Cited by 222Bone health and osteoporosis researchNutritional Studies and DietVitamin D Research Studies

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Veganism, vegetarianism, bone mineral density, and fracture risk: a systematic review and meta-analysis

Iguacel, Isabel, Miguel-Berges, María L, Gómez-Bruton, Alejandro, Moreno, Luis A, Julián, Cristina·2019·Nutrition Reviews

DOI 10.1093/nutrit/nuy045

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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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UK clinical guideline for the prevention and treatment of osteoporosis
Gregson, C. L., Armstrong, D. J., Bowden, J., Cooper, C., Edwards, J., Gittoes, N. J. L., Harvey, N., Kanis, J., Leyland, S., Low, R., et al. (2022) · Archives of Osteoporosis · doi:10.1007/s11657-022-01061-5 · Cited by 593
“Whilst there are inconsistencies in the evidence base for the associations between vegetarian and vegan diets and musculoskeletal health, consumption of a vegetarian or vegan diet has been associated with lower BMD at the lumbar spine and hip than an omnivore diet, and a vegan diet has been associated with higher frac…”
Background
Nutrient Intake and Status in Adults Consuming Plant-Based Diets Compared to Meat-Eaters: A Systematic Review
Neufingerl, N., & Eilander, A. (2021) · Nutrients · doi:10.3390/nu14010029 · Cited by 484
“Our findings are in line with two recent systematic reviews and meta-analysis, which found that vegetarians and vegans had lower lumbar spine, femoral neck, and whole-body BMDs than omnivores [74,75].”
Result
The Safe and Effective Use of Plant-Based Diets with Guidelines for Health Professionals
Craig, W. J., Mangels, A. R., Fresán, U., Marsh, K. A., Miles, F. L., Saunders, A. V., Haddad, E. H., Heskey, C. E., JOHNSTON, P. K., Larson‐Meyer, E., et al. (2021) · Nutrients · doi:10.3390/nu13114144 · Cited by 379
Nutritional intake and bone health
Rizzoli, R., Biver, E., & Brennan‐Speranza, T. C. (2021) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(21)00119-4 · Cited by 318
Association of Healthful Plant-based Diet Adherence With Risk of Mortality and Major Chronic Diseases Among Adults in the UK
Thompson, A. S., Tresserra-Rimbau, A., Karavasiloglou, N., Jennings, A., Cantwell, M., Hill, C., Perez-Cornago, A., Bondonno, N. P., Murphy, N., Rohrmann, S., et al. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.4714 · Cited by 203

See all 222

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
ORCID: Iguacel, Isabel
Moreno, Luis A
Julián, Cristina
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
DOI: 10.1093/nutrit/nuy045
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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Veganism, vegetarianism, bone mineral density, and fracture risk: a systematic review and meta-analysis

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