The consumption of soft drinks has increased considerably during the last decades. Among them, the cola-based preparations are possibly the refreshments with the largest sales worldwide. During the previous years, important concerns have been raised about the effects of colas on human health. In this review, we introduce the cola effects on reproduction including pregnancy miscarriages, ovulatory and menstrual disorders, and reduced semen quality. Although caffeine intoxication may be thought to play the most important role, a component of cola other than caffeine, or in combination with caffeine, may be associated with increased risk of reproductive hazards in heavy cola (> 1 L per day)-consumers. Cola discontinuation usually leads to an uneventful recovery in the most cases suggesting justification of limitations in the maximum recommended daily dose of these soft drinks. Cola is not an essential beverage, and abstaining from drinking more than 1 L per day is a minor intrusion in one’s personal life. Despite these uncertainties, this growing know- ledge may alarm the fertility risk of chronic cola intake in peoples of childbearing age.
Jensdottir, T., Arnadottir, I., Thorsdottir, I. and Holbrook, W.P. (2004) Relationship between dental erosion, soft drink consumption, and gastroesophageal reflux among Icelanders. Clinical Oral Investigation, 8(2), 91-96.
Jensdottir, T., Holbrook, P., Nauntofte, B., Buchwald, C. and Bardow, A. (2006) Immediate erosive potential of cola drinks and orange juices. Journal of Dental Research, 85(3), 226-230.
Tucker, K. (2009) Osteoporosis prevention and nutrition. Current of Osteoporosis Reports, 7(4), 111-117.
Ogur, R., Uysal, B., Ogur, T., Yaman, H., Oztas, E., Ozdemir, A. and Hasde, M. (2007) Evaluation of the effect of cola drinks on bone mineral density and associated factors. Basic and Clinical Pharmacology and Toxicology, 100(5), 334-338.
Matsunami, K. and Imai, A. (1994) Hypokalemia in a pregnant woman with long-term heavy cola consumption. International Journal of Gynaecology and Obstetrics, 44(3), 283-284.
Tsimihodimos, V., Kakaidi, V. and Elisaf, M. (2009) Cola-induced hypokalaemia: Pathophysiological mechanisms and clinical implications. International Journal of Clinical Practice, 63(6), 900-902.
Packer, C. (2009) Cola-induced hypokalaemia: A super- sized problem. International Journal of Clinical Practice, 63(6), 833-835.
Shoham, D., Durazo-Arvizu, R., Kramer, H., Luke, A., Vupputuri, S., Kshirsagar, A. and Cooper, R.S. (2008) Sugary soda consumption and albuminuria: Results from the National Health and Nutrition Examination Survey, 1999-2004. PLoS One, 3(10), e3431.
Assy, N., Nasser, G., Kamayse, I., Nseir, W., Beniashvili, Z., Djibre, A. and Grosovski, M. (2008) Soft drink consumption linked with fatty liver in the absence of traditional risk factors. Canadian Journal of Gastroenterology, 22(10), 811-813.
Acheson, K. (2005) Caffeine and insulin sensitivity. Metabolic Syndrome & Related Disorders, 3(1), 19-25.
Paganini-Hill, A., Kawas, C. and Corrada, M. (2007) Non-alcoholic beverage and caffeine consumption and mortality: The Leisure World Cohort Study. Preventive Medicine, 44(4), 305-310.
Saldana, T., Basso, O., Darden, R. and Sandler, D. (2007) Carbonated beverages and chronic kidney disease. Epidemiology, 18(4), 501-506.
Bech, B., Nohr, E., Vaeth, M., Henriksen, T. and Olsen, J. (2005) Coffee and fetal death: A cohort study with prospective data. American Journal of Epidemiology, 162(10), 983-990.
Parazzini, F., Chatenoud, L., Di Cintio, E., Mezzopane, R., Surace, M., Zanconato, G., Fedele, L. and Benzi, G. (1998) Coffee consumption and risk of hospitalized miscarriage before 12 weeks of gestation. Human Reproduction, 13(8), 2286-2291.
Matijasevich, A., Santos, I. and Barros, F. (2005) Does caffeine consumption during pregnancy increase the risk of fetal mortality? A literature review. Cadernos de Saúde Pública, 21(6), 1676-1684.
Signorello, L. and McLaughlin, J. (2004) Maternal caffeine consumption and spontaneous abortion: A review of the epidemiologic evidence. Epidemiology, 15(2), 229- 239.
Johnson, R., Segal, M., Sautin, Y., Nakagawa, T., Feig, D.I., Kang, D.H., Gersch, M.S., Benner, S. and Sánchez-Lozada, L.G. (2007) Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease. American Journal of Clinical Nu- trition, 86(4), 899-906.
Arnaud, M. (1987) The pharmacology of caffeine. Progress in Drug Research, 31, 273-313.
Benowitz, N. (1990) Clinical pharmacology of caffeine. Annual Reviews of Medicine, 41, 277-288.
Chou, T. and Benowitz, N. (1994) Caffeine and coffee: Effects on health and cardiovascular disease. Comparative Biochemistry & Physiology. Part C, Pharmacology, Toxicology & Endocrinology, 109(2), 173-189.
Fenster, L., Quale, C., Waller, K., Windham, G.C., Elkin, E.P., Benowitz, N. and Swan, S.H. (1999) Caffeine consumption and menstrual function. American Journal of Epidemiology, 149(6), 550-557.
Kitts, D. (1987) Studies on the estrogenic activity of a coffee extract. Journal of Toxicology & Environmental Health, 20(1-2), 37-49.
Christianson, R., Oechsli, F. and van den Berg, B. (1989) Caffeinated beverages and decreased fertility. Lancet, 1(8634), 378-379.
