Alcohol consumption has multiple effects on bone, and alcoholic men have a high risk of osteoporotic fracture. The objective of this study was to assess the association between alcohol consumption and bone mineral density in elders. The authors evaluated 1,154 members of the Framingham Heart Study Cohort at biennial examination 20 (1988-1989). Subjects ranged in age from 68 to 96 years. Bone density was assessed at the radius (ultradistal and shaft) and at the proximal femur and spine. Alcohol consumption, assessed every 2 years from examination 12 (1967-1969) through examination 20, was averaged. The association of alcohol intake with bone density was examined after adjustment for age, weight, height, smoking, and, in women, age at menopause and years of estrogen use. Women who drank at least 7 oz (206.99 ml)/week of alcohol had higher bone densities at most sites (4.2-13.0% range with 7.7% average differences across all sites) than women in the lightest category of intake (< 1 oz (29.57 ml)/week). Men who were heavy drinkers (> or = 14 oz (414 ml)/week) also had higher bone densities than light drinkers, but the difference was less than in women (3.9% average across all sites). Lesser amounts of intake did not affect bone density. The authors conclude that alcohol intake of at least 7 oz (206.99 ml)/week is associated with high bone density in postmenopausal women, an effect possibly related to the augmentation of endogenous estrogen levels by alcohol.