
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Kana Miyamoto
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Ryuta Kubo
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Rui Tajiri
- Department of Oral and Maxillofacial Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Xiao Tian
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Fuka Homma
- Department of Clinical Investigation, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, Kumamoto 860-8556, Japan
| | - Jun Morinaga
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yoshinori Yamanouchi
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Minoru Takebayashi
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Naoto Kajitani
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan; Center for Metabolic Regulation of Healthy Aging, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Yusuke Uehara
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
| | - Takeshi Miyamoto
- Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
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Chen CC, Shen YM, Li SB, Huang SW, Kuo YJ, Chen YP. Association of Coffee and Tea Intake with Bone Mineral Density and Hip Fracture: A Meta-Analysis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1177. [PMID: 37374383 DOI: 10.3390/medicina59061177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/03/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: Osteoporosis is characterized by low bone mass and high bone fragility. Findings regarding the association of coffee and tea intake with osteoporosis have been inconsistent. We conducted this meta-analysis to investigate whether coffee and tea intake is associated with low bone mineral density (BMD) and high hip fracture risk. Materials and Methods: PubMed, MEDLINE, and Embase were searched for relevant studies published before 2022. Studies on the effects of coffee/tea intake on hip fracture/BMD were included in our meta-analysis, whereas those focusing on specific disease groups and those with no relevant coffee/tea intake data were excluded. We assessed mean difference (MD; for BMD) and pooled hazard ratio (HR; for hip fracture) values with 95% confidence interval (CI) values. The cohort was divided into high- and low-intake groups considering the thresholds of 1 and 2 cups/day for tea and coffee, respectively. Results: Our meta-analysis included 20 studies comprising 508,312 individuals. The pooled MD was 0.020 for coffee (95% CI, -0.003 to 0.044) and 0.039 for tea (95% CI, -0.012 to 0.09), whereas the pooled HR was 1.008 for coffee (95% CI, 0.760 to 1.337) and 0.93 for tea (95% CI, 0.84 to 1.03). Conclusions: Our meta-analysis results suggest that daily coffee or tea consumption is not associated with BMD or hip fracture risk.
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Affiliation(s)
- Chun-Ching Chen
- Department of General Medicine, Changhua Christian Hospital, Changhua 500, Taiwan
| | - Yu-Ming Shen
- Department of General Medicine, Changhua Christian Hospital, Changhua 500, Taiwan
| | - Siou-Bi Li
- Department of General Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei 234, Taiwan
| | - Shu-Wei Huang
- Department of Orthopedics, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
| | - Yi-Jie Kuo
- Department of Orthopedics, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 116, Taiwan
| | - Yu-Pin Chen
- Department of Orthopedics, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 116, Taiwan
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Foods, nutrients and hip fracture risk: A prospective study of middle-aged women. Clin Nutr 2022; 41:2825-2832. [PMID: 36402009 DOI: 10.1016/j.clnu.2022.11.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/26/2022] [Accepted: 11/06/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND AIMS Hip fracture affects 1.6 million people globally each year, and increases morbidity and mortality. There is potential for risk reduction through diet modification, but prospective evidence for associations between intake of several foods and nutrients and hip fracture risk is limited. This study aimed to investigate associations between food and nutrient intakes and hip fracture risk in the UK Women's Cohort Study, and to determine the role of body mass index (BMI) as a potential effect modifier. METHODS Dietary, lifestyle, anthropometric, and socio-economic information of UK women, ages 35-69 years, were collected in a survey at recruitment (1995-1998), and included a validated 217-item food frequency questionnaire. Hip fracture cases were identified by linking participant data at recruitment with their Hospital Episode Statistics (HES) up to March 2019. Cox regression models were used to estimate associations between standard portions of food and nutrient intakes and hip fracture risk over a median follow-up time of 22.3 years. RESULTS Among 26,318 women linked to HES data (556,331 person-years), 822 hip fracture cases were identified. After adjustment for confounders, every additional cup of tea or coffee per day was associated with a 4% lower risk of hip fracture (HR (95% CI): 0.96 (0.92, 1.00)). A 25 g/day increment of dietary protein intake was also associated with a 14% lower risk of hip fracture (0.86 (0.73, 1.00)). In subgroup analyses, BMI modified linear associations between dietary intakes of protein, calcium, total dairy, milk, and tea and hip fracture risk (pinteraction = 0.02, 0.002, 0.003, 0.001, and 0.003, respectively); these foods and nutrients were associated with a reduced risk of hip fracture in underweight but not healthy or overweight participants. In particular, risk of hip fracture in underweight participants (28 cases, 545 participants) was 45% lower for every 25 g/day protein consumed (0.55 (0.38, 0.78)). CONCLUSIONS This is the first prospective cohort study internationally of multiple food and nutrient intakes in relation to hip fracture risk by BMI using linkage to hospital records. Results suggest that the potential roles of some foods and nutrients in hip fracture prevention, particularly protein, tea and coffee in underweight women, merit confirmation. PROTOCOL REGISTRATION Clinicaltrials.gov NCT05081466.
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Zeng X, Su Y, Tan A, Zou L, Zha W, Yi S, Lv Y, Kwok T. The association of coffee consumption with the risk of osteoporosis and fractures: a systematic review and meta-analysis. Osteoporos Int 2022; 33:1871-1893. [PMID: 35426508 DOI: 10.1007/s00198-022-06399-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 04/04/2022] [Indexed: 01/11/2023]
Abstract
UNLABELLED To elucidate the association of coffee and bone health would help fracture risk reduction via dietary intervention. Although those who had higher coffee consumption were less likely to have osteoporosis, the associations between coffee consumption and fracture risk need further investigations with better study designs. INTRODUCTION The associations between coffee consumption and the risk of osteoporosis and fracture remain inconclusive. We aimed to better quantify these associations by conducting meta-analyses of observational studies. METHODS Relevant studies were systematically searched on PubMed, Web of Science, Cochrane library, and Embase Database up to November 25, 2021. The odds ratio (OR) or relative risk (RR) with 95% confidence intervals (CI) was pooled and a dose-response analysis was performed. RESULTS Four studies with 7114 participants for osteoporosis and thirteen studies with 391,956 participants for fracture incidence were included in the meta-analyses. High versus low coffee consumption was associated with a lower risk of osteoporosis [pooled OR (95% CI): 0.79 (0.65-0.92)], while it was non-significantly associated with fracture incidence [pooled OR (95% CI): 0.86 (0.67-1.05) at hip and 0.89 (0.42-1.36) at non-hip]. A non-linear association between the level of coffee consumption and hip fracture incidence was shown (P = 0.004). The pooled RR (95% CI) of hip fracture risk in those who consumed 1, 2-3, 4, and ≥ 9 cups of coffee per day was 0.92 (0.87-0.97), 0.89 (0.83-0.95), 0.91 (0.85-0.98), and 1.10 (0.76-1.59), respectively. The significance in the association between coffee consumption and the hip fracture incidence decreased in those studies that had larger sample size, higher quality, and more adjustments. CONCLUSIONS A dose-dependent relationship may exist between coffee consumption and hip fracture incidence. The effect of high versus low coffee consumption was influenced by study designs. Further studies with dedicated designs are needed to confirm the independent effects of coffee consumption on bone health.
