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Study Title and Description

Coffee consumption and risk of fractures: a systematic review and dose-response meta-analysis.



Key Questions Addressed
1 For [population], is caffeine intake above [exposure dose], compared to intakes [exposure dose] or less, associated with adverse effects on bone and calcium balance outcomes?
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Primary Publication Information
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TitleData
Title Coffee consumption and risk of fractures: a systematic review and dose-response meta-analysis.
Author DR Lee,J Lee,M Rota,J Lee,HS Ahn,SM Park,D Shin,
Country
Year 2014
Numbers

Secondary Publication Information
There are currently no secondary publications defined for this study.


Extraction Form: Bone & Calcium Outcomes
Design Details
Question... Follow Up Answer Follow-up Answer
Refid 24576685
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What outcome is being evaluated in this paper? Bone and Calcium
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What is the objective of the study (as reported by the authors)? The data on the association between coffee consumption and the risk of fractures are inconclusive. We performed a comprehensive literature review and meta-analysis to better quantify this association
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Provide a general description of the methods as reported by the authors. Information should be extracted based on relevance to the SR (i.e., caffeine related methods) Data sources and searches: The meta-analysis was performed in accordance with the Meta analysis of Observational Studies in Epidemiology (MOOSE) reporting guidelines. Articles were identified without any language restriction, by searching MEDLINE, EMBASE, Cochrane Library,Web of Science, SCOPUS, and CINAHL from the dates of their respective inceptions to February 2013 Two authors independently evaluated all the retrieved articles for inclusion. For each study, data on the study design, location (city and country), number of subjects (cases, controls, or cohort size), duration of follow-up (for cohort studies), age at screening, gender, variables adjusted for in the analysis, RR estimates for each level of coffee consumption and the corresponding 95% CIs, and – when available – the number of cases and non-cases for each level of coffee consumption were obtained. Authors were contacted if information was not available in published reports. If a study reported more than one set of RR estimates, we used the maximally adjusted RRs. If a study provided multiple RR estimates on different outcomes (e.g., forearm and hip fractures), we used the RRs derived from the outcome with the largest number of events. _x000C_ Quality assessment was performed using the Newcastle–Ottawa Quality Assessment Scale (0-9, low to high quality, respectively) Statistical analysis Computed a pooled RR and the CI for the highest category of coffee consumption compared with the lowest category using random effects Models. Statistical heterogeneity across studies was assessed using Q statistics; a P value of <0.10 was considered statistically significant. Potential inconsistency was quantified using the Higgins I2 statistic,which represents the proportion of the total variation contributed by between study variance. Performed stratified analyses by study design (cohort or case–control), gender, age at screening (≥19 years, ≥50 years, and ≥65 years), methodological quality (high vs. low), level of adjustment (high vs. low), latitude (≥37° vs. b37°), study location (United States, Canada, and Europe vs. Asia-Pacific), duration of follow-up (≥10 years vs. b10 years), and fracture site (hip/ femur or forearm/wrist). The level of adjustment (high vs. low) was defined according to the number of variables (≥4 vs. b4) adjusted for in the analyses, as selected from the following: age, gender, body mass index, alcohol consumption, smoking, calcium intake, physical activity, menopause, bone density, sun exposure or vitamin D intake, estrogen therapy, glucocorticoid therapy, previous fractures, grip strength, and functional mobility. Dose–response analysis was performed using both linear and nonlinear random-effects models. To determine the dose–response relationship, only studies which reported at least 3 categories of coffee consumption and provided the number of cases and controls for each category were included. When coffee consumption was given as a range: value of exposure was assigned as the midpoint between the upper and lower boundaries for each category of coffee consumption; for the highest open ended category, the value of exposure was assigned by keeping the same amplitude of range categories. Publication bias evaluated visually via funnel plots. Begg’s test and Egger’s test were also performed.
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How many outcome-specific endpoints are evaluated? 1
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What is the (or one of the) endpoint(s) evaluated? (Each endpoint listed separately) Risk of fracture
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Clinical, physiological, other Clinical
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What is the study design? Meta-analysis
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Randomized or Non-Randomized?
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What were the diagnostics or methods used to measure the outcome? Objective
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Optional: Name of Method or short description Reported in individual studies
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Caffeine (general) Caffeine (general)
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Coffee, Chocolate, energy drink, gum, medicine/supplement, soda, tea, other? coffee
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Measured or self reported? Self-report
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Children, adolescents, adults, or pregnant included? Adults
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What was the reference, comparison, or control group(s)? (e.g. high vs low consumption, number of cups, etc.) Study included case control and or cohort studies
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What were the listed confounders or modifying factors as stated by the authors? (e.g. multi-variable components of models.  Copy from methods) Varied by individual study, though authors conducted stratified analyses by: the number of variables (≥4 vs. b4) adjusted for in the analyses, as selected from the following: age, gender, body mass index, alcohol consumption, smoking, calcium intake, physical activity, menopause, bone density, sun exposure or vitamin D intake, estrogen therapy, glucocorticoid therapy, previous fractures, grip strength, and functional mobility.
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What were the sources of funding? This work was supported by Wonkwang University in 2013
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What conflicts of interest were reported? None.
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Results & Comparisons

No Results found.