There is no good evidence that choosing tea over coffee prevents osteoporosis or fractures in older women. Observational studies report mixed associations, and their findings differ depending on whether they measure diagnosed osteoporosis, bone mineral density (BMD), or fractures—related outcomes that are not interchangeable.
What studies say about tea and diagnosed osteoporosis
A 2025 observational meta-analysis found that tea consumption was associated with lower odds of osteoporosis: OR 0.75 (95% CI 0.62–0.91). However, the result had substantial heterogeneity (I² = 80.4%), meaning the included studies’ estimates varied considerably. The association does not establish that tea caused the difference or that switching to tea would reduce an individual woman’s risk. Read the 2025 meta-analysis.
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An earlier synthesis, published in 2023, also reported a favorable association: tea drinkers had a pooled relative risk of 0.800 (95% CI 0.674–0.950) compared with non-drinkers, across 10 studies. Its evidence pool and methods differ from those of other reviews, so the estimate should not be treated as a direct comparison with coffee or as proof of prevention.
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Diagnosed osteoporosis
A 2022 review by Zeng and colleagues included four osteoporosis studies with 7,114 participants. In a comparison of high versus low coffee intake, higher intake was associated with lower odds of osteoporosis (OR 0.79, 95% CI 0.65–0.92). This observational result does not show that coffee protects bones, and it does not establish a recommended intake.
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Bone mineral density and hip fractures
A separate 2023 meta-analysis of 20 studies and 508,312 participants found no statistically significant association between daily tea or coffee consumption and BMD or hip-fracture risk in its pooled analyses. The coffee–BMD mean difference was 0.020 (95% CI −0.003 to 0.044), and the tea–BMD mean difference was 0.039 (95% CI −0.012 to 0.090). For hip fractures, the pooled hazard ratio was 1.008 (95% CI 0.760–1.337) for coffee and 0.93 (95% CI 0.84–1.03) for tea. Each confidence interval crossed the null, so the analysis did not establish an association. Read the 2023 meta-analysis.
Fracture findings are inconsistent
The 2022 coffee review found no significant association between high versus low coffee intake and hip fracture (OR 0.86, 95% CI 0.67–1.05) or non-hip fracture (OR 0.89, 95% CI 0.42–1.36). By contrast, an older 2014 meta-analysis of nine cohort and six case-control studies, including 253,514 participants and 12,939 fracture cases, estimated a higher fracture risk among women in the highest versus lowest coffee-intake category (RR 1.14, 95% CI 1.05–1.24). Both findings come from observational evidence; the difference between reviews means the older estimate should not be presented as a settled causal effect. Read the 2014 review.
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Why the results do not answer “tea or coffee?”
The reviews do not provide a controlled, direct test of older women switching from coffee to tea. Their results cannot be combined into one reliable ranking because they differ in several important ways:
- Outcome: A diagnosis of osteoporosis, a BMD measurement, and a new fracture measure different things. A finding for one does not automatically apply to the others.
- Exposure: Studies measure tea, coffee, or total caffeine using different intake categories and cup definitions.
- Population: Some evidence focuses on women or postmenopausal women; other pooled populations are broader.
- Study methods: These are observational studies, which can be affected by differences in diet, health, activity, and other factors between people with different beverage habits.
- Diet context: Calcium intake may matter when interpreting a possible caffeine-related effect.
How calcium fits into the caffeine question
The International Osteoporosis Foundation notes that caffeine increases urinary and faecal calcium losses and that, alongside a diet low in calcium, this has the potential to adversely affect bone health. That is a plausible dietary concern, not proof that coffee causes osteoporosis or fractures.
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The foundation also summarizes one Swedish women’s cohort in which caffeine intake of 330 mg per day—described as four cups or 600 mL—was associated with a 20% higher osteoporotic-fracture risk than intake below 200 mg per day. This is an association reported by one cohort, not a universal safety threshold or an individualized cutoff. International Osteoporosis Foundation: nutrition.
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What older women should take from the evidence
- Do not assume tea is safer for bones than coffee: the available observational evidence does not establish that conclusion.
- Do not switch beverages expecting to prevent osteoporosis or a fracture; a prevention effect has not been demonstrated.
- Consider caffeine alongside overall calcium intake rather than treating one cohort’s estimate as a personal limit.
- Do not replace prescribed osteoporosis care with a beverage change.
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