关于素食者之间骨折风险可能差异的前瞻性证据有限,素食主义者,非素食者我们的目标是在一个有很大比例的非肉食者的前瞻性队列中研究这一点。
在EPIC-Oxford,在基线时(1993-2001年)和随访时(≈2010年)收集饮食信息.参与者在两个时间点被分为四个饮食组(29,380名肉食者,8037名食鱼者,15499名素食者,和1982年的纯素食者在基线分析总骨折)。直到2016年年中,通过与医院记录或死亡证明的联系来确定结果。使用多变量Cox回归,我们估计了总体骨折(n=3941)和特定部位骨折(手臂,n=566;手腕,n=889;臀部,n=945;腿,n=366;脚踝,n=520;其他主要站点,即锁骨,肋骨,和椎骨,n=467),按饮食组平均随访17.6年。
与肉食者相比,经过社会经济因素调整后,生活方式混淆,和体重指数(BMI),吃鱼者髋部骨折的风险较高(风险比1.26;95%CI1.02-1.54),素食者(1.25;1.04-1.50),和素食主义者(2.31;1.66-3.22),相当于2.9(0.6-5.7)的比率差异,2.9(0.9-5.2),10年内每1000人增加14.9例(7.9-24.5例),分别。素食者也有更高的总风险(1.43;1.20-1.70),腿(2.05;1.23-3.41),和其他主要部位骨折(1.59;1.02-2.50)比肉食者。总的来说,在未调整BMI的情况下,显著关联似乎更强,并且略有减弱,但在额外调整膳食钙和/或总蛋白的情况下仍然显著.饮食组进行或不进行BMI调整后,腕关节或踝关节骨折的风险没有显着差异。BMI调整后手臂骨折也是如此。
非肉食者,尤其是素食主义者,有更高的风险,无论是全部或一些特定部位的骨折,尤其是髋部骨折.这是第一个在素食者和素食者中同时具有整体和多个特定骨折部位的饮食组的前瞻性研究,研究结果表明,素食主义者的骨骼健康需要进一步研究。
There is limited prospective evidence on possible differences in fracture risks between vegetarians, vegans, and non-vegetarians. We aimed to study this in a prospective cohort with a large proportion of non-meat eaters.
In EPIC-Oxford, dietary information was collected at baseline (1993-2001) and at follow-up (≈ 2010). Participants were categorised into four diet groups at both time points (with 29,380 meat eaters, 8037 fish eaters, 15,499 vegetarians, and 1982 vegans at baseline in analyses of total fractures). Outcomes were identified through linkage to hospital records or death certificates until mid-2016. Using multivariable Cox regression, we estimated the risks of total (n = 3941) and site-specific fractures (arm, n = 566; wrist, n = 889; hip, n = 945; leg, n = 366; ankle, n = 520; other main sites, i.e. clavicle, rib, and vertebra, n = 467) by diet group over an average of 17.6 years of follow-up.
Compared with meat eaters and after adjustment for socio-economic factors, lifestyle confounders, and body mass index (BMI), the risks of hip fracture were higher in fish eaters (hazard ratio 1.26; 95% CI 1.02-1.54), vegetarians (1.25; 1.04-1.50), and vegans (2.31; 1.66-3.22), equivalent to rate differences of 2.9 (0.6-5.7), 2.9 (0.9-5.2), and 14.9 (7.9-24.5) more cases for every 1000 people over 10 years, respectively. The vegans also had higher risks of total (1.43; 1.20-1.70), leg (2.05; 1.23-3.41), and other main site fractures (1.59; 1.02-2.50) than meat eaters. Overall, the significant associations appeared to be stronger without adjustment for BMI and were slightly attenuated but remained significant with additional adjustment for dietary calcium and/or total protein. No significant differences were observed in risks of wrist or ankle fractures by diet group with or without BMI adjustment, nor for arm fractures after BMI adjustment.
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.