随着全球老龄化加剧,骨质疏松症(osteoporosis)已成为重大公共卫生挑战。咖啡作为广泛消费的饮品,其与骨质疏松症的关系长期存在争议。既往研究多将咖啡视为整体,忽略了其成分的复杂性;本文基于骨代谢平衡,从成分解析的视角,系统阐述咖啡多酚及咖啡因对骨质疏松症的双向调节作用:多酚通过抗氧化、抗炎及调节“肠-骨轴”等机制发挥骨保护效应;咖啡因则通过干扰钙稳态、激活破骨细胞等途径促进骨吸收。通过综述该领域的最新进展并剖析研究的异质性,本文指出咖啡对骨质疏松症的作用取决于所含成分之间的平衡、摄入剂量及个体的生理状态,旨在为不同人群提供差异化精准饮用建议,为精准膳食指导体系的完善提供参考依据。

With the accelerating aging of the global population, osteoporosis has emerged as a major public health challenge. As one of the most widely consumed beverages, the relationship between coffee intake and osteoporosis remains controversial. Previous research has often treated coffee as a single entity, neglecting the complexity of its chemical composition. Based on the principle of bone metabolic homeostasis, this review systematically elaborates on the dual regulatory effects of its key constituents—coffee polyphenols and caffeine—on osteoporosis from a compositional perspective. Polyphenols exert protective effects on bone through mechanisms such as antioxidation, anti-inflammation, and modulation of the gut-bone axis, whereas caffeine promotes bone resorption by disrupting calcium homeostasis and potentially activating osteoclasts. By synthesizing the latest evidence and analyzing sources of heterogeneity across studies, this review concludes that the net impact of coffee on bone health is determined by the balance between these components, total daily intake, and individual physiological conditions. This work aims to provide a scientific basis for personalized dietary recommendations regarding coffee consumption for different populations and to inform the development of precise dietary guidance systems.