[Frontiers in Bioscience E4, 2586-2606, June 1, 2012]

Role of obesity, alcohol and smoking on bone health

Fini Milena1, Salamanna Francesca1, Veronesi Francesca1,Torricelli Paola1,Nicolini Andrea2,Benedicenti Stefano3,Carpi Angelo4, Giavaresi Gianluca1

1Laboratory of Preclinical and Surgical Studies-Rizzoli Orthopaedic Institute, Bologna, Italy, 2Department of Internal Medicine, University of Pisa, Pisa, Italy, 3Department of Medical Science, Dentistry, and Biophysics, University of Genoa, Genoa, Italy, 4Department of Reproduction and Ageing, University of Pisa, Pisa, Italy


1. Abstract
2. Introduction
3. Search strategies
4. Obesity and bone
4.1. Clinical studies
4.2. Experimental studies
4.3. Pathophysiology and the role of cytokines
5. Alcohol-related bone disorders
5.1. Clinical studies
5.2. Experimental studies
5.3. Pathophysiology and the role of cytokines
6. Cigarette smoking and nicotine effects on bone
6.1. Clinical studies
6.2. Experimental studies
6.3. Pathophysiology and the role of cytokines
7. Perspective
8. Acknowledgement
9. References


The burden of osteoporosis is increasing in all societies. In comparison with other organs or apparatuses fewer studies have focused on incorrect lifestyles and bone. This article reviews clinical and experimental studies on the effects of obesity, alcohol abuse and smoking on bone. Overweight and obesity protect bone, thus reducing the fracture risk and the development of osteoporosis in older adults. However, extreme obesity (body mass index > 40 kg/mē) seems to be a risk factor for osteoporosis. Moderate alcohol consumption may have a protective effect, whereas excessive consumption is an important risk factor. Cytokines are the main mediators of the detrimental effects of obesity and alcohol. Smoking contributes to bone loss and fracture probably by interfering with estrogens, calcium and vitamin D. Health information campaigns against these harmful lifestyles should be strengthened by using available scientific information to increase awareness about their consequences on the bone.