Osteoporosis International

, Volume 19, Issue 4, pp 519–527 | Cite as

Association between caffeine intake and bone mass among young women: potential effect modification by depot medroxyprogesterone acetate use

  • C. M. Wetmore
  • L. Ichikawa
  • A. Z. LaCroix
  • S. M. Ott
  • D. ScholesEmail author
Original Article



This study assessed associations between habitual caffeine intake and bone mass among young women. Analyses of the entire study population revealed no significant associations, while analyses restricted to women using depot medroxyprogesterone acetate (DMPA) showed modest inverse associations between caffeine intake and bone mineral content (BMC).


Some previous investigations among postmenopausal women suggest an inverse relationship between caffeine intake and bone mass, yet studies of this association among young women are few.


The association between habitual caffeine intake and bone mass was evaluated prospectively in a population-based cohort of 625 females, aged 14 to 40 years, adjusting for relevant biological and lifestyle factors. Caffeinated beverage intake was self-reported, and bone mineral content (BMC) and bone mineral density (BMD) were measured at baseline and every 6 months throughout a 24-month follow-up period using dual-energy x-ray absorptiometry.


Cross-sectional analyses revealed no significant differences in mean BMC or BMD at baseline. Mean percentage and absolute changes in BMC and BMD were not associated with caffeine use. Repeated measures analyses similarly showed no significant association between caffeine intake at baseline and mean BMC or BMD measured during follow-up. However, among women using depot medroxyprogesterone acetate (DMPA), modest inverse associations between caffeine and BMC (but not BMD) were detected.


Our data suggest that heavy habitual consumption of caffeinated beverages does not adversely impact bone mass among young women in general. Greater caffeine intake may be associated with lower BMC among DMPA users.


Bone content Bone density Caffeine Depot medroxyprogesterone acetate Longitudinal studies Premenopause 



The authors acknowledge and appreciate the assistance of Ken Wu in preparing the data file.


This study was supported by grant number 2R01 HD031165 from the National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Dr. Scholes).

Supplementary material

198_2007_473_MOESM1_ESM.doc (44 kb)
ESM (DOC 44 kb)


