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Bone density in relation to alcohol intake among men and women in the United States

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Abstract

Summary

Studies of postmenopausal women have shown a positive association between BMD and alcohol intake. We found that BMD was higher in men, and possibly postmenopausal women, who drank alcohol compared with those who abstained. Drinking alcohol, but not binge drinking, may benefit bone health of men and postmenopausal women.

Introduction

Osteoporotic fractures account for over 2.5 million physician visits annually for persons ages ≥45 years in the United States. Studies of postmenopausal women show a positive association between bone mineral density (BMD) and alcohol intake, but for men and premenopausal women, the bone–alcohol relationship remains unclear. We examined the association between total hip (TH) and femoral neck (FN) BMD and alcohol intake of men and pre- and postmenopausal women.

Methods

We conducted multiple regression analyses using data from 13,512 persons ages ≥20 years from the Third National Health and Nutrition Examination Survey, 1988–1994. Alcohol intake and binge drinking were measured by questionnaire and hip BMD by dual energy X-ray absorptiometry (DXA).

Results

Accounting for covariates, TH BMD was higher in men (n = 6,868) who had 5–29 (+2.1%, p < 0.01) and >29 drinking occasions/month (+1.7%, p < 0.05) than men who abstained. BMD of premenopausal women (n = 4,136) who drank alcohol did not differ from those who abstained. FN BMD was 3.8% higher in postmenopausal women (n = 2,043) who had >29 drinking occasions/month than those who abstained (p = 0.06). Binge drinking was not associated with BMD of men or women.

Conclusions

Drinking alcohol, but not binge drinking, appears to be beneficial to bone health of men and possibly postmenopausal women.

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References

  1. U.S. Department of Health and Human Services (2004) Bone Health and Osteoporosis: A Report of the Surgeon General. U.S. Department of Health and Human Services, Rockville

  2. Ray NF, Chan JK, Thamer M et al (1997) Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995: report from the National Osteoporosis Foundation. J Bone Miner Res 12:24–34

    Article  PubMed  CAS  Google Scholar 

  3. Magaziner J, Hawkes W, Hebel JR et al (2000) Recovery from hip fracture in eight areas of function. J Gerontol, Ser A, Biol Sci Med Sci 55:M498–M507

    CAS  Google Scholar 

  4. Kim MJ, Shim MS, Kim MK et al (2003) Effect of chronic alcohol ingestion on bone mineral density in males without liver cirrhosis. Korean J Intern Med 18:174–180

    PubMed  CAS  Google Scholar 

  5. Diez A, Puig J, Serrano S et al (1994) Alcohol-induced bone disease in the absence of severe chronic liver damage. J Bone Miner Res 9:825–831

    PubMed  CAS  Google Scholar 

  6. Crilly RG, Anderson C, Hogan D et al (1988) Bone histomorphometry, bone mass, and related parameters in alcoholic males. Calcif Tissue Int 43:269–276

    Article  PubMed  CAS  Google Scholar 

  7. Schnitzler CM, Solomon L (1984) Bone changes after alcohol abuse. S Afr Med J 66:730–734

    PubMed  CAS  Google Scholar 

  8. Ganry O, Baudoin C, Fardellone P (2000) Effect of alcohol intake on bone mineral density in elderly women: the EPIDOS study. Am J Epidemiol 15:773–780

    Google Scholar 

  9. Holbrook TL, Barrett-Connor E (1993) A prospective study of alcohol consumption and bone mineral density. Br Med J 306:1506–1509

    CAS  Google Scholar 

  10. Laitinen K, Valimaki M, Keto P (1991) Bone mineral density measured by dual-energy x-ray absorptiometry in healthy Finnish women. Calcif Tissue Int 48:224–231

    Article  PubMed  CAS  Google Scholar 

  11. New SA, Robins SP, Campbell MK et al (2000) Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health? Am J Clin Nutr 71:142–151

