Vegans are more likely to suffer a bone fracture anywhere in the body compared to people who ate meat, according to a new study.
Those who followed a plant-based diet had a 43% higher risk of fractures compared to meat eaters, and a higher risk of site-specific fractures of the hips, legs and vertebrae, the research, published in BMC Medicine, says.
Vegetarians and people who ate fish but not meat had a higher risk of hip fractures compared to people who ate meat.
However, the risk of fractures was partly reduced once body mass index (BMI), dietary calcium and dietary protein intake were taken into account.
Dr Tammy Tong, Nutritional Epidemiologist at the Nuffield Department of Population Health, University of Oxford, said this was the first comprehensive study on the risks of both total and site-specific fractures in people of different diet groups.
"We found that vegans had a higher risk of total fractures which resulted in close to 20 more cases per 1000 people over a 10-year period compared to people who ate meat," she said.
"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 1000 people over 10 years."
A team of researchers at the Universities of Oxford and Bristol analysed data from nearly 55,000 people in the EPIC-Oxford study.
Men and women living in the UK were recruited between 1993 and 2001, including many who did not eat meat.
Their eating habits were assessed initially at recruitment, then again in 2010. Participants were followed continuously for 18 years on average, until 2016 for the occurrence of fractures.
During the time of the study, 3,941 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.
In addition to a higher risk of hip fractures in vegans, vegetarians and pescetarians than the meat eaters, vegans also had a higher risk of leg fractures and other main site fractures.
The authors observed no significant differences in risks between diet groups for arm, wrist or ankle fractures once BMI was taken into account.
The authors found that the differences in risk of total and site-specific fractures was partly reduced once BMI, dietary calcium and dietary protein intake had been taken into account.
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."
The authors caution that they were unable to differentiate between fractures that were caused by poorer bone health and those that were caused by accidents because data on the causes of the fractures were not available.
