Why Vegetarians Face Higher Hip Fracture Risk

Introduction to Diet and Hip Fracture 0:00

A reasonable estimate is that around 5% of Americans and around 7% of Brits are currently vegetarian. So this is actually a fairly sizable percentage of people. What's the take-home message here? If you're a vegetarian, you should be looking at your protein and calcium intake and look at some of the other micronutrients that are important for bone health. And I've included a couple of links in the show notes below about this. In another quote, Dr. Webster mentions that vegetarian diets are healthy in other ways, particularly regarding cardiovascular disease.

So one shouldn't abandon vegetarian diets, but rather be very thoughtful about the kinds of nutrients that one is taking in. All of us should be thoughtful about our home environment and prevention of falls. And as always, exercise, exercise, exercise. Whatever you can do will only be an additional help in preventing falls and fractures if you do fall. Have you made it past menopause, or are you going through it now? I'm Dr. Pat McShane, and on the Women's HealthSpan Voices podcast, I'll guide you through the health challenges of the menopausal years and beyond, guiding the way to thriving in this powerful era of your womanhood.

Hello and welcome. Today we're going to talk about diet and hip fracture.

UK Biobank Study on Vegetarian Hip Fracture Risk 1:35

For some time, it has been speculated that vegetarian diets lead to a higher incidence of hip fracture, particularly in women, although this hasn't been studied much with men and also not with large populations of people. So this week, there was results published from the UK Biobank study conducted through the University of Leeds in the UK. This included more than 400,000 people, more than half of whom were women. The advantage of the biobank studies is that in the British health system, there's very good follow-up and linkages between hospitalizations and the data that were initially collected about these people's lifestyles and so on.

The study investigators looked at people who ate meat five times a week or more, people who ate meat occasionally, those who ate fish occasionally or a little more than that, and those who ate dairy and eggs perhaps, but not meat or fish. Over a number of years, they determined that the people who were vegetarians had about a 50% increase in hip fracture. This was particularly concerning to me because I have a number of friends who are vegetarian. And also in my own case, I am moving towards a more plant-based diet, although I'm not a vegetarian by any means.

Both the vegetarian men and women were more likely to have hip fractures. And this was really the first time that the incidence in men had been determined in a rigorous fashion. The vegetarians tended to be thinner. And the concern was that vegetarians may be eating a less healthy diet in terms of other nutrients that are important for bone health,

Why Vegetarians May Face Higher Bone Risk 3:40

such as protein and calcium. I'm going to read a couple quotes from the chief study investigator, James Webster, although I'm going to spare you my British accent. E says, additionally, vegetarians were about 17% less likely to meet protein recommendations than meat eaters. So important messages from our study are that vegetarians need to ensure that they are getting a balanced diet with enough protein and maintain a healthy BMI. That's body mass index or weight. This will help vegetarians to maintain healthy bones and muscles.

Vegetarian diets can vary widely from person to person and can be healthy or unhealthy, just like diets that include animal products. However, it is concerning that vegetarian diets often have lower intakes of nutrients that are linked with bone and muscle health. These types of nutrients generally are more abundant in meat and other animal products than in plants, such as protein, calcium, and other micronutrients. Low intake of these nutrients can lead to lower bone mineral density and muscle mass, which can make you more susceptible to hip fracture risk.

This makes it especially important for further research to better understand factors driving the increased risk in vegetarians, whether it be particular nutrient deficiencies or weight management, so we can help people to make healthy choices." End of quote. So to back up a little in the general scheme of hip fracture, It's estimated that about 15% of women will experience a hip fracture during their life. Most of these in women over age 75. Around 75 to 80% of hip fractures are experienced by women.

Hip fractures are found around the world and they are more common in areas receiving less sunlight, either the extreme northern hemisphere or the extreme

Hip Fracture Risks and Prevention Strategies 6:00

southern hemisphere. In the U.S., about 10 years ago, the estimated cost was around $5 billion for the healthcare costs. Hip fractures often lead to frailty and dependence, and the person does not reach the state of mobility that they had prior to their hip fracture. And in around 20 to 30% of cases, especially in older people, it may lead to mortality within a year of the injury. The treatment for hip fracture is surgical, and this is something that we typically try to avoid, at least I do when I'm a surgeon.

The risk factors for hip fracture besides age are osteoporosis, certain medications that one has taken through one's lifetime, and vegetarian diet as we discussed. Things one can do for prevention include going through lists of medications with your physicians or practitioners to determine if any of the medications may make you sleepy or dizzy and lead to falls, since most hip fracture is related to falls. There's a large literature supporting the idea of exercise, especially for strength and balance in the prevention of fractures of all types, but certainly hip fractures.

Another recommendation is to discuss with your physicians possible supplementation, particularly of vitamin D and calcium, but other minerals for bone density and muscle mass as well. Certainly protein intake is important, as we heard from Dr. Webster's quote. Fall prevention is key and avoidance of throw rods and installation of good lighting and good handrails for stairs is very significant on the basis of one's home. Poor vision can also lead to falls, so regular checkups is important for fall prevention as well as prevention of eye damage.

Hip pads are relatively inexpensive and have shown to be protective for hip fractures. These might be considered for people with a history of falls, women with osteoporosis, or those who are very elderly or frail.

Takeaway for Vegetarians and Fall Prevention 8:40

A reasonable estimate is that around 5% of Americans and around 7% of Brits are currently vegetarian. So this is actually a fairly sizable percentage of people. What's the take-home message here? If you're a vegetarian, you should be looking at your protein and calcium intake and look at some of the other micronutrients that are important for bone health. And I've included a couple of links in the show notes below about this. In another quote, Dr. Webster mentions that vegetarian diets are healthy in other ways, particularly regarding cardiovascular disease.

So one shouldn't abandon vegetarian diets, but rather be very thoughtful about the kinds of nutrients that one is taking in. All of us should be thoughtful about our home environment and prevention of falls. And as always, exercise, exercise, exercise. Whatever you can do will only be an additional help in preventing falls and fractures if you do fall. If you have comments or things you would like me to cover, please place them in the notes below and I look forward to seeing you again. Thanks for listening to the Women's Health Span Voices Podcast.

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