Heavy Drinking Can Contribute to Bone Disease

Alcohol Inhibits Formation of Osteoblasts

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Alcohol Can Delay Healing of Fractures. © Getty Images

Of all of the effects of long-term heavy alcohol consumption probably the least known is how heavy drinking can affect bone mass in the body.

Research has shown that chronic and heavy alcohol consumption can contribute to decreased bone formation, increased fracture and delays in the healing of fractures, but little research has been done on alcohol's effect on new bone development.

The development and function of osteoblasts, new bone cells, are at particular risk of alcohol's detrimental effects, which can lead to decreasing bone formation and low bone mass.

Researchers at the Omaha Veterans Affairs Medical Center found that chronic and heavy drinking can inhibit the formation of osteoblasts.

Alcohol Affects Bone Remodeling

"The maintenance of healthy bone in human adults occurs through a process called 'bone remodeling,' said Dennis A. Chakkalakal, a research scientist at the Omaha Veterans Affairs Medical Center, associate professor in the department of surgery at Creighton University, and sole author of the review. "At any given time during adult life, and in various parts of the skeleton, small portions of the 'old bone' are removed by cells called 'osteoclasts,' and new bone is formed by cells called 'osteoblasts.' In a healthy person, the two activities are in balance so that there is no net loss of bone."

However, Chakkalakal reported that chronic and heavy drinking can disrupt the balance by suppressing new bone formation.

"The empty space created by normal bone-removing activity is inadequately filled by newly formed bone," said Chakkalakal.

"This process continues at other skeletal sites during the next remodeling cycle. The cumulative effect of this process during several remodeling cycles is manifested as measurable bone loss over a period of just a few years."

Increased Fracture Risk

Key highlights of the Omaha study include:

  • "Alcohol-induced bone disease" refers to two consequences of chronic alcohol abuse: bone loss (also known osteopenia), which results in increased fracture risk; and deficient bone repair.
  • Alcohol-induced osteopenia is distinct from post-menopausal osteoporosis and disuse osteoporosis.
  • Human, animal, and cell-culture studies show that alcohol's toxic effects on osteoblast activity are dose-dependent.
  • Alcohol can suppress synthesis of an ossifiable matrix, which interferes with fracture healing.
  • Alcohol-induced bone loss is associated with abnormalities of cell dynamics in bone marrow.

Alcohol Affects Osteoblast Activity

"Collectively speaking, evidence indicates there is a common thread that ties together skeletal abnormalities, such as bone loss and deficient bone healing, and chronic consumption of excessive alcohol," Chakkalakal said.

"In both cases, alcohol adversely affects osteoblast activity, thus suppressing new bone formation needed in both normal bone remodeling and fracture healing," he said. "We need future studies that focus on molecular mechanisms by which alcohol inhibits osteoblast activity. We also need a closer examination of the effects of other factors such as malnutrition, smoking and lack of physical activity as there are very few studies that evaluate the effects of these factors."

"Finally, we need more definitive, well-designed studies to sort out the age- and gender-related differences in the effects of moderate and excessive consumption of alcohol," Chakkalakal said.

Abstinence Best Choice With Fractures

"The review underscores the importance of abstinence from alcohol consumption by patients – alcoholics or teetotalers – with fractures and who may want to drink during their convalescence," said VA Research Career Scientist Terrence M. Donohue, Jr.


Chakkalakal, DA. "Alcohol-Induced Bone Loss and Deficient Bone Repair." Alcoholism: Clinical & Experimental Research December 2005

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