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Why would drinking Coca Cola and other fizzy drinks make children more prone to bone fractures? That seems a difficult question to answer but a study in Boston, Massachusetts (Grace Wyshak. Archives of Pediatrics and Adolescent Medicine2000;154:610–13), has provided empirical evidence linking the intake of these drinks with a history of fractures in teenage girls. A total of 460 teenage schoolgirls took part in a retrospective questionnaire survey in which they were asked, among other things, about their physical activities, whether or not they drank carbonated beverages, and whether they had ever had a bone fracture. They were not asked about the quantities of the various drinks they consumed. About 80% replied that they habitually drank carbonated drinks, mostly colas. Twenty per cent reported having had a fracture, some in early childhood. In the whole study group, drinking carbonated beverages increased the odds of having had a bone fracture threefold. In physically active girls, but not inactive girls, drinking colas increased the odds of fracture fivefold compared with drinking non-carbonated drinks or non-cola carbonated drinks. Drinking both cola and non-cola carbonated drinks increased the odds sevenfold compared with drinking only non-carbonated drinks. It all seems rather strange. No explanations are offered other than observations that cola drinks have a high content of phosphoric acid and American teenagers have been drinking about 40% less milk than they used to. The cross sectional design of the study can't prove cause and effect and there are no data about bone mineral density. It's an important subject though, and developments will no doubt be awaited with interest.