Nothing like kicking back after a hard day with a reviving beverage, often alcoholic in nature, but nevertheless relaxing, giving one time to process and analyse life in general. But while an occasional drink is not necessarily detrimental to one’s health – if it becomes a daily habit, you should consider the negative consequences that may well arise. The effect of alcohol on the brain and liver are well-documented, but its harmful effect on bones is less discussed but equally significant.
Bones have a very specific way of staying healthy. They are living tissues that continuously remodel themselves through osteoblasts (bone-building cells) and osteoclasts (bone-resorbing cells). Peak bone mass is achieved by early adulthood, and maintaining it requires a balance of minerals, vitamins, hormones, and physical activity. We are continually told that good bones require the right feed of calcium and Vitamin D. But what is equally important is what we do, and do not, drink.
While water remains your bones’ favourite tipple, nobody wants to make their lives a long drink of water. But of all the other choices out there, alcohol would probably come out tops as the most unfriendly bone beverage – with effects that are dangerous throughout all the stages of our life.
The impact on adolescents and young adults
Because this age group is critical for building peak bone mass, it is vital that nothing disrupts this process. And there is proven evidence that alcohol interferes with bone formation during this crucial period by suppressing osteoblast activity. Chronic alcohol use reduces testosterone in men and disrupts estrogen levels in women, both critical for bone density. The early onset of bone weakening (osteopenia) or osteoporosis due to reduced hormone levels, results in weaker bones in adulthood and extreme difficulties in old age. It’s sobering to remember that interruption of peak bone mass development has lifelong consequences.
Alcohol, calcium and Vitamin D
You didn’t know there was a relationship? Well, it’s definitely the case. Alcohol impairs the absorption of calcium in the intestines. Reduced Vitamin D levels also become a problem when alcohol inhibits liver enzymes responsible for converting Vitamin D into its active form, vital for calcium absorption. Long-term deficiencies lead to weakened bones and an increased risk of fractures. There is also disruption of parathyroid hormone (PTH) levels, leading to secondary hyperparathyroidism, increasing bone resorption and calcium loss from bones.
Apart from seriously affecting bone remodelling with a net loss of bone density, thus making bones weaker and more prone to fractures even in younger years, there is increased risk of early osteoporosis developing and causing fragility fractures in later years. It cannot be emphasized enough that chronic alcohol use is a significant risk factor for developing osteoporosis, especially in post-menopausal women. Alcohol has been shown to accelerate bone loss and delay bone repair, compounding the risks over time. Chronic drinkers experience more frequent fractures, particularly in the hips, spine, and wrists. Poor co-ordination, impairs motor skills, increasing the likelihood of falls and accidents. Alcohol also delays the repairs of fractures, thus prolonging recovery time.
Nutrition
Diet is always a key question in any deterioration of the body. But alcohol drinkers face bad effects on their bones because they invariably follow a poor eating regime. As a result they often lack the essential nutrients for bone health. This in turn affects muscle strength and co-ordination, putting additional strain on bones and increasing the likelihood of falls.
And it’s not only bones that bear the brunt of over-indulgence with regard to alcohol; alcoholism is often accompanied by other diseases such as liver disease, which indirectly weakens bones by disrupting calcium and Vitamin D metabolism.
Because women have on average a lower bone density than men, and they suffer significant hormonal changes during menopause – both conditions that can weaken bones. Drinking alcohol will only introduce further stress on their bones.
Without doubt the long-term consequences of alcohol abuse will exacerbate the severity of bone diseases. The risk of permanent disability from fractures, especially in older adults is considerable. The run-off from this – apart from pain and discomfort – is the high cost of treatment, a reduced quality of life, and loss of independence.
You can prevent alcohol-related bone damage, and you can do it now.
- Define a plan of moderate drinking, such as one drink a day for women, 2 for men.
- Avoid binge drinking.
- Ensure an adequate intake of calcium, Vitamin D, and other bone-healthy nutrients.
- Incorporate weight-bearing exercises like walking or strength training to maintain bone density.
- Avoid smoking, as it compounds the effects of alcohol on bone health.
- Seek professional help if you are struggle with alcohol; there are resources for managing alcohol addiction.
- Always keep an eye on your bones by following a process of early detection and management of potential osteoporosis through bone density scans and medical interventions.
NOFSA (National Osteoporosis Foundation South Africa)
NOFSA is the only non-profit, voluntary health organisation dedicated to promoting lifelong bone health. We focus on reducing the widespread prevalence of osteoporosis while working to find a cure for the disease, and by supporting research and developing programmes of education and advocacy.
Find out more about our work at: www.osteoporosis.org.za
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