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Affiliation(s)
- X Zeng
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, 371 Tongzipo Road, Yuelu District, Changsha, 410000, China
| | - Y Su
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, 371 Tongzipo Road, Yuelu District, Changsha, 410000, China.
| | - A Tan
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, 371 Tongzipo Road, Yuelu District, Changsha, 410000, China
| | - L Zou
- Hunan Provincial Institute of Emergency Medicine, Hunan Provincial People's Hospital, Changsha, China
| | - W Zha
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, 371 Tongzipo Road, Yuelu District, Changsha, 410000, China
| | - S Yi
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, 371 Tongzipo Road, Yuelu District, Changsha, 410000, China
| | - Y Lv
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, 371 Tongzipo Road, Yuelu District, Changsha, 410000, China.
| | - T Kwok
- Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
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Asoudeh F, Bagheri A, Larijani B, Esmaillzadeh A. Coffee consumption and caffeine intake in relation to risk of fractures: a systematic review and dose-response meta-analysis of observational studies. Crit Rev Food Sci Nutr 2022; 63:9039-9051. [PMID: 35475944 DOI: 10.1080/10408398.2022.2067114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Conflicting reports are available about the association of coffee or caffeine intake and risk of fracture. We performed the current updated systematic review and dose-response meta-analysis of coffee consumption and caffeine intake and risk of fracture to quantify this association. MATERIALS AND METHODS PubMed/Medline, ISI Web of Science, and Scopus, Cochrane database were searched up to July 2021. Random-effects model or fixed-effects model was used to pool the study-specific effect sizes (ESs) and 95% confidence intervals (CIs). Dose-response relationship was examined using linear and non-linear dose-response analyses. The certainty of evidence was assessed using NutriGrade tool. RESULTS Out of 22 eligible studies included in the meta-analysis, 15 had cohort and 7 had case-control design. We found no significant association between coffee consumption and risk of fracture, either based on pooling cohort (RR: 0.99; 95% CI: 0.88, 1.12; I2 = 71.4%, Pheterogeneity < 0.01) or case-control studies (OR: 1.13; 95% CI: 0.87, 1.46; I2 = 49.0%, Pheterogeneity=0.08). In the subgroup analysis of cohort studies, we observed that higher coffee intake was inversely associated with risk of fracture in men (RR: 0.85; 95% CI: 0.76 to 0.94). In addition, a positive association was seen between coffee consumption and risk of fracture in studies with less than 12 years of follow-up (RR: 1.14; 95% CI: 1.02 to 1.27). With regard to caffeine intake, a statistically significant positive association was seen with risk of fracture (RR: 1.15; 95% CI, 1.08 to 1.23; I2=26.6%, n = 8). In the dose-response analysis, we found that each additional 100 mg caffeine intake was marginally associated with 2% greater risk of fracture (RR: 1.02; 95% CI: 1 to 1.05; I2= 70.3%, n = 6). CONCLUSION High coffee consumption was protectively associated with risk of fracture in men, while caffeine intake was positive associated with risk.
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Affiliation(s)
- Farzaneh Asoudeh
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Bagheri
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Relationship between Regular Green Tea Intake and Osteoporosis in Korean Postmenopausal Women: A Nationwide Study. Nutrients 2021; 14:nu14010087. [PMID: 35010962 PMCID: PMC8746552 DOI: 10.3390/nu14010087] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/22/2021] [Accepted: 12/24/2021] [Indexed: 11/21/2022] Open
Abstract
Mixed results have been reported regarding whether habitual tea intake affects bone health. This study investigated the relationship between green tea intake and bone mineral density (BMD) in postmenopausal Korean women. We used data from the Korean National Health and Nutrition Examination Surveys from 2008 to 2011 and divided the participants into three groups according to their frequency of green tea intake over the past 12 months. BMD of the lumbar spine, total femur, and femur neck was measured using dual-energy X-ray absorptiometry. The odds ratios (ORs) and 95% confidence intervals (CIs) of osteoporosis and osteopenia according to green tea consumption were analyzed. Participants who did not consume green tea or consumed less than one cup per day were more likely to have osteopenia of the lumbar spine or femur than those who consumed it once to three times a day (OR 1.81 and 1.85, 95% CI, 1.20–2.71; and 1.23–2.77). Moreover, ORs for osteoporosis were 1.91 (95% CI 1.13–3.23) and 1.82 (95% CI 1.09–3.05) in non-consumers and consumers who drank less than one cup per day, respectively, compared with the reference group. These results support that green tea consumption may have benefits on bone health.
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Webster J, Rycroft CE, Greenwood DC, Cade JE. Dietary risk factors for hip fracture in adults: An umbrella review of meta-analyses of prospective cohort studies. PLoS One 2021; 16:e0259144. [PMID: 34758048 PMCID: PMC8580223 DOI: 10.1371/journal.pone.0259144] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/14/2021] [Indexed: 01/08/2023] Open
Abstract
AIM To summarise the totality of evidence regarding dietary risk factors for hip fracture in adults, evaluating the quality of evidence, to provide recommendations for practice and further research. DESIGN Systematic review of meta-analyses of prospective cohort studies. ELIGIBILITY CRITERIA Systematic reviews with meta-analyses reporting summary risk estimates for associations between hip fracture incidence and dietary exposures including oral intake of a food, food group, beverage, or nutrient, or adherence to dietary patterns. INFORMATION SOURCES Medline, Embase, Web of Science, and the Cochrane Library from inception until November 2020. DATA SYNTHESIS The methodological quality of systematic reviews and meta-analyses was assessed using AMSTAR-2, and the quality of evidence for each association was assessed using GRADE. Results were synthesised descriptively. RESULTS Sixteen systematic reviews were identified, covering thirty-four exposures, including dietary patterns (n = 2 meta-analyses), foods, food groups, or beverages (n = 16), macronutrients (n = 3), and micronutrients (n = 13). Identified meta-analyses included 6,282 to 3,730,424 participants with between 322 and 26,168 hip fractures. The methodological quality (AMSTAR-2) of all systematic reviews was low or critically low. The quality of evidence (GRADE) was low for an inverse association between hip fracture incidence and intake of fruits and vegetables combined (adjusted summary relative risk for higher vs lower intakes: 0.92 [95% confidence interval: 0.87 to 0.98]), and very low for the remaining thirty-three exposures. CONCLUSION Dietary factors may play a role in the primary prevention of hip fracture, but the methodological quality of systematic reviews and meta-analyses was below international standards, and there was a lack of high-quality evidence. More long-term cohort studies reporting absolute risks and robust, well-conducted meta-analyses with dose-response information are needed before policy guidelines can be formed. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020226190.
