ArticleThe American journal of clinical nutrition2021
Dietary patterns and hip fracture in the Adventist Health Study 2: combined vitamin D and calcium supplementation mitigate increased hip fracture risk among vegans.
Article in The American journal of clinical nutrition, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- Bone health: biology and nutrition.Current opinion in clinical nutrition and metabolic care · 2024Pooled it
- The gut-bone axis: impact of diet on gut microbiome and osteoporosis.Bone research · 2026Review
- Article
- The Effect of a Lecture-Based Educational Intervention to Improve the Nutrition Knowledge and Behavior of Plant-Based Seventh-Day Adventists Living in the United Kingdom.Health science reports · 2025Article
- Are Dietary Patterns Relevant for Reducing the Risk of Fractures and Sarcopenia?Current osteoporosis reports · 2025Review
- Nutrient adequacy and environmental foot-print of Mediterranean, pesco-, ovo-lacto-, and vegan menus: a modelling study.Frontiers in nutrition · 2025Article
- Dairy and Exercise for Bone Health: Evidence from Randomized Controlled Trials and Recommendations for Future Research.Current osteoporosis reports · 2024Review
- Nutrition and Osteoporosis Prevention.Current osteoporosis reports · 2024Review
- Meat consumption and the risk of hip fracture in women and men: two prospective Swedish cohort studies.European journal of nutrition · 2024Article
- Nutrient Composition of Four Dietary Patterns in Italy: Results from an Online Survey (the INVITA Study).Foods (Basel, Switzerland) · 2024Article
- Risk of Bone Fracture on Vegetarian and Vegan Diets.Current nutrition reports · 2024Review
- Plant-Based Diets and Risk of Hip Fracture in Postmenopausal Women.JAMA network open · 2024Article
- Nutritional strategies to optimise musculoskeletal health for fall and fracture prevention: Looking beyond calcium, vitamin D and protein.Bone reports · 2023Review
- Plant-based alternative proteins-are they nutritionally more advantageous?European journal of clinical nutrition · 2023Article
- Risk of hip fracture in meat-eaters, pescatarians, and vegetarians: a prospective cohort study of 413,914 UK Biobank participants.BMC medicine · 2023Article
- Plant to animal protein ratio in the diet: nutrient adequacy, long-term health and environmental pressure.Frontiers in nutrition · 2023Article
- Fracture Risk in Vegetarians and Vegans: the Role of Diet and Metabolic Factors.Current osteoporosis reports · 2022Review
- Risk of hip fracture in meat-eaters, pescatarians, and vegetarians: results from the UK Women's Cohort Study.BMC medicine · 2022Article
- Low serum levels of vitamin D significantly increase the risk of death in older adults with hip fractures: a prospective cohort.Revista do Colegio Brasileiro de Cirurgioes · 2022Article
- Plant-based dietary patterns are associated with lower body weight, BMI and waist circumference in older Australian women.Public health nutrition · 2022Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundConcerns regarding the adequacy of vegetarian diets with respect to fracture risk continue.
objectivesWe aimed to explore the influence of 5 previously defined dietary patterns on hip fracture risk and whether this association is modified by concomitant calcium and vitamin D supplementation.
methodsThe Adventist Health Study 2 is a prospective cohort study in which participants were enrolled during 2002-2007; proportional hazards regression analyses were used to estimate fracture risk. Participants reside throughout the United States and Canada. A total of 34,542 non-Hispanic white peri- and postmenopausal women and men 45 y and older responded to the biennial hospital history form and were followed for a median of 8.4 y.
resultsThe study identified 679 incident hip fractures during 249,186 person-years of follow-up. Fracture risk varied according to dietary pattern, with a clear effect modification by concurrent supplementation with both vitamin D and calcium. In multivariable models, including adjustment for calcium and vitamin D supplementation, female vegans had 55% higher risk of hip fracture (HR: 1.55; 95% CI: 1.06, 2.26) than nonvegetarians (NVEGs), whereas there was no association between diet pattern and hip fracture risk in men. When further stratifying females on supplement use with both vitamin D and calcium, vegans taking both supplements were at no greater risk of hip fracture than the subjects with other dietary patterns including the NVEGs.
conclusionsWithout combined supplementation of both vitamin D and calcium, female vegans are at high risk of hip fracture. However, with supplementation the excessive risk associated with vegans disappeared. Further research is needed to confirm the adequacy of a vegan diet supplemented with calcium and vitamin D with respect to risk of fracture.
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