Soft Drinks and Osteoporosis in WHI Participants
Condition: Osteoporosis; Diet Habit
MeSH terms: Osteoporosis
Study type: Observational

Summary: 
      Osteoporotic fractures, as a consequence of a reduced mineral bone density (BMD) represents a
      major public health problem. The lifetime risk of fractures exceeds 40% for women and 13% for
      men. At least ten different individual characteristics have already been proposed, evaluated,
      and some of them accepted as risk factors. Some of those risk factors were compiled in a tool
      developed by the World Health Organization in order to predict the ten-risk for a new
      fracture, even without considering BMD in that prediction . Increased consumption of
      carbonated soft drinks has been reported to have associations to a lower bone mineral density
      and an increment in bone fractures among young and also elder subjects.

      However, some prospective studies have not found any significant associations and others
      suggested that risk is only increased for some kinds of beverages, like cola beverages, but
      not to the entire universe of soft drinks. In this sense, a large prospective analysis
      performed on 1413 women and 1125 men from the Framingham Offspring Cohort, analyzed- the
      relation between soft drinks consumption and BMD at the spine and 3 hip sites. Cola intake
      was associated with significantly lower BMD at each hip site, but not the spine, in women but
      not in men. Similar results were observed for diet cola and, although weaker, for
      decaffeinated cola. No significant relations between non-cola carbonated beverage consumption
      and BMD were observed.

      In spite of the fact that reduced bone mineral density and osteoporotic fractures represent
      an increasing burden of disease and disability in postmenopausal women, most of the studies
      performed in this population used BMD as primary outcome, and not common osteoporotic
      fractures (e.g. hip, spine or wrist). Therefore, there is no conclusive evidence of a
      potential causal association between soft drinks (cola and non-cola) and fractures in a
      population in which osteoporotic fractures hold the highest incidence.

      This research proposal is based on using the Women Health Initiative data to analyze the
      relation between cola and non-cola soft drinks consumption on common osteoporotic fractures.
      BMD will be considered a secondary outcome.
    


Intervention name(s): Soft drinks
Intervention type(s): Other
Intervention description(s): Caffeine and Caffeine free soft drinks
Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        The WHI is an ongoing national study that enrolled 161,808 postmenopausal women aged 50-79
        at baseline, enrolled during 1993-1998. Data collection at screening and enrollment
        included questionnaires completed by self-report or interview, physical examination, and
        blood specimen collection. Information on soda intake (total, caffeinated and
        caffeine-free) was collected at the sixth follow-up year in the OS among 79,885 women who
        form the baseline study population for this analysis. After exclusion of participants who
        had incomplete exposure information (n=5,413), had previous history of hip fracture
        (n=471), or less than one day of follow up after Year 6 (n=1659), a cohort of 72,342
        participants contributing 700,388 person/years of follow-up was used for the prospective
        analysis. All participants provided informed consent at baseline and subsequently for
        extended follow-up.
      
Keywords: Osteoporosis; Hip Fractures; Soft Drinks