Coffee, Red Tea, and Milk: Impact on Osteoporosis Prevention

Osteoporosis is a common bone disease that affects millions of people worldwide. It causes the bones to become weak and brittle, increasing the risk of fractures and disability. Osteoporosis can affect anyone, but some factors can increase the likelihood of developing it, such as age, gender, family history, and lifestyle habits. One of the most important factors that influences bone health is nutrition, especially the intake of calcium and vitamin D, which are essential for bone formation and maintenance. However, some foods and beverages may interfere with calcium absorption or increase calcium excretion, such as coffee, tea, and milk. In this article, we will explore the relation between these drinks and osteoporosis, and provide some practical tips on how to prevent and treat this condition.

In this article, you will learn about:

Table of Contents

• Why Osteoporosis Occurs
• Who are at High Risk for Osteoporosis
• Does Coffee, Tea, and Milk Affect Calcium Absorption
• 6 Measures to Prevent Osteoporosis
• Frequently Asked Questions
  • What are the side effects of osteoporosis medications?
  • Can osteoporosis be reversed?
• References

Why Osteoporosis Occurs

Osteoporosis is a condition that affects the bones, making them weak and prone to fractures. It occurs when the body loses more bone than it can make, or when the body does not make enough bone to replace the natural wear and tear. Osteoporosis is a silent disease that often has no symptoms until a fracture happens. According to the World Health Organization, osteoporosis is the second most common chronic disease in the world, affecting about 200 million people worldwide.

There are many factors that influence bone health, such as genetics, nutrition, physical activity, hormones, and aging. Bone is a living tissue that constantly undergoes remodeling, which means old bone is broken down and new bone is formed. The balance between bone formation and bone resorption determines the bone mass and density. When we are young, our bone formation is faster than bone resorption, resulting in increased bone mass and peak bone density around the age of 20 to 30. However, as we age, bone resorption gradually overtakes bone formation, leading to bone loss and reduced bone density. This process is accelerated in women after menopause, due to the decline of estrogen, a hormone that protects bone health.

When the bone density falls below a certain threshold, the bones become porous and fragile, and the risk of fractures increases. Osteoporosis can affect any bone in the body, but the most common sites are the spine, hip, and wrist. Fractures can have serious consequences, such as pain, disability, loss of independence, reduced quality of life, and even death. Therefore, preventing and treating osteoporosis is crucial for maintaining bone health and reducing fracture risk.

Who are at High Risk for Osteoporosis?

Osteoporosis is a condition that causes the bones to become weak and brittle, increasing the risk of fractures and deformities. Some people are more likely to develop osteoporosis than others, depending on various factors. According to the International Osteoporosis Foundation, the following groups are at high risk for osteoporosis:

• Older adults: Age is one of the main risk factors for osteoporosis, as bone density decreases naturally with aging. The risk is especially high for individuals aged 70 and above, who may have other health conditions or reduced mobility that affect their bone health.
• Postmenopausal women: Women experience a rapid loss of bone mass after menopause, due to the decline in estrogen levels. Estrogen is a hormone that protects the bones from resorption, the process of breaking down bone tissue. Postmenopausal women have an average bone mass reduction of 25% between ages 50 to 60, significantly more than men of the same age.
• People with a family history of osteoporosis: Genetics play a role in determining bone strength and density. People who have a parent or sibling with osteoporosis are more likely to inherit the condition or have low bone mass themselves.
• People with poor dietary habits or lifestyle: A balanced diet that provides adequate amounts of calcium, vitamin D, and other nutrients is essential for maintaining bone health. Calcium is the main mineral that builds and strengthens the bones, while vitamin D helps the body absorb calcium from food. People who do not consume enough calcium or vitamin D, or who have malabsorption disorders, may have low bone density. Other lifestyle factors that can harm the bones include smoking, excessive alcohol consumption, physical inactivity, and exposure to environmental pollutants.
• People who use corticosteroid medications for a long time: Corticosteroids are anti-inflammatory drugs that are used to treat various conditions, such as asthma, arthritis, lupus, and cancer. However, long-term use of these medications can interfere with the balance of bone formation and resorption, leading to bone loss and osteoporosis. According to a study published in the Journal of Bone and Mineral Research, the risk of osteoporosis increases by 30% after one year of corticosteroid use, and by 70% after five years.
• People who are underweight or have eating disorders: Having a low body weight or a body mass index (BMI) below 18.5 kg/m² can increase the risk of osteoporosis, as it indicates a lack of fat and muscle tissue that support the bones. People who have eating disorders, such as anorexia nervosa or bulimia nervosa, may also have low bone density due to malnutrition, hormonal imbalances, and excessive weight loss.
• Women who have never given birth: Pregnancy and lactation are periods when women need more calcium and other nutrients to support the growth and development of the fetus and the infant. Women who have never given birth may have lower bone density than women who have had children, as they have not experienced the hormonal and metabolic changes that occur during pregnancy and lactation, which may have a protective effect on the bones.
• People with certain diseases or conditions: Some diseases or conditions can affect the bone metabolism or the production of hormones that regulate bone health. For example, hyperthyroidism, a condition where the thyroid gland produces too much thyroid hormone, can speed up the bone resorption and cause bone loss. Diabetes, a condition where the blood sugar levels are too high, can impair the function of osteoblasts, the cells that form new bone tissue. Liver disease, kidney disease, and gonadal insufficiency, such as early menopause or low testosterone levels, can also increase the risk of osteoporosis.

