Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford
Abstract
Objective To compare fracture rates in four diet groups (meat eaters, fish eaters, vegetarians and vegans) in the Oxford cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford).Design Prospective cohort study of self-reported fracture risk at follow-up.Setting The United Kingdom.Subjects A total of 7947 men and 26,749 women aged 20-89 years, including 19,249 meat eaters, 4901 fish eaters, 9420 vegetarians and 1126 vegans, recruited by postal methods and through general practice surgeries.Methods Cox regression.Results Over an average of 5.2 years of follow-up, 343 men and 1555 women reported one or more fractures. Compared with meat eaters, fracture incidence rate ratios in men and women combined adjusted for sex, age and non-dietary factors were 1.01 (95% CI 0.88-1.17) for fish eaters, 1.00 (0.89-1.13) for vegetarians and 1.30 (1.02-1.66) for vegans. After further adjustment for dietary energy and calcium intake the incidence rate ratio among vegans compared with meat eaters was 1.15 (0.89-1.49). Among subjects consuming at least 525 mg/day calcium the corresponding incidence rate ratios were 1.05 (0.90-1.21) for fish eaters, 1.02 (0.90-1.15) for vegetarians and 1.00 (0.69-1.44) for vegans.Conclusions In this population, fracture risk was similar for meat eaters, fish eaters and vegetarians. The higher fracture risk in the vegans appeared to be a consequence of their considerably lower mean calcium intake. An adequate calcium intake is essential for bone health, irrespective of dietary preferences.Sponsorship The EPIC-Oxford study is supported by The Medical Research Council and Cancer Research UK.
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The EPIC-Oxford cohort had a significantly higher fracture risk compared with meat eaters, fish-eaters, and vegetarians.
“Indeed, this cohort had a significantly higher fracture risk compared with meat eaters, fish-eaters, and vegetarians [270].”
From Nutritional Considerations for the Vegan Athlete (2023) · cites this paper as [270]
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- Authors
- Appleby, P., Roddam, A., Allen, N., & Key, T.
- Affiliations
- Cancer Research UK (GB)
- Corresponding author
- Appleby, P
- Venue
- European Journal of Clinical Nutrition
- Published
- 2007-02-07
- Volume
- 61
- Issue
- 12
- Pages
- 1400-1406
- ISSN
- 0954-3007 (ISSN-L)
- 1476-5640
- OpenAlex
- W2119182433
- Cited by
- 217
- References
- 28
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 16 · 2023: 12 · 2022: 14 · 2021: 17 · 2020: 18 · 2019: 15 · 2018: 18 · 2017: 15 · 2016: 15 · 2015: 10 · 2014: 13 · 2013: 10 · 2012: 5
- FWCI
- 7.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Pathology and Forensic Medicine › Vitamin D Research Studies
- Keywords
- fracture risk, vegetarian diet, vegan diet, meat-eaters, calcium intake, bone health, energy intake
- MeSH terms
- Adult, Aged, Aged, 80 and over, Calcium, Dietary, Female, Follow-Up Studies, Humans, Male, Meat, Middle Aged, Prospective Studies, Diet, Vegetarian, Cohort Studies, Prevalence, Confidence Intervals, Proportional Hazards Models, Odds Ratio, Seafood, Bone Density Conservation Agents, Fractures, Bone
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