Why Are Vegans at a Greater Risk of Bone Fractures? And how can we counter this?

People who do not consume meat, particularly vegans, may be at a higher risk of bone fractures.

vegans have a 43 percent higher risk of fractures anywhere in the body, as well as higher risks of fractures in specific areas such as the hip, according to researchers at Oxford University in England.

“We found that vegans had a higher risk of total fractures, which resulted in close to 20 more cases per 1,000 people over a 10-year period compared to people who ate meat. The biggest differences were for hip fractures, where the risk in vegans was 2.3 times higher than in people who ate meat, equivalent to 15 more cases per 1,000 people over 10 years,” Tammy Tong, PhD, BSc, the study’s lead author and a nutritional epidemiologist at the University of Oxford’s Nuffield Department of Population Health, said in a press releaseTrusted Source.

The research, published in the journal BMC Medicine, analyzed data from over 54,000 people in the EPIC-Oxford study, a large cohort of men and women recruited for the study between 1993 and 2001 in the United Kingdom.

At the start of the study, nearly 30,000 participants were meat eaters, 8,000 didn’t eat meat but did eat fish, 15,000 were vegetarians, and nearly 2,000 were vegans.

Participants were followed for an average of 18 years before being released in 2016. There were 3,941 fractures during that time period. The hip had the most fractures, followed by the wrist, arm, ankle, and leg.

According to the researchers, vegetarians and people who ate fish but not meat had a higher risk of hip fractures than meat eaters. When body mass index (BMI), calcium, and protein intake were considered, this risk was reduced in part.

“Previous studies have shown that low BMI is associated with a higher risk of hip fractures, and low intakes of calcium and protein have both been linked to poorer bone Health. This study showed that vegans, who on average had lower BMI as well as lower intakes of calcium and protein than meat eaters, had higher risks of fractures at several sites,” Tong said.

“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,” she remarked. “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, that is, neither under nor overweight.”

Why are vegans more vulnerable?

The findings of the study, according to Lauri Y. Wright, PhD, an assistant professor of nutrition and dietetics at the University of North Florida, are not surprising.

“The study results are consistent with previous studies, so not a surprise. The findings of increased fractures in non-meat eaters was partially explained by protein and calcium intake as well as BMI. However, there continued to be higher risk of fractures in vegans when those factors were controlled. This may be related to bioavailability of those key nutrients in bone Health,” according to Wright.

“For example, the vegans may have consumed adequate amounts of calcium, but many plant-based sources of calcium like spinach are not as bioavailable as dairy,” she said. “Protein quality is another example. vegans may have consumed an adequate amount of plant proteins, but the amino acid ratio does not support resorption and remodeling as well as the amino acid ratio in animal proteins.” Although this is contradicted in this study.

It’s still possible to be vegan and have strong healthy bones.

“I have many patients that are vegan and when done correctly, studies do not show drawbacks,” Kristin Kirkpatrick, MS, a registered dietitian and manager of wellness nutrition services at the Cleveland Clinic Wellness Institute in Ohio, states to Healthline.

“The key is doing it right,” she elaborated “For example, an individual can easily consume plenty of vegan processed junk food, which would have adverse impact on Health. However, when the focus is whole foods and plants, there is little drawback. Protein can be derived from whole soy, beans, and legumes, as well as nuts and seeds. Supplementation of B12 and vitamin D are also recommended for Health.”

How to Keep Bone Density

Dana Hunnes, PhD, is a senior dietitian at the University of California, Los Angeles and a vegan since 2001.

She claims that finding vegan alternatives to animal products that were fortified with essential vitamins and minerals was much more difficult back then.

“There were fewer vegan products and anyone who wanted to be vegan had to mostly eat fruits, vegetables, and non-fortified food items. When I went vegan… there was literally one brand of soy milk and I don’t believe it had extra calcium or vitamin D in it. Today, there are so many products that mimic animal products and/or have vitamins and minerals supplemented into them”.

She believes that choosing the right foods is critical for vegans’ Health.

“Make sure you get a good balance of fresh produce and potentially some fortified products, including soy milk, almond milk, or cashew milk, which are now mostly all fortified with calcium and vitamin D and other important nutrients,” Hunnes advised.

How to Stay Healthy on a Vegan Diet

She also recommends that vegans engage in weight-bearing exercises, get enough vitamin D and calcium, and consume an adequate amount of calories.

Despite the Oxford study’s findings, Wright believes that a vegan diet can be beneficial with proper planning.

“I don’t see that there are drawbacks to being a vegan, just challenges. The vegan needs to be strategic about planning out the diet to ensure adequate intake of certain key nutrients such as vitamin B12, iron, calcium, and zinc. We know that there are many Health benefits to being a vegan. vegans typically have a healthier body weight, have lower cholesterol levels, and a lower risk for many cancers, heart disease, and diabetes, she explained.

“A meat-free diet can provide all the nutrients you need. It just takes a little planning. To ensure a nutritionally adequate diet, eat a variety of whole grains, fruits, vegetables, legumes, and nuts and include soy,” Wright continued.