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"Moderate intake of alcohol has been reported to have beneficial effects on bone," write Katherine L. Tucker, from Tufts University in Boston, Massachusetts, and colleagues. "However, different classes of alcoholic beverages have not been investigated."
The goal of this study was to evaluate the association between intake of total alcohol or individual alcoholic beverages and bone mineral density.. Using the population-based Framingham Offspring cohort, the investigators studied the relationship between alcohol intakes and BMD at three hip sites and the lumbar spine, after adjustment for potential confounding factors. There were 1182 men, and 1289 postmenopausal and 248 pre-menopausal women, age range 29 to 86 years.
Men were predominantly beer drinkers, whereas women were predominantly wine drinkers. Compared with non-drinkers, men consuming 1 to 2 drinks per day of total alcohol or beer had greater hip bone mineral density (BMD). Among postmenopausal women, those consuming more than 2 drinks per day of total alcohol or wine had significantly greater hip and spine bone mineral density (BMD).
"Moderate consumption of alcohol may be beneficial to bone in men and postmenopausal women," the study authors write. "However, in men, high liquor intakes (more than two drinks per day)) were associated with significantly 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."
"Clearly, this observation must be placed in the context of harmful effects of high alcohol intake in older women, including increased risk of falls — and thus fracture risk — and greater risk of breast cancer and cirrhosis," the study authors conclude.
In an accompanying editorial, Helen M. Macdonald, from the University of Aberdeen in Scotland, notes that the association between alcohol intake and bone health merits further study.
"In light of possible harm with increased dose of alcohol and in agreement with Tucker and colleagues, we would advise caution before making recommendations," Dr. Macdonald writes.
"If nonalcoholic constituents explain the positive associations between bone health and alcohol consumption, it can be argued that they can be obtained from other sources besides alcoholic drinks."