Fact Check: Does beer help in reducing the risk of bone fractures?

Does beer help in reducing the risk of bone fractures?

Claim: A claim on the social media site Pinterest claimed various health benefits of Beer, such as it reduces the risk of heart disease, type II diabetes, and kidney stones. Among the claim one such claim was Beer helps reduce the risk of fracture. The link to the post is here.

Fact Check

The claim is Misleading. The claim without specifying the quantity of consumption, proclaims that consumption of beer can be helpful in reducing risk of fracture, where as in reality, high amounts of beer consumption can be detrimental to bone health 

What are bone fractures?

According to the American Academy of Orthopedic Surgeons, “A fracture is a broken bone, the same as a crack or a break. A bone may be completely fractured or partially fractured in any number of ways (crosswise, lengthwise, in multiple pieces).”(1)The severity of a fracture usually depends on the force that caused the break. If the bone's breaking point has been exceeded only slightly, the bone may crack rather than break all the way through. There are different types of fractures; some common types of fractures include:

If the bone breaks so that bone fragments stick out through the skin or a wound penetrates down to the broken bone, the fracture is called an open fracture.

• Stable fracture: The broken ends of the bone line up and are barely out of place.

• Open (compound) fracture: The bone or a blow that breaks the skin may pierce the skin at the time of the fracture. The bone may or may not be visible in the wound.

• Transverse fracture. This type of fracture has a horizontal fracture line.

• Oblique fracture. This type of fracture has an angled pattern.

• Comminuted fracture. The bone shatters into three or more pieces in this type of fracture.

Causes of fracture:

The most common causes of fractures include trauma, Osteoporosis and overuse. Repetitive motion can tire muscles and place more force on bone. This can result in stress fractures, most commonly seen in athletes.

On speaking to the medical dialogues team, Dr Anup Khatri, senior Consultant- Orthopedics, Gleneagles Hospital, Parel, Mumbai, explained, “Fractures are usually caused by trauma ranging from a trivial fall at home to accidents. Undisplaced fractures may be treated with immobilisation in a plaster cast, whereas displaced fractures may necessitate surgical fixation by plating or nailing. Stress fractures result from repetitive strain on a bone, commonly seen in the foot. Rest, activity modification, and braces or crutches are needed to offload the affected area. Fragility fractures, such as osteoporotic bones or pathologic fractures, such as tumours, are seen in weakened bones even without trauma or fall. In such fractures, the underlying disease causing bone weakness must be treated along with the fracture."

Beer and its constituents:

Beers are alcoholic beverages brewed from germinated barley (malt), hops, yeast, and water. (2) A 100 of beer contains 92 g of water along with 0.46g of protein and 3.55g of carbohydrate. It also contains calcium, iron, magnesium, Phosphorus and potassium. It also contains several minerals in scarce amounts.

Does beer reduce the risk of fracture?

There is mixed evidence on the relation of alcohol and beer and bone health

A study by Gaddini et al. showed low to moderate alcohol intake can slow age-related bone loss by reducing remodelling. Although all of those possible mechanisms could account for the beneficial influence of alcohol on bones, chronic excessive alcohol consumption may result in a loss of bone mass and raise fracture risk. (3)

Having said that Another study by Sampson et al. mentioned that long-term alcohol use could negatively impact bone growth and remodelling, leading to lower bone density and a higher risk of fractures. This can happen directly or indirectly through effects on various cells, hormones, and growth factors involved in bone metabolism. In adolescents, alcohol reduces peak bone mass, leading to weaker bones in adulthood that are more prone to fractures. In adults, alcohol can disrupt the balance between bone erosion and remodelling, contributing to alcoholic bone disease by inhibiting osteoblasts, which are cells responsible for forming new bone. (4)

The analyses by Gordon J et al. led to congruent results, suggesting a null relationship between moderate alcohol intake (cautiously quantified as one standard drink per day) and BMD, with a steadily increased risk of fracture for higher alcohol consumption. Moreover, the results from prospective cohorts suggest that moderate alcohol consumption is inversely associated with risk of hip fractures in middle-aged and older men and women.(5)

The scientific community does not strongly agree that beer consumption directly reduces fracture risk. At the same time, there is some evidence suggests potential benefits associated with beer's silicon content. However, these advantages only apply to moderate beer drinking and are not strong enough to support the active recommendation of beer as a fracture prevention strategy.

Expert Opinion:

On conversing with medical dialogues, Dr Daivik T Shetty,  Orthopaedic surgeon at KMC hospital, Mangalore team mentioned, “Multiple studies demonstrated that alcohol consumption in the form of beer of 0 to 22 g/d was linked to a slight decrease in the risk of osteoporotic fractures and hip fractures, whereas beer consumption of > 49 g/d and > 40 g/d was correlated with a significantly elevated risk of osteoporotic and hip fractures, respectively. But because of other harmful effects of beer, such as affecting nutritional status and the intake of micronutrients, leading to malnutrition and deficiencies in calcium and vitamin D, beer consumption can be considered counterproductive in fracture healing.”

Medical Dialogues Final intake:

 Although some evidence supports the positive effects of some ingredients in beer, such as silicon, on bone density, the benefits are not clear-cut. The potential risks of higher consumption and the associated negative health impacts, such as loss of bone mass and other health issues drink heavily relies on moderation. Hence, the claim "beer consumption can reduce the risk of fractures" without any exaplantion on the quantity and emphasis on moderation is best assessed as "misleading" based on the available evidence.

References:

1. https://orthoinfo.aaos.org/en/diseases--conditions/fractures-broken-bones/

2. Geoffrey W. Smithers,Alcoholic Beverages,Editor(s): Geoffrey W. Smithers,Encyclopedia of Food Safety (Second Edition),Academic Press,2024, https://doi.org/10.1016/B978-0-12-822521-9.00191-X.

3. G.W. Gaddini, R.T. Turner, K.A. Grant, U.T. Iwaniec, Alcohol: a simple nutrient with complex actions on bone in the adult skeleton,Alcohol Clin. Exp. Res., 40 (4) (2016), pp. 657-671, 10.1111/acer.13000

4. Sampson HW. Alcohol's harmful effects on bone. Alcohol Health Res World. 1998;22(3):190-4. PMID: 15706795; PMCID: PMC6761900.

5. Godos J, Giampieri F, Chisari E, Micek A, Paladino N, Forbes-Hernández TY, Quiles JL, Battino M, La Vignera S, Musumeci G, Grosso G. Alcohol Consumption, Bone Mineral Density, and Risk of Osteoporotic Fractures: A Dose-Response Meta-Analysis. Int J Environ Res Public Health. 2022 Jan 28;19(3):1515. doi: 10.3390/ijerph19031515. PMID: 35162537; PMCID: PMC8835521.