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DrG's Medisense Feature Article
13063-Cola_Drinks_&_Bone_Density
Cola
Drinks and Bone Density
by Ann Gerhardt, MD
May 2013
Print Version
Bottom
Line at the Top: Drink
water.
Carbonated cola drinks increase risk of bone fractures in teenage
girls. Women of child-bearing age who drink 3 or more colas
per
week have lower bone density, even if calcium and vitamin D intake are
adequate. In older adults, colas are associated with lower
bone
density. So what is it in colas that is the culprit?
We like to blame things on sugar and artificial sweeteners, but these
studies have proven that bone density is unrelated to soda’s
type
or amount of sweetener. It’s not the carbonation
that
causes bone loss, either. People who drink carbonated waters,
selzers and sodas that aren’t colas don’t have any
worse
bone density than non-fuzzy water drinkers.
Scientists have narrowed the bone problem down to cola drinks, like
Coke and Pepsi, as beverages that cause calcium to leach out of bones
and impair bone strength. Lose enough calcium over time and
your
bone density falls, increasing the risk of fracture. This is
often attributed to the caffeine content, though colas usually have
only about 50 mg caffeine per can, about 1/5th the amount in a cup of
coffee, and colas also contain phosphoric acid.
Soda manufacturers add phosphoric acid to colas to add a tangy flavor
and help keep the carbonation bubbles from going flat. Long
ago
“phosphates” were a popular soft drink (back when
Coca Cola
contained real cocaine). Citric acid would work as an
alternative, but it’s more expensive and has a different
flavor.
Phosphorus is essential for health, and a diet of meat, beans and nuts
contains quite a bit of it. The body does best when
phosphorus
intake matches that of calcium, but when excess phosphate circulates in
blood, particularly as an acid, bone releases calcium to the blood to
bind it. Both are then lost in the urine. Lose
enough, and
bone density declines.
So is it the caffeine or phosphoric acid? Katherine Tucker at
Tufts University found that women who consume decaffeinated cola (with
phosphoric acid) had lower bone density, but not as low as those who
drank caffeinated colas. Robert Heaney of Creighton
University
found that decaffeinated cola, drunk in one sitting, did not increase
urinary calcium excretion. Two good scientists, using
different
measures, came up with different conclusions. Perhaps the
caffeine and phosphoric acid together exert a synergistic effect on
bone.
Until someone can definitively determine the culprit, we should avoid
colas and probably avoid beverages with either caffeine or phosphoric
acid. Read labels to detect both, since some non-cola sodas
contain a lot of caffeine (Mountain Dew) and there may be non-colas
with phosphoric acid.
Of course, sodas aren’t the whole issue with bone:
We also
need adequate protein, calories, weight bearing exercise, calcium,
vitamin D, and a slew of other nutrients. Plenty of things to
eat
and drink besides colas.