Would you like coffee or tea? Green tea please.
Who doesn’t like to start the day with their hands wrapped around a hot beverage breathing in the nurturing aroma? Tea and coffee are two of the most popular beverages in the world. Beverages that many of us long for in the mornings, and perhaps even throughout the day. Women with osteoporosis often shy away from coffee and tea because the caffeine in these beverages has been reported to decrease bone mineral density, disrupt calcium absorption and increase the risk of bone fracture. Yet, coffee and tea contain many bio-active compounds that actually can benefit bone health. Let’s look at the latest research to determine if having a cup of one of these warm beverages will do harm to your bones or your body.
Although coffee has been shown to be beneficial for various health conditions, the effect of coffee on osteoporosis is still conflicting.
Coffee intake is known to have potential benefits on prevention of type 2 diabetes, Parkinson’s disease, Alzheimer’s disease, cardiovascular disease and cancers, and recently, it was found that higher coffee consumption is associated with longer telomeres, a positive marker for aging. Coffee contains a complex mixture of both health promoting and health compromising compounds. Coffee is a source of anti-oxidants, is rich in vitamin B3, magnesium, and potassium and also contains a common polyphenol called chlorogenic acid, which has been shown to have antioxidant and anti-inflammatory activities. Because oxidative stress is a risk factor for age-related bone loss, the beneficial effects of consuming foods and drinks with a high antioxidant content may help to prevent bone mass density loss. Studies have both shown coffee to be detrimental to bone health as well as having protective benefits in postmenopausal women. In one study women drinking more than 4 cups of coffee a day had a 2-4% lower bone density than women who only drank 1 cup of coffee or less a day. However, in another study, moderate coffee consumption was seen to have protective benefits on bone health. The most notable difference between these two studies was the amount of coffee consumed, over 4 cups of coffee a day in the study showing lower bone density compared to only 2-3 cups of coffee or less in the other.
Caffeine is the most widely known compound in coffee and could be the culprit leading to observed bone loss. A daily intake of 330 mg of caffeine, equivalent to 4 cups of coffee, or more has been associated with a modestly increased risk of osteoporotic fractures. 
Caffeine affects our bones in several different ways:
- Increases urinary excretion of not only calcium, but other valuable bone building nutrients
- Can cause gastric distress, interfering with digestion and reducing the absorption of nutrients.
- Can cause elevated cortisol level. The caffeine content in just 12 ounces of coffee can increases blood cortisol levels by 30% in one hour!
Some good news for tea drinkers.
Tea is also a rich source of flavonoids and there is strong evidence that tea consumption is associated with higher bone mineral density.  The benefits of tea appear to also be associated with the anti-inflammatory, antioxidant and phytoestrogen compounds in tea as well as providing nutrients such as chromium, manganese, zinc and selenium. Tea does have caffeine, but less than the amount in coffee. An 8 ounce cup of tea provides 15-57mg of caffeine whereas a cup of coffee provides 80-135mg of caffeine. Because of the tannins in tea, caffeine uptake into the blood stream is slower so you don’t get the same cortisol rush as you do with coffee and it returns to normal more quickly.
However the #1 hot bone beverage is green tea.
Green tea has been shown to contain a group of chemicals that can stimulate bone formation and help slow its breakdown giving it the potential to help in the prevention and treatment of osteoporosis. Epigallocatechin gallate (EGCG), the most abundant flavonoid in green tea, enhances bone remodeling by suppressing the activity of two key enzymes that play a role in breaking down bone. EGC, epigallocatechin, a predominant catechin in green tea, has been shown to significantly raise bone mineralization. Other catechins in green tea also provide this beverage with anti-oxidant and anti-inflammatory properties to enhance bone health.   
Like the caffeine content in coffee and tea, the amount of EGCG in green varies as well, averaging between 20 and 80 mg/cup. Loose green tea has more EGCG than the tea bags. Naturally brewed green tea also contains approximately 84 mg of caffeine.
- If you LOVE your cup of Joe in the mornings, drinking one cup will probably not negatively impact your bone health. But because coffee is also a highly acidic, you will need to sip your coffee while eating lots of alkaline foods that will balance out the acid. Such as a green smoothie, a large bowl of oatmeal with nuts and berries, or a bowl of fruit sprinkled with nuts. Adding milk or cream to your coffee, doesn’t do the trick, as dairy products are acid forming in the body as well.
- Drinking tea in moderate amounts may be beneficial to bones, however be aware of the stimulating and diuretic effects of the caffeine. Black tea also is a mildly acidic food and should be paired with an alkaline snack or meal.
- Because of the abundant polyphenols in green tea, it is the clear winner for optimizing bone health. The bitter taste of green tea can be mellowed by adding a slice of ginger, a wedge of lemon or a little raw honey. Green tea, as well as herbal teas, are alkaline in nature and don’t disturb the delicate acid-alkaline balance in our body. Again, take caution with excess intake of caffeine.
When consuming any caffeinated beverage it is important to increase your water intake to prevent dehydration. Also be sure that you are supplementing appropriately to counter act the potential loss of minerals in the urine. Although it appears that caffeine intake of less than 75 mg a day will not harm your bones, everyone has different sensitivities and tolerances. If you are someone that gets stomach upset from drinking a caffeinated beverage or gets the jitters, my advice would be to steer clear of all the above.
You can also get decaffeinate brands of coffee, tea and green tea. The decaffeinated process does remove some of the beneficial phenols and catechins, but not all of them.
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3. Hallström⁎, H., Wolk, A., Glynn, A., Warensjö, E., Byberg, L., & Michaëlsson, K. (2012). Coffee consumption in relation to osteoporotic fracture risk and bone mineral density: A prospective longitudinal cohort study. Bone,50. doi:10.1016/j.bone.2012.02.093
4. Choi, E., Choi, K., Park, S. M., Shin, D., Joh, H., & Cho, E. (2016). The Benefit of Bone Health by Drinking Coffee among Korean Postmenopausal Women: A Cross-Sectional Analysis of the Fourth & Fifth Korea National Health and Nutrition Examination Surveys. Plos One,11(1). doi:10.1371/journal.pone.0147762
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