Vegans Have Higher Risk of Fractures. What to Eat for Bone Health

A new study out of the UK finds that people who eat a vegan or vegetarian diet have a 43 percent higher risk of bone fractures. Before you say "pass the milk" here is how to safeguard your bone health and exactly what to eat to get your daily calcium.

First of all, there are more upsides to adhering to a whole-food, plant-based diet than potential pitfalls (and all diets have those). You will lower your lifetime risk of diabetes, heart disease, high blood pressure, certain cancers and premature death from all causes. Eating a diet high in fruit and vegetables will provide you with more energy and clearer skin, as well as better digestion and help you lose weight if that is a goal. For all the ways eating plant-based enhances your health, check out these six surprising benefits of eating a plant-based diet.

As with any diet, eating plant-based or vegan also requires some conscientious planning to ensure you’re eating a well-rounded diet and getting adequate amounts of calcium, iron, and vitamins such as vitamin B12 and vitamin D. It may be a smart idea to supplement, especially with vitamins B12, may be a smart idea for anyone not eating fortified foods. Going vegan—as is the case with any restrictive way of eating—can take a toll on your health unless you carefully and deliberately plan your nutrients and eat a variety of nutrient-dense foods.

To that point, the study of 55,000 men and women living in the UK and published in the journal BMC Medicine found that vegetarians and vegans (and fish eaters) had a 43 percent higher risk of experiencing bone fractures than individuals who ate meat. Keep in mind these are averages, and if you make a point of getting enough calcium, with supplements or foods like Black Strap Molasses, you can keep your bones healthy and strong.

The study concludes: "Non-meat eaters, especially vegans, had higher risks of either total or some site-specific fractures, particularly hip fractures. This is the first prospective study of diet group with both total and multiple specific fracture sites in vegetarians and vegans, and the findings suggest that bone health in vegans requires further research."

Most prominently, vegans had a 2.3 times higher risk of hip fracture than those who ate meat, “equivalent to 15 more cases per 1,000 people over 10 years,” as lead study author Tammy Tong noted in Medical News Today. It’s worth noting that the data represents a small sample size of vegans studied—nearly 2,000 at the time of the study’s recruitment between 1993 and 2001—versus the nearly 30,000 meat-eaters. Around 15,000 vegetarians and 8,000 pescatarians at the time of recruitment also participated in the study.

This analysis doesn’t mean the plant-based set is doomed to a life of stress fractures. Rather, that they just need to take some precautions around the diet to ensure they’re getting proper nutrition to keep their bones strong.

How Much Calcium Do You Need

“Vegans tend to have lower intakes of calcium and protein than their meat-eating counterparts and should take extra steps to protect their bones by focusing on both of these nutrients,” say The Nutrition Twins Tammy Lakatos Shames, R.D.N., C.D.N., C.F.T., C.L.T., and Lyssie Lakatos, R.D.N., C.D.N., C.F.T., C.L.T.

A woman over 50 and man over 70 needs more calcium to prevent bone fractures, and anyone with a history of stress fractures from sports or running should pay close attention.

“How much calcium you need actually varies by your stage of life, which is important to take into consideration,” says Brooklyn-based dietitian Maya Feller, RD. “For most adults, 1,000 mg a day is fine.” Women over 50 and men over 70, however, require about 1,200 mg. Things get a little trickier with kids: Children ages 1 to 3 need 700 mg, while those ages 4 to 8 need 1,000mg and ages 9 to 18 need 1,300mg.

How to Get Calcium on a Plant-Based Diet: Tofu, Dates and Dark Leafy Vegetables

So how can you reach that recommended daily intake if you want to consume less animal milk—or give it up altogether? Feller recommends calcium-packed foods like tofu, which has about 434 mg of calcium per serving; Pinto beans (and other beans), a cup of which can provide around 26 percent of your recommended daily intake; Almonds and other nuts; and spinach, kale and other leafy greens.

Figs are especially high in calcium, with 65 mg in 2 figs. Broccoli delivers 60 mg of calcium in one cup and oranges contain 55 mg of calcium in one orange.

Alternative milks made from soy, nuts, rice and peas are often additionally fortified with calcium. That can also be true of certain cereals, breads, whole grains, orange juice, and non-dairy cheeses. You’ll need to become a label-reader to make sure you’re choosing wisely. Some of them even boast more calcium per cup than regular daily milk, so if this is your concern choose almond milk for your am sip.

Vegans “should focus on including leafy green vegetables and broccoli, calcium-fortified tofu, sesame seeds and tahini, pulses, and dried fruit as well as calcium fortified milk alternatives and calcium fortified juices,” add The Nutrition Twins, suggesting vegans may also want to talk to their healthcare professionals about taking a calcium supplement that includes vitamin K, vitamin D, and boron, “which are all essential for bone health”

It's as simple as adding dates, tofu, dark leafy greens, or simply a tablespoon of Black Strap Molasses, which has 41 grams of calcium in one serving. (Add it to tea or any recipe that requires a sweet taste like your favorite ginger cookies. But first, the study findings, which should make plant-based eaters more conscious of their calcium intake. Below we have the best foods for bone health!

Another excellent choice for bone health? Prunes. Amy Gorin, MS, RDN, a plant-based registered dietitian in Stamford, CT and owner of Plant-Based Eats adds: “One of the top ways that vegan eaters can help protect their bone health is to eat five to six prunes a day. It may sound surprising, but prunes boast many bone-helping vitamins and minerals, including potassium, vitamin K, phosphorous, and boron,” she says. “And research in Osteoporosis International found that eating five to six prunes a day can help prevent bone loss. Other research in The British Journal of Nutrition found that eating even more prunes, like 10 to 12 a day, is connected with increased bone mineral density.”

Prunes for a snack? Sign us up for the sweet treat. Lentil stew for dinner? Check. Sautéed spinach with garlic and EVOO for a side? You betcha. As it turns out, protecting our bone health could be a lot tastier than we thought. Bring on the delicious plant-based grub.