Bone health and vegan diets

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Bone health is a hot topic this week, following the publication of the latest EPIC-Oxford paper. We’ve asked Vegan Society Dietitian Heather to give us the low-down and provide some tips about how we can look after our bones.

EPIC-Oxford study

The EPIC-Oxford study involves vegan participants, generating useful research about vegan health in the UK. The latest paper has found higher fracture rates among vegans. Although the causes are not clear, the paper considers a number of factors, including calcium, vitamin D, protein, B12, activity and body mass index. Further research is warranted but it is possible for vegans to follow guidelines about protecting bone health.

How to look after your bones

Bone health is a complex topic. It’s important to bear in mind that early habits are influential because we have a window of opportunity to optimise our peak bone mass during our childhood and twenties. However, there is much that we can do to look after our bones later in life.

Calcium is often connected with bone health but in reality it’s important that our overall diet is well-planned. Research in this area suggests that other nutrients deserve special attention too, including protein and vitamin K. The latter can be obtained by ensuring that your daily diet contains greens like spinach, kale or broccoli. Thinking about protein at each mealtime can help to protect intakes of iron and zinc, as well as ensuring that your diet contains plenty of good quality protein.

Regarding calcium, it’s not just our total intake that matters. It's recommended that everyone eats at least two portions of calcium-rich foods with good absorbability on a daily basis. For instance, a vegan might aim to consume at least 400ml (two glasses) of fortified plant milk throughout the day in cereal, drinks and cooking. Fortified yoghurt alternatives, soya and linseed bread fortified with extra calcium and calcium-set tofu are also valuable plant-based sources of this mineral.

However, calcium is only one piece of the puzzle; vitamin D is another crucial factor because it affects the absorption of dietary calcium. In the UK, there are public health guidelines about vitamin D, including a recommendation to use a supplement from October to March as a minimum.

The EPIC-Oxford paper also mentions B12. The Vegan Society provides guidelines about B12, highlighting how to obtain an adequate amount from fortified foods or supplementation. The Vegan Society markets a supplement designed for vegans called VEG 1, which includes B12 and vitamin D.

Last but not least, we need to consider non-dietary factors. Generally, someone is more likely to break a bone if their body mass index is low, so maintaining or working towards a healthy weight can help us to look after our bones. We should consider our activity routines too. Does yours include muscle strengthening exercise and weight bearing activity with impact, such as star jumps, skipping, dancing or jogging?

My take-home message is that it’s good for us to talk to about bone health and there are lots of ways to support healthy vegan living. For further information, you can check out the resources about vegan diets available from our nutrition zone, including our page about bone health. However, if you have concerns about your diet in relation to bone health, please talk to your doctor about a referral to a dietitian.

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