Active Healthy Living - Beverages & Bone Health - The Coca-Cola Company Beverage Institute for Health & Wellness

Although bone mass peaks ~ age 30 to 35, it's never too late to improve bone health. According to the International Osteoporosis Foundation (IOF), good nutrition, including adequate calcium and vitamin D, a nutrient that promotes calcium absorption, plus regular weight-bearing exercise can do much to slow the natural process of bone loss. The IOF also recommends avoiding excess alcohol and smoking, which can reduce bone mass and increase fracture risk.

Unfortunately, many adolescents and adults do not meet current calcium or physical activity recommendations. Milk is an excellent source of calcium and a good source of other bone-building nutrients, including vitamins A and B12, protein, potassium, phosphorus, and riboflavin. In the United States, milk and some calcium-fortified juices and beverages also have added Vitamin D.

Over the years, some epidemiological studies have linked the consumption of cola-type soft drinks to poorer bone heath in girls. However, clinical research confirms that soft drinks, including colas, which contain phosphoric acid and caffeine, do not significantly impact calcium balance.

Learn more: Understanding the Relationship Between Bone Health and Beverages with Phosphoric Acid and Caffeine.

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News, Articles and Research Briefs
What Experts Say
- IOM Updates Guidance on Vitamin D, Calcium: A Pediatrician's Perspective on What Health Professionals Need to Know
  – An interview with Dr. Steven Abrams
  In this interview, Dr. Steven Abrams provides insight about conclusions and implications of the new calcium and vitamin D recommendations, especially as they apply to infants, children and adolescents.
- Beverages & Bone Health: Helpful, Harmful or No Effect?
  An interview with Dr. Robert Heaney In this interview, bone health expert Dr. Robert P. Heaney discusses why overall diet quality and weight-bearing exercise are critical for bone health and explains how calcium-balance research confirmed that soft drinks containing caffeine, carbonation and phosphoric acid will not negatively impact bone health as long as calcium intake is adequate.
- The 2004 Surgeon General’s Report on Bone Health and Osteoporosis
  Written for a scientific audience, the 2004 U.S. Surgeon General’s Report on Bone Health and Osteoporosis was prepared by some of the country’s top scientists, doctors, and public health experts. The full report is more than 400 pages long and took more than 2 years to complete.
- Negative Dietary Factors and Practice. National Osteoporosis Foundation
  In this article, the IOF reviews the science related to negative dietary behaviors and poor bone health.
- Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents - Position of the American Academy of Pediatrics
  Wagner CL, Greer FR and the Section on Breastfeeding and Committee on Nutrition, American Academy of Pediatrics (AAP). Pediatrics 2008; 122(5):1142-1152. “It is now recommended that all infants and children, including adolescents, have a minimum daily intake of 400 IU of vitamin D beginning soon after birth. The current recommendation replaces the previous recommendation of a minimum daily intake of 200 IU/day of vitamin D supplementation beginning in the first 2 months after birth and continuing through adolescence.”
- Total Diet Approach to Communicating Food and Nutrition Information - Position of the American Dietetic Association
  “It is the position of the American Dietetic Association that the total diet or overall pattern of food eaten is the most important focus of a healthful eating style. All foods can fit within this pattern, if consumed in moderation with appropriate portion size and combined with regular physical activity.”
- Final Rule - Food Labeling: Health Claims; Calcium and Osteoporosis, and Calcium, Vitamin D, and Osteoporosis.
  Federal Register: September 29, 2008 (Volume 73, Number 189 Page 56477-56487)
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Webinars, Podcasts and Continuing Professional Education (CPE) Programs
- Promoting Healthy Bones: Sorting Out the Science (Webinar)
  In this webinar, bone health expert Dr. Robert P. Heaney discusses the diet and lifestyle factors most important to maintaining bone health and reviews research confirming that soft drinks containing caffeine and phosphoric acid will not negatively impact bone health as long as calcium intake is adequate.
  
  Kids Need More Vitamin D (AAP - Podcast)
  This podcast from the American Academy of Pediatrics provides parents tips on how to help kids get more vitamin D.
  
  Translating Epidemiology into Sound Public Health Advice (CPE Program)
  In this program, Dr. Douglas Weed, one of the country’s leading physician epidemiologist, discusses key differences between the scientific literature and how the media communicates nutritional epidemiological data to the lay public. Dr. Weed explores effective communication techniques for use with your patients regarding the risks/benefits of "weak" associations, including what can and cannot be said about association, causation, and risk; and what recommendations (dietary, public health, policy) should and should not be made.
  
  Understanding and Effectively Communicating Food and Nutrition Science: Leading Consumers to Better Health (CPE Program - IFIC)
  This free CPE program is available on The International Food Information Council website. Topics covered include identifying elements of nutrition research that are relevant to appropriate interpretation and components of a nutrition study that assist in determining strengths and weaknesses of the research, consumer attitudes and preferences that impact food and nutrition communications and “7 Guiding Principles” for successful communication of food and nutrition research.
  
  Helping Consumers Get the “Big Picture:” Practical Approaches to Promoting a Healthful, Balanced Eating Pattern (CPE Program - IFIC)
  This free CPE program is available on The International Food Information Council website. Topics covered include scientific support for a balanced, food-based eating plan and dietary patterns; nutrients of concern and food group shortfalls common in the diets of many consumers; common consumer stumbling blocks that lead to inadequate eating pattern; and practical counseling and communications strategies to encourage consumers to adopt more healthful eating patterns.
  
