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Vegetarian women at increased risk for hip fracture

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August 31, 2022

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Disclosures:
The authors report no relevant financial disclosures.


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In a large cohort of women, those who were vegetarians demonstrated an elevated risk for hip fracture compared with their meat-eating counterparts, according to recent research.

For the analysis, which featured data from the U.K. Women’s Cohort Study, Janet E. Cade, PhD, professor of nutritional epidemiology and public health at University of Leeds, United Kingdom, and colleagues sought to compare the hip fracture risk among occasional meat-eaters, pescatarians and vegetarians with regular meat-eaters. They also aimed to assess whether BMI affected associations between each diet group and hip fracture risk.

Pescatarian women have a lower risk for hip fractures than meat eaters.
Women who eat a pescatarian diet have a lower risk for hip fractures compared with meat-eaters, whereas the risk for hip fractures is higher in women eating a vegetarian diet. Data were derived from Webster J, et al. BMC Med. 2022;doi:10.1186/s12916-022-02468-0.

The study included 26,318 U.K. women aged 35 to 69 years. Researchers used a validated 217-item food frequency questionnaire completed from 1995 to 1998 to classify women as regular meat-eaters ( 5 servings/week), occasional meat-eaters (< 5 servings/week), pescatarian (ate fish but not meat) or vegetarian (ate neither meat nor fish). They determined incident hip fractures via linkage to Hospital Episode Statistics through March 2019.

In all, 3.1% of the cohort experienced a hip fracture during a median follow-up of 22.3 years. Researchers adjusted for cofounders and found that compared with meat-eaters, vegetarians (HR = 1.33; 95% CI, 1.03-1.71) had the greatest risk for hip fracture, whereas occasional meat-eaters (HR = 1; 95% CI, 0.85-1.18) and pescatarians (HR = 0.97; 95% CI, 0.75-1.26) did not demonstrate an increased risk.

Results also indicated no clear evidence of a BMI effect modification in any diet group (P for interaction = .3).

In other data, the prevalence of cardiovascular disease, cancer or diabetes at recruitment was highest among regular meat-eaters (10.2%) and lowest among vegetarians (5.8%). Regular meat-eaters had the highest absolute dietary intakes of protein, vitamin D and vitamin B12, whereas vegetarians had the lowest.

“Overall, vegetarians, but not occasional meat-eaters or pescatarians, were at a higher risk of hip fracture compared to regular meat-eaters in this cohort of U.K. women,” Webster and colleagues concluded. “Further research is needed to confirm this in other populations, such as men and non-European populations, and to identify the factors responsible for the observed risk difference. In particular, further research exploring the roles of BMI and nutrients abundant in animal-sourced foods is recommended so that public health interventions and policy guidelines aiming to reduce hip fracture risk in vegetarians through dietary change or weight management can be formed.”

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