The DOI matches its Crossref record; 90 of the 90 references it cites were found in a registry or an index.
Veganism, vegetarianism, bone mineral density, and fracture risk: a systematic review and meta-analysis
Abstract
Context: The numbers of vegans and vegetarians have increased in the last decades. However, the impact of these diets on bone health is still under debate. Objective: This systematic review and meta-analysis sought to study the impact of vegetarian and vegan diets on bone mineral density (BMD) and fracture risk. Data Sources: A systematic search was conducted of PubMed, Scopus, and Science Direct, covering the period from the respective start date of each database to November 2017. Data Extraction: Two investigators evaluated 275 studies against the inclusion criteria (original studies in humans, written in English or Spanish and including vegetarian or vegan diets and omnivorous diets as factors with BMD values for the whole body, lumbar spine, or femoral neck and/or the number of fractures as the outcome) and exclusion criteria (articles that did not include imaging or studies that included participants who had suffered a fracture before starting the vegetarian or vegan diet). The quality assessment tool for observational cohort and cross-sectional studies was used to assess the quality of the studies. Results: Twenty studies including 37 134 participants met the inclusion criteria. Compared with omnivores, vegetarians and vegans had lower BMD at the femoral neck and lumbar spine and vegans also had higher fracture rates. Conclusions: Vegetarian and vegan diets should be planned to avoid negative consequences on bone health. Systematic Review Registration: PROSPERO registration no. CRD42017055508.
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“In support, a recent systematic review and meta-analysis revealed that vegans had a lower bone mineral density than omnivores [271].”
From Nutritional Considerations for the Vegan Athlete (2023) · cites this paper as [271]
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Smith, B., Craven, K., & Kolasa, K. M. (2025) · Nutrition Today · doi:10.1097/nt.0000000000000772
Elevated Risk of Osteoporosis for Vegetarian Modified by Smoking and Milk ConsumptionPreprint
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Vegetarianism and veganism - what's the right attitude?
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“A systematic review and meta-analysis conducted in adult populations suggested that vegetarian and, particularly, vegan diets may be associated with lower BMD at clinically relevant skeletal sites, including the femoral neck and lumbar spine, compared with omnivorous diets [15].”
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The Structure of Plant-based Diets and Their Relationship with Health
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“Studies on vegan and vegetarian diets in adults have systematically shown lower bone mineral density and higher fracture risk [9–12] as well as higher bone resorption marker and catabolic PTH concentrations [13–15] relative to omnivores.”
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“Nevertheless, systematic reviews and meta-analyses indicate that vegetarian diets can FrontiersinNutrition 06 frontiersin.org provide sufficient protein and micronutrients and do not appear to impair muscular strength or bone health when nutritional requirements are achieved (58, 84).”
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“Reduced intake of calcium, vitamin D, and protein has been associated with lower bone mineral density and increased fracture risk in some vegan populations [ 33, 34 ].”
Metadata
- Authors
- Iguacel, I., Miguel-Berges, M. L., Gómez-Bruton, A., Moreno, L. A., & Julián, C.
- Affiliations
- Universidad de Zaragoza (ES)
- University of Zaragoza, Zaragoza, Spain
- Corresponding author
- Iguacel, Isabel
- Venue
- Nutrition Reviews
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-10-29
- Volume
- 77
- Issue
- 1
- Pages
- 1-18
- ISSN
- 0029-6643 (ISSN-L)
- 1753-4887
- OpenAlex
- W2905381903
- Cited by
- 222
- References
- 90
- Citations by year
- 2026: 21 · 2025: 32 · 2024: 35 · 2023: 35 · 2022: 30 · 2021: 32 · 2020: 27 · 2019: 10
- FWCI
- 3.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Nutrition Reviews (publishedVersion)
- PubMed (publishedVersion)
- Zaguan (University of Zaragoza Repository) (submittedVersion)
- Funders
- FPU Predoctoral Programs (FPU014/00922)
- Spanish Ministry of Education and Science
- 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 › Endocrinology, Diabetes and Metabolism › Vitamin D Research Studies
- Keywords
- vegan diet, vegetarian diet, bone mineral density, fracture risk, bone health, femoral neck, lumbar spine, omnivorous diet, calcium intake
- MeSH terms
- Humans, Risk Factors, Diet, Vegetarian, Bone Density, Fractures, Bone
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