BACKGROUND: Concerns regarding the adequacy of vegetarian diets with respect to fracture risk continue. OBJECTIVES: We 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. METHODS: The 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. RESULTS: The 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. CONCLUSIONS: Without 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.
BACKGROUND: Concerns regarding the adequacy of vegetarian diets with respect to fracture risk continue. OBJECTIVES: We 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. METHODS: The 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. RESULTS: The 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. CONCLUSIONS: Without 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.
Authors: Bernhard Haring; Carolyn J Crandall; Chunyuan Wu; Erin S LeBlanc; James M Shikany; Laura Carbone; Tonya Orchard; Fridtjof Thomas; Jean Wactawaski-Wende; Wenjun Li; Jane A Cauley; Sylvia Wassertheil-Smoller Journal: JAMA Intern Med Date: 2016-05-01 Impact factor: 21.873
Authors: Ester Al de Jonge; Jessica C Kiefte-de Jong; Albert Hofman; André G Uitterlinden; Brenda Ct Kieboom; Trudy Voortman; Oscar H Franco; Fernando Rivadeneira Journal: Am J Clin Nutr Date: 2016-11-30 Impact factor: 7.045
Authors: Karen Jaceldo-Siegl; Jing Fan; Joan Sabaté; Synnove F Knutsen; Ella Haddad; W Lawrence Beeson; R Patti Herring; Terrence L Butler; Hannelore Bennett; Gary E Fraser Journal: Public Health Nutr Date: 2011-05-06 Impact factor: 4.022
Authors: Heike A Bischoff-Ferrari; Bess Dawson-Hughes; John A Baron; Peter Burckhardt; Ruifeng Li; Donna Spiegelman; Bonny Specker; John E Orav; John B Wong; Hannes B Staehelin; Eilis O'Reilly; Douglas P Kiel; Walter C Willett Journal: Am J Clin Nutr Date: 2007-12 Impact factor: 7.045