Grodstein, F., Goldman, M., Ryan, L. and Cramer, D. (1993) Relation of female infertility to consumption of caffeinated beverages. American Journal of Epidemiology, 137(12), 1353-1360.
Stanton, C. and Gray, R. (1995) Effects of caffeine consumption on delayed conception. American Journal of Epidemiology, 142(12), 1322-1329.
Bolúmar, F., Olsen, J., Rebagliato, M. and Bisanti, L. (1997) Caffeine intake and delayed conception: A European multicenter study on infertility and subfecundity. European study group on infertility subfecundity. American Journal of Epidemiology, 145(4), 324-334.
Alderete, E., Eskenazi, B. and Sholtz, R. (1995) Effect of cigarette smoking and coffee drinking on time to conception. Epidemiology, 6(4), 403-408.
Joesoef, M., Beral, V., Rolfs, R., Aral, S. and Cramer, D. (1990) Are caffeinated beverages risk factors for delayed conception? Lancet, 335(8682), 136-137.
Jensen, T., Henriksen, T., Hjollund, N., Scheike, T., Kolstad, H., Giwercman, A., Ernst, E., Bonde, J.P., Skakkebaek, N.E. and Olsen, J. (1998) Caffeine intake and fecundability: A follow-up study among 430 Danish couples planning their first pregnancy. Reproductive Toxicology, 12(3), 289-295.
Chavarro, J., Rich-Edwards, J., Rosner, B. and Willett, W. (2009) Caffeinated and alcoholic beverage intake in relation to ovulatory disorder infertility. Epidemiology, 20(3), 374-381.
Lueth, N., Anderson, K., Harnack, L., Fulkerson, J. and Robien, K. (2008) Coffee and caffeine intake and the risk of ovarian cancer: The Iowa Women’s Health Study. Cancer Causes & Control, 19(10), 1365-1372.
Endocrine Society (2010) Sperm and cola don’t mix wee. EndocrineNews, May 2010, 27.
Jensen, T., Swan, S., Skakkebaek, N., Rasmussen, S. and J?rgensen, N. (2010) Caffeine intake and semen quality in a population of 2,554 young Danish men. American Journal of Epidemiology, 171(8), 883-891.
Vine, M., Setzer, R.J., Everson, R. and Wyrobek, A. (1997) Human sperm morphometry and smoking, caffeine, and alcohol consumption. Reproductive Toxicology, 11(2-3), 179-184.
Marshburn, P., Sloan, C. and Hammond, M. (1989) Semen quality and association with coffee drinking, cigarette smoking, and ethanol consumption. Fertility and Sterility, 52(1), 162-165.
(1997) Reproductive toxicology. Caffeine. Environmental Health Perspectives, 105(Suppl. 1), 1279-1280.
Jensen, T., Jacobsen, R., Christensen, K., Nielsen, N. and Bostofte, E. (2009) Good semen quality and life expectancy: A cohort study of 43,277 men. American Journal of Epidemiology, 170(5), 559-565.
Jensen, T., J?rgensen, N., Asklund, C., Carlsen, E., Kristensen, T.S., Holm, M. and Skakkebaek, N.E. (2007) Self-rated health and semen quality among 3,457 young Danish men. Fertility and Sterility, 88(5), 1366-1373.
Ramlau-Hansen, C., Nohr, E., Thulstrup, A., Bonde, J., Storgaard, L. and Olsen, J. (2007) Is maternal obesity related to semen quality in the male offspring? A pilot study. Human Reproduction, 22(10), 2758-2762.
Ramlau-Hansen, C., Thulstrup, A., Storgaard, L., Toft, G., Olsen, J. and Bonde, J. (2007) Is prenatal exposure to tobacco smoking a cause of poor semen quality? A follow-up study. American Journal of Epidemiology, 165 (12), 1372-1379.
Ramlau-Hansen, C., Thulstrup, A., Bonde, J., Olsen, J. and Bech, B. (2008) Semen quality according to prenatal coffee and present caffeine exposure: Two decades of follow-up of a pregnancy cohort. Human Reproduction, 23(12), 2799-2805.
Goldstein, A. and Warren, R. (1962) Passage of caffeine into human gonadal and fetal tissue. Biochemical Pharmacology, 11(2), 166-168.
Aldridge, A., Aranda, J. and Neims, A. (1979) Caffeine metabolism in the newborn. Clinical Pharmacology and Therapeutics, 25(4), 447-453.
Aldridge, A., Bailey, J. and Neims, A. (1981) The disposition of caffeine during and after pregnancy. Seminars in Perinatology, 5(4), 310-314.
Weng, X., Odouli, R. and Li, D. (2008) Maternal caffeine consumption during pregnancy and the risk of miscarriage: A prospective cohort study. American Journal of Obstetrics and Gynecology, 198(3), e271-e278.
Fernandes, O., Sabharwal, M., Smiley, T., Pastuszak, A., Koren, G. and Einarson, T. (1998) Moderate to heavy caffeine consumption during pregnancy and relationship to spontaneous abortion and abnormal fetal growth: A meta-analysis. Reproductive Toxicology, 12(4), 435-444.
Signorello, L. and McLaughlin, J. (2008) Caffeine and miscarriage: Case closed? American Journal of Obstetrics and Gynecology, 199(5), e14-e15.
Leviton, A. and Cowan, L. (2002) A review of the literature relating caffeine consumption by women to their risk of reproductive hazards. Food and Chemical Toxicology, 40(9), 1271-1310.
Savitz, D., Chan, R., Herring, A., Howards, P. and Hartmann, K. (2008) Caffeine and miscarriage risk. Epidemiology, 19(1), 55-62.
Graham, N., Hammond, C.J. and Gold, M. (2008) Caffeine in miscarriages: It’s not just in the coffee. American Journal of Obstetrics and Gynecology, 199(5), e15.