Osteoporosis and Alcohol: How Does Drinking Affect Bone Health?

Remember as a kid being told to “drink your milk!”? It may have been annoying at the time, but it was actually great advice. This is because milk contains a lot of calcium — the most important mineral for strong, healthy bones. While we might not give much thought to our bones after entering adulthood, we really should — particularly if we’re regularly consuming alcohol.

What does alcohol do to your bones? Does alcohol affect bone density? And can you drink alcohol if you have osteoporosis? In this post, we’ll explore the connection between alcohol, bone density, and bone health in general. We’ll also see how heavy drinking can put us at risk of developing osteoporosis. We’ll also look at other osteoporosis risk factors and share tips on how to maintain healthy bones. Let’s dive in!

How Does Alcohol Affect Our Bones?

Healthy bones are vital for keeping us healthy and functioning properly. In addition to supporting our body and allowing us to move, they also help protect our internal organs and store many essential nutrients. 

But, as with many other bodily parts, our bones can be affected by certain lifestyle choices, such as the amount of physical exercise we get and the foods or drinks we consume. This is why we’re told to drink our milk as kids!

Given the negative impact alcohol can have on so many bodily systems, it’s perhaps unsurprising to learn that alcohol can also be harmful to bone health. What does alcohol do to your bones, exactly? Multiple studies have shown that chronic, heavy drinking can increase the risk of osteoporosis — a bone disease that weakens our bones, making them thinner and less dense than they should be. It’s estimated that roughly half of those struggling with alcohol misuse also have decreasing bone mass.

So, how does alcohol affect the bones in our body? Does alcohol deplete vitamin D? And can you drink alcohol if you have osteoporosis? Let’s take a closer look at the effects of alcohol on bones and joints.

1. Vitamin D and Alcohol

One way that alcohol directly affects our bone health is by interfering with vitamin and mineral absorption. Our bones are a major storage center for calcium and other important minerals, like vitamin D and magnesium. Calcium is absorbed from our food and drinks via the small intestine, and our kidneys are responsible for getting rid of excess calcium in the body.

Studies show that alcohol consumption disrupts how our body absorbs calcium and vitamin D. This can cause nutrient deficiencies that impact our body’s ability to build strong bones and maintain a strong bone density, putting us at a higher risk for fractures after falls.

2. Bone cell turnover

Other effects of alcohol on bones and joints are more direct. For example, alcohol has a direct effect on our bone cell turnover rate. Our bones are constantly breaking down and rebuilding in small areas through a process called “remodeling.” Bone cells, called osteoclasts, break down parts of our bones to release more calcium into our bloodstream — a process called resorption. Osteoblasts, cells that stimulate bone formation, fill these holes with new, stronger bone.

Research indicates that heavy alcohol consumption increases bone resorption and reduces our body’s ability to promote new bone formation and repair. Over time, this results in impaired bone cell turnover and weaker bones.

3. Hormone production

One indirect way that alcohol affects our bone health is by interfering with the function of the parathyroid hormone (PTH), which regulates calcium levels. Here’s how it works: when we have decreased amounts of calcium in our bloodstream, our body produces PTH. This triggers the activity of osteoclasts, which dissolve small areas of bone and release more calcium into our blood.

Having more PTH tells our kidneys to hold onto calcium and stop eliminating it from our body. PTH also activates vitamin D, which boosts calcium absorption in our intestine. When calcium levels go up, further PTH production stops.

Drinking alcohol interferes with this process because it causes additional PTH to be released. Over time, this can result in too much calcium being drawn directly from our bones. As we’ve learned, when there’s not enough calcium present, our bone density diminishes.

Furthermore, research shows that men who drink heavily produce less testosterone, which is an important hormone for producing osteoblasts. In women, chronic consumption of alcohol can decrease estrogen — an important hormone that can inhibit bone breakdown and stimulate bone formation. (This is why a decrease in estrogen during menopause is often associated with bone loss.)

4. The risk of falling

Another indirect way that alcohol can affect our bone health is by increasing our risk of falling. This may sound obvious, but the more alcohol we consume, the greater our chance of becoming intoxicated and losing our coordination and balance. Falling increases our risk of bone fractures, especially if we’re already prone to thin, weak bones. Perhaps not surprisingly, research shows that in older adults, light to moderate drinking is associated with fewer falls than heavy drinking is.

How Much Alcohol Affects Bone Health?

While the occasional alcoholic beverage likely won’t be harmful, research shows that heavy alcohol consumption can decrease bone strength, increase fracture risk, and lead to osteoporosis. Heavy drinking is defined as more than 4 drinks per day or 14 drinks per week for men, and more than three drinks per day or 7 drinks per week for women.

For this reason, experts recommend that if we do choose to drink, we should only drink light to moderate amounts — one drink per day or fewer for women, and two drinks per day or fewer for men. However, if we’ve already been diagnosed with osteoporosis and continue drinking, it can worsen the condition and increase our risk for bone fractures.

Interestingly, while heavy alcohol consumption negatively impacts bones at all ages, research has also found that excessive drinking is especially harmful to younger bones that are still growing. This is largely because alcohol reduces peak bone mass, which can result in weaker adult bones than normal.

