Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, LS2 9JT, UK.
School of Medicine, University of Leeds, Leeds, LS2 9JT, UK.
BMC Med. 2023 Jul 27;21(1):278. doi: 10.1186/s12916-023-02993-6.
Meat-free diets may be associated with a higher risk of hip fracture, but prospective evidence is limited. 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.
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). Incident hip fractures were identified by record linkage to Hospital Episode Statistics up to September 2021. 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.
Among 413,914 women, 3503 hip fractures were observed. 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. 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. There was limited evidence of effect modification by BMI on hip fracture risk across diet groups (p = 0.08), and no clear evidence of effect modification by age or sex (p = 0.9 and 0.3, respectively). Mediation analyses suggest that BMI explained 28% of the observed risk difference between vegetarians and regular meat-eaters (95% CI: 1.1%, 69.8%).
Vegetarian men and women had a higher risk of hip fracture than regular meat-eaters, and this was partly explained by their lower BMI. Ensuring adequate nutrient intake and weight management are therefore particularly important in vegetarians in the context of hip fracture prevention.
NCT05554549, registered retrospectively.
无肉饮食可能与髋部骨折风险增加有关，但前瞻性证据有限。我们旨在研究英国生物库中偶尔吃肉者、食鱼素食者和素食者与常规肉食者相比髋部骨折的风险，并探讨任何观察到的风险差异的潜在中介因素的作用。
根据招募时（2006-2010 年）的饮食和生活方式信息，将中年英国成年人分为常规肉食者（n=258765）、偶尔肉食者（n=137954）、食鱼素食者（n=9557）或素食者（n=7638）。通过与医院发病统计数据的记录链接，截至 2021 年 9 月，确定了髋部骨折的发生情况。使用多变量 Cox 回归模型，以常规肉食者为参照组，在中位随访时间 12.5 年后，估计每个饮食组与髋部骨折风险之间的关联。
在 413914 名女性中，观察到 3503 例髋部骨折。在校正混杂因素后，素食者（HR（95%CI）：1.50（1.18，1.91））但不是偶尔肉食者（0.99（0.93，1.07））或食鱼素食者（1.08（0.86，1.35））髋部骨折风险高于常规肉食者。这相当于素食者在 10 年内每 1000 人中髋部骨折的风险增加 3.2（1.2，5.8）。在不同饮食组之间，BMI 对髋部骨折风险的影响存在有限的修饰作用（p=0.08），且 BMI 对年龄（p=0.9）和性别（p=0.3）无明显修饰作用。中介分析表明，BMI 解释了素食者与常规肉食者之间观察到的风险差异的 28%（95%CI：1.1%，69.8%）。
素食男性和女性髋部骨折风险高于常规肉食者，这部分归因于他们较低的 BMI。因此，在预防髋部骨折方面，确保素食者摄入足够的营养和管理体重尤为重要。
NCT05554549，回顾性注册。
