Tzu Chi Med J. doi: 10.4103/tcmj.tcmj_84_20. eCollection Apr-Jun 2021
Factors, such as hormonal changes in postmenopausal women, natural aging degeneration, race, gender, body size, lifestyle, physical activity, sunlight, dietary intake, medications, or other environmental issues, can affect the rate of bone formation or reabsorption, cause changes in bone mineral content, and influence the development of osteoporosis. Do vegetarian diets adversely affect bone mineral density (BMD)? Among postmenopausal Buddhists, long-term practitioners of vegan vegetarian were found to have a higher risk exceeding the lumbar fracture threshold and a lower level of hip BMD after controlling for other variables. However, results of several prospective longitudinal studies failed to show a harmful effect of vegetarianism on bone health. In the Taiwanese adult population, researchers also did not find that a vegetarian diet significantly affects age-related BMD decline. Due to the various levels of nutrients in the diet (such as protein, alkali, calcium, Vitamin K, and phytoestrogens) and major lifestyle factors (such as smoking and physical exercise), determining the impact of a vegetarian diet on bone health is very complex. Good-quality vegetarian food can provide a healthy foundation for building and maintaining healthy bones and preventing fractures.
In the relation between vegetarian/vegan diet and bone health, it is imperative to consider the possible impact of overall diet quality. A healthy bone diet prescription may increase plant protein intake in people who follow a vegetarian diet plan. The nutritional deficiencies associated with poor bone health can be avoided when a vegetarian or vegan diet is properly planned with high biological value proteins, a variety of fruits and vegetables, legumes, whole grains, nuts, and various soy products. Long-term female vegetarians may need effective nutritional supplements (particularly calcium and Vitamin D) to increase BMD levels and reduce the risk of osteoporosis. Maintaining a healthy lifestyle, by increasing physical activity, reducing caffeine intake, limiting drinking, and quitting smoking, is also crucial for good bone health