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Affiliation(s)
- James Webster
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - Catherine E. Rycroft
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | | | - Janet E. Cade
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
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11
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Feng W, Wang X, Huang D, Lu A. Role of diet in osteoporosis incidence: Umbrella review of meta-analyses of prospective observational studies. Crit Rev Food Sci Nutr 2021:1-10. [PMID: 34644187 DOI: 10.1080/10408398.2021.1989374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
An umbrella review and meta-analysis were conducted to summarize evidence for the association between dietary factors and the incidence of osteoporosis in adults. Only systematic reviews or meta-analyses were eligible for this study. Two researchers independently performed reading, data extraction, and quality evaluation of the included literature. The outcomes included in this study were all associated with osteoporosis, including osteoporotic fractures and low bone density. A total of 54 studies were included in this study, with 83 adjusted hazard ratios on diet, dairy group (n = 13), alcohol (n = 2), tea (n = 6), coffee (n = 3), micronutrient (n = 31), dietary pattern (n = 21), and foods (n = 7) regarding the incidence of osteoporosis. Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) quality assessment method was used in this study. The high, medium, low and very low quality studies accounted for 27.7, 41, 21.7 and 9.6% of this study, respectively. Based on the included literature studies in this umbrella review, it was found that dietary factors have a relevant impact on the incidences of human osteoporosis, appropriate consumption of dairy products, vegetables, fruits, and micronutrients, as well as reduced intake of alcohol and coffee, can reduce the risk of osteoporosis.
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Affiliation(s)
- Weili Feng
- Orthopaedics Department, Xiaolan Hospital, Southern Medical University, Zhongshan, Guangdong Prov., P.R. China
| | - Xiaoping Wang
- Orthopaedics Department, Xiaolan Hospital, Southern Medical University, Zhongshan, Guangdong Prov., P.R. China
| | - Daoqiang Huang
- Orthopaedics Department, Xiaolan Hospital, Southern Medical University, Zhongshan, Guangdong Prov., P.R. China
| | - Anqi Lu
- School of Physical Education and Sports Training, Shanghai University of Sport, Shanghai Municipality, P.R. China
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12
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Mortensen SJ, Beeram I, Florance J, Momenzadeh K, Mohamadi A, Rodriguez EK, von Keudell A, Nazarian A. Modifiable lifestyle factors associated with fragility hip fracture: a systematic review and meta-analysis. J Bone Miner Metab 2021; 39:893-902. [PMID: 33991260 DOI: 10.1007/s00774-021-01230-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 04/10/2021] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Among the various hip fracture predictors explored to date, modifiable risk factors warrant special consideration, since they present promising targets for preventative measures. This systematic review and meta-analysis aims to assess various modifiable risk factors. MATERIAL AND METHODS We searched four online databases in September 2017. We included studies that reported on modifiable lifestyle risk factors for sustaining fragility hip fractures. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). The inclusion criteria consisted of (1) adult patients with osteoporotic hip fracture, (2) original study, (3) availability of full text articles in English, and (4) report of a modifiable lifestyle risk factor. RESULTS Thirty-five studies, containing 1,508,366 subjects in total, were included in this study. The modifiable risk factors that were significantly associated with an increased risk of hip fracture were the following: weight < 58 kg (128 lbs) (pooled OR 4.01, 95% CI 1.62-9.90), underweight body mass index (BMI) (< 18.5) (pooled OR 2.83, 95% CI 1.82-4.39), consumption of ≥ 3 cups of coffee daily (pooled OR 2.27, 95% CI 1.04-4.97), inactivity (pooled OR 2.14, 95% CI 1.21-3.77), weight loss (pooled OR 1.88, 95% CI 1.32-2.68), consumption of ≥ 27 g (approx. > 2 standard drinks) alcohol per day (pooled OR 1.54, 95% CI 1.12-2.13), and being a current smoker (pooled OR 1.50, 95% CI 1.22-1.85). Conversely, two factors were significantly associated with a decreased risk of hip fracture: obese BMI (> 30) (pooled OR 0.58, 95% CI 0.34-0.99) and habitual tea drinking (pooled OR 0.72, 95% CI 0.66-0.80). CONCLUSION Modifiable factors may be utilized clinically to provide more effective lifestyle interventions for at risk populations. We found that low weight and underweight BMI carried the highest risk, followed by high coffee consumption, inactivity, weight loss, and high daily alcohol consumption.
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Affiliation(s)
- Sharri J Mortensen
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, RN115, Boston, MA, 02215, USA.
| | - Indeevar Beeram
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, RN115, Boston, MA, 02215, USA
- Boston University School of Medicine, Boston, MA, USA
| | | | - Kaveh Momenzadeh
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, RN115, Boston, MA, 02215, USA
| | - Amin Mohamadi
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, RN115, Boston, MA, 02215, USA
| | - Edward K Rodriguez
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, RN115, Boston, MA, 02215, USA
- Harvard Medical School Orthopaedic Trauma Initiative, Boston, MA, USA
- Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Arvind von Keudell
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Medical School Orthopaedic Trauma Initiative, Boston, MA, USA
| | - Ara Nazarian
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, RN115, Boston, MA, 02215, USA
- Harvard Medical School Orthopaedic Trauma Initiative, Boston, MA, USA
- Department of Orthopaedic Surgery, Yerevan State Medical University, Yerevan, Armenia
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Nordestgaard AT. Causal relationship from coffee consumption to diseases and mortality: a review of observational and Mendelian randomization studies including cardiometabolic diseases, cancer, gallstones and other diseases. Eur J Nutr 2021; 61:573-587. [PMID: 34319429 DOI: 10.1007/s00394-021-02650-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 07/23/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE High coffee consumption is associated with low risk of mortality and morbidity, but the causality remains unclear. This review aims to discuss findings from observational studies on coffee consumption in context of Mendelian randomization studies. METHODS The PubMed database was searched for all Mendelian randomization studies on coffee consumption and corresponding observational studies. RESULTS High coffee consumption is associated with low risk of all-cause and cardiovascular mortality in observational studies (HRs of 0.85-0.90 vs. no/low consumers), with no support of causality in Mendelian randomization studies. Moderate/high consumption is associated with low risk of cardiometabolic diseases, including ischemic heart disease (HRs of 0.85-0.90 vs. no/low consumption), stroke (HRs of approximately 0.80 vs. no/low consumption), type 2 diabetes (HRs of approximately 0.70 vs. no/low consumption) and obesity in observational studies, but not in Mendelian randomization studies. High consumption is associated with low risk of endometrial cancer and melanoma and high risk of lung cancer in observational studies, but with high risk of colorectal cancer in Mendelian randomization studies. In observational and Mendelian randomization studies, high coffee consumption is associated with low risk of gallstones (HRs of 0.55-0.70 for high vs. no/low self-reported and 0.81 (0.69-0.96) for highest vs. lowest genetic consumption). CONCLUSION High coffee consumption is associated with low risk of mortality, cardiometabolic diseases, some cancers and gallstones in observational studies, with no evidence to support causality from Mendelian randomization studies for most diseases except gallstones.