Knowing the risk factors for osteoporosis can help people take preventive measures to protect their bones and prevent fractures. The next section will discuss some of the ways to prevent osteoporosis and maintain bone health.

Does Coffee, Tea, and Milk Affect Calcium Absorption?

Does Drinking Coffee Lead to Calcium Loss? Should You Consume Less?

According to the European Food Safety Authority, a daily caffeine intake of up to 300 mg is recommended and does not significantly impact health. Physiologically, caffeine increases the excretion of calcium in urine, leading to calcium loss. However, from a clinical perspective, there is currently no direct evidence that drinking coffee causes osteoporosis. Caffeine is listed as one of the risk factors, but not the primary cause. Light and dark roasted coffees have similar caffeine levels and do not significantly affect bone density.
For individuals with existing osteoporosis who enjoy coffee, it’s essential to supplement calcium to prevent exacerbating calcium loss. To enjoy coffee healthily, ensure an adequate intake of calcium-rich foods, such as dairy products, nuts, seeds, and leafy greens. You can also add milk or cream to your coffee to increase the calcium content. Moreover, limit your coffee consumption to no more than three cups per day and avoid drinking it on an empty stomach or before bedtime.

Can Drinking Black Tea Prevent Osteoporosis? Should You Consume More?

Past studies suggested that tea polyphenols in black tea contribute to increased bone density, potentially preventing osteoporosis. However, there is no conclusive scientific evidence supporting a direct link between tea consumption and osteoporosis or fractures. Intense tea contains a significant amount of caffeine, affecting calcium absorption, so it’s advisable to drink tea moderately and not on an empty stomach. Additionally, tea also contains oxalic acid, which can form insoluble calcium oxalate and reduce calcium availability. Therefore, it’s best to avoid drinking tea with meals or calcium supplements. Instead, drink tea between meals or with snacks that contain some calcium, such as cheese, yogurt, or nuts.

Can Drinking Milk Prevent Osteoporosis? Should You Consume More?

An article in the Journal of the American Medical Association suggests that milk can offset the bone risks associated with coffee consumption. Adults need approximately 800 to 1200 mg of calcium daily, primarily from dairy products, dried shrimp, small dried fish, seaweed, black sesame, soy products, and dark green vegetables. Dairy is the best source due to its high calcium content and high absorption rate. Milk, for example, provides around 270 mg of calcium per 240 ml, about a quarter of the recommended daily intake for adults. The ideal calcium-phosphorus ratio and lactose content in milk enhance calcium absorption, strengthening teeth and bone density, preventing osteoporosis. However, those with lactose intolerance should obtain calcium from alternative sources like black sesame and fortified soy milk, or take lactase enzyme supplements before drinking milk.

6 Measures to Prevent Osteoporosis:

Osteoporosis is a serious condition that affects millions of people worldwide, especially older adults. It can lead to fractures, pain, disability, and reduced quality of life. Fortunately, there are some preventive measures that can help reduce the risk of osteoporosis and its complications. Here are six of them:

