title: Alcohol: A Simple Nutrient with Complex Actions on Bone in the Adult Skeleton.
abstract: BACKGROUND
  Alcohol is an important nonessential component of diet, but the overall impact of drinking on bone health, especially at moderate levels, is not well understood. Bone health is important because fractures greatly reduce quality of life and are a major cause of morbidity and mortality in the elderly. Regular alcohol consumption is most common following skeletal maturity, emphasizing the importance of understanding the skeletal consequences of drinking in adults.
  
  
  METHODS
  This review focuses on describing the complex effects of alcohol on the adult skeleton. Studies assessing the effects of alcohol on bone in adult humans as well as skeletally mature animal models published since the year 2000 are emphasized.
  
  
  RESULTS
  Light to moderate alcohol consumption is generally reported to be beneficial, resulting in higher bone mineral density (BMD) and reduced age-related bone loss, whereas heavy alcohol consumption is generally associated with decreased BMD, impaired bone quality, and increased fracture risk. Bone remodeling is the principal mechanism for maintaining a healthy skeleton in adults and dysfunction in bone remodeling can lead to bone loss and/or decreased bone quality. Light to moderate alcohol may exert beneficial effects in older individuals by slowing the rate of bone remodeling, but the impact of light to moderate alcohol on bone remodeling in younger individuals is less certain. The specific effects of alcohol on bone remodeling in heavy drinkers are even less certain because the effects are often obscured by unhealthy lifestyle choices, alcohol-associated disease, and altered endocrine signaling.
  
  
  CONCLUSIONS
  Although there have been advances in understanding the complex actions of alcohol on bone, much remains to be determined. Limited evidence implicates age, skeletal site evaluated, duration, and pattern of drinking as important variables. Few studies systematically evaluating the impact of these factors have been conducted and should be made a priority for future research. In addition, studies performed in skeletally mature animals have potential to reveal mechanistic insights into the precise actions of alcohol and associated comorbidity factors on bone remodeling.
authors.affiliation: Skeletal Biology Laboratory, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon.
authors.forename: Gino W
authors.initials: GW
authors.lastname: Gaddini
authors.affiliation: Skeletal Biology Laboratory, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon.|Center for Healthy Aging Research, Oregon State University, Corvallis, Oregon.
authors.forename: Russell T
authors.initials: RT
authors.lastname: Turner
authors.affiliation: Division of Neuroscience, Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, Oregon.
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Grant
authors.affiliation: Skeletal Biology Laboratory, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon.|Center for Healthy Aging Research, Oregon State University, Corvallis, Oregon.
authors.forename: Urszula T
authors.initials: UT
authors.lastname: Iwaniec
mesh_terms: D000328:Adult; D000375:Aging / Q000187:drug effects / Q000502:physiology; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000378:metabolism; D000818:Animals; D015519:Bone Density / Q000187:drug effects* / Q000502:physiology; D016723:Bone Remodeling / Q000187:drug effects* / Q000502:physiology; D000431:Ethanol / Q000008:administration & dosage* / Q000009:adverse effects / Q000378:metabolism; D006801:Humans; D010024:Osteoporosis / Q000139:chemically induced / Q000378:metabolism
chemical_list: D000431:Ethanol
keywords: Bone Formation; Bone Mineral Density; Bone Remodeling; Bone Resorption; Osteoporosis