Pamela Cruz. Pen sula 360 Press
Compared with meat eaters, vegans have a higher risk of total, hip, leg and vertebral fractures, while fish eaters and vegetarians have a higher risk of hip fractures only, according to the prospective EPIC-Oxford study.
The paper, published Sunday in the journal BMC Medicine, says these risk differences were likely due in part to their lower Body Mass Index (BMI) and possibly lower calcium and protein intake.
Previously, based on epidemiological studies, it was known that vegetarians have lower bone mineral density (BMD) than non-vegetarians, but the associations of vegetarian diets with fracture risks were unclear.
For the study, 54,898 men and women were recruited from across the UK between 1993 and 2001, either through general practice or by postal questionnaire; of these, 30,391 maintained the same diet for 14 years.
As the study concluded in 2010 and obtained results during 17.6 years of the participants' lives, they were divided into four dietary groups: 29,380 meat eaters, 8,037 fish eaters, 15,499 vegetarians and 1,982 vegans.
Compared with meat eaters, and after adjustment for socioeconomic factors, lifestyle confounders, and BMI, hip fracture risks were higher in fish eaters, vegetarians, and vegans.
Vegans also had higher risks of total, leg and other fractures compared with meat eaters. Overall, she notes, the significant associations appeared to be strongest without adjustment for BMI and were slightly attenuated, but still significant, with additional adjustment for dietary calcium or total protein.
Separately, no significant differences were observed in the risks of wrist or ankle fractures by diet group with or without BMI adjustment, or for arm fractures after BMI adjustment.
In this sense, the study concludes that people who do not eat meat, especially vegans, have a higher risk of total fractures or fractures in specific areas, particularly in the hip.
Similarly, she explains that more studies are needed, especially from non-European and contemporary populations, to examine the generality of the findings and explore possible heterogeneity by factors including age, sex, menopausal status and BMI.