    PubMed  CAS  Google Scholar 

  12. Feskanich D, Korrick SA, Greenspan SL et al (1999) Moderate alcohol consumption and bone density among postmenopausal women. J Women's Health 8:65–73

    Article  CAS  Google Scholar 

  13. Felson DT, Zhang Y, Hannan MT et al (1995) Alcohol intake and bone mineral density in elderly men and women. The Framingham study. Am J Epidemiol 142:485–492

    PubMed  CAS  Google Scholar 

  14. Hansen MA, Overgaard K, Riis BJ et al (1991) Potential risk factors for development of postmenopausal osteoporosis - examined over a 12-year period. Osteoporos Int 1:95–102

    Article  PubMed  CAS  Google Scholar 

  15. Rapuri PB, Gallagher JC, Balhorn KE et al (2000) Alcohol intake and bone metabolism in elderly women. Am J Clin Nutr 72:1206–1213

    PubMed  CAS  Google Scholar 

  16. Bauer DC, Browner WS, Cauley JA et al (1993) Factors associated with appendicular bone mass in older women. Ann Intern Med 118:665–667

    Google Scholar 

  17. MacInnis RJ, Cassar C, Nowson CA et al (2003) Determinants of bone density in 30- to 65-year-old women: a co-twin study. J Bone Miner Res 18:1650–1656

    Article  PubMed  CAS  Google Scholar 

  18. Angus RM, Sambrook PN, Pocock NA et al (1988) Dietary intake and bone mineral density. Bone Miner 4:265–277

    PubMed  CAS  Google Scholar 

  19. Stevenson JC, Lees B, Devenport M et al (1989) Determinants of bone density in normal women: risk factors for future osteoporosis? Br Med J 298:924–928

    Article  CAS  Google Scholar 

  20. Grainge MJ, Coupland, CAC, Cliffe SJ et al (1998) Cigarette smoking, alcohol and caffeine consumption, and bone mineral density in postmenopausal women. Osteoporos Int 8:355–363

    Article  PubMed  CAS  Google Scholar 

  21. Bainbridge KE, Sowers M, Lin X et al (2004) Risk factors for low bone mineral density and the 6-year rate of bone loss among premenopausal and perimenopausal women. Osteoporos Int 15:439–446

    Article  PubMed  Google Scholar 

  22. New SA, Bolton-Smith C, Grubb DA et al (1997) Nutritional influences on bone mineral density: a cross-sectional study in premenopausal women. Am J Clin Nutr 65:1831–1839

    PubMed  CAS  Google Scholar 

  23. Kroger H, Tuppurainen M, Honkanen R et al (1994) Bone mineral density and risk factors for osteoporosis-a population-based study of 1600 perimenopausal women. Calcif Tissue Int 55:1–7

    Article  PubMed  CAS  Google Scholar 

  24. Macdonald HM, New SA, Golden MHN et al (2004) Nutritional associations with bone loss during the menopausal transition: evidence of a beneficial effect of calcium, alcohol, and fruit and vegetable nutrients and of a detrimental effect of fatty acids. Am J Clin Nutr 79:155–165

    PubMed  CAS  Google Scholar 

  25. Laitinen K, Valimaki M (1991) Alcohol and bone. Calcif Tissue Int 49:S70–S73

    Article  PubMed  Google Scholar 

  26. Gavaler JS, Love K, Van Thiel D et al (1991) An international study of the relationship between alcohol consumption and postmenopausal estradiol levels. Alcohol Alcohol, (Suppl 1):327–330

  27. Hankinson SE, Willett WC, Manson JE et al (1995) Alcohol, height, and adiposity in relation to estrogen and prolactin levels in postmenopausal women. J Natl Cancer Inst 87:1297–1302

    Article  PubMed  CAS  Google Scholar 

  28. Onland-Moret NC, Peeters, PHM, van der Schouw YT et al (2005) Alcohol and endogenous sex steroid levels in postmenopausal women: a cross-sectional study. J Clin Endocrinol Metab 90:1414–1419

