BACKGROUND Acidic beverages may be involved in regulating the cell proliferation of the gastric mucosa. We therefore analyzed the interaction of Coca-Cola consumption and gastric mucosal proliferation by means of flow cytometry. METHODS Sixteen healthy students agreed to participate in this study. All volunteers underwent an oesophagogastroduodenoscopy after a 12-h overnight fast. Endoscopic changes in the gastric mucosa were determined quantitatively. One day later, after a 12-h overnight fast, all volunteers received standard Coca-Cola (200 ml, pH 2.6, 4 degrees C). One hour later all volunteers again underwent oesophagogastroduodenoscopy, to measure gastric mucosal damage. During both the first and the second endoscopy at least four biopsy specimens were taken from the antrum for flow cytometric analysis. RESULTS The endoscopic analysis showed that there was no difference before and after Coca-Cola consumption. However, the flow cytometric analysis showed that Coca-Cola inhibited the proliferation index and the S phase. Before Coca-Cola consumption G0/G1: 60 (57-62), G2/M: 0.6 (0.2-1), S: 40 (37-42), and PI: 0.40 (0.38-0.43) and after Coca-Cola consumption G0/G1: 70 (60-73), G2/M: 1.9 (1.2-2.5), S: 28 (26-32), and PI: 0.30 (0.27-0.34) the cell population G0/G1 and G2/M phases were significantly increased (P < 0.0001, 0.0003), and the cell population S and PI phases were significantly low compared with the pre-consumption data (P < 0.0002, 0.0001). CONCLUSIONS The cell cycle analysis reflects that Coca-Cola inhibits a crucial event in the cell cycle occurring at the G1/S border.