Do lifestyle choices explain the effect of alcohol on bone mineral density in women around menopause?

BACKGROUND Moderate alcohol consumption has been shown to be positively associated with increased bone mineral density (BMD). However, other lifestyle choices have also been shown to have an effect on bone health. OBJECTIVE The objective was to examine the association between alcohol intake and BMD in women around menopause in the United Kingdom and to determine whether any association is independent of other lifestyle choices. DESIGN A cross-sectional study design was used to examine the relation between alcohol intake and BMD in a cohort of 3218 women aged 50-62 y from the Aberdeen Prospective Osteoporosis Screening Study. Women were grouped into clusters according to their lifestyle choices. ANCOVA was used to examine the effect of categorized alcohol intake on BMD adjusted for cluster of lifestyle and other baseline covariates. The ANCOVA was repeated for different types of alcoholic beverage (eg, beer, liquor, and wine) separately. RESULTS Three lifestyle clusters were identified and were based on different levels of the following 3 factors: smoking pack-years, fruit and vegetable intakes, and physical activity. In the lifestyle-adjusted models, women who consumed >1 drink/d of alcohol had a significantly greater femoral neck BMD (P = 0.008) and lumbar spine BMD (P = 0.007) than did those who never consumed alcohol. For separate alcoholic drinks, only beer had a positive significant effect on lumbar spine BMD after adjustment for lifestyle (P = 0.005). CONCLUSION Moderate alcohol intake appears to be positively associated with BMD independently of the type of lifestyle led by women around menopause.