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Soft drinks, tea and coffee consumption in relation to risk of fracture: evidence from china health and nutrition survey

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Abstract

Introduction

To investigate the association between soft drinks, tea and coffee consumption, and risk of fracture in the China Health and Nutrition Survey.

Materials and methods

A cross-sectional study with multi-stage random cluster sampling was conducted in nine Chinese provinces in 2004, 2006, 2009 and 2011. A total of 36,740 participants were included the data analyses. Self-administered questionnaires and physical examinations provided data on beverages consumption, fracture history, and other potential risk factors. Binary logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for potentially confounding variables.

Results

The prevalence of fracture increased over the 7-year period of the surveys, with 1833 (5.3%) participants reporting a fracture history. Soft drink consumption increased over this time period, and tea consumption was relatively stable, whereas coffee consumption tended to increase sharply. Consumers of soft drinks ≥ 3 times/week (versus never) had a higher risk of fracture (OR = 1.86, 95% CI = 1.43–2.32, p < 0.001, p for trend = 0.039). Consumers of tea ≥ 5 cups/day (versus never) also had a higher risk of fracture (OR = 1.21, 95% CI = 1.09–1.45, p = 0.028, p for trend < 0.001). Similarly, consumers of coffee ≥ 2 cups/day (versus never) had a higher risk of fracture (OR = 1.84, 95% CI = 1.01–3.34, p = 0.045, p for trend = 0.002). Subgroup analyses by gender suggested that coffee consumption increased risk of fracture in females (OR = 1.84, 95% CI = 1.32–2.63, p = 0.001).

Conclusion

Our findings suggest that high consumption of soft drinks, tea and coffee is associated with an increased risk of fracture in the Chinese population. Which has important public health implications given the widespread consumption of these beverages.

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Acknowledgements

This study used data from the China Health and Nutrition Survey (CHNS). We thank the China Centre for Disease Control and Prevention, and the University of North Carolina at Chapel Hill. We also thank the participants for their active cooperation, and the investigators for their excellent work. The authors thank all the patients who participated in this cohort study. We would like to thank Editage (www.editage.com) for the English language editing

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Author notes

  1. Yang Li and Mei Huang contributed equally to this work.

Authors and Affiliations

  1. Department of Nursing, Air Force Medical University, 169 Changle West Road, Xi’an, 710061, China

    Yang Li, Mei Huang, Yan Hua, Yue Lin, Juan Du & Chunping Ni

  2. Department of Public Health, Xi’an Jiaotong University Health Science Center, 76 Yanta West Road, Xi’an, 710061, China

    Zhaozhao Hui & Xiaoqin Wang

  3. Department of Nursing, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710004, China

    Yue Zhang

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  1. Yang Li
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Contributions

YL and MH analyzed and interpreted the data, and was a major contributor in writing the manuscript. YH explained the data regarding the relationship between drinks and fracture. ZH and YZ contributed to the statistical analysis. YL and JD contributed to the creation of figures and tables. XW and CN made substantial contributions to design the study. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Chunping Ni or Xiaoqin Wang.

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Conflict of interest

All authors have no conflicts of interest.

Ethical approval

Data of this study was from the China Health and Nutrition Survey (CHNS). CHNS was approved by the Institutional Review Committees of the University of North Carolina at Chapel Hill and the National Institute of Nutrition and Food Safety, Chinese Center for Disease Control and Prevention (approval number: H-2013–0360).

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Li, Y., Huang, M., Hua, Y. et al. Soft drinks, tea and coffee consumption in relation to risk of fracture: evidence from china health and nutrition survey. J Bone Miner Metab 41, 621–630 (2023). https://doi.org/10.1007/s00774-023-01432-z

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  • DOI: https://doi.org/10.1007/s00774-023-01432-z

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