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Affiliation(s)
- Ask T Nordestgaard
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark.
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14
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Xia SL, Ma ZY, Wang B, Guo SY, Zhou XX, Gao F. The Association between Tea Consumption and the Risk of Fracture: A Dose-Response Meta-Analysis of Prospective Cohort Studies. J Nutr Health Aging 2021; 25:1046-1052. [PMID: 34725660 DOI: 10.1007/s12603-021-1677-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Inconsistent results exist on the role of tea consumption on subsequent risk of fracture. A dose-response meta-analysis was therefore conducted to assess the association of tea consumption with the risk of fracture based on prospective cohort studies. METHODS The electronic databases of PubMed, Embase, and the Cochrane library were systematically searched to identify prospective cohort studies from inception until September 2020. The categories of high versus low and dose-response meta-analyses for tea consumption on the risk of fracture were calculated using the random-effects model. Eight prospective cohort studies recruited 774,134 individuals selected for the final meta-analysis. RESULTS An increment of 1 cup in tea consumption was not associated with the risk of fracture [relative risk (RR), 0.98; 95% confidence interval (CI), 0.96-1.00; P = 0.102]. Moreover, the highest tea consumption category was associated with a reduced risk of fracture (RR, 0.93; 95% CI, 0.88-0.98; P = 0.005). Furthermore, heavy (RR, 0.91; 95% CI, 0.85-0.98; P = 0.008) and mild (RR, 0.97; 95% CI, 0.94-1.00; P = 0.046) tea consumption were associated with lower risk of fracture. However, moderate tea consumption was not associated with the risk of fracture (RR, 0.98; 95% CI, 0.94-1.02; P = 0.281). CONCLUSION This study found that increased tea consumption may provide a protective role in the risk of fracture. The benefits of tea consumption should be further explored according to the characteristics of the individuals.
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Affiliation(s)
- S-L Xia
- Feng Gao, 1500 Zhoupu Zhouyuan Road, Pudong New Area, Shanghai 201318, China, Tel: 86-021-68135590, of Missouri Sinclair School of Nursing, Columbia, USA,
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15
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Nascimento-Souza MA, Paiva PGD, Silva AD, Duarte MSL, Ribeiro AQ. Coffee and Tea Group Contribute the Most to the Dietary Total Antioxidant Capacity of Older Adults: A Population Study in a Medium-Sized Brazilian City. J Am Coll Nutr 2020; 40:713-723. [DOI: 10.1080/07315724.2020.1823281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
| | - Pedro Gontijo de Paiva
- Department of Chemical Engineering, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Alessandra da Silva
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
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Abstract
Most studies show a positive association between higher tea intake and bone mineral density (BMD), while associations with fracture are inconclusive. Although a few studies have investigated the potential effects of rooibos tea on the bone cell metabolism, only 1 or 2 doses were tested or specific flavonoids were evaluated in isolation. A dose-response study is needed to comprehensively identify whether a level that modulates bone cell activity is associated with dietary or supplemental levels of red rooibos (RR) tea. We investigated if RR tea stimulates mineralization in a dose-dependent manner. Mineralization was induced in Saos-2 cells in the presence of RR tea (0.1–10 µg/mL of polyphenols) or control (dH2O) for 5 days. Cell activity, mRNA, protein expression and activity of key regulators of mineralization were measured. A positive dose-dependent relationship was observed between RR tea concentration and mineralization accompanied with similar trends in cell activity. With high concentrations of tea, protein expression of enzymes directly regulating mineralization (ALP and NPP1) were unchanged but ALP activity was significantly elevated. Osteopontin (OPN) was significantly downregulated midway through mineralization while sclerostin (SOST) was upregulated in response to higher concentrations of RR tea. In conclusion, RR tea stimulated osteoblast mineralization in a dose-dependent manner and were accompanied with downregulation of OPN, increased ALP activity, and increased cell activity.
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Yuan S, Michaëlsson K, Wan Z, Larsson SC. Associations of Smoking and Alcohol and Coffee Intake with Fracture and Bone Mineral Density: A Mendelian Randomization Study. Calcif Tissue Int 2019; 105:582-588. [PMID: 31482193 DOI: 10.1007/s00223-019-00606-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 08/22/2019] [Indexed: 02/07/2023]
Abstract
The causal associations of smoking and alcohol and coffee intake with fracture and bone mineral density are unknown. We investigated the associations using Mendelian randomization (MR). Summary-level data from UK Biobank for bone fractures (main outcome) (53,184 cases; 373,611 non-cases) and estimated bone mineral density (eBMD) (n = 426,824 individuals) were used. Single-nucleotide polymorphisms associated with smoking initiation (n = 378) and alcohol (n = 99) and coffee (n = 15) intake at the genome-wide significance threshold (P = 5 × 10-8) were identified from published genome-wide association studies. Univariable and multivariable inverse-variance weighted, weighted median, MR-Egger, and MR-PRESSO methods were used for statistical analyses. Genetic predisposition to smoking initiation was associated with fracture but not eBMD. The odds ratio of fracture per one-unit increase in log odds of smoking was 1.09 (95% confidence interval 1.04, 1.15; P = 8.58 × 10-4) after adjustment for alcohol intake in the multivariable MR analysis. The association remained in complementary analyses. Genetically predicted alcohol and coffee intake was not associated with fracture or eBMD. Nevertheless, genetic liability to alcohol dependence, based on variants in the ALD1B gene, was associated with fracture and lower eBMD. The odds ratio was 1.06 (95% confidence interval 1.01, 1.12; P = 0.018) per genetically predicted one-unit higher log odds of liability to alcohol dependence. This MR study strengthens the causal inference on an association between smoking and higher fracture risk but found no linear association of modestly higher alcohol and coffee intake with fracture or BMD. However, alcohol dependence may increase fracture risk.
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Affiliation(s)
- Shuai Yuan
- Department of Surgical Sciences, Uppsala University, The EpiHub, MTC-huset, 75185, Uppsala, Sweden
| | - Karl Michaëlsson
- Department of Surgical Sciences, Uppsala University, The EpiHub, MTC-huset, 75185, Uppsala, Sweden
| | - Zihao Wan
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Susanna C Larsson
- Department of Surgical Sciences, Uppsala University, The EpiHub, MTC-huset, 75185, Uppsala, Sweden.
