Alcohol Use and Bone Health in Men

Alcohol Use and Bone Health in Men

Book Chapter

2010

Osteoporosis in Men

435 - 442

2010

9780123746023 (ISBN)

Alcohol is consumed by approximately two-thirds of men across the lifespan in the USA and alcohol abuse is widely appreciated as a risk factor for fragility fracture. However, moderate alcohol consumption is associated with higher bone mineral density (BMD) and lower fracture risk. The mechanism(s) of these apparently contradictory observations are not well defined and the issues surrounding alcohol use and bone health are exceedingly complex. This chapter reviews the epidemiology of alcohol use/abuse among men, explores the effects of alcohol on musculoskeletal metabolism, bone mineral density, falls and fracture risk. Despite the reported beneficial effect on BMD, excessive intake of alcoholic beverages is clearly detrimental and increases fracture risk. As such, despite the difficulties of defining "high" alcohol intake, including this as a clinical fracture risk factor is appropriate. Perhaps it is reasonable to consider alcohol as a drug with potential toxicities when utilized in high doses, but as a "nutrient" at low doses in association with a well-balanced diet. However, despite the multiple studies relating "moderate" alcohol intake with higher BMD, it is not appropriate to recommend consumption of alcoholic beverages as a way to enhance bone health. It must be appreciated that the relationship between alcohol intake and skeletal health is extraordinarily complex being influenced by a variety of physiologic, nutritional and psychosocial factors. It is therefore not surprising that these relationships remain poorly defined.