Does Moderate Alcohol Use Protect against Low Bone Density and Osteoporotic Fractures?

Heavy alcohol use can increase the risk for osteoporosis and osteoporotic fractures. To assess the association of moderate alcohol use with bone density, osteoporotic fracture, and bone changes over time, researchers conducted a systematic review and meta-analysis of the literature published before May 2007. Thirty-three studies met content and quality criteria for inclusion in at least 1 of the analyses.

• In 4 studies assessing the relationship between alcohol consumption and bone density, femoral neck bone density increased 0.045 g/cm2 for each drink per day over the range of 0–3 drinks per day.

• In studies assessing the relationship between alcohol consumption and hip fracture risk, compared with abstainers, risk for hip fracture decreased for individuals consuming >0–0.5 drinks per day (5 studies; pooled relative risk [RR], 0.84*), >0.5–1 drinks per day (11 studies; RR, 0.80) and >1–2 drinks per day (10 studies; RR, 0.91*). Risk of hip fracture increased for individuals consuming >2 drinks per day (6 studies; RR, 1.39).

• Several studies indicated that, compared with abstainers, moderate alcohol use was generally associated with decreased bone loss over time.

Comments:

These data suggest moderate alcohol use is associated with increased bone density at the hip and decreased risk for osteoporotic hip fractures. Although the researchers note that the exact range of alcohol use to improve bone outcomes cannot be determined from the existing data, the beneficial alcohol use levels reported in this study are, in general, consistent with current low-risk drinking recommendations.

Kevin L. Kraemer, MD, MSc

Reference:

Berg KM, Kunins HV, Jackson JL, et al. Association between alcohol consumption and both osteoporotic fracture and bone density. Am J Med. 2008;121(5):406–418.