In so-called alternative medicine (SCAM), we have numerous diets that are either promoted for specific conditions or that are popular in a more general sense. Meat-free forms of nutrition can perhaps not be characterised as SCAM, but they are certainly popular with consumers as well as practitioners of SCAM. It is often said that meat-free diets are healthy, but few entusiasts like to consider that it might be associated with health risks.
This study tested whether vegetarianism and veganism are risk factors for bone factures in a prospective cohort with a large proportion of non-meat eaters.
In EPIC-Oxford, dietary information was collected at baseline (1993–2001) and at follow-up (≈ 2010). Participants were categorised into four diet groups at both time points (with 29,380 meat eaters, 8037 fish eaters, 15,499 vegetarians, and 1982 vegans at baseline in analyses of total fractures). Outcomes were identified through linkage to hospital records or death certificates until mid-2016. The risks were calculated of total (n = 3941) and site-specific fractures (arm, n = 566; wrist, n = 889; hip, n = 945; leg, n = 366; ankle, n = 520; other main sites, i.e. clavicle, rib, and vertebra, n = 467) by diet group over an average of 17.6 years of follow-up.
Compared with meat eaters and after adjustment for socio-economic factors, lifestyle confounders, and body mass index (BMI), the risks of hip fracture were higher in
- fish eaters (hazard ratio 1.26; 95% CI 1.02–1.54),
- vegetarians (1.25; 1.04–1.50),
- vegans (2.31; 1.66–3.22).
This was equivalent to rate differences of 2.9 (0.6–5.7), 2.9 (0.9–5.2), and 14.9 (7.9–24.5) more cases for every 1000 people over 10 years, respectively. The vegans also had higher risks of total (1.43; 1.20–1.70), leg (2.05; 1.23–3.41), and other main site fractures (1.59; 1.02–2.50) than meat eaters. Overall, the significant associations appeared to be stronger without adjustment for BMI and were slightly attenuated but remained significant with additional adjustment for dietary calcium and/or total protein. No significant differences were observed in risks of wrist or ankle fractures by diet group with or without BMI adjustment, nor for arm fractures after BMI adjustment.
The authors concluded that non-meat eaters, especially vegans, had higher risks of either total or some site-specific fractures, particularly hip fractures. This is the first prospective study of diet group with both total and multiple specific fracture sites in vegetarians and vegans, and the findings suggest that bone health in vegans requires further research.
The effect is by no means large, and I doubt that it will persuade many non-meat eaters to change their diet. However, perhaps the study can serve as a reminder that people who avoid meat might some lack essential nutrients and that they should therefore consider making sure that no deficiencies can develop.
10 Responses to Vegetarians and vegans are at an increased risk of bone fractures
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Genuine question – has anyone seen Sandra recently?
she commented a few hours ago here:
https://edzardernst.com/2020/11/are-antioxidant-supplements-good-or-bad-for-cancer-patients/#comment-128645
Regrettably, as Edzard’s says, she’s back. And just as ignorant, pompous, Dunning-Krugeresque, narcissistic, unpleasant and stupid as ever, merrily kicking her favourite dead horses and claiming they’re still alive.
Theoretically vegetarians could have better calcification of their bones. Leafy greens are a better source of absorbable calcium than milk. And leafy greens are the best source of Vitamin K which is essential for utilizing Vitamin D. The biggest problem is getting sufficient B-12. I have read that Spirulina has a lot.
I think the problem in the real world is that vegetarians dont eat quality; they eat a lot of soy and grains which are counter productive.
Hearing news like this is not going to change their eating patterns since so much of it is dependent on taste preference and aversion to harming animals. It would be best to encourage veg-ers to eat quality.
the risks of red meat consumption:
https://www.bmj.com/content/371/bmj.m4141?utm_source=etoc&utm_medium=email&utm_campaign=tbmj&utm_content=weekly&utm_term=20201204
An analysis
https://www.reddit.com/r/vegan/comments/k13ity/dr_greger_epic_oxford_study_shows_that_british/?utm_medium=android_app&utm_source=share
But it is worth bearing in mind that well-balanced and predominantly plant-based diets can result in improved nutrient levels and have been linked to lower risks of diseases including heart disease and diabetes. Individuals should take into account the benefits and risks of their diet, and ensure that they have adequate levels of calcium and protein and also maintain a healthy BMI.
Also type of fracture was not taken into account perhaps the vegans had more sport/trauma related fractures compared to say osteoporotic fractures in frail ppl.
nobody would dispute the importance of a healthy lifestyle, including diet. but the health benefits of veganism/vegetarianism are often exaggerated and, in fact, are not supported by lots of good evidence.
Agree more can be done around quality of research.
I could argue the same point for diets such as paleo.
But based on evolutionary reasoning I would say a varied diet of nearly everything is probably best.
Although there was a time when GPs recommended cigarette smoking in moderation was healthy. So I’m always cautious about inflammatory food groups which are consumed “moderately” but actually, average joe is consuming heavily eg the standard western diet.
https://edzardernst.com/2015/04/the-paleo-diet/