The femur is the thigh bone, equipped with a spherical head free to rotate in the corresponding cavity of the pelvis, forming the hip joint. Fracture of the femoral neck, just below the head of the bone, is the leading cause of hospitalization in the elderly. Every year, more than 90,000 and 90% of the injured are over 65, mostly women. The reason why it is mainly the elderly and especially women who suffer a hip fracture is the weakening of the bones with age, accentuated in the female population by the hormonal changes of menopause.
The prevalence of hip fracture cases in a group of people, therefore, is an indicator of bone fragility in that group. Doctor, what significance should we attach to the study’s results on the risk of hip fracture for women who follow a vegetarian diet? At first reading, one might think that a vegetarian diet makes women’s bones more fragile. In reality, this is not the case. The question is more complex. The authors observe in the conclusions of the work that a healthy diet must be complete and balanced.
The vegetarian diet imposes certain limitations on those who follow it. It is essential to be aware of these limitations and their health consequences and adequately compensate for them. A diet that excludes meat and its derivatives is poorer in some nutritional principles that contribute to the health of the musculoskeletal system. It is necessary to balance the choice of foods and possibly take supplements following your doctor’s instructions.
What nutrients are essential for bone health?
The progressive loss of bone density with advancing age is an inevitable physiological phenomenon but is influenced by various factors that can accelerate or slow it down, including nutrition. Calcium is the main mineral component of the skeletal system. Vitamin D regulates calcium metabolism and is responsible for its balance in the bones. Adequate calcium and vitamin D intake are therefore essential for bone health. The primary dietary source of calcium is milk with all its derivatives, which is part of the diet of lacto-ovo-vegetarians, i.e., those who exclude meat consumption but not other foods of animal origin.
Green leafy vegetables, oilseeds, such as almonds, walnuts, and peanuts, some water, and meat and fish, which are not part of the vegetarian diet, are also rich in calcium. Vitamin D is found mainly in foods of animal origin: fatty fish, fish oil, and meat. However, its requirement is almost entirely met by that synthesized by the skin exposed to the sun’s ultraviolet rays. Any deficiency due to poor exposure to the outdoors can be compensated for by taking a supplement under medical supervision. Another essential vitamin for bone health is B12. Several studies have shown a correlation between its deficiency and a greater risk of fractures. Foods of animal origin, meat, eggs, and milk, are the only sources of vitamin B12. Those who adopt a vegan diet must necessarily take a supplement.
Those who exclude meat but take milk and eggs must evaluate, together with their doctor, whether the B12 intake guaranteed by their diet is sufficient or deficient. Finally, proteins contribute to maintaining bone and muscle mass, and inadequate protein intake is associated with an increased risk of fractures. In principle, proteins of vegetable origin are less digestible and assimilable than those of animal origin. Therefore those who adopt a vegetarian diet should take 5-10% more than the amount foreseen for an omnivorous diet.
What else can mitigate bone fragility and fracture risk in old age?
Two factors that accelerate the process of weakening of bones are smoking and alcohol abuse. Conversely, physical activity strengthens the musculoskeletal system and reduces the risk of frailty fractures in old age. Exposure to sunlight is a protective factor because it induces vitamin D synthesis. These healthy habits are all the more effective in preventing bone fragility, the earlier they are adopted in life.
In particular, to preserve bone health in adults and the elderly, it is necessary to ensure an adequate intake of calcium in the diet of children and adolescents. At around twenty years of age, an individual’s skeletal system reaches the so-called “peak bone mass,” i.e., the maximum calcium content in bone tissue. If the peak is not optimal, the risk of excessive calcium loss increases over the years, of bone fragility and fractures in old age.
Also Read: 5 Vegan Foods That Are Packed With Protein