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Study Title and Description

Soda consumption and risk of hip fractures in postmenopausal women in the Nurses' Health Study.



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 Soda consumption and risk of hip fractures in postmenopausal women in the Nurses' Health Study.
Author TT Fung,MH Arasaratnam,F Grodstein,JN Katz,B Rosner,WC Willett,D Feskanich,
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 25099544
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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)? Examine the association of soda, including specific types of soda, and risk of hip fracture in postmenopausal women.
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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) Subjects: Participants in the Nurses’ Health Study, an ongoing, prospective cohort study of women initiated in 1976 when 121,700 nurses aged 30–55 y who were living in 11 US states responded to a questionnaire. In the NHS, a food-frequency questionnaire (FFQ) was completed in 1980, 1984, 1986, and every 4 y thereafter to update dietary information. For this study, women who were postmenopausal at the initial 1980 FFQ entered the study population follow-up at that time; other women entered at the biennial questionnaire when they reached menopause, including surgical menopause. Ascertainment of hip fractures: Participants reported hip fractures on biennial questionnaires, which also included information on the bone site and month and year of the fracture. Only fractures of the proximal femur were classified as a hip fractures for the analysis. Dietary assessment: Soda and other food and supplement intakes were assessed repeatedly via a validated semi-quantitative FF. The FFQ included items on carbonated beverages that were regular (sugar-sweetened) or diet, with or without caffeine, and as a cola or noncola type. Statistics: Cox proportional hazards models used to examine the relation between soda consumption and hip fractures. cumulative averages for beverage, food, and nutrient intakes from available FFQs to reduce the within-person variation were calculated and represent long-term intake. Exposure variables for the consumption of total soda and the various subtypes were modeled as categorical variables on the basis of frequency. Linear trend in hip-fracture risk with increasing soda consumption was assessed by assigning the median intake per day of each category to minimize the influence of outliers. Multivariable analysis was adjusted for age; energy intake; physical activity; smoking; BMI; thiazide use; postmenopausal hormone use; intakes of vitamin D, calcium, retinol, protein, caffeine, and alcohol; and the Alternate Mediterranean diet score. In addition, regular and diet sodas were adjusted for one another, caffeinated and noncaffeinated sodas were adjusted for one another, and cola and noncola were adjusted for one another. Analyses also included secondary analyses related to diabetes, postmenopausal hormone use, BMI, and physical activity.
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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 hip fracture
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Clinical, physiological, other Clinical
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What is the study design? Cohort
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Randomized or Non-Randomized?
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What were the diagnostics or methods used to measure the outcome? Subjective
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Optional: Name of Method or short description self-reporting of fracture, supported by a validation study
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Caffeine (general) Caffeine (general)
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Coffee, Chocolate, energy drink, gum, medicine/supplement, soda, tea, other? soda
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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.) amount of caffeine (mg/day) in caffeinated soda (servings/week) evaluated by quintile
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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) Multivariable analysis was adjusted for age; energy intake; physical activity; smoking; BMI; thiazide use; postmenopausal hormone use; intakes of vitamin D, calcium, retinol, protein, caffeine, and alcohol; and the Alternate Mediterranean diet score. In addition, regular and diet sodas were adjusted for one another, caffeinated and noncaffeinated sodas were adjusted for one another, and cola and noncola were adjusted for one another.
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What were the sources of funding? Supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant nos. T32 AR 055885, P60 AR 47782, AG30521) and the NIH (grant no. CA87969)
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What conflicts of interest were reported? None of the authors had a conflict of interest.
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Results & Comparisons

No Results found.