Several years ago, a well-known medical doctor – and an outspoken proponent of a vegan diet – suffered a fall in his bathroom. Sadly, the accident left this man with a fractured pelvis, a broken femur and other injuries.
An unfortunate incident like this would normally spark nothing but sympathy. But in this case, it actually stirred a heated debate. That’s because this doctor had used his considerable platform for many years to preach that the best bone-building diet is one based on starchy carbohydrates and complete avoidance of animal foods.
As you are about to learn, the science appears to suggest just the opposite. So, it should come as no surprise that a fair number of critics were quick to point out that a minor fall in the bathroom should not produce enough force to snap the strongest bone in the human body (the femur). And, of course, there were a quite a few refrains of “We told you so.”
Now, it’s certainly not my intention to make light of anyone’s misfortune. And I’m glad to report the doctor did recover from his injuries. But it’s worth investigating what role his diet might have played to weaken his bones and reduce their mineral density.
Fractures are a major cause of morbidity and low quality of life as we age. But that’s not all. In fact, having a hip or vertebral fracture also increases the risk of death by 20% over and above what’s expected in the five years following a fracture.
This is why maintaining bone density is critical.
And while many “plant-based” proponents preach that a vegetarian diet is a “cure all” for chronic – including osteoporosis – the research tells a much different story.
Vegans Have DOUBLE the Risk of Fractures of Meat Eaters
A recent study published in BMC Medicine evaluated over 50,000 subjects in the UK. Among the participants, roughly 29,000 ate meat, 8,000 ate fish (but not meat), 15,000 were vegetarians and 2,000 were vegans when the study began.
The researchers followed up with the participants continuously for 18 years. During this time, 4,000 of the subjects experienced bone fractures. The results showed that meat eaters had the lowest risk of fractures among all the groups – while vegans had the highest risk.
In fact, vegans were 43% more likely to have broken a bone. And when it came to hip fractures, vegans were nearly 2.5 times more likely to experience this life-altering injury!
According to the lead researcher, Dr. Tammy Tong:
“This study showed that vegans, who on average had lower BMI as well as lower intakes of calcium and protein than meat eaters, had higher risks of fractures at several sites.”
Nutrients for Bone Health: How A Nutrient-Poor Diet Increases the Risk of Osteoporosis
It’s well-known that vegetarian diets contain lower amounts of calcium, vitamin D, vitamin B-12 – all of which have vital roles in maintaining bone health. So, let’s take a look at how each of these nutrients – found abundantly in an omnivorous diet – help to protect bone health as we age:
Calcium
Calcium is well known as the “bone nutrient”.
And despite the fact we’ve been told that calcium supplements are beneficial, studies show that supplementation does not actually reduce fracture risk.
However, calcium-rich foods – such as milk and yogurt – have been shown to have bone-loss prevention benefits. The reason? Dairy foods contain a spectrum of other important nutrients – including vitamin D, protein, potassium and magnesium – that work synergistically to promote healthy bones.
Another great source of calcium that’s often overlooked? Small fish with bones, such as sardines and mackerel, as well as canned or pouched wild salmon.
Vitamin D
Vitamin D (cholecalciferol) is another well-known nutrient that enhances mineralization and bone formation.
As you probably know, vitamin D3 in the diet is obtained from animal sources (fatty fish, egg yolks, and fortified milk) and in much lower quantities as ergocalciferol (vitamin D2) from plant sources, most notably mushrooms that have been exposed to UV light.
Your best source of vitamin D is still regular, moderate sun exposure (without burning).
Vitamin B-12
Vitamin B12 is available in its natural form exclusively from animal products. Therefore, deficiency is extremely common among vegetarians. And there is significant research which shows the value of this important nutrient in osteoporosis prevention.
- An analysis of four studies, published in the Journal of Nutrition & Metabolism showed a 4% lower fracture risk for each 50-pmol/L increase in blood levels of vitamin B-12.
- The Framingham Osteoporosis Study found that plasma vitamin B-12 concentrations of less than 148 pmol/L were significantly associated with lower bone density compared with higher concentrations.