  1. 1.
    U.S. Surgeon General (2004) Bone health and osteoporosis: a report of the surgeon general. In: U.S. Department of Health and Human Services, Office of the Surgeon General, Rockville, MDGoogle Scholar
  2. 2.
    Harnack L, Stang J, Story M (1999) Soft drink consumption among US children and adolescents. J Am Diet Assoc 99:436–441PubMedCrossRefGoogle Scholar
  3. 3.
    Wyshak G, Frisch RE (1994) Carbonated beverages, dietary calcium, the dietary calcium/phosphorus ratio, and bone fractures in girls and boys. J Adolesc Health 15:210–215PubMedCrossRefGoogle Scholar
  4. 4.
    Heaney R, Recker R (1982) Effects of nitrogen, phosphorus, and caffeine on calcium balance in women. J Lab Clin Med 99:46–52PubMedGoogle Scholar
  5. 5.
    Heaney RP, Rafferty K (2001) Carbonated beverages and urinary calcium excretion. Am J Clin Nutr 74:343–347PubMedGoogle Scholar
  6. 6.
    Heaney RP (2002) Effects of caffeine on bone and the calcium economy. Food Chem Toxicol 40:1263–1270PubMedCrossRefGoogle Scholar
  7. 7.
    Massey LK, Whiting SJ (1993) Caffeine, urinary calcium, calcium metabolism and bone. J Nutr 123:1611–1614PubMedGoogle Scholar
  8. 8.
    Hallstrom T, Wolk A, Glynn A, Michaelsson K (2006) Coffee, tea and caffeine consumption in relation to osteoporotic fracture risk in a cohort of Swedish women. Osteoporos Int 17:1055–1064PubMedCrossRefGoogle Scholar
  9. 9.
    Barrett-Connor E, Chang J, Edelstein S (1994) Coffee-associated osteoporosis offset by daily milk consumption. The Rancho Bernardo Study. JAMA 271:280–283PubMedCrossRefGoogle Scholar
  10. 10.
    Harris S, Dawson-Hughes B (1994) Caffeine and bone loss in healthy postmenopausal women. Am J Clin Nutr 60:573–578PubMedGoogle Scholar
  11. 11.
    Ilich JZ, Brownbill RA, Tamborini L, Crncevic-Orlic Z (2002) To drink or not to drink: how are alcohol, caffeine and past smoking related to bone mineral density in elderly women? J Am Coll Nutr 21:536–544PubMedGoogle Scholar
  12. 12.
    Bauer D, Browner W, Cauley J, Orwoll E, Scott J, Black D, Tao J, Cummings S (1993) Factors associated with appendicular bone mass in older women. Ann Intern Med 118:657–665PubMedGoogle Scholar
  13. 13.
    Lloyd T, Schaeffere JM, Walker MA, Demers LM (1991) Urinary hormonal concentrations and spinal bone densities of premenopausal vegetarian and nonvegetarian women. Am J Clin Nutr 54:1005–1010PubMedGoogle Scholar
  14. 14.
    Barger-Lux MJ, Heaney RP, Stegman MR (1990) Effects of moderate caffeine intake on the calcium economy of premenopausal women. Am J Clin Nutr 52:722–725PubMedGoogle Scholar
  15. 15.
    Cooper C, Atkinson E, Wahner H, O'Fallon W, Riggs B, Judd H, Melton Lr (1992) Is caffeine consumption a risk factor for osteoporosis? J Bone Miner Res 7:465–471PubMedCrossRefGoogle Scholar
  16. 16.
    Hernandez-Avila M, Stampfer M, Ravnikar V, Willett W, Schiff I, Francis M, Longcope C, McKinlay S (1993) Caffeine and other predictors of bone density among pre- and perimenopausal women. Epidemiology 4:128–134PubMedCrossRefGoogle Scholar
  17. 17.
    Rapuri PB, Gallagher JC, Kinyamu HK, Ryschon KL (2001) Caffeine intake increases the rate of bone loss in elderly women and interacts with vitamin D receptor genotypes. Am J Clin Nutr 74:694–700PubMedGoogle Scholar
  18. 18.
    Grainge M, Coupland C, Cliffe S, Chilvers C, Hosking D (1998) Cigarette smoking, alcohol and caffeine consumption, and bone mineral density in postmenopausal women. Osteoporos Int 8:355–363PubMedCrossRefGoogle Scholar
  19. 19.
    Hannan M, Felson D, Dawson-Hughes B, Tucker K, Cupples L, Wilson P, Kiel D (2000) Risk factors for longitudinal bone loss in elderly men and women: the Framingham Osteoporosis Study. J Bone Miner Res 15:710–720PubMedCrossRefGoogle Scholar
  20. 20.
    Johansson C, Mellstrom D, Lerner U, Osterberg T (1992) Coffee drinking: a minor risk factor for bone loss and fractures. Age Ageing 21:20–26PubMedCrossRefGoogle Scholar
  21. 21.
