Carbonated soft drink consumption and bone mineral density in adolescence: the Northern Ireland Young Hearts project

J Bone Miner Res. 2003 Sep;18(9):1563-9. doi: 10.1359/jbmr.2003.18.9.1563.


In an observational study of 1335 boys and girls aged 12 and 15 years, higher intakes of carbonated soft drinks (CSDs) were significantly associated with lower bone mineral density at the heel, but only in girls. Owing to the upward trend in CSD intake in adolescence, this finding may be of concern.

Introduction: High consumption of carbonated soft drinks (CSD) during adolescence may reduce bone mineral accrual and increase fracture risk. The aim of this study was to examine the relationship between CSD consumption and bone mineral density (BMD) in a representative sample of adolescents.

Materials and methods: This was a cross-sectional observational study in 36 postprimary schools in Northern Ireland. Participants included 591 boys and 744 girls either 12 or 15 years old. BMD was measured by DXA, and usual beverage consumption was assessed by the diet history method. Adjusted regression modeling was used to investigate the influence of CSD on BMD.

Results: A significant inverse relationship between total CSD intake and BMD was observed in girls at the dominant heel (beta, -0.099; 95% CI, -0.173 to -0.025). Non-cola consumption was inversely associated with dominant heel BMD in girls (beta, -0.121; 95% CI, -0.194 to -0.048), and diet drinks were also inversely associated with heel BMD in girls (beta, -0.087; 95% CI, -0.158 to -0.016). However, no consistent relationships were observed between CSD intake and BMD in boys. Cola consumption and nondiet drinks were not significantly related to BMD in either sex.

Conclusion: CSD consumption seems to be inversely related to BMD at the dominant heel in girls. It is possible that the apparent association results from the displacement of more nutritious beverages from the diet. Although the inverse association observed between CSD consumption and BMD is modest and confined to girls, this finding may have important public health implications given the widespread use and current upward trend in CSD consumption in Western populations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Animals
  • Bone Density*
  • Calcium, Dietary / administration & dosage
  • Carbonated Beverages / adverse effects*
  • Cross-Sectional Studies
  • Eating
  • Female
  • Humans
  • Male
  • Milk
  • Northern Ireland
  • Phosphorus, Dietary / administration & dosage
  • Sex Characteristics


  • Calcium, Dietary
  • Phosphorus, Dietary