  A Practical Guide to Risk Communications (CPE Program - IFIC)
  This free CPE program is available on The International Food Information Council website. Topics covered include defining risk and understanding risk communication realities from the consumer’s perspective, strategies for addressing the inherent uncertainties in risk communication and how to guide consumers in making informed decisions about risk.
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Printable Downloads (brochures, educational handouts and monographs)
- Bone Up on Bone Loss! Exercise to Build Healthy Bones! (NIH)
  This U.S. National Institutes of Health (NIH) handout is designed to teach parents, children, and health care professionals about the importance of calcium for children and teens.
  
  Bone Appétit: The role of food and nutrition in building and maintaining strong bones (IOF)
  Dawson-Hughes B and the International Osteoporosis Foundation. 2006.
  
  The Surgeon General’s Report on Bone Health and Osteoporosis: What it means for you
  This consumer booklet is based on the 2004 U.S. Surgeon General’s Report on Bone Health and Osteoporosis. Information includes the role of vitamin D in health, recommended daily intake, and how to meet the recommended levels.
  
  Dietary Supplement Fact Sheet: Calcium -- Office of Dietary Supplements, National Institutes of Health(NIH)
  
  Vitamin D Consumer Fact Sheet (NIH/ODS)
  Office of Dietary Supplements • National Institutes of Health
  
  IFIC Review: Physical Activity, Nutrition and Bone Health (IFIC)
  
  Improving Public Understanding: Guidelines For Communicating Emerging Science on Nutrition, Food Safety, and Health (IFIC)
  
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Tools for Active Healthy Living (calculators and widgets)
- Bone Health Check Up (NIH)
  
  Calcium Counter (NIH)
  
  ChooseMyPlate SuperTracker (USDA)
  
  Exercise is Medicine Toolkits & Handouts (ACSM)
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Related References
- Dietary Reference Intakes for Calcium and Vitamin D
  Institute of Medicine, Food and Nutrition Board. Washington, DC: National Academy Press,2010.
  
  Estimation of total usual calcium and vitamin D intakes in the United States.
  Bailey RL, Dodd KW, Goldman JA, Gahche JJ, Dwyer JT, Moshfegh AJ, Sempos CT, Picciano MF. J Nutr. 2010 Apr;140(4):817-22. Epub 2010 Feb 24.
  
  Facts and statistics about osteoporosis and its impact. National Osteoporosis Foundation
  
  Bone Appétit: The role of food and nutrition in building and maintaining strong bones. Dawson-Hughes B and the International Osteoporosis Foundation. 2006.
  
  Bone Health and Osteoporosis: A Report of the Surgeon General. U.S. Department of Health and Human Services. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, 2004.
  
  Intake of dietary calcium to reduce the incidence of osteoporosis. American Medical Association, Council on Scientific Affairs. Arch Fam Med, 1997;6:495-499.
  
  National Institutes of Health. Consensus Development Conference Statement, Osteoporosis Prevention, Diagnosis, and Therapy, 2000.
  
  Meeting adequate intake for dietary calcium without dairy foods in adolescents aged 9 to 18 years (National Health and Nutrition Examination Survey 2001-2002). Gao X, Wilde PE, Lichtenstein AH, Tucker KL. J Am Diet Assoc. 2006 Nov;106(11):1759-65.
  Carbonated beverages and urinary calcium excretion. Heaney RP, Rafferty K. Am J Clin Nutr. 2001;74:343-7.
  Potassium intake and the calcium economy. Rafferty K, Davies KM, Heaney RP. J Am Coll Nutr. 2005;24(2):99-106.
  Associations of adequate intake of calcium with diet, beverage consumption, and demographic characteristics among children and adolescents. Storey ML, Forshee RA, Anderson PA. J Am Coll Nutr. 2004;23(1):18-33.
  Editorial, Got Soda? Fitzpatrick L and Heaney RP. J Bone Mineral Res, 2003; 18(9):1570-1572.
  Calcium intake trends and health consequences from childhood through adulthood. Nicklas TA. J Am Coll Nutr. 2003;22(5):340-56.
  Carbonated beverage consumption and bone mineral density among older women: the Rancho Bernardo Study. Kim SH, Morton DJ, Barrett-Connor EL. Am J Public Health 1997;87(2):276-279
  Dietary protein: an essential nutrient for bone health. Bonjour JP. J Am Coll Nutr. 2005;24(6 Suppl):526S-36S.
  Effects of caffeine on bone and the calcium economy. Heaney RP. Food Chem Toxicol. 2002;40(9):1263-70.
  Effect of consuming different caloric sweeteners on bone health and possible mechanisms. Tsanzi E, Fitch CW, Tou JC. Nutrition Reviews, 2008; 66(6):301-308.
  Effects of nitrogen, phosphorus, and caffeine on calcium balance in women. Heaney RP, Recker RR. J Lab Clin Med. 1982;99(1):46-55.
  Nutrient effects on the calcium economy: emphasizing the potassium controversy. Rafferty K, Heaney RP. J Nutr. 2008;138(1):166S-71S.
  Carbonated beverages and urinary calcium excretion. Heaney RP, Rafferty K. Am J Clin Nutr. 2001;74(3):343-7.
  Effects of moderate caffeine intake on the calcium economy of premenopausal women. Barger-Lux MJ, Heaney RP, Stegman MR. Am J Clin Nutr 1990;52,722–725. Close
Related Websites (additional information)
- International Osteoporosis Foundation (IOF)
  
  National Osteoporosis Foundation (NOF)
  
  American Dietetic Association (ADA)
  
  ChooseMyPlate.gov (USDA)
  International Food Information Council (IFIC)
  
  European Food Information Council (EUFIC)
  
  Asian Food Information Council (AFIC)
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