Moderate drinking may lower hip fracture risk

NEW YORK (Reuters Health) - A drink or two a day may make for stronger bones, according to a new review of the published literature, but more than two drinks each day appears to increase the fracture risk.

Men and women who had one half to one alcoholic beverages daily were 20 percent less likely than teetotalers to sustain a hip fracture, but having more than two drinks a day actually increased fracture risk, Dr. Karina M. Berg of Montefiore Medical Center in the Bronx, New York, and colleagues found.

"The overall message is that moderate alcohol use is beneficial to bone -- the key here is moderate," Berg told Reuters Health in an interview.

Heavy drinking is a known risk factor for porous bones and osteoporotic fractures, Berg and her team note in the American Journal of Medicine, but a number of studies have also linked moderate drinking to a lower risk of fractures and greater bone density. To better understand the relationship, she and her colleagues identified published high-quality studies that evaluated the effects of drinking on bone health and looked at the combined results.

People who had one half to one drink daily had a significantly lower risk of hip fractures than abstainers, but people who consumed more than a couple of drinks daily were 39 percent more likely to fracture a hip than were the abstainers, the researchers found.

They also found that compared with abstainers, moderate drinkers appeared to have a higher bone density, and that this relationship was linear. However, there was not enough evidence to determine the impact of alcohol on bone density in moderate drinkers compared with heavy drinkers.

Heavier drinkers' higher fracture risk was likely due at least in part to falls, Berg and her team note, while it's possible that some of the non-drinkers stopped consuming alcohol for health reasons, which could help explain why abstainers were at increased fracture risk.

In addition, moderate drinking may be a sign of other moderate behaviors or healthy habits that are good for bone, such as eating a balanced, nutritious diet, Berg said.

But she cautioned that people who don't drink shouldn't start for their bones' sake, because of the other known risks of alcohol.

SOURCE: The American Journal of Medicine, May 2008.