{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:09:30Z","timestamp":1791846570352,"version":"4.3.4"},"reference-count":88,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2007,1,2]],"date-time":"2007-01-02T00:00:00Z","timestamp":1167696000000},"content-version":"unspecified","delay-in-days":2314,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Public Health Nutr."],"published-print":{"date-parts":[[2000,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S136898000000029X_sec01\"><jats:title>Objective<\/jats:title><jats:p>To assess whether alcoholic and caffeinated beverages are associated with risk of fractures in women.<\/jats:p><\/jats:sec><jats:sec id=\"S136898000000029X_sec02\"><jats:title>Setting<\/jats:title><jats:p>Population-based sample surveyed by post.<\/jats:p><\/jats:sec><jats:sec id=\"S136898000000029X_sec03\" sec-type=\"subjects\"><jats:title>Subjects<\/jats:title><jats:p>A total of 34703 postmenopausal Iowan women aged 55\u201369 years were surveyed.<\/jats:p><\/jats:sec><jats:sec id=\"S136898000000029X_sec04\"><jats:title>Design<\/jats:title><jats:p>A cohort of women reported alcoholic and caffeinated beverage intake and were followed for 6.5 years for fracture occurrence. Relative risks (RR) and 95% confidence intervals (CI) were computed using Cox proportional hazards regression. Covariates included age, tobacco use, physical activity, body mass index (BMI), waist to hip ratio (WHR), oestrogen use and calcium intake.<\/jats:p><\/jats:sec><jats:sec id=\"S136898000000029X_sec05\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>At least one fracture was reported by 4378 women (389 upper arm, 288 forearm, 1128 wrist, 275 hip, 416 vertebral and 2920 other fractures). The adjusted RR for highest versus lowest caffeine intake quintiles was 1.09 (95% CI 0.99\u20131.21) for combined fracture sites. Wrist fractures were associated positively (RR for extreme quintiles 1.37, 95% CI 1.11\u20131.69) and upper arm fractures were negatively associated (RR 0.67, 95% CI 0.48\u20130.94) with caffeine intake. The age-adjusted RR of total fractures for highest versus lowest frequency of beer usage was 1.55 (95% CI 1.25\u20131.92) and for liquor was 1.25 (95% CI 1.03\u20131.54). No other association was found between any specific fracture site and alcohol intake.<\/jats:p><\/jats:sec><jats:sec id=\"S136898000000029X_sec06\" sec-type=\"conclusion\"><jats:title>Conclusions<\/jats:title><jats:p>We found a modest increase in fracture risk associated with highest caffeine intake, varying by site. Alcohol intake was low, but it also showed a weak positive association with fracture risk.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s136898000000029x","type":"journal-article","created":{"date-parts":[[2008,6,4]],"date-time":"2008-06-04T21:29:38Z","timestamp":1212614978000},"page":"253-261","source":"Crossref","is-referenced-by-count":43,"title":["Association of fractures with caffeine and alcohol in postmenopausal women: the Iowa Women's Health Study"],"prefix":"10.1017","volume":"3","author":[{"given":"Solveig A","family":"Hansen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron R","family":"Folsom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence H","family":"Kushi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A","family":"Sellers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2007,1,2]]},"reference":[{"key":"S136898000000029X_ref050","doi-asserted-by":"publisher","DOI":"10.1016\/0026-0495(87)90201-0"},{"key":"S136898000000029X_ref069","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115027"},{"key":"S136898000000029X_ref013","doi-asserted-by":"publisher","DOI":"10.1016\/S0271-5317(85)80071-3"},{"key":"S136898000000029X_ref055","doi-asserted-by":"publisher","DOI":"10.1016\/0169-6009(89)90085-8"},{"key":"S136898000000029X_ref007","doi-asserted-by":"publisher","DOI":"10.1007\/BF02556636"},{"key":"S136898000000029X_ref028","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/65.6.1826"},{"key":"S136898000000029X_ref067","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115960"},{"key":"S136898000000029X_ref005","doi-asserted-by":"publisher","DOI":"10.3181\/00379727-177-41911"},{"key":"S136898000000029X_ref063","doi-asserted-by":"publisher","DOI":"10.15288\/jsa.1987.48.212"},{"key":"S136898000000029X_ref011","doi-asserted-by":"publisher","DOI":"10.1016\/0024-3205(90)90616-Y"},{"key":"S136898000000029X_ref012","doi-asserted-by":"publisher","DOI":"10.1016\/S0271-5317(84)80132-3"},{"key":"S136898000000029X_ref031","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199503233321202"},{"key":"S136898000000029X_ref006","doi-asserted-by":"publisher","DOI":"10.1007\/BF02556635"},{"key":"S136898000000029X_ref082","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/20.3.671"},{"key":"S136898000000029X_ref084","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-116-9-716"},{"key":"S136898000000029X_ref009","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/117.7.1224"},{"key":"S136898000000029X_ref052","first-page":"229","article-title":"Changes in bone mass in alcoholics","volume":"90","author":"Nilsson","year":"1973","journal-title":"Clin. Orthop."