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18
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Xiang W, Gu K, Wang W, Jiang X. Tea consumption and risk of fractures: an updated meta-analysis. Osteoporos Int 2019; 30:1941-1951. [PMID: 31338520 DOI: 10.1007/s00198-019-05095-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 07/14/2019] [Indexed: 10/26/2022]
Abstract
UNLABELLED This meta-analysis included 16 studies, involving seven cohort studies and nine case-control studies, and the results indicated that tea consumption may be associated with a reduced the risk of fractures. INTRODUCTION Regarding relationship of tea consumption with the risk of fractures remains controversial. We performed a meta-analysis to elucidate the association between tea consumption and the risk of fractures. METHODS Relevant articles were identified up to March 2019 by searching PubMed, Web of Science, and Embase databases. The pooled relative risks (RRs) with 95% confidence intervals (CIs) were computed utilizing fixed or random effects model based on heterogeneity. RESULTS Altogether 16 studies (seven cohort and nine case-control studies) were included in this meta-analysis, involving 772,707 participants with 37,166 fracture cases. The RRs (95% CIs) of fracture for the highest versus lowest category of tea consumption were 0.86 (0.78-0.94). Subgroup analysis indicated significant associations in cohort studies (0.90 (0.86-0.94)) and case-control studies (0.77 (0.69-0.85)). CONCLUSIONS The current meta-analysis indicates that tea consumption may be associated with a reduced the risk of fractures.
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Affiliation(s)
- W Xiang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, No. 38 Dengzhou Road, Qingdao, 266021, Shandong, People's Republic of China
| | - K Gu
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, No. 38 Dengzhou Road, Qingdao, 266021, Shandong, People's Republic of China
| | - W Wang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, No. 38 Dengzhou Road, Qingdao, 266021, Shandong, People's Republic of China
| | - X Jiang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, No. 38 Dengzhou Road, Qingdao, 266021, Shandong, People's Republic of China.
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Yi M, Wu X, Zhuang W, Xia L, Chen Y, Zhao R, Wan Q, Du L, Zhou Y. Tea Consumption and Health Outcomes: Umbrella Review of Meta-Analyses of Observational Studies in Humans. Mol Nutr Food Res 2019; 63:e1900389. [PMID: 31216091 DOI: 10.1002/mnfr.201900389] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/26/2019] [Indexed: 02/05/2023]
Abstract
SCOPE The aim of this article is to conduct an umbrella review to study the strength and validity of associations between tea consumption and diverse health outcomes. METHODS AND RESULTS Meta-analyses of observational studies examining associations between tea consumption and health outcomes in all human populations and settings are screened. The umbrella review identifies 96 meta-analyses with 40 unique health outcomes. Tea consumption shows greater benefits than harm to health in this review. Dose-response analyses of tea consumption indicates reduced risks of total mortality, cardiac death, coronary artery disease, stroke, and type 2 diabetes mellitus with increment of two to three cups per day. Beneficial associations are also found for several cancers, skeletal, cognitive, and maternal outcomes. Harmful associations are found for esophageal and gastric cancer when the temperature of intake is more than 55-60 °C. CONCLUSION Tea consumption, except for very hot tea, seems generally safe at usual levels of intake, with summary estimates indicating the largest reduction for diverse health outcomes at two to three cups per day. Generally, tea consumption seems more beneficial than harmful in this umbrella review. Randomized controlled trials are further needed to understand whether the observed associations are causal.
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Affiliation(s)
- Mengshi Yi
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiaoting Wu
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Wen Zhuang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Lin Xia
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yi Chen
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Rui Zhao
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Qianyi Wan
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Liang Du
- Chinese Evidence-Based Medicine/Cochrane Center, Chengdu, 610041, China
| | - Yong Zhou
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
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20
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Habitual Tea Consumption and Risk of Fracture in 0.5 Million Chinese Adults: A Prospective Cohort Study. Nutrients 2018; 10:nu10111633. [PMID: 30400175 PMCID: PMC6265708 DOI: 10.3390/nu10111633] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 10/20/2018] [Accepted: 10/23/2018] [Indexed: 01/08/2023] Open
Abstract
Background: Tea consumption may have favorable effects on risk of fracture. However, little is known about such association in Chinese adults. The aim of this study was to examine the association between tea consumption and risk of hospitalized fracture in Chinese adults. Methods: The present study included 453,625 participants from the China Kadoorie Biobank (CKB). Tea consumption was self-reported at baseline. Hospitalized fractures were ascertained through linkage with local health insurance claim databases. The results: During a median of 10.1 years of follow-up, we documented 12,130 cases of first-time any fracture hospitalizations, including 1376 cases of hip fracture. Compared with never tea consumers, daily tea consumption was associated with lower risk of any fracture (hazard ratio (HR): 0.88; 95% confidence interval (CI): 0.83, 0.93). Statistically significant reduced risk of hip fracture was shown among daily consumers who most commonly drank green tea (HR: 0.80; 95% CI: 0.65, 0.97) and those who had drunk tea for more than 30 years (HR: 0.68; 95% CI: 0.52, 0.87). Our conclusions: Habitual tea consumption was associated with moderately decreased risk of any fracture hospitalizations. Participants with decades of tea consumption and those who preferred green tea were also associated with lower risk of hip fracture.
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White Tea is More Effective in Preservation of Bone Loss in Adult Rats Co-Exposed to Lead and Cadmium Compared to Black, Red or Green Tea. ANNALS OF ANIMAL SCIENCE 2018. [DOI: 10.2478/aoas-2018-0026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Lead (Pb) and cadmium (Cd) are toxic metals occurring commonly in the human environment that show mutagenic, genotoxic and carcinogenic effects. Dietary components could prevent heavy metals intoxication by reducing their accumulation in the body. The purpose of the study was to check possible protective effect of regular consumption of white, black, red, or green tea on bone metabolism during long-term exposure to Pb and Cd in adult rats. The 12 week-long exposure to Pb and Cd (50 mg Pb and 7 mg Cd/kg of the diet) in a rat model was studied. Twelve-week-old adult male Wistar rats were randomly divided into a negative control group (Pb and Cd exposure without tea), a control (without Pb and Cd and teas), and groups co-exposed to Pb and Cd and supplemented with green, red, black, or white tea (n=12 each group). The experiment lasted for 12 weeks. The co-exposure to Pb and Cd led to the increase of bone resorption depending on the tea treatment, which was confirmed by the mechanical testing and histomorphometrical examination of cancellous bone. Pb and Cd influenced mechanical strength, reduced the densitometric and geometric parameters and the thickness of growth plate and articular cartilages. Concluding, white tea exerted the best protective effect on bone tissue and hyaline cartilage against heavy metal action.
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Dai Z, Jin A, Soh AZ, Ang LW, Yuan JM, Koh WP. Coffee and tea drinking in relation to risk of hip fracture in the Singapore Chinese Health Study. Bone 2018; 112:51-57. [PMID: 29660426 PMCID: PMC5970083 DOI: 10.1016/j.bone.2018.04.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/26/2018] [Accepted: 04/13/2018] [Indexed: 01/01/2023]
Abstract
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 <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 <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.
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Affiliation(s)
- Zhaoli Dai
- Boston University School of Medicine, Clinical Epidemiology Research & Training Unit, USA.
| | - Aizhen Jin
- National Registry of Diseases Office, Health Promotion Board, Singapore
| | - Avril Zixin Soh
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Li-Wei Ang
- Epidemiology & Disease Control Division, Ministry of Health, Singapore
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Woon-Puay Koh
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Health Services and Systems Research, Duke-NUS Medical School, Singapore.
