Background: Previous studies on the influence of alcohol intake and smoking on bone mineral density (BMD) in men are inconsistent and the effect of these variables on BMD in physically active men is yet to be explored.
Objective: To investigate the influence of alcohol intake and smoking on BMD in a cohort of males with well-defined lifestyle conditions.
Design: Men from the armed forces (n=400) having uniform and defined routines were enrolled. BMD was measured by DXA and participants were grouped according to lifestyle variables. Hormonal parameters were measured by immunoassays.
Results: Participants with intake of >24 g/wk of alcohol had significantly higher BMD at femur compared to non-alcohol consumers (p=0.0001) and a linear increase in mean femoral BMD over increasing categories of alcohol intake (p(trend)<0.0001) was observed. Smoking was negatively associated with femoral BMD. In multiple regression analysis, age, BMI, alcohol consumption and smoking were independent predictors of femoral BMD, explaining 10.6% variance. At lumbar spine, age, height and BMI were independent predictors, explaining 9.4% variance in BMD. The concentrations of total testosterone, free testosterone, bioavailable testosterone and PTH were low (p<0.0001) whereas estradiol (p=0.02), free and bioavailable estradiol (p<0.001) were high in alcohol consumers compared to non-consumers. In multiple regression analysis alcohol intake and height explained 5.5% variance in estradiol(.)
Conclusions: In physically active men with well-defined lifestyle conditions, alcohol consumption was associated with higher femoral BMD, the effect of alcohol is complex and is probably partly mediated by influencing the sex steroid levels.