Abstract
Summary
In this cross-sectional study based on Korean elderly men and women, heavy alcohol intake for men was related to low whole-body BMD and light alcohol intake for women was associated with high whole-body, lumbar, and total femur BMD.
Purpose
Alcohol is a risk factor of osteoporosis but previous studies on its effect on bone health has been controversial. The aim of this study was to evaluate the association between alcohol intake and bone mineral density in Korean elderly men and women.
Methods
Based on the Fourth and Fifth Korean National Health and Nutrition Examination Surveys (KNHANES), 2657 men and 2080 women 50 to 79 years of age were included. Bone mineral density (BMD) was measured using dual energy X-ray absorptiometry (DXA). Alcohol consumption was determined by self-administered questionnaires and classified into four groups according to sex: non-drinkers (0 g/day), light drinking (1–19 g/day men, 1–9 g/day women), moderate drinking (20–39 g/day men, 10–29 g/day women), and heavy drinking (≥ 40 g/day men, ≥ 20 g/day women). The adjusted mean values calculated by linear regression analysis for BMD were determined according to the amount of alcohol consumed.
Results
Light drinkers had the highest whole-body BMD for both men (mean 1.164, SD 0.047–1.281) and women (mean 1.046, SD 0.912–1.180). Among men, mean whole-body BMD for heavy drinkers was significantly lower than that among light drinkers (P = 0.031). Among women, BMD for light drinkers was significantly higher in the whole body, lumbar, and total femur than that for non-drinkers (P < 0.001, P = 0.026, P = 0.040, respectively).
Conclusions
Heavy alcohol intake may be associated with lower BMD in men while light alcohol intake may associate with higher BMD among women. Future longitudinal studies investigating the effect of alcohol consumption on bone mineral density are needed to validate the findings of this study.
Similar content being viewed by others
References
Reginster JY, Burlet N (2006) Osteoporosis: a still increasing prevalence. Bone 38:S4–S9
Park EJ, Joo IW, Jang MJ, Kim YT, Oh K, Oh HJ (2014) Prevalence of osteoporosis in the Korean population based on Korea National Health and Nutrition Examination Survey (KNHANES), 2008-2011. Yonsei Med J 55:1049–1057
Chakkalakal DA (2005) Alcohol-induced bone loss and deficient bone repair. Alcohol Clin Exp Res 29:2077–2090
Holbrook TL, Barrett-Connor E (1993) A prospective study of alcohol consumption and bone mineral density. BMJ 306:1506–1509
McLernon DJ, Powell JJ, Jugdaohsingh R, Macdonald HM (2012) Do lifestyle choices explain the effect of alcohol on bone mineral density in women around menopause? Am J Clin Nutr 95:1261–1269
Pedrera-Zamorano JD, Lavado-Garcia JM, Roncero-Martin R, Calderon-Garcia JF, Rodriguez-Dominguez T, Canal-Macias ML (2009) Effect of beer drinking on ultrasound bone mass in women. Nutrition 25:1057–1063
Ilich JZ, Brownbill RA, Tamborini L, Crncevic-Orlic Z (2002) To drink or not to drink: how are alcohol, caffeine and past smoking related to bone mineral density in elderly women? J Am Coll Nutr 21:536–544
Kouda K, Iki M, Fujita Y, Tamaki J, Yura A, Kadowaki E, Sato Y, Moon JS, Morikawa M, Tomioka K, Okamoto N, Kurumatani N (2011) Alcohol intake and bone status in elderly Japanese men: baseline data from the Fujiwara-kyo osteoporosis risk in men (FORMEN) study. Bone 49:275–280
Tapson F (2004) Alcoholic drinks, measures & units in the United Kingdom
Hyeon JH, Gwak JS, Hong SW, Kwon H, Oh SW, Lee CM (2016) Relationship between bone mineral density and alcohol consumption in Korean men: the Fourth Korea National Health and Nutrition Examination Survey (KNHANES), 2008-2009. Asia Pac J Clin Nutr 25:308–315
Seo S, Chun S, Newell MA, Yun M (2015) Association between alcohol consumption and Korean young women’s bone health: a cross sectional study from the 2008 to 2011 Korea National Health and Nutrition Examination Survey. BMJ Open 5:e007914
Jang HD, Hong JY, Han K, Lee JC, Shin BJ, Choi SW, Suh SW, Yang JH, Park SY, Bang C (2017) Relationship between bone mineral density and alcohol intake: a nationwide health survey analysis of postmenopausal women. PLoS One 12:e0180132
Malik P, Gasser RW, Kemmler G, Moncayo R, Finkenstedt G, Kurz M, Fleischhacker WW (2009) Low bone mineral density and impaired bone metabolism in young alcoholic patients without liver cirrhosis: a cross-sectional study. Alcohol Clin Exp Res 33:375–381
Maurel DB, Jaffre C, Rochefort GY, Aveline PC, Boisseau N, Uzbekov R, Gosset D, Pichon C, Fazzalari NL, Pallu S, Benhamou CL (2011) Low bone accrual is associated with osteocyte apoptosis in alcohol-induced osteopenia. Bone 49:543–552
Sampson HW, Perks N, Champney TH, DeFee B 2nd (1996) Alcohol consumption inhibits bone growth and development in young actively growing rats. Alcohol Clin Exp Res 20:1375–1384
