What older female vegetarians need to know

The benefits of a vegetarian diet are well studied. Vegetarians have reduced risk of diabetes, heart disease and cancer. Plus, their diet has a smaller environmental impact compared to meat eaters. However, a recent study has found that older, female vegetarians have a higher risk of hip fracture.

The study followed 26,300 women between the ages of 35 and 69 in the United Kingdom for a median time of 22 years. Women were divided into groups — vegetarians, regular meat eaters (five servings of meat a week) and pescatarians. The vegetarians had the highest rate of hip fracture.

This study is likely not the final word on the true risk of hip fracture in vegetarians. Other studies have shown that diets high in fruit and vegetable protein are associated with lower hip fracture risk. At the same time, some vegetarian diets have been recognized to have lower levels of nutrients associated with bone mineral density. Animal meats tend to have high amounts of calcium, vitamins D and B12, and protein. The researchers did not account for how well-balanced the diets were for either group; neither group did any blood tests. They also did not separate vegans from the vegetarians because there were so few vegans.

They did have to account for body mass index (BMI). Vegetarians in general have a lower BMI than non-vegetarians. A higher BMI in older women is associated with higher bone density because of the endogenous estrogens from peripheral fat. But don’t get too excited — it is also associated with an increase in falls and falls account for 90% of hip fractures.

Don’t get too disappointed, women with a higher BMI are less likely to break their hips than average-sized women because of the extra “padding.” Unfortunately, they are far more likely to break an ankle because coming down on a foot the wrong way with excess weight makes it snap easier. All of this was taken into account to compare similar-sized women. They also accounted for many other factors, such as diabetes, cancer, smoking, alcohol consumption and the amount of exercise.

All of this taken together resulted in the conclusion that the risk of a vegetarian breaking a hip was 1.33 times higher than a meat eater or pescatarian breaking a hip. So, for every three meat eaters who break a hip, there are four vegetarians who do. The pescatarians rate of fracture was similar to the red meat eaters.

The study also revealed that slender women with a BMI less than 23.5 were 1.46 times more likely to break a hip than women with a BMI over 23.5, regardless of diet type.

A large study like this one helps assure us that the findings are not random. However, the study could not elucidate the true cause of the fractures. Some dietary levels of calcium and vitamin D were estimated but not measured in the blood. Furthermore, the study started in the late 1990s. The awareness of a well-balanced diet and the actual vegetarian food products available to vegetarians and vegans has grown over the years. Lastly, the study didn’t account for cause of hip fractures. It is possible that more slender, vegetarian women are more active specifically in activities that are riskier for hip fracture, than the meat eaters.