Takeaway
Compared with meat eaters, vegans were at an increased risk of total and site-specific fracture of the hip, leg and vertebrae.
Vegetarians and fish eaters had a higher risk of hip fractures than meat eaters.
Why this matters
Findings suggest that bone health in vegans requires further research.
Study design
Dietary information of 54,898 participants in the EPIC-Oxford study was collected at baseline (1993-2001) and follow-up (2010).
Participants were categorised into meat eaters (n=29,380), fish eaters (n=8037), vegetarians (n=15,499) and vegans (n=1982) at both time points and followed continuously for 17.6 years on average until 2016 for the occurrence of fractures.
Funding: UK Medical Research Council and others.
Key results
3941 fractures occurred in total, including 566 arm, 889 wrist, 945 hip, 366 leg, 520 ankle and 467 fractures at other main sites, defined as the clavicle, ribs and vertebrae.
After adjustments for socio-economic factors, lifestyle confounders and body mass index (BMI), compared with meat eaters, the risks of hip fracture were higher in:
fish eaters (adjusted HR [aHR], 1.26; 95% CI, 1.02-1.54);
vegetarians (aHR, 1.25; 95% CI, 1.04-1.50); and
vegans (aHR, 2.31; 95% CI, 1.66-3.22).
The vegans also had higher risks of:
total fracture (aHR, 1.43; 95% CI, 1.20-1.70);
hip fracture (aHR, 2.31; 95% CI, 1.66-3.22);
leg fracture (aHR, 2.05; 95% CI, 1.23-3.41); and
other main site fractures (aHR, 1.59; 95% CI, 1.02-2.50).
vertebral fracture (aHR, 2.42; 95% CI, 2.31-4.48).
Overall, the significant associations were stronger before adjustment for BMI and were slightly attenuated but remained significant after further adjustment for dietary calcium and/or total protein.
No significant differences were seen in risks for arm, wrist and ankle fractures between diet groups.
Limitations
The cause of fracture or calcium that was taken in supplement form was not considered.
Limited generalisability.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Sarfaroj Khan. Increased Risk of Bone Fractures in Non-meat Eaters - Medscape - Dec 15, 2020.
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