    Lloyd T, Johnson-Rollings N, Eggli DF, Kieselhorst K, Mauger EA, Cusatis DC (2000) Bone status among postmenopausal women with different habitual caffeine intakes: a longitudinal investigation. J Am Coll Nutr 19:256–261PubMedGoogle Scholar
  22. 22.
    Lloyd T, Rollings N, Eggli DF, Kieselhorst K, Chinchilli V (1997) Dietary caffeine intake and bone status of postmenopausal women. Am J Clin Nutr 65:1826–1830PubMedGoogle Scholar
  23. 23.
    Reid I, Ames R, Evans M, Sharpe S, Gamble G (1994) Determinants of the rate of bone loss in normal postmenopausal women. J Clin Endocrinol Metab 79:950–954PubMedCrossRefGoogle Scholar
  24. 24.
    Rico H, Canal ML, Manas P, Lavado JM, Costa C, Pedrera JD (2002) Effects of caffeine, vitamin D, and other nutrients on quantitative phalangeal bone ultrasound in postmenopausal women. Nutrition 18:189–193PubMedCrossRefGoogle Scholar
  25. 25.
    Conlisk AJ, Galuska DA (2000) Is caffeine associated with bone mineral density in young adult women? Prev Med 31:562–568PubMedCrossRefGoogle Scholar
  26. 26.
    Lloyd T, Rollings N, Kieselhorst K, Eggli DF, Mauger EA (1998) Dietary caffeine intake is not correlated with adolescent bone gain. J Am Coll Nutr 17:454–457PubMedGoogle Scholar
  27. 27.
    McGartland C, Robson P, Murray L, Cran G, Savage M, Watkins D, Rooney M, Boreham C (2003) Carbonated soft drink consumption and bone mineral density in adolescence: the Northern Ireland Young Hearts project. J Bone Miner Res 18:1563–1569PubMedCrossRefGoogle Scholar
  28. 28.
    Packard P, Recker R (1996) Caffeine does not affect the gain in spine bone in young women. Osteoporos Int 6:149–152PubMedCrossRefGoogle Scholar
  29. 29.
    Rubin L, Hawker G, Peltekova V, Fielding L, Ridout R, Cole D (1999) Determinants of peak bone mass: clinical and genetic analyses in a young female Canadian cohort. J Bone Miner Res 14:633–643PubMedCrossRefGoogle Scholar
  30. 30.
    Heaney RP (2005) BMD: the problem. Osteoporos Int 16:1013–1015PubMedCrossRefGoogle Scholar
  31. 31.
    Deng H-W, Xu F-H, Davies KM, Heaney R, Recker RR (2002) Differences in bone mineral density, bone mineral content, and bone areal size in fracturing and non-fracturing women, and their interrelationships at the spine and hip. J Bone Miner Metab 20:358–366PubMedCrossRefGoogle Scholar
  32. 32.
    Scholes D, LaCroix A, Ichikawa L, Barlow W, Ott S (2002) Injectable hormone contraception and bone density: results from a prospective study. Epidemiology 13:581–587PubMedCrossRefGoogle Scholar
  33. 33.
    Scholes D, LaCroix A, Ichikawa L, Barlow W, Ott S (2004) The association between depot medroxyprogesterone acetate contraception and bone mineral density in adolescent women. Contraception 69:99–104PubMedCrossRefGoogle Scholar
  34. 34.
    Scholes D, LaCroix A, Ichikawa L, Barlow W, Ott S (2005) Change in bone mineral density among adolescent women using and discontinuing depot medroxyprogesterone acetate contraception. Arch Pediatr Adolesc Med 159:139–144PubMedCrossRefGoogle Scholar
  35. 35.
    Scholes D, LaCroix A, Ott S, Ichikawa L, Barlow W (1999) Bone mineral density in women using depot medroxyprogesterone acetate for contraception. Obstet Gynecol 93:233–238PubMedCrossRefGoogle Scholar
  36. 36.
    Barone J, Roberts H (1996) Caffeine consumption. Food Chem Toxicol 34:119–129PubMedCrossRefGoogle Scholar
  37. 37.
    Chandra A, Martinez GM, Mosher WD, Abma JC, Jones J (2005) Fertility, family planning, and reproductive health of U.S. women: data from the 2002 National Survey of Family Growth. Vital Health Stat 23:1–160Google Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2007

Authors and Affiliations

  • C. M. Wetmore
    • 1
  • L. Ichikawa
    • 2
  • A. Z. LaCroix
    • 1
    • 2
  • S. M. Ott
    • 3
  • D. Scholes
    • 1
    • 2
    Email author
  1. 1.Department of Epidemiology, School of Public Health and Community MedicineUniversity of WashingtonSeattleUSA
  2. 2.Center for Health StudiesGroup Health CooperativeSeattleUSA
  3. 3.Department of Medicine, School of MedicineUniversity of WashingtonSeattleUSA

Personalised recommendations