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Middle-aged vegetarian women are more likely to suffer a hip fracture compared to regular meat eaters, new research reveals. Using hospital records, the study found that vegetarians had a 33 percent higher risk compared to people who ate meat at least five times a week.

Scientists say the study does not conclude that vegetarians should simply add meat back into their diet, and stresses the need for more research into why they face a higher risk.

“Our study highlights potential concerns regarding risk of hip fracture in women who have a vegetarian diet,” says study lead author James Webster, a doctoral researcher at the University of Leeds, in a statement. “However, it is not warning people to abandon vegetarian diets. As with any diet, it is important to understand personal circumstances and what nutrients are needed for a balanced, healthy lifestyle.

Vegetarian diets have gained popularity in recent years. A 2018 Gallup poll shows that 5% of Americans keep meat off their plates. Previous studies have shown that a vegetarian diet can reduce the risks of several chronic diseases including diabetes, heart disease and cancer, compared to omnivorous diets.

There is also a growing call to reduce meat consumption globally in order to lower carbon emissions and prevent catastrophic climate change. Understanding the health effects of a vegetarian diet is therefore becoming increasingly important to public health.

For the study, researchers investigated the risk of hip fracture in occasional meat-eaters, pescatarians (people who eat fish, but not meat) and vegetarians, compared to regular meat-eaters. Over a 20-year period they found 822 hip fractures among 26,318 middle-aged UK women – amounting to just over 3 percent.

After adjusting for other factors like smoking and age, vegetarians were the only diet group with an elevated risk of hip fracture.

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“Hip fracture is a global health issue with high economic costs that causes loss of independence, reduces quality of life, and increases risk of other health issues,” says study co-author Janet Cade, leader of the Nutritional Epidemiology Group in the School of Food Science and Nutrition at Leeds. “Plant-based diets have been linked with poor bone health, but there has been a lack of evidence on the links to hip fracture risk. This study is an important step in understanding the potential risk plant-based diets could present over the long-term and what can be done to mitigate those risks.”

The research team also found that the average BMI (body mass index) among vegetarians was slightly lower than the average among regular meat-eaters.” Previous research has shown a link between low BMI and a high risk of hip fracture. Lower BMI can mean people are underweight which can mean poorer bone and muscle health and a higher risk of hip fracture.

“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,” says Webster. “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 that we can help people to make healthy choices.”

The study’s results are published in the journal BMC Medicine.

South West News Service writer Danny Halpin contributed to this report.