Features December 2012 Issue

Bottom’s Up: Can Alcohol Boost Bone Strength?

An occasional drink may benefit your bones and joints, but too much may be harmful.

In vino veritas: “In wine [there is] truth.”

Truth is, wine and other alcoholic beverages may confer some health benefits. A number of studies suggest that moderate alcohol consumption may promote cardiovascular health and reduce your risk of heart disease and heart attacks.

The benefits of moderate drinking may not end there. Some research suggests it may reduce the risk of certain types of arthritis, while a study published online in the journal Menopause suggests that moderate alcohol intake may slow bone loss and thus reduce the risk of osteoporosis.

But there’s a catch. While drinking moderately may be beneficial, enjoying any more than a drink or two per day can have damaging effects on your bones and joints.

“The bottom line is that alcohol in moderation doesn’t appear to have deleterious effects on many things, and actually has some beneficial effects overall,” says Chad Deal, MD, head of the Center for Osteoporosis and Metabolic Bone Disease at Cleveland Clinic. “It’s just heavy alcohol consumption that’s a risk.”

The Evidence for Imbibing
The National Institutes of Health defines moderate alcohol consumption as no more than two standard drinks a day for men and one a day for women or anyone over age 65. A standard drink equates to one 12-ounce bottle of beer or wine cooler, one 5-ounce glass of wine, or 1 ounces of 80-proof distilled spirits.

In the Menopause study, investigators studied 40 postmenopausal women who regularly consumed one or two drinks a day, were on no hormone replacement therapy, and had no history of osteoporosis-related fractures. They found evidence of increased bone turnover (which leads to a thinning of the bone structure) during a two-week period when the participants stopped drinking. Surprisingly, they also found that less than a day after the women resumed their normal drinking, their bone turnover rates returned to previous levels.

Other studies support the idea that moderate alcohol intake may help reduce inflammation, your body’s response to injury, which has been implicated in conditions ranging from cardiovascular disease and cancer to rheumatoid arthritis (RA). In a study published July 10 in the British Medical Journal, researchers concluded that moderate alcohol consumption was associated with a reduced risk of RA in women. Specifically, women who drank more than three glasses of beer, wine, or liquor per week over a 10-year period had slightly less than half the risk of RA as teetotalers or those who drank less than one glass per week, the study found.

The benefits of moderate drinking for joint health may not end there. In findings presented at the European League Against Rheumatism’s 2010 Congress of Rheumatology, Dutch researchers concluded that people who regularly consumed alcohol not only reduced their risk of RA, but also had about a 30 percent lower risk of osteoarthritis. Overall, however, evidence supporting a beneficial effect of alcohol consumption on osteoarthritis is limited.

And Dr. Deal cautions that large epidemiologic studies such as these do not carry the scientific weight of a randomized, controlled trial and thus do not prove conclusively that alcohol can benefit bone and joint health.

Nevertheless, “These studies are just another piece of information that moderate alcohol consumption is probably good for your bone health,” he says. “It’s probably good for your heart health, and it’s probably good for reducing rheumatoid arthritis.

“Would a physician recommend drinking one drink a day to improve your health? I don’t think anyone would do that,” he adds. “It’s just that if that is your lifestyle, you can be assured that there are no deleterious side effects.”

Potential Downsides
A little alcohol may be good, but a lot certainly isn’t better. Overindulging in alcohol is a major risk factor for gout, a form of inflammatory arthritis characterized by the formation of uric acid crystals in the joints. Heavy drinkers tend to smoke, which increases the risk of RA. Alcohol consumption also can augment the potentially liver-toxic side effects of certain RA medications, particularly methotrexate (Rheumatrex) and leflunomide (Arava).

Although the Menopause study suggests that moderate drinking may have beneficial effects on bone metabolism, heavy alcohol consumption can be toxic to osteoblasts, the cells responsible for bone formation, Dr. Deal says. And, according to the National Institutes of Health, excessive drinking interferes with the balance of bone-building calcium and can increase parathyroid hormone levels, which can lower your body’s calcium reserves. In short, drinking too much can weaken your bones and contribute to osteoporosis. It also can impair your thinking, balance, and walking ability and thus make you more susceptible to falls, which can be devastating if you have osteoporosis.

“Overall, moderate alcohol consumption is safe and may be beneficial,” Dr. Deal emphasizes, “but heavy alcohol consumption is not, and that’s defined as three drinks or more per day.”