title: Association between alcohol consumption and both osteoporotic fracture and bone density.
abstract: OBJECTIVE
  Alcoholism is a risk factor for osteoporotic fractures and low bone density, but the effects of moderate alcohol consumption on bone are unknown. We performed a systematic review and meta-analysis to assess the associations between alcohol consumption and osteoporotic fractures, bone density and bone density loss over time, bone response to estrogen replacement, and bone remodeling.
  
  
  METHODS
  MEDLINE, Current Contents, PsychINFO, and Cochrane Libraries were searched for studies published before May 14, 2007. We assessed quality using the internal validity criteria of the US Preventive Services Task Force.
  
  
  RESULTS
  We pooled effect sizes for 2 specific outcomes (hip fracture and bone density) and synthesized data qualitatively for 4 outcomes (non-hip fracture, bone density loss over time, bone response to estrogen replacement, and bone remodeling). Compared with abstainers, persons consuming from more than 0.5 to 1.0 drinks per day had lower hip fracture risk (relative risk=0.80 [95% confidence interval, 0.71-0.91]), and persons consuming more than 2 drinks per day had higher risk (relative risk=1.39 [95% confidence interval, 1.08-1.79]). A linear relationship existed between femoral neck bone density and alcohol consumption. Because studies often combined moderate and heavier drinkers in a single category, we could not assess relative associations between alcohol consumption and bone density in moderate compared with heavy drinkers.
  
  
  CONCLUSIONS
  Compared with abstainers and heavier drinkers, persons who consume 0.5 to 1.0 drink per day have a lower risk of hip fracture. Although available evidence suggests a favorable effect of alcohol consumption on bone density, a precise range of beneficial alcohol consumption cannot be determined.
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10467, USA. kberg@montefiore.org
authors.forename: Karina M
authors.initials: KM
authors.lastname: Berg
authors.forename: Hillary V
authors.initials: HV
authors.lastname: Kunins
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Jackson
authors.forename: Shadi
authors.initials: S
authors.lastname: Nahvi
authors.forename: Amina
authors.initials: A
authors.lastname: Chaudhry
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Harris
authors.forename: Rubina
authors.initials: R
authors.lastname: Malik
authors.forename: Julia H
authors.initials: JH
authors.lastname: Arnsten
mesh_terms: D000428:Alcohol Drinking; D015519:Bone Density / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D000431:Ethanol / Q000494:pharmacology*; D006620:Hip Fractures / Q000150:complications*; D006801:Humans; D010024:Osteoporosis / Q000150:complications*
chemical_list: D000431:Ethanol