Background: Moderate intake of alcohol has been reported to have beneficial effects on bone. However, different classes of alcoholic beverages have not been investigated.

Objective: Our aim was to determine the association between intake of total alcohol or individual alcoholic beverages and bone mineral density (BMD).

Design: Adjusting for potential confounding factors, we examined alcohol intakes and BMD at 3 hip sites and the lumbar spine in 1182 men and in 1289 postmenopausal and 248 premenopausal women in the population-based Framingham Offspring cohort (age: 29-86 y).

Results: Men were predominantly beer drinkers, and women were predominantly wine drinkers. Compared with nondrinkers, hip BMD was greater (3.4-4.5%) in men consuming 1-2 drinks/d of total alcohol or beer, whereas hip and spine BMD were significantly greater (5.0-8.3%) in postmenopausal women consuming >2 drinks/d of total alcohol or wine. Intake of >2 drinks/d of liquor in men was associated with significantly lower (3.0-5.2%) hip and spine BMD than was intake of 1-2 drinks/d of liquor in men. After adjustment for silicon intake, all intergroup differences for beer were no longer significant; differences for other alcohol sources remained significant. Power was low for premenopausal women, and the associations were not significant.

Conclusions: Moderate consumption of alcohol may be beneficial to bone in men and postmenopausal women. However, in men, high liquor intakes (>2 drinks/d) were associated with significantly lower BMD. The tendency toward stronger associations between BMD and beer or wine, relative to liquor, suggests that constituents other than ethanol may contribute to bone health. Silicon appears to mediate the association of beer, but not that of wine or liquor, with BMD. Other components need further investigation.