The Effects of Alcohol Consumption on the Risk of Hip Fracture

Among elderly people, falls leading to hip fracture are a major health problem associated with severe morbidity and increased mortality. The role that alcohol consumption may play in hip fracture has been a topic of concern for many decades. This meta-analysis is based on prospective studies with more than 26,000 incidences of hip fracture.

• The analysis shows a “J-shaped” association between alcohol consumption,* especially of wine, and the risk of hip fracture, with a slightly decreased risk for “light” drinking and an increased risk for “heavy” drinking.
• Hazard ratios were 0.88 for “light” alcohol consumption, 1.00 for “moderate”, and 1.71 for “heavy” consumption.
• Some of the estimated “protection” from light drinking is apparently from the effects of alcohol on increasing bone mineral density.

Comments:

The definition of “moderate” drinking was broad in this study: up to <50 g in a day (or 4–5 standard drinks). Noting the major differences in risk between “light” and “heavy” consumption, these results may be confounded by other lifestyle factors. Nevertheless, this large meta-analysis supports a protective effect of “light” alcohol consumption on the risk of hip fracture, with an increase in bone density from alcohol being a probable important factor. The data suggest that wine consumption may have the most favorable effect, perhaps indicating that polyphenols and other compounds also play a role. It is unclear whether the increase in risk associated with heavy consumption relates to a decrease in bone mineral density, falls, or other causes.

R. Curtis Ellison, MD

Reference:

Zhang X, Yu Z, Yu M, Qu X. Alcohol consumption and hip fracture risk. Osteoporos Int. 2015;26(2):531–542.