![]() ![]() ![]() Hip fractures result in a significant loss of independence and quality of life, risk of refracture, other chronic illnesses, and premature mortality. Prevalence of chronic diseases, including frailty, osteoporosis, and sarcopenia, is therefore rising, which increases the risk of falls and fractures. Global population growth and longevity increase the number of older adults worldwide. Ensuring adequate nutrient intake and weight management are therefore particularly important in vegetarians in the context of hip fracture prevention. Vegetarian men and women had a higher risk of hip fracture than regular meat-eaters, and this was partly explained by their lower BMI. Mediation analyses suggest that BMI explained 28% of the observed risk difference between vegetarians and regular meat-eaters (95% CI: 1.1%, 69.8%). There was limited evidence of effect modification by BMI on hip fracture risk across diet groups ( p interaction = 0.08), and no clear evidence of effect modification by age or sex (p interaction = 0.9 and 0.3, respectively). This is equivalent to an adjusted absolute risk difference of 3.2 (1.2, 5.8) more hip fractures per 1000 people over 10 years in vegetarians. After adjustment for confounders, vegetarians (HR (95% CI): 1.50 (1.18, 1.91)) but not occasional meat-eaters (0.99 (0.93, 1.07)) or pescatarians (1.08 (0.86, 1.35)) had a greater risk of hip fracture than regular meat-eaters. ResultsĪmong 413,914 women, 3503 hip fractures were observed. Multivariable Cox regression models were used to estimate associations between each diet group and hip fracture risk, with regular meat-eaters as the reference group, over a median follow-up time of 12.5 years. Incident hip fractures were identified by record linkage to Hospital Episode Statistics up to September 2021. Middle-aged UK adults were classified as regular meat-eaters ( n = 258,765), occasional meat-eaters ( n = 137,954), pescatarians ( n = 9557), or vegetarians ( n = 7638) based on dietary and lifestyle information at recruitment (2006–2010). We aimed to investigate the risk of hip fracture in occasional meat-eaters, pescatarians, and vegetarians compared to regular meat-eaters in the UK Biobank, and to explore the role of potential mediators of any observed risk differences. Meat-free diets may be associated with a higher risk of hip fracture, but prospective evidence is limited.
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