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Moderate Drinking Appears to be Associated with Higher Bone Density in Elderly Women
Chronic alcoholism has been shown by several studies to lead to osteopenia and an increased incidence of skeletal fractures. Alcohol may have a direct effect on bone cells and an indirect or modulating effect through regulatory hormones. There have been conflicting reports regarding the effect of moderate drinking on bone, however. Some studies have found a positive correlation between moderate alcohol use and bone mineral density (BMD),particularly in post menopausal women, whilst others did not. The aim of this study by Rapuri PB, Gallagher JC, Balhorn KE and Ryschon KL, was to examine the relationships of alcohol use with BMD, calcitropic hormones (25-hydroxy - and 1,25 - dihydroxy-cholecalciferol), calcium absorption and other biochemical indices of mineral metabolism in elderly women.

Between 1992 and 1994, 489 elderly women ( aged 65 - 77) were recruited for the osteoporosis study. Seven day food consumption diaries were used to collect dietary data and BMD was determined by dual-energy X-ray absorptiometry. 43 women were excluded for taking diazide diuretics and 1 woman with suspected Pagets disease. The final study comprised 297 teetotaller and 148 women drinking <28.6 g/week (n=69), 28.6 - 57.2 g/week (n=33), 57.2 - 142.9 g/week (n=26) or 143 g/week (n=20).

Compared with non-drinking women, drinking women had significantly higher spine (10%), total body (4.5%) and mid-radius (6%) BMD. Alcohol use in excess of 28.6 g/week was associated with a higher BMD, the maximum effect being seen for an intake of 28.6 -57.2 g/week (16% for spine, 12% for total body and 14% for mid-radius BMD). In drinkers there was a marked reduction in bone remodelling markers, serum osteocalcin and the ratio between urinary cross-linked N-telopeptides of type 1 collagen and creatinine. Compared with teetotallers, serum parathyroid hormone levels were significantly lower in drinkers.

In elderly women, moderate drinking appears to be associated with higher BMD. The protective effect of alcohol could be the result of lower bone remodelling due to reduced serum parathyroid hormone levels or such factors as elevated oestrogen levels.

Source. Rapuri PB, Gallagher JC, Balhorn KE, Ryschon KL. Alcohol intake and bone metabolism in elderly women. Am J Clin Nutr 72 (2000) 1206 - 1213.

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