Vegans 43% more likely to suffer bone fractures, study suggests

Study finds vegans are at more than double the risk of suffering from a hip fracture than meat-eaters

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Those who follow a vegan diet are at a 43 per cent higher risk of bone fracture compared to those who eat meat, according to newly published research in the journal BMC Medicine.

The study, conducted on nearly 50,000 participants living in the UK, also found that vegetarians and people who ate fish but not meat had a higher risk of hip fractures, compared to those who ate meat. The risk of fractures, however, was partly reduced once body mass index (BMI), dietary calcium and dietary protein intake were taken into account.

Though lower intakes of dietary calcium and protein have also been reported among non-meat eaters, prior research had been unclear about the association of vegetarian diets with the fracture risk. 

“This is the first comprehensive study on the risks of both total and site-specific fracture in people of different diet groups,” said the lead author of the research,  Dr Tammy Tong, a nutritional epidemiologist at the Nuffield Department of Population Health, University of Oxford.  

The research 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 study found that the biggest differences were for hip fractures where the risk in vegans was more than twice that for those who ate meat.  

A team of researchers at the Universities of Oxford and Bristol analysed data from a survey of 54,898 participants. Of the 3,941 reported fractures experienced by participants, vegans, vegetarians and pescetarians were seen as being disproportionately represented when compared to  meat-eaters. 

Dr Tong said: "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.

“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, that is, neither under nor overweight."

Limitations of the study included that most of the participants were white European – potentially an important factor,  considering previous studies have observed differences in bone mineral density and fracture risks by ethnicity.

The authors also had no data on the specific causes of fractures, and were unable to track potential dietary calcium supplementation, with nutrient intake in the study being self-reported instead of objectively measured.