In the men, no significant associations were observed between BMD and cola intake. For the women, however, significant negative linear associations were seen for cola consumption at each of the hip sites (P < 0.001 for total hip, femoral neck, and Ward’s area, and P < 0.01 for trochanter). No significant associations with spine BMD were observed for either men or women (data not shown). Additional analysis of cola subgroups for the women showed that the trends were not unique to the sugared, caffeinated colas, but were evident for all cola subgroups tested, with the exception of sugared decaffeinated cola (Table 4). The latter was consumed by <16% of women; only 1% reported consumption of ≥3 times/wk. Each of the hip sites was significantly associated with sugared cola intake as well as with diet cola intake (P < 0.05–0.01). Total caffeinated cola showed stronger associations with hip BMD (P < 0.01–0.001) than did total decaffeinated cola (P < 0.05 at Ward’s area and approaching significance, ie, P < 0.1, at total hip and femoral neck). Sugared decaffeinated soda intake was not significant at any site, but it should be noted that this was the least commonly used form of cola by the women (Table 2). Additional adjustment for the calcium-to-phosphorus intake ratio, total fruit and vegetable intake, and the protein-to-potassium intake ratio did not change the significance level or materially change the coefficient of association between cola and BMD, with the exception of the femoral neck and Ward’s area for sugared cola. In each of these cases, significance changed from P < 0.05 to P = 0.06.
