The impact of alcohol consumption on bone mineral density

Alcohol use is widely prevalent across different regions and cultural settings worldwide. While prior studies have suggested a positive impact of light alcohol consumption on bone mineral density (BMD), the relationship between different levels of alcohol consumption and BMD remains controversial. A study conducted cross-sectional analyses within the Rotterdam Study (RS) and UK Biobank (UKB) to examine this association, followed by one- and two-sample Mendelian randomization (MR) to assess potential causality.
The study included 4,087 Europeans from the Rotterdam Study and 29,856 from the UK Biobank. In the cross-sectional analyses, the association between alcohol consumption (g/day) and bone outcomes [i.e., bone mineral density (BMD) and trabecular bone score (TBS)] were examined. For MR analyses, genetic variants associated with alcohol consumption and problematic alcohol use [defined as a combination of alcohol use disorders (AUD), alcohol dependence, and measures of Alcohol Use Disorders Identification Test-Problems (AUDIT-P)] were used as the instrumental variable (IV) for both exposures in both one- and two-sample MR.
Cross-sectional analyses revealed a positive relationship between alcohol consumption and lumbar spine BMD (LS-BMD) (RS: β = 0.108; UKB: β = 0.095, femoral neck BMD (FN-BMD) (RS: β = 0.140; UKB: β = 0.102), and lumbar spine TBS (LS-TBS) (RS: β = 0.128; UKB: β = 0.084) in both studies, while alcohol consumption was only significantly associated with total body BMD (TB-BMD) (RS: β = 0.059; UKB: β = 0.058) in UKB. Alcohol consumption was also positively associated with total body BMD (TB-BMD), although this association reached statistical significance only in the UKB cohort (RS: β = 0.059; UKB: β = 0.058). In contrast, neither one-sample nor two-sample Mendelian randomization analyses provided evidence of a causal effect of genetically predicted alcohol consumption or problematic alcohol use on any bone outcomes.
In two independent studies, the researchers observed a positive cross-sectional association of alcohol consumption with femoral neck BMD, lumbar spine BMD and TBS in European participants. However, MR findings did not demonstrate a causal link, suggesting that other factors or biases may confound the observed positive relationship. Further research is warranted to better understand the underlying mechanisms and potential confounders of this association.
Source: X. He, H. Lu, S. Ghatan, J. Li, F. Koromani, C. Medina-Gomez, M.C. Zillikens, K. Trajanoska The impact of alcohol consumption on bone mineral density: Insights from cross-sectional and Mendelian randomization studies. Bone. 2026 Jun 30;212:117999.