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.
