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.
Highlights
Hip fracture, one of the most serious complications of osteoporosis, has become a major health problem in many countries in recent decades because of the rapid increase in incidence
Study selection We included studies which met the following criteria: (1) it had a prospective cohort study design; (2) the exposure of interest was consumption of coffee; (3) the endpoint of interest was incidence of hip fracture; (4) the relative risk (RR) and the corresponding 95% confidence interval (CI) of hip fracture relating to the total or to all categories of coffee intake were reported or could be calculated from the data provided; and (5) the frequency and dose of coffee consumption were provided
After 115 duplicates were excluded, 103 citations were screened through titles and abstracts, 88 of them were excluded mainly because they were case–control studies, cross-sectional studies, reviews, or irrelevant studies
Summary
One of the most serious complications of osteoporosis, has become a major health problem in many countries in recent decades because of the rapid increase in incidence. Identifying and confirming the modifiable risk factors and protective factors of hip fracture incidence is of significant importance for developing preventive strategies. The potential influence factors for hip fractures include daily calcium intake [2], physical activity level [3,4], body mass index (BMI) [5,6], smoking [7], and alcohol consumption [8]. Epidemiological studies have, found that high dietary caffeine intake is associated with reduced bone mineral density and increased body calcium loss [11,12]. An earlier meta-analysis by Liu et al [13] suggested that
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