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Abstract
BACKGROUND Previous reports have suggested a potential association of tea consumption with the risk of osteoporosis. As such association is controversial, we conducted a meta-analysis to assess the relationship between tea consumption and osteoporosis. METHODS AND FINDINGS We systematically searched PubMed, EMBASE and WanFang databases until March 30, 2016, using the keywords "tea and osteoporosis," without limits of language. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were derived by using random-effects models throughout the analyses. We conducted the analysis of the statistical heterogeneity using Cochrane I. The funnel plot was used to speculate the publication bias, while the subgroup analysis and multiround elimination method were employed. RESULTS Our study was based on 17 journal articles, including 2 prospective cohort studies, 4 case-control studies, and 11 cross-sectional studies. In the present study, the total OR of osteoporosis for the highest versus the lowest categories of tea consumption was 0.62 (95% CI, 0.46-0.83), with significant heterogeneity among studies (I = 94%, P < .01). There was, however, no publication bias of the meta-analysis about tea consumption and osteoporosis. Subgroup analysis showed that tea consumption could reduce the risk of osteoporosis in all examined subgroups. CONCLUSION In the present study, it can be concluded from the results that tea consumption can reduce the risk of osteoporosis.
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Affiliation(s)
- Kang Sun
- Tea Research Institute, Nanjing Agricultural University, Nanjing, P. R. China
| | - Le Wang
- Tea Research Institute, Nanjing Agricultural University, Nanjing, P. R. China
| | - Qingping Ma
- Tea Research Institute, Nanjing Agricultural University, Nanjing, P. R. China
| | - Qiaoyun Cui
- Tea Research Institute, Nanjing Agricultural University, Nanjing, P. R. China
| | - Qianru Lv
- Tea Research Institute, Nanjing Agricultural University, Nanjing, P. R. China
| | - Wenzheng Zhang
- Center of Cell Biology and Cancer Research, Albany Medical College, Albany, NY
| | - Xinghui Li
- Tea Research Institute, Nanjing Agricultural University, Nanjing, P. R. China
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da Veiga DTA, Bringhenti R, Bolignon AA, Tatsh E, Moresco RN, Comim FV, Premaor MO. The yerba mate intake has a neutral effect on bone: A case-control study in postmenopausal women. Phytother Res 2017; 32:58-64. [PMID: 29027270 DOI: 10.1002/ptr.5947] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 08/25/2017] [Accepted: 09/18/2017] [Indexed: 01/17/2023]
Abstract
Nutritional factors have been associated with osteoporosis and fractures. The intake of coffee may increase the risk of fracture whereas the intake of black and green tea is associated with its reduction. Recently, consumption of yerba mate was associated with increased bone mineral density in postmenopausal women. Nonetheless, its influence on fracture is not known. The aim of this study was to evaluate the effect of yerba mate tea intake on fractures, bone markers, calcium homeostasis, and oxidative stress in postmenopausal women. A case-control study was carried out in South Brazil, 46 women with fractures and 49 controls completed the study. There was no significant difference between the frequency of fractures in women who drank mate tea and women who did not (48.3% vs. 48.5%, p = .99). Moreover, there was no significant difference concerning the serum levels of total calcium, phosphorus, PTH, vitamin D, P1NP, and CTX in the subjects with the history of yerba mate use when compared to controls. Higher serum levels of NOx were found in women who drank the yerba mate infusion. In conclusion, the yerba mate intake is not associated with fracture, and it appears to have a neutral effect on the bone metabolism.
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Affiliation(s)
- Denise T A da Veiga
- Departamento de Clinica Medica, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Raísa Bringhenti
- Departamento de Clinica Medica, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Aline A Bolignon
- Phytochemical Laboratory, Department of Industrial Pharmacy, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Etiane Tatsh
- Laboratório de Bioquímica Clínica, Departamento de Análises Clínicas e Toxicológicas, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Rafael N Moresco
- Laboratório de Bioquímica Clínica, Departamento de Análises Clínicas e Toxicológicas, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Fabio V Comim
- Departamento de Clinica Medica, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Melissa O Premaor
- Departamento de Clinica Medica, Federal University of Santa Maria, Santa Maria, RS, Brazil
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Grosso G, Godos J, Galvano F, Giovannucci EL. Coffee, Caffeine, and Health Outcomes: An Umbrella Review. Annu Rev Nutr 2017; 37:131-156. [PMID: 28826374 DOI: 10.1146/annurev-nutr-071816-064941] [Citation(s) in RCA: 305] [Impact Index Per Article: 43.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
To evaluate the associations between coffee and caffeine consumption and various health outcomes, we performed an umbrella review of the evidence from meta-analyses of observational studies and randomized controlled trials (RCTs). Of the 59 unique outcomes examined in the selected 112 meta-analyses of observational studies, coffee was associated with a probable decreased risk of breast, colorectal, colon, endometrial, and prostate cancers; cardiovascular disease and mortality; Parkinson's disease; and type-2 diabetes. Of the 14 unique outcomes examined in the 20 selected meta-analyses of observational studies, caffeine was associated with a probable decreased risk of Parkinson's disease and type-2 diabetes and an increased risk of pregnancy loss. Of the 12 unique acute outcomes examined in the selected 9 meta-analyses of RCTs, coffee was associated with a rise in serum lipids, but this result was affected by significant heterogeneity, and caffeine was associated with a rise in blood pressure. Given the spectrum of conditions studied and the robustness of many of the results, these findings indicate that coffee can be part of a healthful diet.
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Affiliation(s)
- Giuseppe Grosso
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Catania 95123, Italy; .,NNEdPro Global Centre for Nutrition and Health, St. John's Innovation Centre, Cambridge CB4 0WS, United Kingdom
| | - Justyna Godos
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Catania 95123, Italy; .,Biomedical and Biotechnological Sciences, University of Catania, Catania 95124, Italy; ,
| | - Fabio Galvano
- Biomedical and Biotechnological Sciences, University of Catania, Catania 95124, Italy; ,
| | - Edward L Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115; .,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115
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Lo HC, Kuo DP, Chen YL. Impact of beverage consumption, age, and site dependency on dual energy X-ray absorptiometry (DEXA) measurements in perimenopausal women: a prospective study. Arch Med Sci 2017; 13:1178-1187. [PMID: 28883860 PMCID: PMC5575220 DOI: 10.5114/aoms.2017.66033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 05/18/2015] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION The aim of this study was to determine the best site for bone mineral density (BMD) measurements based on T-scores, age, and beverage consumption. MATERIAL AND METHODS In this prospective study, 271 women stratified by age (average age: 61.9 years) underwent dual energy X-ray absorptiometry (DEXA) scanning of their lumbar spine, hips, and forearms. Osteoporosis was defined as a BMD of 2.5 standard deviations or more below the mean peak bone mass based on a reference population of adult women (translated as a T-score ≤ -2.5), as measured by DEXA. Participants were also evaluated regarding alcohol and caffeine consumption by a semiquantitative questionnaire. RESULTS A significant discrepancy was observed in the classification of osteoporosis at different locations, with hip and forearm showing the best correlation (Pearson's r = 0.627, p < 0.001). In addition, for participants over 50 years of age, hip and forearm showed the best correlation. Significant correlations were also noted between forearm T-scores and caffeine consumed and, to a lesser extent, the level of alcohol consumption. In the group ≤ 50 years of age, lumbar spine and forearm T-scores were only associated with alcohol consumption. In the group over 50 years of age, hip and forearm T-scores were only associated with caffeine consumption. CONCLUSIONS Bone mineral density measurements at the hip and forearm correlated with caffeine consumption in elderly Taiwanese women. This is an important finding since age and caffeine consumption are known risk factors for osteoporosis.