- The National Health & Nutrition Survey study also discovered that bone mineral density is reduced and osteoporosis risk increases with vitamin B-12 deficiency. B-12 is also associated with bone density in a dose-dependent manner. Further, the researchers discovered that osteoporosis and osteopenia were two times more prevalent among those with vitamin B-12 levels in the lowest range.
- The Journal of Nutrition reported that the prevalence of osteoporosis was nearly 7 times higher in women with serum vitamin B-12 concentrations less than 210 pmol/L, compared to those with concentrations of 320 pmol/L or higher.
Low vitamin B-12 can also lead to elevated homocysteine – a dangerous inflammatory factor associated with fracture risk (possibly due to its impact on weakening collagen crosslinking). Elevated homocysteine is also strongly correlated to cardiovascular and neurodegenerative diseases.
Optimize your vitamin B12 levels by enjoying grass-fed beef, bison, and lamb, as well as liver, wild seafood, pastured eggs and dairy.
Zinc
Zinc is a mineral associated with an omnivorous diet that is frequently inadequate in vegetarian diets. It is also well known to promote bone health. So, it’s no surprise that lower bone and serum concentrations of zinc are found in patients with osteoporosis.
The British Journal of Nutrition conducted a 2-year control trial in postmenopausal women. The women were randomly assigned to treatments with either calcium, copper and zinc or calcium and corn starch. Researchers found improved bone health among the group that supplemented with zinc.
Zinc is found in nuts, grains and beans. However, it is less bioavailable than animal sources, due to the presence of mineral-binding phytates. Optimize your zinc levels with grass-fed meats and clean-sourced seafood (especially oysters).
Protein
For many years, it was purported that a high-protein diet could lead to calcium loss and contribute to lower bone mineral density. However, more recent studies show that higher dietary protein intakes – not lower – were associated with greater bone mineral density and lower risk of fractures.
In the Framingham Osteoporosis Study, four-year bone loss was lowest among those with the highest protein intakes. What’s more, those in the lowest quartile of protein intake had a significantly greater risk of hip fracture compared to those with higher protein intake.
Similar results were discovered by the Iowa Women’s Health Study, which found an inverse association for protein intake and risk of hip fractures.
For optimal protein intake, include grass-fed meats, pastured eggs and dairy (if tolerated) and wild fish.
Omega-3 Fatty Acids
Essential fatty acids – including omega-3s and omega-6s – exert important influences on bone health via metabolism and inflammation.
Vegetarian diets are notoriously high in omega-6 fatty acids and low in omega-3s. This can cause an inflammatory state that increases the risk of osteoporosis.
- The Rancho Bernardo Study found higher ratios of omega–6 to omega–3 fatty acids were associated with reduced bone mineral density in the pelvis.
- The Framingham Osteoporosis Study found that more than 3 servings of fatty fish per week were protective against bone mineral loss in the femoral neck bone (a section of bone at the top of the femur).
While more research is needed to better understand the effects of fatty acids on bone health, it’s well established that the standard American diet and vegetarian diets are imbalanced in favor of inflammatory omega-6 fatty acids. And they are usually deficient in anti-inflammatory omega-3s.
It is important to note that vegetarian sources of omega-3s do exist, including walnuts, flaxseed and algal oils. However, these plant-based omega-3s are primarily in the form of alpha-linolenic acid (ALA), which must be converted in the body to the most usable forms of omega-3 (EPA & DHA). This is a very inefficient process, which means that plant-based sources of omega-3 are inadequate for optimal health.
An Ancestral Omnivorous Diet for Bone Health
A disease-fighting diet is one that contains the entire spectrum of nutrients the human body needs. Diets that exclude ancestral food groups – notoriously meat – set us up for nutrient deficiencies that lead to the degeneration of our health.
And of course, the nutrients listed above are not the only ones found in animal products that help to build and strengthen bone. In my next article, I’ll cover how zinc, protein, omega-3 fatty acids and other critical vitamins and minerals help to reduce your risk of fractures – and therefore increase your ability to enjoy healthy longevity.
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