Osteoporosis and Alcohol

Written by yvonnethornton on July 16th, 2012

Like any reputable physician, I don’t condone heavy drinking, but that doesn’t mean I don’t necessarily partake in a glass of my favorite wine every now and then.  The truth is, a little alcohol once in a while never hurt anyone.  While recent studies suggest that a little bit of drinking may actually help our bones, my personal opinion is that one might be jumping the gun a bit.  Nevertheless, in the “spirit” of being complete and open, I wanted you to know about the recent research that has been covered by the media.

As odd as the connection may seem, a study by the College of Public Health and Human Sciences at Oregon State University found that even small amounts of alcohol have an impact on bone metabolism.  Their study of 40 postmenopausal women who drank moderately did show some benefit.  In fact, according to the principal investigator, “moderate alcohol [use] may slow bone loss by lowering bone turnover.”  That can help to reduce a woman’s risk for osteoporosis later in life.  Urzula Iwaniec, associate professor at OSU, explained that bones are living tissue with old bones constantly being replaced by new bone.  This is why increasing the metabolism of bones helps to stimulate the growth of new bone and keep older, thinning bones at bay.  One of the problems I had with this study is the sample size.  The number of patients studied was way too small to arrive at such a conclusion.  The three main mechanisms by which osteoporosis develops are an inadequate peak bone mass (the skeleton develops insufficient mass and strength during growth), excessive bone resorption, and inadequate formation of new bone during remodeling. An interplay of these three mechanisms underlies the development of fragile bone tissue.  This study only addresses one aspect of osteoporosis and fails to investigate the other possibilities.

Women who are postmenopausal are normally most at risk for bone thinning because of their reduced estrogen.  With that said, researchers did warn against drinking by young adult women, whose bones are still building and that excessive drinking is not a healthy idea for anyone.  However, even the lead author concluded that “the study doesn’t prove that moderate alcohol consumption wards off osteoporosis; it merely shows an association between the two.”  Those who drank one or two alcoholic beverages per day showed increased bone metabolism, and when they stopped drinking for two weeks, the risks for osteoporosis immediately began to show in their blood.  When they resumed drinking again, researchers were amazed to see their bone marker turnover rate return to previous levels.  Unfortunately, the researchers did not test any other hypothesis or mechanism for this change. They believe the reason for this effect is the ability for alcohol to act like estrogen, but it may not be due to this mechanism with respect to bone turnover.

We once thought that calcium and Vitamin D supplementation should be taken to prevent bone fractures.  However, the United States Preventive Services Task Force, an independent panel of experts in prevention and primary care, recently issued a draft statement in June, 2012 recommending that healthy postmenopausal women should not take low doses of calcium or vitamin D supplements to prevent fractures.  Why?  Because the supplements were found not to prevent fractures and only increased the risk of other problems, such as kidney stones.   So the risk outweighed the benefit and taking these supplements may actually be harming you.

While this seminal study about imbibing alcohol doesn’t give us an excuse to throw our healthy calcium- and vitamin D-rich diets out the window, it may be another factor to consider when it comes to our bones.  We already know that red wine may help prevent heart disease, so perhaps, in time, larger studies may support the conclusions of this research and that we may pour ourselves a drink and raise a glass to women’s health.

– Yvonne S. Thornton, M. D., M. P. H.


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