Caffeine and the calcium economy revisited

We report an analysis of data from 560 calcium balance studies carried out on 190 women aged 34.8–69.3 years at the time of study. The main purposes were to confirm a previously observed association between caffeine intake and calcium balance, and to attribute the association, if possible, to specific component(s) of balance. We found a caffeine relationship such that for every 6 fl oz (177.5 ml) serving of caffeine-containing coffee, calcium balance was more negative by 0.114 mmol/day (4.6 mg/day) (P<0.001). The relationship was localized to the input side of the balance equation, and both of its components (i.e. calcium intake and calcium absorption efficiency) were independently and inversely associated with caffeine intake. There was no evidence that the putative caffeine effect is confined to, or is greater among, subjects with low calcium intakes or those who are older or estrogen-deprived. The magnitude of the negative effect of caffeine on calcium balance suggests that it can be offset by increasing calcium intake by about 1 mmol (40 mg) for every 177.5 ml serving of caffeine-containing coffee.