How fizzy soft drinks, salt, caffeine, saturated fat, oxalates and phytates can impact bone health

The carbon dioxide which gives drinks their fizz is sometimes assumed to be another culprit, but there is no evidence it harms bones – so those who enjoy fizzy water need not be concerned.

Research has shown that frequent, long-term consumption of soft drinks can contribute to reduced bone density and increased fracture risk later in life. One large-scale study from China found that daily consumers of soft drinks were more than four times more likely to experience fractures compared with non-consumers.

Even sugar free fizzy drinks can have a negative impact on bone density.Credit: AP

As Thomson points out, what we consume is only one half of the picture.

“If you’re drinking a lot of fizzy drinks, it’s likely to be at the expense of other drinks which could be more beneficial, for instance milky ones containing calcium,” she says.

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Salt

According to the British Heart Foundation, adults are eating up to 40 per cent more than the government guidelines, consuming 8.4 grams a day on average.

This also has implications for our bone health, because a high-salt diet has been shown in a wealth of research to increase calcium loss through urine, reducing the calcium available to maintain bone density.

One 2024 study of postmenopausal women in Southern India, for instance, showed that those consuming more than 7.2 grams of salt per day had significantly lower bone mineral density (BMD) at the lumbar spine and neck, as well as twice the risk of osteoporosis as those who consumed less.

Southern says that our increased consumption of ultra-processed foods, or UPFs, has made it more difficult to keep track of how much salt we’re eating. As a rule, however, “if your diet is high in UPFs you’re going to be having much more salt than someone who’s eating more home-cooked foods”, she says.

“Trying to eat fewer processed foods is always going to be a better choice for your bone health.”

Caffeine

A 2021 University of South Australia study found that high doses of caffeine (800 milligrams, or six to eight cups of coffee a day) consumed over a six-hour period almost doubled the amount of calcium leached from bones and excreted in urine.

However, two to three cups daily have been associated with a potential bone-boosting effect. Research has shown that metabolites of coffee produced during its digestion appeared to produce better bone density in the lumbar spine and necks of habitual coffee drinkers.

Another recent prospective study of almost 500,000 people from the UK Biobank showed that moderate caffeine consumption, such as one to two cups of coffee or three to four cups of tea per day, was associated with a lower incidence of osteoporosis.

“I always caution anyone who’s on high levels of caffeine to reduce their intake for their bone health,” says Southern. “Two cups of coffee per day is accepted to be a safe amount, so I advise sticking to that.”

Two or three cups of coffee daily can be beneficial but any more than that can impact your body’s ability to retain calcium.Credit: iStock

Energy drinks and soft drinks often contain very high caffeine levels, too, so it’s worth adding up everything you consume in a day and trying to keep your intake under the NHS-recommended 400ml.

Saturated fat

Foods high in saturated fat, including processed meats, pizza, croissants, cakes and chocolate, diminish bone mineral density, although the exact mechanism isn’t fully understood. It’s thought it might be a result of excess fat binding to calcium before it can be absorbed and used by our bones, or simply because high-fat diets are often low in other nutrients needed by our bones.

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An optimal diet for bone health involves reducing our levels of UPFs and saturated fat and aiming to eat 700mg of calcium every day, found in dairy products including milk and cheese, as well as leafy green vegetables, almonds and bony fish such as sardines. The Royal Osteoporosis Society has a calcium calculator to help you work out if you’re getting enough.

“Forty per cent of our bones are calcium, so it’s vital we eat enough, particularly for women approaching menopause, when we can lose a significant percentage of bone density,” says Southern.

Vitamin D is also essential to ensure we absorb the calcium, and a supplement is recommended in the winter months. A balanced diet consisting of lean protein from fish, chicken and plant sources, fruit, vegetables and wholegrain carbohydrates is the most supportive of bone health.

Oxalates and phytates

Oxalates and phytates are compounds found in some foods which can reduce the amount of calcium available to our bones by binding with it and inhibiting its absorption.

Foods high in oxalates include rhubarb and spinach, while lower amounts can be found in most plant foods and tea. Phytates, meanwhile, are found in plant foods, seeds, grains, nuts and dried beans.

Wheat bran contains high levels of phytates and, uniquely, appears to reduce the absorption of calcium in other foods eaten at the same time – for instance, if we eat milk and 100 per cent wheat bran cereal together, our body can only absorb a portion of the calcium from the milk instead of the full amount. If you don’t want to choose a different breakfast, ensure you’re getting enough calcium during the rest of the day to compensate.

Since foods containing oxalates and phytates are healthy, Thomson doesn’t recommend cutting down on them. “If you’re eating enough calcium overall, you don’t need to worry,” she says.

Wheat bran contains high levels of phytates, which can inhibit your body’s ability to absorb calcium from food such as milk eaten at the same time.
Credit: iStock

Alcohol

There’s a clear link between heavy drinking and poor bone health. “If you’re drinking a lot, alcohol can have a damaging effect on the osteoclasts, the bone-building cells,” says Thomson. It can also interfere with our body’s ability to absorb calcium and affect hormone levels that are important for bone health.

One recent meta-analysis of data concluded that increased alcohol consumption, starting at three alcoholic drinks per day, is associated with a higher risk of osteoporotic hip fracture.

“Alcohol is known to disrupt our gut microbiome, which can prevent us getting all the nutrients from our food,” says Southern. “Generally, it also leads to poor food choices – all of which can impact on our bone health.”

The Royal Osteoporosis Society recommends sticking to the government recommendation of 14 units of alcohol per week and having regular days where you don’t drink at all.

The Telegraph, London

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