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Affiliation(s)
- Huan-Chu Lo
- Department of Radiology, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, China
- Department of Diagnostic Radiology, National Defense Medical Center, Triservice General Hospital, Taipei, Taiwan, China
- Department of Radiology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
| | - Duen-Pang Kuo
- Department of Radiology, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, China
| | - Yen-Lin Chen
- Department of Radiology, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, China
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Tea consumption may decrease the risk of osteoporosis: an updated meta-analysis of observational studies. Nutr Res 2017. [DOI: 10.1016/j.nutres.2017.02.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Hantikainen E, Grotta A, Ye W, Adami HO, Surkan PJ, Serafini M, Michaëlsson K, Bellocco R, Trolle Lagerros Y. Prospective study of dietary Non Enzymatic Antioxidant Capacity on the risk of hip fracture in the elderly. Bone 2016; 90:31-6. [PMID: 27237609 DOI: 10.1016/j.bone.2016.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 05/19/2016] [Accepted: 05/23/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Dietary antioxidants may play an important role in the prevention of bone loss and associated fractures by reducing levels of oxidative stress. We prospectively investigated the association between dietary Non Enzymatic Antioxidant Capacity (NEAC) and the risk of hip fracture and whether this effect was modified by smoking. METHOD In the Swedish National March Cohort 13,409 men and women over the age of 55 who had not experienced cancer, cardiovascular disease or hip fracture, were followed through record-linkages from 1997 through 2010. NEAC was assessed by a validated food frequency questionnaire collected at baseline. We categorized the distribution of NEAC into sex-specific quartiles and used multivariable adjusted Cox proportional hazards regression models to estimate hazard ratios (HRs) with 95% confidence intervals (95% CI). RESULTS During a mean follow-up time of 12.4years, we identified 491 incident cases of first hip fracture. Subjects in the highest quartile of dietary NEAC had a 39% lower risk of incident hip fracture compared to those in the lowest quartile (HR: 0.61; 95% CI: 0.44-0.85). The association was non-linear (p for non-linearity: 0.004) with a potential threshold between the first and the second quartile and no further risk reduction at higher levels of dietary NEAC. Due to a low smoking prevalence in our study population, we had limited power to detect effect modification between dietary NEAC and smoking on a multiplicative or additive scale. CONCLUSION Higher dietary NEAC intake is associated with lower risk of hip fracture in the elderly.
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Affiliation(s)
- Essi Hantikainen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 171 77 Stockholm, Sweden.
| | - Alessandra Grotta
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 171 77 Stockholm, Sweden.
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 171 77 Stockholm, Sweden.
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 171 77 Stockholm, Sweden; Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room: E8527, Baltimore, MD 21205, USA.
| | - Mauro Serafini
- Functional Food and Metabolic Stress Prevention Laboratory, Center of Nutrition, Council for Agricultural Research and Economics, Via Ardeatina 546, 00100 Rome, Italy.
| | - Karl Michaëlsson
- Department of Surgical Sciences, Section of Orthopedics, Uppsala Clinical Research Center, Akademiska sjukhuset ing. 61 6 tr, 751 85 Uppsala, Sweden.
| | - Rino Bellocco
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 171 77 Stockholm, Sweden; Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Edificio U7, Via Bicocca degli Arcimboldi 8, 20126 Milan, Italy.
| | - Ylva Trolle Lagerros
- Clinical Epidemiology Unit, T2, Department of Medicine, Karolinska Institutet, SE-171 76 Stockholm, Sweden; Department of Medicine, Karolinska University Hospital, Huddinge, C2:84, SE-141 86 Stockholm, Sweden.
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Hirata H, Kitamura K, Saito T, Kobayashi R, Iwasaki M, Yoshihara A, Watanabe Y, Oshiki R, Nishiwaki T, Nakamura K. Association between Dietary Intake and Bone Mineral Density in Japanese Postmenopausal Women: The Yokogoshi Cohort Study. TOHOKU J EXP MED 2016; 239:95-101. [DOI: 10.1620/tjem.239.95] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Harumi Hirata
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Kaori Kitamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Toshiko Saito
- Department of Health and Nutrition, Niigata University of Health and Welfare
| | - Ryosaku Kobayashi
- Department of Physical Therapy, Niigata University of Health and Welfare
| | - Masanori Iwasaki
- Division of Community Oral Health Development, Kyushu Dental University
| | - Akihiro Yoshihara
- Division of Oral Science for Health Promotion, Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences
| | - Yumi Watanabe
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Rieko Oshiki
- Department of Physical Therapy, Niigata University of Health and Welfare
| | | | - Kazutoshi Nakamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences
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Myers G, Prince RL, Kerr DA, Devine A, Woodman RJ, Lewis JR, Hodgson JM. Tea and flavonoid intake predict osteoporotic fracture risk in elderly Australian women: a prospective study. Am J Clin Nutr 2015; 102:958-65. [PMID: 26269364 DOI: 10.3945/ajcn.115.109892] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 07/23/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Observational studies have linked tea drinking, a major source of dietary flavonoids, with higher bone density. However, there is a paucity of prospective studies examining the association of tea drinking and flavonoid intake with fracture risk. OBJECTIVE The objective of this study was to examine the associations of black tea drinking and flavonoid intake with fracture risk in a prospective cohort of women aged >75 y. DESIGN A total of 1188 women were assessed for habitual dietary intake with a food-frequency and beverage questionnaire. Incidence of osteoporotic fracture requiring hospitalization was determined through the Western Australian Hospital Morbidity Data system. Multivariable adjusted Cox regression was used to examine the HRs for incident fracture. RESULTS Over 10 y of follow-up, osteoporotic fractures were identified in 288 (24.2%) women; 212 (17.8%) were identified as a major osteoporotic fracture, and of these, 129 (10.9%) were a hip fracture. In comparison with the lowest tea intake category (≤1 cup/wk), consumption of ≥3 cups/d was associated with a 30% decrease in the risk of any osteoporotic fracture (HR: 0.70; 95% CI: 0.50, 0.96). Compared with women in the lowest tertile of total flavonoid intake (from tea and diet), women in the highest tertile had a lower risk of any osteoporotic fracture (HR: 0.65; 95% CI: 0.47, 0.88), major osteoporotic fracture (HR: 0.66; 95% CI: 0.45, 0.95), and hip fracture (HR: 0.58; 95% CI: 0.36, 0.95). For specific classes of flavonoids, statistically significant reductions in fracture risk were observed for higher intake of flavonols for any osteoporotic fracture and major osteoporotic fracture, as well as flavones for hip fracture (P < 0.05). CONCLUSION Higher intake of black tea and particular classes of flavonoids were associated with lower risk of fracture-related hospitalizations in elderly women at high risk of fracture.
