Vegetarian diets are generally considered healthy, but new research suggests they may have a significant risk: an increased chance of bone fractures.

Between 1993 and 2001, British researchers collected diet, health and behavioral data on 54,858 people, average age 50. They categorized them by diet: 29,380 meat eaters, 8,037 who ate fish but no meat, 15,499 vegetarians, and 1,982 vegans, who ate no meat, fish, dairy products or eggs. They followed them for an average of 18 years, tracking the number and location of fractures.

The study, in BMC Medicine, controlled for sex, physical activity, smoking, alcohol intake, dietary supplement use and other factors, and found that compared with meat eaters, vegetarians had a 9 percent increased risk for any fracture, and vegans a 43 percent increased risk.

Vegetarians and fish eaters had a roughly 25 percent increased risk for hip fracture, and the risk for hip fracture in vegans was more than twice that of meat eaters. The risk for leg fracture was 81 percent higher in vegans than in meat eaters.

The associations were weaker, but still significant, after additional adjustments for protein and calcium intake.

“It’s very important that vegetarians and vegans have adequate intakes of protein and calcium,” said the lead author, Tammy Y.N. Tong, a nutritional epidemiologist at the University of Oxford. “If they can’t get it from diet, they should use supplements.”

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