Alcohol and Osteoporosis: What's The Connection?

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Summary: Learn how alcohol and osteoporosis can impact one another, and why you shouldn’t consume excessive alcohol with osteoporosis.

Disclaimer: If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Well Guide contain information from peer-reviewed research, medical societies and governmental agencies; however, these articles are not a substitute for professional medical advice, diagnosis, or treatment.

Osteoporosis is a significant public health concern, affecting more than 200 million people worldwide (Sànchez-Riera, 2014). While financially costly, osteoporosis can also lead to substantial disability and decreased quality of life (Gao, 2023). As a result, there’s a lot of interest in learning as much as we can about how to protect bones as we get older. While we can’t control all risk factors, like genetics or hormonal changes during menopause, there are steps you can take to protect your bones.

One of the risk factors for osteoporosis we do have control over is alcohol consumption. Excess alcohol consumption has consistently been shown to harm bone health and can increase the risk of osteoporosis (Akkawi, 2018)

Most people recognize that drinking too much is harmful, but when it comes to bone health, this is especially true. In this article, we will examine the complex relationship between alcohol and bone health, including how alcohol affects our bones and what the research says about the potential benefits and risks of alcohol consumption on osteoporosis.

Facts about how drinking alcohol affects your bone health

Alcohol is a modifiable risk factor (something you can change) for developing osteoporosis, but the relationship is complex. While studies tell us that heavy drinking harms bone health, some research suggests that moderate drinking may somewhat protect bones (Cheraghi, 2019), (Berg, 2008). 

Several studies have noted relationships between low to moderate alcohol intake and a lower risk of hip fractures, but the data isn't consistent (Fung, 2019). A study comparing various levels of alcohol intake and bone health found that men who drank moderate amounts of alcohol (up to two drinks each day) had higher BMD values, but drinking three or more alcoholic beverages daily was linked to an increased risk of hip fracture (Godos, 2022).

In other words, too much alcohol can weaken your bones and increase your risk of fractures, but exactly how much is too much is still being studied.

How does alcohol affect your bone density?

There are likely several explanations as to why alcohol may affect bone density. Alcohol may interfere with the balance of bone building and breakdown balance, favoring breakdown (Chakkalakal, 2006). Research indicates that alcohol can impact the structure of bones, potentially affecting the thickness of the outer layer and the volume of the inner trabecular bone (Maurel, 2012).

Excessive alcohol intake may also indirectly impact bone health by disrupting hormone balance. Men may make less testosterone, which is essential for bone formation, and for women, alcohol can influence estrogen balance to favor bone loss (Godos, 2022).

Alcohol can also impair nutrient absorption, making it difficult for the body to get enough bone-building nutrients (Abukhadir, 2013). Chronic alcohol intake is linked to poor nutrition and can lead to vitamin D, calcium, and magnesium deficiencies─all essential for bone health (Butts, 2023).

But why would moderate amounts of alcohol potentially improve BMD? It likely depends on the age of the person, overall diet, and the type of alcohol being consumed. There’s also an indication that the type of alcoholic beverage matters, too, where options like red wine contain other potential health-promoting compounds like resveratrol, a polyphenolic antioxidant linked to improved bone health in animal models (Godos, 2022).

It is important to note that even with these study outcomes, alcohol should not be considered a treatment or preventative measure for low BMD. The potential negative impacts on overall health and well-being far outweigh any potential benefits regarding bone health.  

Can you drink alcohol if you have osteoporosis?

It's best to limit alcohol if you have osteoporosis. That doesn't mean you can never enjoy a glass of wine or a cocktail, but given alcohol is connected to worse bone health and there isn’t a consensus on how much alcohol is safe for those with osteoporosis, keeping drinking to special occasions is likely a good plan.

Examining your drinking habits is a good first step. If alcohol is a big part of your life, it may be worth a discussion with a medical professional to assess your situation.

Heavy alcohol consumption and osteoporosis

Heavy alcohol intake is associated with many health risks beyond bone health, including heart disease, liver damage, and certain types of cancer (Esser, 2022). For individuals with osteoporosis, consuming more than two drinks per day is linked to a higher risk of 23% for any fracture, 38% for any osteoporotic fracture, and 68% for hip fracture, compared to those with moderate or no alcohol consumption (Kanis, 2005).

The chance of falling is also increased with heavy alcohol consumption, which can directly contribute to fractures in those with osteoporosis. Older adults are already at a higher risk for falls, and adding heavy alcohol consumption can further increase this risk (Salari, 2022).

How much alcohol is too much for osteoporosis?

In general, the National Institute of Health recommends women limit their alcohol intake to one drink per day, and men limit their intake to two (NIH, 2023). Light to moderate alcohol intake is usually classified as one drink daily or less for women while heavy is more than four drinks a day or eight or more a week for women (NIH, 2023).

However, it’s important to note that recommendations can change depending on individual factors such as age, medication use, and overall health, so talk to your healthcare provider to discuss the best plan for you.

Want to enjoy a drink without the buzz? Try these non-alcoholic options

If you want to transform your favorite cocktails into bone-healthy options, consider these tips:

  • Replace alcohol with mineral water or a splash of juice to maintain the flavor profile.
  • Use fresh fruits such as lemon, lime, orange, or berries, which are rich in Vitamin C (beneficial for bones).
  • Include a dash of turmeric or ginger, both known for their anti-inflammatory properties, in your cocktail recipes.
  • Try shrubs, a fermented fruit and vinegar mixture, as a flavorful alternative to sugary syrups.
  • Experiment with different herbs like basil, mint, or rosemary for added flavor and potential bone health benefits.

Key takeaways: alcohol and bone health

Light alcohol consumption may not pose a significant risk to bone health. However, excessive alcohol intake can raise the risk of osteoporosis and fractures.

For those who prefer non-alcoholic options or need to limit their alcohol intake, plenty of delicious and bone-friendly alternatives are available.

Alcohol is only one factor among many that can affect bone health. A nutrient-dense diet, regular exercise, stress reduction, and smoking cessation are essential for maintaining strong and healthy bones so you can continue to enjoy an active and fulfilling life.

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