Coffee, Tea, and Bone Health: A 10-Year Study in Older Women
Highlights
- A longitudinal study followed older women for approximately 10 years to examine coffee and tea consumption in relation to bone mineral density (BMD)
- Tea consumption was associated with slightly higher total hip BMD in older postmenopausal women
- No significant overall association was found between coffee consumption and femoral neck or total hip BMD during the primary follow-up period
- Analyses suggested that consuming more than five cups of coffee per day may be associated with lower BMD
- The associations between these beverages and bone health may vary according to individual factors such as alcohol intake and body mass index (BMI)
Summary
Coffee and tea are among the most widely consumed beverages in the world, yet their long-term relationship with bone health remains uncertain. Because both beverages contain biologically active compounds, including caffeine, researchers have investigated whether habitual consumption may influence bone mineral density (BMD) and osteoporosis risk.
A study published in Nutrients examined the longitudinal associations between coffee and tea consumption and BMD in older postmenopausal women. Using data from the Study of Osteoporotic Fractures (SOF), researchers analyzed repeated measurements of beverage consumption and BMD collected over approximately 10 years.
The study found that tea consumption was associated with slightly higher total hip BMD. Coffee consumption, meanwhile, showed no significant overall association with either femoral neck or total hip BMD during the primary follow-up period.
However, analyses examining the amount of coffee consumed suggested that very high intake may be important. Consumption of more than five cups of coffee per day showed a trend toward lower BMD, although this finding should be interpreted cautiously because the statistical tests did not establish a significant nonlinear relationship.
Following Bone Health Over Time
The researchers used data from the Study of Osteoporotic Fractures, a large prospective cohort that originally enrolled 9,704 women aged 65 years and older.
For the primary analysis, coffee and tea consumption and BMD measurements were evaluated across four study visits spanning approximately 10 years. Femoral neck and total hip BMD were measured using dual-energy X-ray absorptiometry (DXA).
The analysis included 24,638 observations across the four study visits. During follow-up, mean femoral neck BMD declined from approximately 0.65 g/cm² to 0.62 g/cm², while total hip BMD declined from approximately 0.76 g/cm² to 0.73 g/cm².
To better isolate the relationship between beverage consumption and BMD, the researchers adjusted for multiple factors including age, BMI, smoking, comorbidities, age at menopause, alcohol use, calcium and protein intake, physical activity, estrogen use, steroid use, and baseline BMD.
Tea Consumption and Total Hip BMD
One of the study’s main findings involved tea consumption.
At the primary endpoint, women who consumed tea had a slightly higher adjusted total hip BMD than women who did not drink tea. In the extensively adjusted model, the estimated total hip BMD was 0.718 g/cm² among tea drinkers compared with 0.715 g/cm² among non-tea drinkers.
The difference of approximately 0.003 g/cm² was statistically significant. However, the researchers emphasized that this difference is below the threshold generally considered clinically meaningful for the management of an individual patient.
Nevertheless, the authors noted that small differences in BMD across a large population could potentially have epidemiological or public health relevance. Further studies examining fracture outcomes directly will be needed to determine whether the observed association translates into meaningful reductions in fracture risk.
Coffee Showed No Overall Association with BMD
In contrast with tea, coffee consumption was not significantly associated overall with either femoral neck BMD or total hip BMD during the primary follow-up period.
This finding is important because previous research examining coffee and bone health has produced conflicting results. Some studies have associated higher coffee intake with lower BMD, while others have reported no association or even potentially protective relationships.
The current study therefore does not support the conclusion that ordinary coffee consumption is necessarily harmful to bone density in older women.
Could Very High Coffee Intake Be Different?
The researchers also examined coffee intake according to the number of cups consumed per day.
Natural spline analyses suggested that approximately two to three cups of coffee per day may have little relationship with BMD. At higher levels of consumption, however, the curves began to trend downward.
In particular, consumption exceeding approximately five cups per day visually appeared to be associated with lower femoral neck and total hip BMD.
Importantly, the statistical tests for nonlinearity were not significant in the primary analysis. The finding should therefore be considered a possible trend rather than evidence that drinking more than five cups of coffee directly causes bone loss.
Individual Factors May Influence the Relationship
The study also explored whether the associations between coffee, tea, and BMD differed according to individual characteristics.
Lifetime alcohol intake appeared to modify the relationship between coffee consumption and femoral neck BMD. Coffee consumption showed a more favorable association among women with lower lifetime alcohol intake, while the authors concluded that women with higher alcohol intake may benefit from limiting coffee consumption.
BMI also appeared to modify the relationship between tea consumption and femoral neck BMD. Among women classified as having obesity, tea consumption was associated with higher femoral neck BMD.
However, the researchers emphasized that these subgroup findings should be interpreted cautiously. Subgroup analyses may have limited statistical power and can produce chance findings, meaning these results should primarily be considered hypotheses for future research.
Why Might Coffee and Tea Affect Bone Differently?
Coffee and tea contain multiple biologically active compounds that could influence bone metabolism through different mechanisms.
Caffeine has received particular attention because experimental research suggests that it may influence calcium balance and cellular processes involved in bone formation and resorption. However, the effects observed in humans appear to be complex and may depend on factors such as calcium intake, genetics, and the amount of caffeine consumed.
Tea also contains catechins, including compounds such as epigallocatechin (EGC). Previous experimental research discussed by the authors suggests that these compounds may promote osteoblast activity and inhibit osteoclast differentiation, providing one possible biological explanation for the observed association between tea consumption and BMD.
These mechanisms remain an area of ongoing research and do not establish that drinking tea directly increases bone density.
A Long-Term View of Diet and Bone Health
A major strength of this study is its use of repeated measurements. Rather than relying on a single assessment of beverage consumption or BMD, researchers repeatedly measured both variables over an extended period.
This approach provides a more detailed picture of how dietary habits and bone density change as women age.
However, the study also has important limitations. Coffee and tea consumption was self-reported, and information about cup size, beverage strength, and specific types of coffee or tea was not available. The long follow-up also resulted in substantial missing data, and residual confounding cannot be completely excluded.
In addition, the study population consisted almost entirely of older White women in the United States. The findings therefore may not apply equally to men, younger individuals, or people from other racial and ethnic populations.
Overall, the findings suggest that tea consumption is associated with slightly higher total hip BMD in older postmenopausal women, while moderate coffee consumption does not appear to have a significant overall relationship with BMD. Very high coffee consumption may warrant further investigation, particularly among individuals with other lifestyle factors that could influence bone health.
Reference
Liu, R. Y., & Liu, E. (2025). Longitudinal Association of Coffee and Tea Consumption with Bone Mineral Density in Older Women: A 10-Year Repeated-Measures Analysis in the Study of Osteoporotic Fractures. Nutrients, 17, 3660.