For instance, one study examined binge drinking and college-age women’s bone density. Researchers found decreased bone mineral density in the vertebrae of women who had more instances of binge drinking episodes. They concluded that heavy drinking before women have reached peak bone mass — which usually occurs by the late twenties — could negatively impact skeletal health.

The good news is that studies also suggest that if we have a history of alcohol misuse and quit drinking, our body can restart the healthy bone-building process.

Is Alcohol the Only Risk Factor for Osteoporosis?

As we’ve established, heavy alcohol consumption is certainly a risk factor for osteoporosis. But it’s not the only one: menopause, lifestyle factors, and certain health conditions also play a role. Our risk of developing osteoporosis naturally increases with age. In fact, 25% of women and 6% of men 65 and older have osteoporosis.

During menopause, females are particularly susceptible to losing bone mass. This is largely due to the loss of estrogen, which negatively impacts bone density. In general, women are at a greater risk of osteoporosis than men because they tend to have less bone tissue. However, while males lose bone mass more slowly than females, by 65-70 years old, they typically lose bone mass at the same rate.

Other lifestyle factors that increase our risk of osteoporosis include eating a high calorie diet; not getting enough calcium or vitamin K and D; having a sedentary lifestyle; eating a diet low in fruits, whole grains, and vegetables; smoking; stress; a history of falls; and being underweight.

Some health conditions — such as rheumatoid arthritis, chronic liver disease, diabetes, and cardiovascular disease — can also increase our risk of osteoporosis. Furthermore, prolonged use of some corticosteroid medications, such as prednisone, cortisone, prednisolone and dexamethasone, can be damaging to our bones.

Can You Drink Alcohol if You Have Osteoporosis?

What about those of us who have already been diagnosed with osteoporosis — can you drink alcohol if you have osteoporosis? Science says it’s not a good idea. For one thing, alcohol can further weaken our bones. Besides, it can also interfere with medications and increase the risk of potentially dangerous falls. However, it’s always best to consult with a healthcare provider for personalized advice.

Tips for Protecting Our Bone Health

In addition to limiting or eliminating our alcohol intake, we can help support optimal bone health and protect ourselves from osteoporosis in several ways:

• Include plenty of calcium in your diet: A diet low in calcium contributes to diminished bone density, early bone loss, and an increased risk of fractures. We should make it a point to consume calcium-rich foods, including dairy products, almonds, broccoli, kale, canned salmon with bones, sardines, and soy products such as tofu.
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  The recommended amount of calcium for all adults ages 19 to 50 and men ages 51 to 70 is 1,000 milligrams (mg) a day. The recommendation increases to 1,200 mg a day for women aged 51 and older and for men aged 71 and older. If it’s difficult to get enough calcium from our diet, a doctor can recommend supplements.
• Pay attention to vitamin D: Vitamin D is important for building strong bones. People with low vitamin D levels tend to have lower bone density and are more at risk for bone loss than people who get enough. The easiest and least expensive way to get vitamin D is to spend time outside in the sun, as our body naturally produces vitamin D when it’s exposed to sunlight. We can also get vitamin D from our diet, but only a handful of foods contain significant amounts of it: cod liver oil, swordfish, mackerel, salmon, canned tuna, beef liver, egg yolks, and sardines.
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  The recommended amount of vitamin D for adults ages 19 to 70 is 600 international units (IUs) a day. This increases to 800 IUs a day for adults aged 71 and older. Keep in mind that many of us are deficient in vitamin D without realizing it. So it might be a good idea to have our doctor check our vitamin D levels to determine if a vitamin D supplement would be beneficial.
• Incorporate magnesium and zinc into your diet: Magnesium and zinc promote bone health. Magnesium helps convert vitamin D into a form that boosts calcium absorption; zinc encourages the formation of bone-building cells and prevents excessive bone breakdown. Trace amounts of magnesium are found in most foods, but we might want to take a supplement with magnesium glycinate, citrate, or carbonate. Good sources of zinc include beef, shrimp, spinach, flaxseeds, oysters, and pumpkin seeds.
• Stay active: Weight-bearing exercises, such as walking, running, climbing stairs, or playing sports, increase bone strength. Other activities that put resistance on the bones, such as weight training or using our own body weight, are beneficial as well. Plus, regular physical activity can improve our balance, helping prevent falls.
• Don’t smoke: Similar to alcohol, smoking is also linked to an increased risk of developing osteoporosis. If we’re currently smoking, it’s best to quit. If we’ve never smoked, don’t ever start!

The Bottom Line

Alcohol can negatively impact our bone health, particularly if we’re regularly drinking large amounts. Heavy alcohol consumption not only increases our risk of developing osteoporosis, but it affects the absorption of important vitamins and minerals for bone health and reduces our body’s ability to promote new bone formation. In addition to decreasing or eliminating our alcohol intake, we can support optimal bone health and reduce our chance of developing osteoporosis by eating a diet rich in calcium, vitamin D, magnesium and zinc, staying active, and not smoking.

If you want to cut back on your alcohol consumption and start living healthier, consider trying Reframe. We’re a neuroscience-backed app that has helped millions of people reduce their alcohol consumption and develop healthier lifestyle habits.