Moderate wine consumption linked to higher bone density

An integrative review in Nutrients summarized clinical and experimental studies on whether wine consumption affects bone mineral density (BMD). The authors searched PubMed, Scopus, and Embase for papers up to April 2025, and assessed wine specifically (rather than “general alcohol” or pure polyphenols). Seven studies were included out of 108 identified. The conclusion is cautious: light/moderate wine consumption may be associated with higher BMD — particularly at the spine and femoral neck — but the evidence is still limited and mixed.

Background of the study

Osteoporosis and related fractures are a major cause of disability in the elderly; therefore, the effects of diet and lifestyle on bone mineral density (BMD) have long been studied. Observational data provide an ambiguous picture for alcohol: at high doses, the risk of fractures and a decrease in BMD increase, while at light-moderate consumption, some groups (men, postmenopausal women) have been described as having higher BMD - the so-called J-shaped relationship. However, most studies considered "alcohol in general" rather than wine as a separate beverage, which made it difficult to understand the specific contribution of wine components.

Biologically, wine has two “faces.” Ethanol in excess damages bone tissue (via hormonal shifts, oxidative stress, and impaired remodeling), while non-alcoholic components, polyphenols, potentially maintain the balance between osteoblasts and osteoclasts. Resveratrol and other phenols activate SIRT1 in experimental models, improve osteoblastogenesis, and inhibit bone resorption; this creates a plausible mechanism by which wine (especially red wine) may be different from “alcohol in general.”

However, until recently the field remained fragmented: different types of designs, heterogeneous doses and methods of assessing BMD, confounding of lifestyle and dietary influences, and, most importantly, the lack of randomized trials isolating the effect of wine specifically. Against this backdrop, a review in Nutrients appeared, which specifically asked, “Does wine consumption affect BMD?” and systematically selected studies that examined wine separately from other beverages.

Additional context is wine’s place in dietary patterns. In the Mediterranean diet, wine often appears in moderation along with fruits, vegetables, fish, and olive oil; the pattern itself is associated with higher BMD and lower fracture risk. But this is a “package” effect, and the contribution of the glass is difficult to isolate—another argument for a review that focuses specifically on wine.

How they searched and what they included

Reviews, in vitro studies, and studies where wine was not separated from other beverages were excluded. Both humans (prospective cohorts, case-control studies in twins, cross-sections, longitudinal studies) and animals were evaluated. Of the 108 records, 44 remained for screening after deduplication, 9 for full-text evaluation, and 7 for the final analysis. The main measurement method was DXA; evaluation points were: femoral neck, spine, entire femur, trochanter, etc.

• 5 clinical studies, 2 animal experiments.
• A number of studies have differentiated between red and white wine; the dose has often been considered as “standard glasses/day” (≈150 ml, 12% vol., ~16.6 g pure alcohol per glass).

Main results

In clinical studies, the associations are positive, but not always and not for everyone.

• Spine and femoral neck: Several studies have shown higher BMD with moderate wine consumption in these areas. In postmenopausal women in a large cohort, positive results were seen in several skeletal areas.
• Red vs. white: In some studies, a positive association was more often noted for red wine (probably due to the higher proportion of polyphenols), although there was no uniformity.
• Dose dependence and gender: more pronounced effects were observed in men (hormonal profile hypothesis), in postmenopausal women the results were more heterogeneous.
• Animal studies: Low doses of red wine in female rats improved hip BMD; toxic high doses of alcohol in male rats, on the contrary, decreased BMD. The conclusion for humans is that excess alcohol is harmful.

Possible mechanisms (why this might happen)

Wine polyphenols - quercetin, catechins, anthocyanins, resveratrol - in cell and animal models:

• stimulate osteoblasts (via ER, ERK1/2, p38 MAPK, Wnt), ↑BMP-2;
• suppress osteoclasts (↓RANKL-induced differentiation, ↓ROS, ↓TNF-α/IL-6).

Restrictions

The review emphasizes that these are associations, not causation:

• Most clinical data are observational (risk of confounding: lifestyle, diet, health status);
• there are no randomized trials that have isolated the effect of wine on BMD;
• strong heterogeneity of protocols: type of wine, strength (ABV), volumes, frequency, measurement methods;
• The benefits of polyphenols can be offset by the disadvantages of alcohol when taken in excess doses.

What does this mean in practice?

If there is a benefit, it is seen in light-to-moderate consumption, not in high doses. The authors explicitly suggest considering non-alcoholic alternatives with comparable polyphenol levels (grape juice, low-alcohol options, individual supplements), although in one rat study, pure resveratrol and red wine appeared better than juice, perhaps due to bioavailability. RCTs are needed to set the record straight.

Context: Wine as part of the diet

In a number of dietary patterns (e.g. Mediterranean diet), moderate regular wine appears alongside vegetables, fish, olive oil - and such patterns are associated with lower fracture risk and higher BMD. But this is an effect of the entire pattern, not the "magic of the glass."

Conclusion

Today, the "picture of the day" is this: a moderate glass of wine is statistically often "close" to slightly denser bone in the spine and hip, but we do not yet see a cause-and-effect arrow. Without randomized trials and standardized doses, the conversation remains cautious - and with the obligatory caveat of the risks of alcohol itself.

Source: Duarte ND et al. Influence of Wine on Bone Mineral Density. Nutrients. 2025;17(12):1981. doi:10.3390/nu17121981.