    Article  PubMed  CAS  Google Scholar 

  29. Dorgan JF, Reichman ME, Judd JT et al (1994) The relation of reported alcohol ingestion to plasma levels of estrogens and androgens in premenopausal women (Maryland, United States). Cancer Causes Control 5:53–60

    Article  PubMed  CAS  Google Scholar 

  30. (1994) Plan and operation of the Third National Health and Nutrition Examination Survey, 1988–94. National Center for Health Statistics, Hyattsville

  31. Wahner HW, Looker AC, Dunn WL et al (1994) Quality control of bone densitometry in a national health survey (NHANES III) using three mobile examination centers. J Bone Miner Res 9:951–960

    Article  PubMed  CAS  Google Scholar 

  32. Kalkwarf HJ, Khoury JC, Lanphear BP (2003) Milk intake during childhood and adolescence, adult bone density, and osteoporotic fractures in US women. Am J Clin Nutr 77:257–265

    PubMed  CAS  Google Scholar 

  33. Benson BW, Shulman JD (2005) Inclusion of tobacco exposure as a predictive factor for decreased bone mineral content. Nicotine Tob Res 7:719–724

    Article  PubMed  CAS  Google Scholar 

  34. Winer BJ (1971) Statistical principles in experimental design. McGraw-Hill, New York

    Google Scholar 

  35. Knoke JD, Barrett-Connor E (2003) Weight loss: a determinant of hip bone loss in older men and women. Am J Epidemiol 158:1132–1138

    Article  PubMed  Google Scholar 

  36. Williams FMK, Cherkas LF, Spector TD et al (2005) The effect of moderate alcohol consumption on bone mineral density: a study of female twins. Ann Rheum Dis 64:309–310

    Article  PubMed  CAS  Google Scholar 

  37. Nguyen TV, Eisman JA, Kelly PJ et al (1996) Risk factors for osteoporotic fractures in elderly men. Am J Epidemiol 144:255–263

    PubMed  CAS  Google Scholar 

  38. Siris ES, Miller PD, Barrett-Connor E et al (2001) Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. JAMA 286:2815–2822

    Article  PubMed  CAS  Google Scholar 

  39. Baron JA, Farahmand BY, Weiderpass E et al (2001) Cigarette smoking, alcohol consumption, and risk of hip fracture in women. Arch Intern Med 161:983–988

    Article  PubMed  CAS  Google Scholar 

  40. Tuppurainen M, Kroger H, Honkanen R et al (1995) Risks of perimenopausal fractures - a prospective population-based study. Acta Obstet Gynecol Scand 74:624–628

    Article  PubMed  CAS  Google Scholar 

  41. Huopio J, Kroger H, Honkanen R et al (2000) Risk factors for perimenopausal fractures: a prospective study. Osteoporos Int 11:219–227

    Article  PubMed  CAS  Google Scholar 

  42. Myking O, Aakvaag A, Digranes O (1987) Androgen-oestrogen imbalance in men with chronic alcoholism and fatty liver. Alcohol Alcohol 22:7–15

    PubMed  CAS  Google Scholar 

  43. Callaci JJ, Juknelis D, Patwardhan A et al (2004) The effects of binge alcohol exposure on bone resorption and biomechanical and structural properties are offset by concurrent bisphosphonate treatment. Alcohol Clin Exp Res 28:182–191

    Article  PubMed  Google Scholar 

  44. DeJong W (2003) Definitions of binge drinking. JAMA 289:1635

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We extend special acknowledgement to Jane Khoury for her assistance with data acquisition, analyses, and interpretation.

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  1. Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 7035, Cincinnati, OH, 45229, USA

    K. S. Wosje & H. J. Kalkwarf

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  1. K. S. Wosje
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Correspondence to K. S. Wosje.

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Wosje, K.S., Kalkwarf, H.J. Bone density in relation to alcohol intake among men and women in the United States. Osteoporos Int 18, 391–400 (2007). https://doi.org/10.1007/s00198-006-0249-0

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