Calcium + Vit D Supplementation & Reduced Hip Fracture Risk in Vegan Women

August 10, 2021

Andrew Brennan : August 2021

The rise of plant-based milks replacing dairy & often contributing to lower dietary calcium levels

For a whole host of reasons, populations are moving towards the adoption of plant-based diets. The vegan diet, once the preserve of the counter culture, is resolutely mainstream. As vegan diets are adopted, there has been a focus from food & beverage manufacturers in providing the balance of nutrients that can be missing from such diets – B vitamin & iron supplementation spring to mind. Another concern that people may not have been aware of for vegans, particularly females, is the association that this diet has with a higher risk of hip fracture.

A major new study highlighted by online publication Nutraingredients shows that supplementation of Calcium & Vitamin D removes the increased risk of hip fracture among vegan females. The final study involved a cohort of 34,542 caucasian & peri / post-menopausal individuals (over 45 years of age) in North America, recruited between 2002 and 2007.

Hip Fractures a concern for vegan females.

A standardised, comprehensive questionnaire was used to identify dietary components – the Food Frequency Questionnaire FFQ. Individuals were placed into 5 dietary groups: lacto-ovo-vegetarian, Pescitarian, semi-vegetarian and non-vegetarian. Follow up correspondence throughout the period of the trial requested information on hip fracture status.


In the vegan group, 32% supplemented with Calcium and Vitamin D with approximately 50% in the other dietary groups. Magnesium supplementation was higher in groups that also supplemented with Calcium and Vitamin D. Mean supplement dosage was uniform throughout groups at approx. 660mg Ca / D and approx. 13.5 micrograms vitamin D/d. The non-supplemented vegans had 11.2% lower dietary vitamin D intake than the supplemented vegans, and 31 – 51% lower dietary D intake than other groups.

Higher calcium supplementation levels led to higher total calcium and vitamin intakes among women.

In females, a significant association of dietary pattern with hip fracture was identified, with a higher proportion of cases among the the vegan group. The incidence of hip fracture per 1,000 PYRS was 3.9 and 2.4 for vegans and non vegans respectively. Age adjusted models in the female cohort showed increasing risk of hip fracture from non vegans to vegans, with vegans having a 53% higher risk of fracture than non vegans (age adjusted).

However, it was found that the vegan diet, when supplemented with Calcium and Vitamin D, was associated with the same or lower risk of fracture than non vegan or other categories. The results suggest that Calcium and Vitamin D are independently important and necessary for an optimal diet.

The male cohort within the study had markedly lower incidences of hip fracture, which are attributed to hormonal and anatomical differences across sexes.

The study concludes: “Among women, a vegan diet was associated with significantly higher risk of hip fracture. However, a vegan diet supplemented with both Vitamin D and calcium yielded no greater risk of hip fracture than the non vegan diet”

Study can be accessed here: https://doi.org/10.1093/ajcn/nqab095

Source: Nutraingredients

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