},{"key":"S136898000000029X_ref056","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.1990.tb01198.x"},{"key":"S136898000000029X_ref044","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198310000-00016"},{"key":"S136898000000029X_ref032","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009082"},{"key":"S136898000000029X_ref041","first-page":"E507","article-title":"Effect of alcohol ingestion on bone and mineral metabolism in rats","volume":"238","author":"Baran","year":"1980","journal-title":"Am. J. Physiol."},{"key":"S136898000000029X_ref014","doi-asserted-by":"publisher","DOI":"10.1016\/S0271-5317(88)80124-6"},{"key":"S136898000000029X_ref026","first-page":"299","article-title":"Premenopausal bone mineral contents relates to height, weight and calcium intake during early adulthood","volume":"4","author":"Picard","year":"1988","journal-title":"Bone Miner."},{"key":"S136898000000029X_ref025","doi-asserted-by":"publisher","DOI":"10.1172\/JCI113201"},{"key":"S136898000000029X_ref060","first-page":"265","article-title":"Dietary intake and bone mineral density","volume":"4","author":"Angus","year":"1988","journal-title":"Bone Miner."},{"key":"S136898000000029X_ref024","first-page":"669","article-title":"Longitudinal changes in radial bone mass. Dietary caffeine, milk and activity","volume":"35","author":"Eliel","year":"1983","journal-title":"Calcif. Tissue Int."},{"key":"S136898000000029X_ref018","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/42.5.877"},{"key":"S136898000000029X_ref078","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a114319"},{"key":"S136898000000029X_ref010","first-page":"46","article-title":"Effects of nitrogen, phosphorus and caffeine on calcium balance in women","volume":"99","author":"Heaney","year":"1982","journal-title":"J. Lab. Clin. Med."},{"key":"S136898000000029X_ref072","first-page":"327","article-title":"An international study of the relationship between alcohol consumption and postmenopausal estradiol levels","volume":"1","author":"Gavaler","year":"1991","journal-title":"Alcohol and Alcoholism"},{"key":"S136898000000029X_ref036","doi-asserted-by":"publisher","DOI":"10.1006\/pmed.1995.1064"},{"key":"S136898000000029X_ref061","doi-asserted-by":"publisher","DOI":"10.1007\/BF02556372"},{"key":"S136898000000029X_ref040","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/32.1.25"},{"key":"S136898000000029X_ref019","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-118-9-199305010-00001"},{"key":"S136898000000029X_ref008","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.5650010303"},{"key":"S136898000000029X_ref049","doi-asserted-by":"crossref","first-page":"42","DOI":"10.7326\/0003-4819-103-1-42","article-title":"Bone disease in alcohol abuse","volume":"103","author":"Bilke","year":"1985","journal-title":"Ann. Intern. Med."},{"key":"S136898000000029X_ref068","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a116485"},{"key":"S136898000000029X_ref045","first-page":"497","article-title":"Bone and mineral metabolism and chronic alcohol abuse","volume":"59","author":"Lalor","year":"1986","journal-title":"Q. J. Med."},{"key":"S136898000000029X_ref027","doi-asserted-by":"publisher","DOI":"10.1007\/BF01880450"},{"key":"S136898000000029X_ref003","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-4887.1978.tb03717.x"},{"key":"S136898000000029X_ref029","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115709"},{"key":"S136898000000029X_ref034","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/21.5.953"},{"key":"S136898000000029X_ref037","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.5650101125"},{"key":"S136898000000029X_ref075","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115014"},{"key":"S136898000000029X_ref023","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1976.03630030032007"},{"key":"S136898000000029X_ref048","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-73-1-118"},{"key":"S136898000000029X_ref043","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.5650020110"},{"key":"S136898000000029X_ref015","doi-asserted-by":"publisher","DOI":"10.1016\/S0271-5317(88)80124-6"},{"key":"S136898000000029X_ref004","doi-asserted-by":"publisher","DOI":"10.1016\/0300-483X(82)90041-5"},{"key":"S136898000000029X_ref042","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.1982.tb05386.x"},{"key":"S136898000000029X_ref088","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.5650111218"},{"key":"S136898000000029X_ref002","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-69823-1_4"},{"key":"S136898000000029X_ref079","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.79.11.1554"},{"key":"S136898000000029X_ref035","doi-asserted-by":"publisher","DOI":"10.1007\/BF01623818"},{"key":"S136898000000029X_ref030","first-page":"139","volume-title":"Osteoporose: