The authors state that moderate intake of alcohol has been reported to have beneficial effects on bone. However, different classes of alcoholic beverages have not been investigated. Their objective was to determine the association between intake of total alcohol or individual alcoholic beverages and bone mineral density (BMD). Adjusting for potential confounding factors, the authors examined alcohol intakes and BMD at 3 hip sites and the lumbar spine in 1,182 men and in 1,289 postmenopausal and 248 premenopausal women in the population-based Framingham Offspring cohort (age: 2986 y). Men were predominantly beer drinkers and women were predominantly wine drinkers.
Results showed that compared with nondrinkers, hip BMD was greater (3.44.5%) in men consuming 12 drinks/day of total alcohol or beer, whereas hip and spine BMD were significantly greater (5.08.3%) in postmenopausal women consuming > 2 drinks/d of total alcohol or wine. Intake of > 2 drinks/d of liquor in men was associated with significantly lower (3.05.2%) hip and spine BMD than was intake of 12 drinks/d of liquor in men. After adjustment for silicon intake, all intergroup differences for beer were no longer significant; differences for other alcohol sources remained significant. Power was low for premenopausal women, and the associations were not significant. The authors conclude that moderate consumption of alcohol may be beneficial to bone in men and postmenopausal women. However, in men, high liquor intakes (> 2 drinks/d) may be associated with lower BMD. The tendency toward stronger associations between BMD and beer or wine, relative to liquor, suggests that constituents other than ethanol may contribute to bone health. Silicon appears to mediate the association of beer, but not that of wine or liquor, with BMD. Other components need further investigation.
Professor R Curtis Ellison comments: A number of previous studies have suggested that moderate alcohol intake may improve bone mineral density (BMD) and lower the risks of fractures in the elderly. Results from this well-done study support such findings. Further, while polyphenols in wine have been thought to provide additional health benefits, this study suggests that silicon present in beer may be an important factor associated with its improvement in BMD. For the three hip sites studied, male subjects reporting a total alcohol intake of 1-2 drinks/d had the highest BMD; men reporting > 2 drinks/d of liquor (but not beer or wine) had poorer bone density. For women, the highest levels of BMD were among those reporting > 2 drinks/day, but the average intake within this category was not given.
In an accompanying editorial ‘Alcohol and recommendations for bone health: should we still exercise caution?’ (Am J Clin Nutr 2009;89:9991000), Helen M. Macdonald states that while most studies support improved bone health from moderate alcohol intake, the greater effects in women from >2 drinks/day in the present study should not be taken to indicate that drinking guidelines for women need to be increased. Further, servings today are often larger than in the past -- there is more alcohol in a ‘typical drink’ -- which would argue against recommending that women drink more drinks per day.
A meta-analysis by Berg et al (Association between alcohol consumption and both osteoporotic fracture and bone density. Am J Med 2008;121:406-418). involving the review of 33 previous studies, supports a reduced risk of hip fracture and higher bone density among men and women who consume small to moderate amounts of alcohol (in comparison with non-drinkers). There is probably a “J-shaped” curve, with increased risk of fractures among heavier drinkers.
Source: Tucker KL, Jugdaohsingh R, Powell JJ, Qiao N, Hannan MT, Sripanyakorn S, Cupples LA, Kiel DP. Am J Clin Nutr 2009;89:11881196. http://www.nutrition.org/media/publications/ajcnApril309.pdf