Alcohol Consumption, Bone Mineral Density, and Risk of Osteoporotic Fractures: A Dose–Response Meta-Analysis

Justyna Godos, Francesca Giampieri, Emanuele Chisari, Agnieszka Micek, Nadia Paladino, Tamara Y. Forbes-Hernández, José L. Quiles, Maurizio Battino, Sandro La Vignera, Giuseppe Musumeci and Giuseppe Grosso
Additional contact information
Justyna Godos: Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
Francesca Giampieri: Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain
Emanuele Chisari: Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA 19107, USA
Agnieszka Micek: Institute of Nursing and Midwifery, Faculty of Health Sciences, Medical College, Jagiellonian University, 31-501 Krakow, Poland
Nadia Paladino: Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
Tamara Y. Forbes-Hernández: Department of Physiology, Institute of Nutrition and Food Technology ‘‘José Mataix”, Biomedical Research Centre, University of Granada, 18100 Granada, Spain
José L. Quiles: Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain
Maurizio Battino: Department of Clinical Sciences, Polytechnic University of Marche, 60131 Ancona, Italy
Sandro La Vignera: Department of Clinical and Experimental Medicine, University of Catania, 95131 Catania, Italy
Giuseppe Musumeci: Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
Giuseppe Grosso: Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy

IJERPH, 2022, vol. 19, issue 3, 1-12

Abstract: Excess alcohol consumption is known to be detrimental to human health. However, the role of light-to-moderate alcohol intake is under investigation for potential certain health benefits—mostly related to the cardiovascular system. Nevertheless, there is no univocal agreement on this matter, and research is still ongoing to clarify whether there might be other potential outcomes affected by alcohol intake. In this regard, there is evidence that excess alcohol intake may negatively influence the risk of osteoporotic fractures. However, there is no comprehensive evidence of literature assessing the role of alcohol consumption in bone mineral density (BMD) and the risk of osteoporotic fractures. Thus, the aim of this study was to quantitatively assess the dose–response relationship between alcohol intake and BMD and risk of osteoporotic fractures. The Embase and MEDLINE electronic databases were searched from their inception to December 2021 for articles providing a quantifiable measurement of alcohol consumption for at least three categories and (1) a measurement of BMD (and dispersion as continuous variables) in some area of the body or (2) risk of osteoporotic fracture provided as relative risk (RR) or hazard ratio (HR), with a 95% confidence interval (CI) as the measure of the association of each category with alcohol intake. A total of 11 studies including 46,916 individuals with BMD assessment and 8 studies including 240,871 individuals with risk of fracture analysis were included. Compared to non-drinkers, consumption of up to two standard drinks of alcohol per day was correlated with higher lumbar and femur neck BMD values, while up to one standard drink of alcohol was correlated with higher hip BMD compared to no alcohol consumption. Higher risk of hip fractures was found starting from three standard drinks of alcohol per day (RR = 1.33, 95% CI: 1.04; 1.69 for three alcoholic drinks/d, and RR = 1.59, 95% CI: 1.23; 2.05 for four alcoholic drinks/d) compared to no alcohol consumption, with no evidence of heterogeneity. Concerning the risk of any osteoporotic fractures, the risk steadily increased with higher intake of alcohol, although never reaching statistical significance. In conclusion, there is consistent evidence that increased alcohol consumption is associated with higher risk of osteoporotic hip fracture; however, the role of alcohol at lower doses is uncertain, as BMD was even higher in light drinkers compared to abstainers.

Keywords: alcohol; osteoporosis; bone mineral density; meta-analysis; bone health; fractures (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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