By Deborah Jeanne Sergeant
Vegetarians may be at higher risk for hip fractures. A University of Leeds research paper compared the rate of hip fracture among 26,318 women who occasionally eat meat; pescatarians, people who eat fish but not meat; and vegetarians.
Even after adjusting for factors like smoking and age, vegetarians evidenced a 33% greater risk of hip fracture in the median 22.3-years the women were followed for the study.
Because pescatarian and vegetarian diets limit animal products, it can be challenging to get certain nutrients in sufficient amounts for maintaining bone health. The Leeds study was conducted in the UK where the fluid milk supply is not fortified with vitamin D. Most Americans who drink milk consume vitamin D-fortified milk, which aids in calcium absorption. Few foods contain sufficient levels of vitamin D. The body generates vitamin D through sun exposure, which is limited in northern climates. Because vegans and some vegetarians do not drink milk, they need to take vitamin D supplements or find other sources of vitamin D.
Mary Jo Parker, registered dietitian in private practice in Williamsville, encourages vegetarians to look for alternative sources of calcium and vitamin D-fortified milk such as dairy alternatives “such as soy milk and some almond and other milks (check labels for amounts and if fortified), tofu (it is packed in a calcium brine), and greens and green vegetables like broccoli, kale and spinach. Other vegetables, like Brussels sprouts and cabbage are not only sources of calcium, but vitamin K, which helps with bone density as well.”
She added that minerals like calcium are not as available to the body when sourced from plants.
Adding supplements may be warranted. Parker also said that prunes, which are rich in vitamin K, can help increase bone density.
“Eating six per day were shown to improve density in studies,” Parker said.
Vitamin B-12 can be tough for vegans to obtain, as its main dietary sources are from meat, such as beef liver (2,977 daily value per serving), tuna (385), and ground beef (100), although 2% milk (54) and eggs (19) offer B-12. Tempe (fermented soybeans) and shiitake mushrooms represent low-level sources of vitamin B-12. Non-meat eaters or minimal meat eaters may need to supplement with B-12.
Nuts and seeds are rich in minerals like magnesium, which also aid in absorbing calcium.
Although some foods may represent good sources of important nutrients, it is vital to not label some “super foods” while ignoring many other healthful foods. Justine Hays, registered dietitian and senior Snap-Ed nutritionist with Cornell Cooperative Extension in Niagara County, likes to see clients consume a wide array of foods to support good health.
“For all folks, we recommend a variety of calcium-rich foods, such as dark green leafy vegetables, fortified juices, dairy and non dairy milks, and if a healthcare professional recommends, a calcium supplement,” she said.
A balanced, healthful diet can aid in avoiding hip fractures. However, building and maintain bone health also relies upon fitness to avoid falls. Practicing balance-dependent activities can help keep that sense sharp into later life. Strength training can also help build bone, as it stresses the areas where bone and muscle connect. More muscle mass also can provide more cushion to bones in case of a fall.
“Weight bearing exercise, such as walking, jumping, dancing, and using hand weights can also help strengthen bones,” Parker said.
Anyone who feels unsteady while standing or walking should seek a care provider’s recommendation in finding a balance class.