Turner RT (2000) Skeletal response to alcohol. Alcohol Clin Exp Res 24:1693–1701
Chen JR, Lazarenko OP, Shankar K, Blackburn ML, Badger TM, Ronis MJ (2010) A role for ethanol-induced oxidative stress in controlling lineage commitment of mesenchymal stromal cells through inhibition of Wnt/beta-catenin signaling. J Bone Miner Res 25:1117–1127
Bonewald LF, Johnson ML (2008) Osteocytes, mechanosensing and Wnt signaling. Bone 42:606–615
Cui Q, Wang Y, Saleh KJ, Wang GJ, Balian G (2006) Alcohol-induced adipogenesis in a cloned bone-marrow stem cell. J Bone Joint Surg Am 88(Suppl 3):148–154
Liu Y, Kou X, Chen C, Yu W, Su Y, Kim Y, Shi S, Liu Y (2016) Chronic high dose alcohol induces osteopenia via activation of mTOR signaling in bone marrow mesenchymal stem cells. Stem Cells 34:2157–2168
Gonzalez-Reimers E, Garcia-Valdecasas-Campelo E, Santolaria-Fernandez F, Sanchez-Perez MJ, Rodriguez-Rodriguez E, Gomez-Rodriguez MA, Vina-Rodriguez J (2008) Prognostic value of nutritional status in alcoholics, assessed by double-energy X-ray absorptiometry. Alcohol Alcohol 43:314–319
Jugdaohsingh R, O’Connell MA, Sripanyakorn S, Powell JJ (2006) Moderate alcohol consumption and increased bone mineral density: potential ethanol and non-ethanol mechanisms. Proc Nutr Soc 65:291–310
Rapuri PB, Gallagher JC, Balhorn KE, Ryschon KL (2000) Alcohol intake and bone metabolism in elderly women. Am J Clin Nutr 72:1206–1213
Sripanyakorn S, Jugdaohsingh R, Mander A, Davidson SL, Thompson RP, Powell JJ (2009) Moderate ingestion of alcohol is associated with acute ethanol-induced suppression of circulating CTX in a PTH-independent fashion. J Bone Miner Res 24:1380–1388
Marrone JA, Maddalozzo GF, Branscum AJ, Hardin K, Cialdella-Kam L, Philbrick KA, Breggia AC, Rosen CJ, Turner RT, Iwaniec UT (2012) Moderate alcohol intake lowers biochemical markers of bone turnover in postmenopausal women. Menopause 19:974–979
Vantyghem MC, Danel T, Marcelli-Tourvieille S, Moriau J, Leclerc L, Cardot-Bauters C, Docao C, Carnaille B, Wemeau JL, D’Herbomez M (2007) Calcitonin levels do not decrease with weaning in chronic alcoholism. Thyroid 17:213–217
Ellerington MC, Hillard TC, Whitcroft SI, Marsh MS, Lees B, Banks LM, Whitehead MI, Stevenson JC (1996) Intranasal salmon calcitonin for the prevention and treatment of postmenopausal osteoporosis. Calcif Tissue Int 59:6–11
Gavaler JS (2005) Should we consider an acceptable drinking level specifically for postmenopausal women? Preliminary findings from the postmenopausal health disparities study. Alcohol Alcohol 40:469–473
Onland-Moret NC, Peeters PH, van der Schouw YT, Grobbee DE, van Gils CH (2005) Alcohol and endogenous sex steroid levels in postmenopausal women: a cross-sectional study. J Clin Endocrinol Metab 90:1414–1419
Gaddini GW, Turner RT, Grant KA, Iwaniec UT (2016) Alcohol: a simple nutrient with complex actions on bone in the adult skeleton. Alcohol Clin Exp Res 40:657–671
Berg KM, Kunins HV, Jackson JL, Nahvi S, Chaudhry A, Harris KA, Jr., Malik R, Arnsten JH (2008) Association between alcohol consumption and both osteoporotic fracture and bone density. Am J Med 121:406–418
Muhlbauer RC, Lozano A, Reinli A, Wetli H (2003) Various selected vegetables, fruits, mushrooms and red wine residue inhibit bone resorption in rats. J Nutr 133:3592–3597
Tucker KL, Jugdaohsingh R, Powell JJ, Qiao N, Hannan MT, Sripanyakorn S, Cupples LA, Kiel DP (2009) Effects of beer, wine, and liquor intakes on bone mineral density in older men and women. Am J Clin Nutr 89:1188–1196
Fairweather-Tait SJ, Skinner J, Guile GR, Cassidy A, Spector TD, MacGregor AJ (2011) Diet and bone mineral density study in postmenopausal women from the TwinsUK registry shows a negative association with a traditional English dietary pattern and a positive association with wine. Am J Clin Nutr 94:1371–1375
Jugdaohsingh R, Tucker KL, Qiao N, Cupples LA, Kiel DP, Powell JJ (2004) Dietary silicon intake is positively associated with bone mineral density in men and premenopausal women of the Framingham Offspring cohort. J Bone Miner Res 19:297–307
Sripanyakorn S, Jugdaohsingh R, Elliott H, Walker C, Mehta P, Shoukru S, Thompson RP, Powell JJ (2004) The silicon content of beer and its bioavailability in healthy volunteers. Br J Nutr 91:403–409
Acknowledgements
We would like to express our gratitude towards the Ministry of Health and Welfare for providing KNHANES data and the participants of the national surveys in the Republic of Korea.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
None.
Electronic supplementary material
ESM 1
(PPTX 371 kb)
Rights and permissions
About this article
Cite this article
Cho, Y., Choi, S., Kim, K. et al. Association between alcohol consumption and bone mineral density in elderly Korean men and women. Arch Osteoporos 13, 46 (2018). https://doi.org/10.1007/s11657-018-0462-4
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s11657-018-0462-4