Drink less for strong bones

Heavy drinking is a health risk for many reasons, including the effects on your bones.

There is strong evidence from research that chronic heavy alcohol use, especially during adolescence and young adulthood, can dramatically affect bone health and increase the risk of osteoporosis (thinning of the bones) later in life. This is despite tenuous evidence that moderate drinking may protect against osteoporosis. Worse still, the effects of heavy drinking on bone health cannot be reversed, even if alcohol consumption stops.

Other lifestyle factors, including smoking, diet, weight-bearing exercise, obesity and hormone replacement therapy, can influence the risk of osteoporosis in women.

What do doctors advise? Drink less for strong bones. 

Calcium is an essential nutrient for healthy bones, and alcohol is its enemy. "Alcohol has multiple effects on calcium," says Dr Primal Kaur, an osteoporosis specialist at Temple University Health System in Philadelphia. "The bones deteriorate because not enough calcium is getting into bones -- and the body is leaching it away from bones."

How does alcohol harm your bones?

When you drink too much your digestive system does not absorb enough calcium, Dr Kaur explains. "Alcohol interferes with the pancreas and its absorption of calcium and vitamin D. Alcohol also affects the liver, which is important for activating vitamin D -- which is also important for calcium absorption."

Heavy drinking also interferes with the hormones that are important to bone health. Some studies suggest that alcohol reduces the production of oestrogen and can lead to irregular periods. As oestrogen declines, bone remodelling slows and leads to bone loss. If you're going through the menopause, this adds to the bone loss that is naturally occurring, says Dr Kaur.

There is also an increase in two potentially bone-damaging hormones, cortisol and parathyroid hormone. High levels of cortisol seen in people with alcoholism can reduce bone formation and increase bone breakdown. Chronic alcohol consumption also increases parathyroid hormone, which leaches calcium from the bones.

Moreover, excess alcohol kills osteoblasts, the bone-making cells, she adds. To compound the problem, nutritional deficiencies from heavy drinking can lead to peripheral neuropathy - nerve damage to the hands and feet. And chronic alcohol abuse can affect balance, leading to falls.

Drinking and your risk of fracture

Heavy drinkers are more likely to suffer frequent fractures due to brittle bones and nerve damage, especially hip and spine fractures. Those fractures will probably heal slowly because of malnutrition.

When you stop drinking, your bones may recover. However, while some studies have found that lost bone can be partially restored when alcohol abuse ends, others suggest the process is irreversible. So it is better to avoid heavy drinking in the first place.

If you're a smoker, it's important that you kick that habit too. If you are a heavy drinker who also smokes, it makes your bone problems even worse. You need to quit both habits, or osteoporosis treatment is not going to work. In fact, studies suggest that stopping smoking helps people recover from alcoholism.