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Is a Vegetarian Diet Good for your Bones?

There is a strong trend toward plant-based diets, due to the multiple health benefits these diets seem to offer. However, a new study published online August 11, in BMC Medicine, suggests vegetarian diets may increase your chance of hip fracture.

The researchers found that middle-aged women who never eat meat may be more likely to break a hip than women who regularly consume meat and/or fish. More research is needed to understand the reasons for the increased hip fracture risk but being underweight, not getting enough key nutrients, and exercise habits may be contributing factors.

The body mass index or BMI was lower in the vegetarians in the study than in the meat eaters. Low body mass may lead to poor bone and muscle health which could result in an increased risk of hip fractures. Also, the less fat you have, the less cushioning when you fall. Falls are the cause of most hip fractures.

The study looked at rates of hip fractures in over 26,000 women aged 35 to 69 who ate meat no more than four times a week (occasional meat eaters); pescatarians who ate fish but not meat; vegetarians; and regular meat-eaters who consumed meat at least five times a week. The study had women fill out food frequency questionnaires, and then compared them against hospital records to determine who had a hip fracture. There were 822 hip fractures over the 20 year follow-up period.

Once researchers controlled for other factors known to increase hip fracture risk, such as smoking status and physical activity level, they found vegetarians were the only group who had an elevated risk of hip fracture.

It is possible to get most of the nutrients you need for bones from plant sources but it takes good planning and may require some supplement use. It can be a challenge on a vegetarian diet to eat the amount of protein you need as you age.  Multiple studies have found that vegetarians have lower intakes of protein, omega-3 fatty acids, vitamin B12 and require a higher level of zinc supplementation. Vegetarians need to be sure to get enough protein, calcium, magnesium, potassium, boron, zinc, copper, manganese, vitamin D and vitamin K2.

To get the heart and other health benefits of a plant-based diet vegetarians can work to maintain a healthy weight, and eat lots of fruits and vegetables, nuts, legumes, beans and whole grains. Like everyone, they need to focus on exercise specific to bone building and balance exercises. New research published in JCEM found that vegans who lift weights or do strength training have stronger bones than vegans who only do other forms of exercise, such as biking or swimming. The researchers concluded that resistance training seems to be particularly important for maintaining bone health when adhering to a plant based diet.

More research is needed before drawing any conclusions about fracture risk in vegetarians. The above studies were observational which indicates correlations but does not prove a definite cause. If you choose to follow a vegetarian diet be sure you are getting all the nutrients you need for healthy bones and that you are participating in a bone building exercise program.

posted on 10/15/2022