Both men and women who follow a vegetarian diet have a 50 per cent higher risk of hip fracture than people who regularly eat meat, according to the findings of a large-scale study.

Women who are vegetarian have an increased risk of hip fracture, but the reasons for this are unknown, and studies on the impact of a vegetarian diet on men have been small and inconclusive.

Researchers at the University of Leeds examined data from 413,914 people - both men and women - and discovered that vegetarian men are at a higher risk of hip fracture than meat-eating men. It also identifies some of the factors that may put vegetarians, both men and women, at risk.

Individuals in the study, who were recruited between 2006 and 2010, provided information on their diet and were classified as either regular meat eaters who ate meat five or more times a week; occasional meat eaters who ate meat fewer than five times a week; a pescatarian who ate seafood but not meat; or a vegetarian who could consume dairy foods but not seafood or meat.

The data on the individuals was linked to their hospital records and cases of hip fracture were recorded in the follow-up period to 2021.
There were 3503 cases of hip fracture among the 413,914 participants, for an overall incidence rate of less than 1 per cent.

Although the overall risk of hip fracture was low, there was a significant difference in risk between vegetarians and regular meat eaters.
The researchers discovered that vegetarians had a 50 per cent higher risk than regular meat eaters, regardless of gender. The risk was the same for occasional and regular meat eaters.

Pescatarians were slightly more at risk than regular meat eaters, but the difference was insignificant. The researchers calculated how these relative differences might translate to real-world situations.

They predicted that 6.5 regular meat eaters and 6.5 occasional meat eaters would experience a hip fracture on average, while 7 pescatarians and 9.5 vegetarians would.

James Webster, a doctoral researcher in the School of Food Science and Nutrition who led the study, said: “Hip fractures are a growing problem in an ageing society, and can trigger debilitating health conditions and a loss of quality of life.

“This study shows that whilst vegetarians face a greater risk of hip fracture than meat-eaters, this translates to just 3 more hip fractures per 1000 people over 10 years. The health benefits of a vegetarian diet, including a lower risk of cancer and cardiovascular disease, may still outweigh any increases in hip fracture risk.

“Our analysis suggests that low BMI may be a key factor in why their risk is higher. “Additionally, vegetarians were about 17 per cent less likely to meet protein recommendations than meat-eaters. So, important messages from our study are that vegetarians need to ensure they are getting a balanced diet with enough protein and maintain a healthy BMI. This will help vegetarians to maintain healthy bones and muscles.”

Professor Janet Cade, who leads the Nutritional Epidemiology Group at the University of Leeds and supervised the research, said: “Hip fracture is a major health issue and diet may have a part to play in affecting risk.

“This research, using the large UK Biobank, confirms our previous work, showing that a vegetarian diet increases the risk of hip fracture compared to regular meat eaters, in both men and women. Whilst vegetarian diets have health benefits, understanding diet quality and the balance of key nutrients may help to reduce risk and improve future bone health.”