1. Eat a balanced diet rich in calcium and other nutrients. Calcium is the main building block of bones, and it is essential for maintaining bone health. Some good sources of calcium include dairy products, dark green leafy vegetables, nuts, seeds, tofu, and fortified foods. You may also need to take calcium supplements if your diet is inadequate or if you have certain medical conditions. Other nutrients that are important for bone health include vitamin D, magnesium, phosphorus, and protein. Vitamin D helps your body absorb calcium from food and supplements, and it can be obtained from sunlight exposure, fatty fish, eggs, and fortified foods. Magnesium and phosphorus are also involved in bone formation and metabolism, and they can be found in whole grains, beans, nuts, seeds, and dairy products. Protein is necessary for building and repairing bone tissue, and it can be obtained from meat, poultry, fish, eggs, dairy products, soy, and legumes.
2. Exercise regularly and moderately. Physical activity is beneficial for your bones, as it stimulates bone formation and reduces bone loss. It also improves your muscle strength, balance, coordination, and posture, which can prevent falls and fractures. The best types of exercise for bone health are weight-bearing and resistance exercises, which involve moving your body against gravity or using weights or bands. Some examples are walking, jogging, hiking, climbing stairs, dancing, playing tennis, lifting weights, and doing push-ups or squats. You should aim for at least 30 minutes of moderate exercise on most days of the week, and vary your routine to avoid boredom and injury. However, avoid excessive or high-impact exercise, as it may cause more harm than good to your bones and joints. Consult with your doctor before starting any new exercise program, especially if you have osteoporosis or other health conditions.
3. Consider taking medication for osteoporosis if needed. If you have osteoporosis or a high risk of developing it, your doctor may prescribe medication to slow down bone loss and reduce fracture risk. There are different types of medication for osteoporosis, such as bisphosphonates, hormone therapy, selective estrogen receptor modulators (SERMs), denosumab, and teriparatide. Each medication has its own mechanism of action, benefits, and side effects, and they may not be suitable for everyone. Therefore, it is important to follow your doctor’s instructions and advice on how to take your medication, how long to take it, and what to expect from it. You should also inform your doctor of any other medications or supplements you are taking, as they may interact with your osteoporosis medication. Do not stop taking your medication without consulting your doctor, as this may increase your fracture risk.
4. Get enough sun exposure. Sunlight is a natural source of vitamin D, which is essential for calcium absorption and bone health. Exposure to sunlight for about 10 to 15 minutes, three to four times a week, can provide sufficient vitamin D for most people. However, the amount of sun exposure you need may vary depending on your skin color, age, location, season, and time of day. Too much sun exposure can also cause skin damage and increase the risk of skin cancer, so you should always protect yourself with sunscreen, clothing, and hats. If you have limited sun exposure or low vitamin D levels, you may need to take vitamin D supplements to meet your daily requirement. Your doctor can check your vitamin D level and advise you on the appropriate dosage of supplements.
5. Avoid smoking and limit alcohol and caffeine intake. Smoking, alcohol, and caffeine can have negative effects on your bone health, as they can interfere with calcium absorption, hormone balance, and bone metabolism. Smoking can also reduce blood flow to the bones, impair healing, and increase inflammation. Alcohol can impair your judgment and coordination, increasing your risk of falls and fractures. Caffeine can increase urinary calcium excretion, leading to calcium loss from the bones. Therefore, you should quit smoking and limit your alcohol and caffeine consumption to moderate amounts. The recommended limit for alcohol is no more than one drink per day for women and two drinks per day for men. The recommended limit for caffeine is no more than 300 milligrams per day, which is equivalent to about three cups of coffee or six cups of tea.
6. Have regular check-ups and bone density tests. Osteoporosis is often called a silent disease, as it may not cause any symptoms until a fracture occurs. Therefore, it is important to have regular check-ups and bone density tests to monitor your bone health and detect osteoporosis early. A bone density test is a painless and non-invasive procedure that uses X-rays to measure the amount of mineral in your bones. It can help diagnose osteoporosis, assess your fracture risk, and evaluate your response to treatment. The most common bone density test is called a dual-energy X-ray absorptiometry (DXA) scan, which measures the bone density of your spine, hip, and wrist. Your doctor can recommend how often you should have a bone density test, depending on your age, risk factors, and medical history.

Frequently Asked Questions

What are the side effects of osteoporosis medications?

Medications for osteoporosis may have side effects, depending on the type, dose, and duration of treatment. Common side effects include nausea, stomach pain, heartburn, constipation, diarrhea, headache, dizziness, and flu-like symptoms. Some medications may also cause more serious side effects, such as jaw problems, bone fractures, kidney problems, blood clots, stroke, and cancer. It is essential to consult with a healthcare professional to understand the potential risks and benefits of your medication, and to report any unusual or severe symptoms. You should also follow the instructions on how to take your medication correctly, such as when to take it, what to eat or drink with it, and how to store it.

Can osteoporosis be reversed?

Osteoporosis is a condition characterized by weakened bones, and while it can be managed and treated, complete reversal may not be possible. However, various measures, including medication, lifestyle changes, and proper nutrition, can slow down bone loss and improve bone density. Some studies have shown that certain medications, such as teriparatide and romosozumab, can stimulate new bone formation and increase bone mass. However, these medications are not widely available, have limited indications, and may have serious side effects. Therefore, they are not suitable for everyone, and they require careful monitoring by a doctor. Consult with a healthcare provider for personalized advice on how to prevent and treat osteoporosis.

References

1. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA). Scientific Opinion on the safety of caffeine. EFSA Journal. 2015;13(5):4102.
2. Heaney RP. Effects of caffeine on bone and the calcium economy. Food and Chemical Toxicology. 2002;40(9):1263-1270.
3. Wang Y, Ho CT. Polyphenolic chemistry of tea and coffee: a century of progress. Journal of Agricultural and Food Chemistry. 2009;57(18):8109-8114.
4. Hegarty VM, May HM, Khaw KT. Tea drinking and bone mineral density in older women. The American Journal of Clinical Nutrition. 2000;71(4):1003-1007.
5. Taiwan Food and Drug Administration. Tea and osteoporosis. 2018. 

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