Osteoporosis International

, Volume 7, Issue 1, pp 65–71 | Cite as

The influence of alcohol consumption on the risk of vertebral deformity

  • M. Naves Diaz
  • T. W. O'Neill
  • A. J. Silman
Original Article


The influence of alcohol consumption on the risk of osteoporosis is not well established. The aim of this study was to determine the relationship between frequency of alcohol consumption and the risk of vertebral deformity across different European populations. A population survey method was used. Men and women aged 50 years and over were recruited from population-based sampling frames in 36 centres from 19 European countries. Subjects were invited to attend by letter of invitation for an interviewer-administered questionnaire and lateral spinal radiographs. Vertebral deformity was defined morphometrically using the McCloskey-Kanis method. Data from 14 237 individuals were available for this analysis. Alcohol consumption was compared between the 809 men and 884 women with vertebral deformity and the 5905 men and 6639 women without vertebral deformity. The frequency of alcohol intake was greater in men than women. Overall, there was no detectable association between frequency of alcohol intake and vertebral deformity in either men or women. Stratification by age showed that women 65 years and over who took alcohol on more than 5 days per week had a reduced risk of vertebral deformity compared with those taking alcohol less than once per week. This protection was most obvious after adjusting for age, centre, body mass index, smoking, current level of physical activity and previous fractures (odds ratio [OR]=0.65; 95% confidence intervals [CI]=0.43, 0.99). There was a smaller and non-significant protective effect amongst men aged 65 years and over and this was most apparent amongst moderately frequent drinkers (1–4 days per week) (OR=0.81; 95% CI=0.62, 1.08). There was no association between the occurrence of vertebral deformity and frequency of alcohol consumption in younger men and women. Overall, the effects of the frequency of alcohol consumption on vertebral deformity were modest. In older women, regular consumption on more than 5 days per week is associated with a reduced risk. Further, prospective data are required to confirm these findings. It is also necessary to investigate, in terms of amount of alcohol consumed, at what level the benefits of regular intake are obviated by the increased risks from alcohol excess.


