New study on bone health in vegans finds vegans have higher bone fracture risk than vegetarians, omnivores or pescaterians.

new diet study headlines: vegans are more likely to break bones

last week we looked at a low carb study, now its vegans breaking bones

they found vegans were more likely to experience a bone fracture than meat-eaters. Pescaterians and vegetarians had slightly higher risk for some specific fractures, like hip

vegans had the highest risks, especially in the lower body, hip and leg. Arm and rib fractures were not more frequent than in meat-eaters

vegans don’t consume dairy so if they dont get enough calcium from food, they could end up with too little. big difference in bone health between vegans who get enough calcium and those who don’t.

looking only at vegans who ate enough calcium, risk of fractures didn’t go away. protein? protein may affect calcium absorption and some vegans eat less protein. among vegans who ate enough, still higher risk of fractures

body weight or BMI has impact on bone health. fractures are more common in low BMI, especially hip, where vegans had highest risk. vegans had lower average BMI than meat-eaters (27% of women had BMI under 20)

18.5 - 25 = normal, under that = underweight and over that = overweight

to test if BMI was the culprit they compared those with higher BMI to those with lower. higher fracture risk was only seen in the low BMI vegans. So the study is saying the problem is not the vegan diet, it’s having an excessively low BMI

why would low BMI cause bones to break? more weight stimulates your body to increase bone density to hold that weight, so being underweight can result in lower bone density. Also, fat and muscle can protect bones from impact

So more fractures were seen at low BMI, in women where there was a higher fraction of underweight people, and in individuals who were inactive, and we know physical activity helps increase bone density

If the problem was lack of calcium, you’d expect all types of fractures to be increased, wrist, leg, hip etc. the sites more likely to break were areas where higher BMI can be protective, like the leg which supports body weight so bone density will increase with BMI, and the hip where having some fat can provide that cushioning effect.

the ankles are more likely to break in heavier people, and ankle fractures were not increased in vegans, pointing to a specific cause like excessively low BMI in some vegans, not a general problem affecting all bones

we’re talking about bone health, we’ve talked about calcium, protein and BMI… what about VitD?? they didn’t measure VitD, and vegans can have lower levels

Asking if vegans have weak bones is like asking if vegans have low b12. depends. If you ignore b12, you’ll risk deficiency. Same with bones. This study says you can eat a vegan diet and have good bone health, if u cover the basics

takeaways to optimize bone health: Calcium. low oxalate leafy greens like kale and collard greens not have more calcium than milk and it’s more absorbable. sardines are also high in calcium. sesame seeds and beans are high in calcium too (also tofu). get b12 AND vitamin D; can help with bone health. vitD from sunlight! eat enough calories to maintain a healthy BMI. women have less muscle and lower BMIs. you don’t wana be overweight but excessively underweight isn’t healthy either. mirror tells us if we need to put some meat on those bones. Resistance training is a stimulus for building bone density. get adequate protein which may help with calcium absorption and maintaining a healthy BMI.

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References:
https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-020-01815-3/tables/2
https://kopernio.com/viewer?doi=10.1038%2Fsj.ejcn.1602659
Avi Bitterman's detailed analysis of the study: https://www.youtube.com/watch?v=9RULbeJnfIg

Disclaimer: The contents of this video are for informational purposes only and are not intended to be medical advice, diagnosis, or treatment, nor to replace medical care. The information presented herein is accurate and conforms to the available scientific evidence to the best of the author's knowledge as of the time of posting. Always seek the advice of your physician or other qualified health provider with any questions regarding any medical condition. Never disregard professional medical advice or delay seeking it because of information contained in Nutrition Made Simple!.

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