What is a hip fracture and why are vegetarians more prone to it? It's a break of the femur close to the joint between the thigh bone and the pelvis. It is a devastating injury; up to 50% of people die within one year.
Vegetarians in the United Kingdom are less likely to be obese and have a lower risk of getting cancer; and fewer cardiovascular diseases too. But new research from the University of Leeds[1] after following nearly half a million persons for twelve years has found that they are 50% more likely to suffer from a hip fracture; that's not small beer.
"It has been estimated that 1 in 3 females and 1 in 12 men will sustain a hip fracture in their lifetime."
- BMC Family Practice[5]
So roughly 1 in 2 vegetarian women in the UK will fall and break their hips.
Or do their hips break and then they fall?
50% of people die within a year of having a hip fracture.
Much is made of the pain, death and cost to society of hip fractures; few consider the associated disability. The complete loss of a previously independent way of life can be even more devastating.
"Vegetarians face a 50% greater risk of hip fracture than meat-eaters; this translated to just 3 more per 1000 people over 10 years."
- BMC Medicine
That's a pretty low risk except for those three persons; for them it is an unmitigated disaster.
Yet Blue Zone Adventists in Loma Linda are no more prone to hip fracture than meat-eaters; clearly it's all about lifestyle[2].
Those living the 5 Blue Zone places of the world are ten times more likely to live and enjoy a busy, active lifestyle in their 90's and even 100. There are no old age homes. The elderly continue to dwell on their own or with family members; stress levels are very low.
This elderly woman in her mid seventies combines walking, gardening and a plant-based diet but has no osteoporosis; she is not at risk of a hip fracture. She eats small amounts of meat, on average perhaps once a week. She lives with her husband in a cottage attached to their daughter's home. High levels of sunshine for vitamin D, food that is completely unprocessed or refined and a low stress manner mitigate against bone disease.
Yet vegetarians living in the UK are certainly more prone to hip fractures than both regular and occasional meat-eaters; and when compared to pescatarians too.
Clearly zero meat and fish intake is not friendly towards bone health; unless vegetarians make certain modifications to their lifestyles. Then they need have no additional concerns with hip fractures.
Researchers have long concluded that the elderly should be enjoying rather more protein to avoid frailty syndrome[3]. And that it should include all the essential amino acids; those that mammals are unable to synthesise themselves. Yet vegetarians in the UK are 17% less likely to meet the recommendations as compared to those eating meat.
The issues at stake are firstly the total amount of protein and secondly whether their diet includes all the essential amino acids; both are important.
Vegetarians are certainly able to get all of their protein needs from non-meat sources; but it would seem that those in the UK, and perhaps universally need to work harder at it.
Legumes, seeds and whole grains are the three main sources of protein open to vegans. For the purposes of this column we'll omit the thorny issue of dairy products. Because of their acidifying nature some still contend that milk is for babies and humans are the only adults that enjoy cheese.
Others believe that because the plant-based diet is very alkalising this neutralises the acidic nature of dairy products.
Rhizobia bacteria that attach to the roots of legumes live in a symbiotic relationship with the plants. They are able to extract nitrogen from the air and in return get nutrients they cannot assimilate.
That nitrogen the bacteria turn into amino acids which the plants can then utilise and store; and which animals can consume for protein. It's a complex subject obviously but for the purposes of this report we will concern ourselves with those that are eaten green or are then dried.
Green beans and peas are more palatable obviously, and have lower levels of so-called antinutrients that concern some. But they are only available year round in the temperate zones of the world; which don't include the United Kingdom.
They also have to eat dried lentils, chickpeas and beans in the winter months; or those that are canned which raises other issues for those concerned about the health of both themselves and that of the planet. What is a hip fracture then becomes significant if vegetarians are reluctant to use them.
In addition legumes do not contain all the essential amino acids; in particular they are low in methionine. For this reason nutrition-conscious vegetarians enjoy a balance that includes nuts and seeds.
Those who come from a long tradition of veganism understand these basic principles. However younger people are changing to plant-based diets either because of perceived health benefits or concerns for the planet; they are less likely to intuitively grasp the importance of balancing their protein sources.
Hummus is a nutritious condiment that ticks all the right boxes.
Hummus is a protein-rich side dish made from a legume and a seed; chickpeas and tahini. It is usually enjoyed with whole lemon pulp, freshly-roasted cumin and a herb such as parsley.
It takes only five minutes to make hummus. From the grocery store the protein costs more than steak and is usually filled with various chemicals; it doesn't keep.
Obviously no researcher could ever find a vegetarian population group that eats hummus regularly and walks daily to recommendations, so it is speculative to assume they are not more prone to hip fracture. Racquet sports and in particular tennis come up regularly in the literature too incidentally.
The take home for vegans weighing what is a hip fracture, and why they are vulnerable, is that they need not be overly anxious; but they do have to accept that various lifestyle changes may be necessary. Regular walks are not too onerous and should be enjoyed anyway.
More difficult are other good sources of protein. What is not well understood, for example is that the bran of wheat is where the more important amino acids are to be found. But true wholemeal bread is impossible to find; you have to bake it yourself.
What is a hip fracture and why are vegetarians more prone to it?
Eggs and dairy products also contain all the essential amino acids. There is no reason why lacto vegetarians should be concerned about hip fracture but good protein sources remain paramount.
What is a hip fracture and why are vegetarians more prone to it? There are simple things they can do to ameliorate this scourge.
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