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Affiliation(s)
- Gael Myers
- School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, School of Public Health, Curtin University, Bentley, Australia
| | - Richard L Prince
- School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, and
| | - Deborah A Kerr
- School of Public Health, Curtin University, Bentley, Australia
| | - Amanda Devine
- School of Exercise and Health Sciences, Edith Cowan University, Joondalup, Australia; and
| | - Richard J Woodman
- Flinders Centre for Epidemiology and Biostatistics, Flinders University of South Australia, Adelaide, Australia
| | - Joshua R Lewis
- School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, and
| | - Jonathan M Hodgson
- School of Medicine and Pharmacology, Royal Perth Hospital, University of Western Australia, Perth, Australia;
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Li S, Dai Z, Wu Q. Effect of coffee intake on hip fracture: a meta-analysis of prospective cohort studies. Nutr J 2015; 14:38. [PMID: 25928220 PMCID: PMC4412140 DOI: 10.1186/s12937-015-0025-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 04/08/2015] [Indexed: 12/02/2022] Open
Abstract
Several observational studies suggest an association between coffee intake and hip fracture risk. However, the results among them are inconsistent. We aimed to evaluate the association between coffee consumption and risk of hip fracture by performing a meta-analysis of prospective cohort studies. PubMed, Embase, and Web of Science were searched through July 2014 to identify studies that met pre-stated inclusion criterion and reference lists of retrieved articles were reviewed. Information on the characteristics of the included study, risk estimates, and control for possible confounding factors were extracted independently by two authors. A random effects model of meta-analysis was used to calculate the pooled risk estimate. Ten prospective cohort studies involving 5408 patients with hip fracture and 205,930 participants were included in this systematic review. Compared with individuals who did not or seldom drink coffee, the pooled relative risks of hip fracture was 1.13 (95% confidence interval: 0.86 to 1.48) for individuals with the highest coffee consumption. Exception of any single study did not materially alter the combined risk estimate. Visual inspection of funnel plot and Begg’s and Egger’s tests did not indicate evidence of publication bias. In summary, integrated evidence from prospective cohort studies does not suggest a statistically significant association between coffee consumption and risk of hip fracture in developed countries.
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Affiliation(s)
- Shuai Li
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, P. R. China.
| | - Zhipeng Dai
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, P. R. China.
| | - Qiang Wu
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, P. R. China.
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Zhang X, Yu Z, Yu M, Qu X. Alcohol consumption and hip fracture risk. Osteoporos Int 2015; 26:531-42. [PMID: 25266483 DOI: 10.1007/s00198-014-2879-y] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Accepted: 08/27/2014] [Indexed: 01/22/2023]
Abstract
SUMMARY The present meta-analysis shows that a nonlinear association between alcohol consumption and the risk of hip fracture was observed. Light alcohol consumption was inversely significantly associated with hip fracture risk, whereas heavy alcohol consumption was associated with an elevated hip fracture risk. INTRODUCTION Previous studies examining the association between alcohol consumption and the risk of hip fracture have reported conflicting findings. Therefore, we conducted a meta-analysis of prospective cohort studies to assess the association between alcohol consumption and the risk of hip fracture. METHODS PubMed and EMBASE were searched for prospective cohort studies on the relationship between alcohol consumption and the risk of hip fractures. Relative risks (RR) with 95% confidence intervals (CI) were derived using random-effects models throughout the whole analysis. RESULTS Eighteen prospective cohort studies were included with 3,730,424 participants and 26,168 hip fracture cases. Compared with non-drinkers, the pooled RR of hip fractures for alcohol consumption was 1.03 (95% CI, 0.91-1.15), with high heterogeneity between studies (P<0.001, I2=72.6%). A nonlinear relationship between alcohol consumption and the risk of hip fracture was identified (P nonlinearity=0.003). Compared with non-drinkers, the pooled RRs of hip fractures were 0.88 (95% CI, 0.83-0.89) for light alcohol consumption (0.01-12.5 g/day), 1.00 (95% CI, 0.85-1.14) for moderate alcohol consumption (12.6-49.9 g/day), and 1.71 (95% CI, 1.41-2.01) for heavy alcohol consumption (≥50 g/day). CONCLUSIONS There was no evidence of publication bias. In conclusion, a nonlinear association between alcohol consumption and the risk of hip fracture was observed in this meta-analysis. Further, light alcohol consumption was inversely significantly associated with hip fracture risk, whereas heavy alcohol consumption was associated with an elevated hip fracture risk.
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Affiliation(s)
- X Zhang
- Department of Clinical Medicine, Shanghai Medical College, Fudan University, Shanghai, China
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Xiao F, Qu X, Zhai Z, Jiang C, Li H, Liu X, Ouyang Z, Gu D. Association between loop diuretic use and fracture risk. Osteoporos Int 2015; 26:775-84. [PMID: 25491766 DOI: 10.1007/s00198-014-2979-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 11/26/2014] [Indexed: 11/27/2022]
Abstract
SUMMARY Loop diuretic use has been shown to be associated with an increased fracture risk, but the findings have been inconsistent. The present meta-analysis suggests that loop diuretics show a significant positive association with the overall risk of total fractures and, specifically, hip fractures. INTRODUCTION Despite being widely used, there is limited, prospective randomized trial evidence regarding the skeletal effects of loop diuretics. Previous observational studies have reported conflicting findings regarding the association between loop diuretic use and the risk of fractures. METHODS This meta-analysis of observational studies assessed the association between loop diuretic use and the risk of fractures. The PubMed, EMBASE, and OVID databases were searched for prospective cohort and case-control studies. Relative risks (RR) with 95% confidence intervals (CI) were derived using random-effects models throughout the analysis. RESULTS Thirteen studies (4 cohort studies and 9 case-control studies) were included, involving 842,644 participants and 108,247 fracture cases. Compared with non-users, people who had taken loop diuretics had an approximately 15% higher risk of total fractures (95% CI, 1.04-1.26; p<0.01), with high heterogeneity between studies (I2=80.5%; p<0.01). The RR was 1.14 (95% CI, 1.08-1.19) for hip fractures and 0.99 (95% CI, 0.93-1.05) for lower arm or wrist fractures. The RR was 1.05 (95% CI, 1.00-1.11) in prospective cohort studies and 1.22 (95% CI, 1.00-1.44) in case-control studies. There was no evidence of publication bias. CONCLUSION The results suggest that loop diuretics show a significant positive association with the overall risk of total fractures and hip fractures.
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Affiliation(s)
- F Xiao
- Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
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