pour une prevention nutritionnelle du risque? Colloque International","author":"Hunter","year":"1992"},{"key":"S136898000000029X_ref021","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1994.03510280042030"},{"key":"S136898000000029X_ref064","first-page":"6828","article-title":"Association of incident carcinoma of the endometrium with body weight and fat distribution in older women: early findings of the Iowa Women's Health Study","volume":"49","author":"Folsom","year":"1989","journal-title":"Cancer Res."},{"key":"S136898000000029X_ref066","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a114086"},{"key":"S136898000000029X_ref039","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a116314"},{"key":"S136898000000029X_ref047","doi-asserted-by":"publisher","DOI":"10.1007\/BF02556634"},{"key":"S136898000000029X_ref087","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199709043371003"},{"key":"S136898000000029X_ref051","doi-asserted-by":"publisher","DOI":"10.1007\/BF02012547"},{"key":"S136898000000029X_ref022","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/21.1.20"},{"key":"S136898000000029X_ref054","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.1988.tb00185.x"},{"key":"S136898000000029X_ref057","doi-asserted-by":"publisher","DOI":"10.1016\/0169-6009(91)90041-W"},{"key":"S136898000000029X_ref073","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.306.6891.1506"},{"key":"S136898000000029X_ref046","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(89)90297-0"},{"key":"S136898000000029X_ref058","doi-asserted-by":"publisher","DOI":"10.1016\/0378-5122(94)90017-5"},{"key":"S136898000000029X_ref033","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(88)90065-7"},{"key":"S136898000000029X_ref080","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a116315"},{"key":"S136898000000029X_ref071","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a008899"},{"key":"S136898000000029X_ref038","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.1997.12.7.998"},{"key":"S136898000000029X_ref017","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/60.4.573"},{"key":"S136898000000029X_ref081","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/69.1.147"},{"key":"S136898000000029X_ref065","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a114780"},{"key":"S136898000000029X_ref085","doi-asserted-by":"publisher","DOI":"10.1007\/BF02405345"},{"key":"S136898000000029X_ref077","doi-asserted-by":"publisher","DOI":"10.1136\/jech.46.2.133"},{"key":"S136898000000029X_ref016","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/52.4.722"},{"key":"S136898000000029X_ref086","doi-asserted-by":"publisher","DOI":"10.1016\/0169-6009(89)90074-3"},{"key":"S136898000000029X_ref059","doi-asserted-by":"publisher","DOI":"10.1006\/pmed.1997.0170"},{"key":"S136898000000029X_ref083","doi-asserted-by":"publisher","DOI":"10.3109\/00016349509013475"},{"key":"S136898000000029X_ref020","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199303000-00008"},{"key":"S136898000000029X_ref001","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1056\/NEJM199208273270908","article-title":"The prevention and treatment of osteoporosis","volume":"327","author":"Riggs","year":"1992","journal-title":"N. Engl. J. Med."},{"key":"S136898000000029X_ref053","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.298.6678.924"},{"key":"S136898000000029X_ref074","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115013"},{"key":"S136898000000029X_ref070","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115052"},{"key":"S136898000000029X_ref076","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.74.12.1374"},{"key":"S136898000000029X_ref062","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-124-2-199601150-00001"}],"container-title":["Public Health Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S136898000000029X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,8]],"date-time":"2019-05-08T20:40:06Z","timestamp":1557348006000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S136898000000029X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,9]]},"references-count":88,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2000,9]]}},"alternative-id":["S136898000000029X"],"URL":"https:\/\/doi.org\/10.1017\/s136898000000029x","relation":{},"ISSN":["1368-9800","1475-2727"],"issn-type":[{"value":"1368-9800","type":"print"},{"value":"1475-2727","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,9]]}}}