Alcohol consumption Multicentre study Osteoporosis Vertebral deformity 


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  1. 1.
    Israel Y, Orrego H, Holt S, Macdonald DW, Meema HE. Identification of alcohol abuse: thoracic fractures on routine X-rays as indicators of alcoholism. Alcoholism 1980;4:420–2.Google Scholar
  2. 2.
    Seeman E, Melton LJ III, O'Fallon WM, Riggs BL. Risk factors for spinal osteoporosis in men. Am J Med 1983;75:977–83.Google Scholar
  3. 3.
    Johnson RD, Davidson S, Saunders JB, Williams R. Fractures on chest radiography as indicators of alcoholism in patients with liver disease. BMJ 1984; 288:365–6.Google Scholar
  4. 4.
    Johnell O, Kristenson H, Redlund-Johnell I. Lower limb fractures and registration for alcoholism. Scand J Soc Med 1985;13:95–7.Google Scholar
  5. 5.
    Bikle DD, Genant HK, Cann C, Recker RR, Halloran BP, Strewler GJ. Bone disease in alcohol abuse. Ann Intern Med 1985;103:42–8.Google Scholar
  6. 6.
    Harding A, Dunlap J, Cook S, et al. Osteoporotic correlates of alcoholism in young males. Orthopedics 1988;11:279–82.Google Scholar
  7. 7.
    Cummings SR, Kelsey JL, Nevitt MC, O'Dowd KJ. Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev 1985;7:178–208.Google Scholar
  8. 8.
    Rico H. Alcohol and bone disease. Alcohol Alcoholism 1990; 25:345–52.Google Scholar
  9. 9.
    Laitinen K, Valimaki M. Alcohol and bone. Calcif Tissue Int 1991;49:S70–3.Google Scholar
  10. 10.
    Cooper C, Barker DJP, Morris J, Briggs RSJ. Osteoporosis, falls, and age in fracture of proximal femur. BMJ 1987;295:13–5.Google Scholar
  11. 11.
    Hansen MA, Overgaard K, Riis BJ, Christiansen C. Potential risk factors for development of postmenopausal osteoporosis: examined over a 12-year period. Osteoporosis Int 1991;1:95–102.Google Scholar
  12. 12.
    Laitinen K, Valimaki M, Keto P. Bone mineral density measured by dual-energy X-ray absorptiometry in healthy Finnish women. Calcif Tissue Int 1991;48:224–31.Google Scholar
  13. 13.
    Holbrook TL, Barrett-Connor E. A prospective study of alcohol consumption and bone mineral density. BMJ 1993;306:1506–9.Google Scholar
  14. 14.
    Felson DT, Zhang Y, Hannan MT, Kannel WB, Kiel DP. Alcohol intake and bone mineral density in elderly men and women: the Framingham study. Am J Epidemiol 1995;142:485–92.Google Scholar
  15. 15.
    Slemenda CW, Christian JC, Reed T, Reister TK, Williams CJ, Johnston CC. Long-term bone loss in men: effects of genetic and environmental factors. Ann Intern Med 1992;117:286–91.Google Scholar
  16. 16.
    Felson DT, Kiel DP, Anderson JJ, Kannel WB. Alcohol consumption and hip fractures: the Framingham Study. Am J Epidemiol 1988;128:1102–10.Google Scholar
  17. 17.
    O'Neill TW, Felsenberg D, Varlow J, et al. The prevalence of vertebral deformity in European men and women: the European Vertebral Osteoporosis Study. J Bone Miner Res 1996;11:1010–18.Google Scholar
  18. 18.
    O'Neill TW, Cooper C, Algra D, et al. Design and development of a questionnaire for use in a multicentre study of vertebral osteoporosis in Europe: the European Vertebral Osteoporosis Study (EVOS). Rheumatol Eur 1995;24:75–81.Google Scholar
  19. 19.
    O'Neill TW, Varlow J, Felsenberg D, et al. Variation in vertebral height ratios in population studies. J Bone Miner Res 1994;9:1895–907.Google Scholar
  20. 20.
    McCloskey EV, Spector TD, Eyres KS, et al. The assessment of vertebral deformity: a method for use in population studies and clinical trials. Osteoporosis Int 1993; 3:138–47.Google Scholar
  21. 21.
    O'Neill TW, Marsden D, Matthis C, et al. Survey response rates: national and regional differences in a European multicentre study of vertebral osteoporosis. J Epidemiol Community Health 1995;49:87–93.Google Scholar
  22. 22.
    O'Neill TW, Marsden D, Silman AJ and the European Vertebral Osteoporosis Study Group. Differences in characteristics of responders and non-responders in a prevalence survey of vertebral osteoporosis. Osteoporosis Int 1995;5:327–34.Google Scholar
  23. 23.
    O'Neill TW, Cooper C, Cannata J, et al. Reproducibility of a questionnaire on risk factors for osteoporosis in a multicentre prevalence survey: the European Vertebral Osteoporosis Study. Int J Epidemiol 1994;23:559–65.Google Scholar
  24. 24.
    Felson DT, Zhang Y, Hannan MT, Anderson JJ. Effects of weight and body mass index on bone mineral density in men and women: the Framingham Study. J Bone Miner Res 1993;8:567–73.Google Scholar
  25. 25.
    Angus RM, Sambrook PN, Pocock NA, Eisman IA. Dietary intake and bone mineral density. Bone Miner 1988;4:265–77.Google Scholar
  26. 26.
    lohnell O, Gullberg B, Kanis JA, et al. Risk factors for hip fracture in European women: the MEDOS study. J Bone Miner Res 1995;10:1802–15.Google Scholar
  27. 27.
    Hui SL, Slemenda CW, Johnston CC Jr. The contribution of bone loss to postmenopausal osteoporosis. Osteoporosis Int 1990; 1:30–4.Google Scholar
  28. 28.
    The Health of the Nation. Department of Health: a strategy for health in England (Cm 1986). London: HMSO, 1992:68–70.Google Scholar
  29. 29.
    Gordon GG, Southren AL, Vittek J, Lieber CS. The effect of alcohol ingestion on hepatic aromatase activity and plasma steroid hormones in the rat. Metabolism 1979;28:20–4.Google Scholar
  30. 30.
    Wild RA, Buchanan JR, Myers C, Demers LM. Declining adrenal androgens: an association with bone loss in aging women. Proc Soc Exp Biol Med 1987; 186:355–60.Google Scholar
  31. 31.
    Dymling JF, Ljungberg O, Hillyard CJ, Greenberg PB, Evans IMA, MacIntyre I. Whisky: a new provocative test for calcitonin secretion. Acta Endocrinol 1976;82:500–9.Google Scholar

Copyright information

© European Foundation for Osteoporosis and the National Osteoporosis Foundation 1997

Authors and Affiliations

  • M. Naves Diaz
    • 2
  • T. W. O'Neill
    • 1
  • A. J. Silman
    • 2
  1. 1.Rheumatic Diseases CentreHope HospitalSalford, ManchesterUK
  2. 2.ARC Epidemiology Research UnitUniversity of ManchesterManchesterUK

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