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Minerals, Trace Elements, Vitamin D and Bone Health

Vegetarianism, bone loss, fracture and vitamin D: a longitudinal study in Asian vegans and non-vegans



The effect of vegan diet on bone loss has not been studied. The aim of this study was to examine the association between veganism and bone loss in postmenopausal women.


The study was designed as a prospective longitudinal investigation with 210 women, including 105 vegans and 105 omnivores. Femoral neck (FN) bone mineral density (BMD) was measured in 2008 and 2010 by dual-energy X-ray absorptiometry (Hologic QDR4500). The incidence of vertebral fracture was ascertained by X-ray report. Serum levels of C-terminal telopeptide of type I collagen (βCTX) and N-terminal propeptide of type I procollagen (PINP) were measured by Roche Elecsys assays. Serum concentration of 25-hydroxyvitamin D and parathyroid hormone were measured by electrochemiluminescence.


Among the 210 women who initially participated in the study in 2008, 181 women had completed the study and 29 women were lost to follow-up. The rate of loss in FN BMD was −1.91±3.45%/year in omnivores and −0.86±3.81%/year (P=0.08) in vegans. Lower body weight, higher intakes of animal protein and lipid, and corticosteroid use were associated with greater rate of bone loss. The 2-year incidence of fracture was 5.7% (n=5/88) in vegans, which was not significantly different from omnivores (5.4%, n=6/93). There were no significant differences in βCTX and PINP between vegans and omnivores. The prevalence of vitamin D insufficiency in vegans was higher than in omnivores (73% versus 46%; P=0.0003).


Vegan diet did not have adverse effect on bone loss and fracture. Corticosteroid use and high intakes of animal protein and animal lipid were negatively associated with bone loss.

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The study was in fact partly supported by a grant from the Department of Science and Technology of Ho Chi Minh City and the University Commission for Development (CUD) program, Belgium. Dr N Nguyen is supported by a grant from the Australian Medical Bioinformatics Resource (AMBeR). Professor T Nguyen is a recipient of a senior research fellowship from the Australian National Health and Medical Research Council.

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Correspondence to L T Ho-Pham.

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Contributors: Study concept and design: LTH-P, TVN and NDN; acquisition of data: LTH-P, BQV, TQL and NDN; and analysis and interpretation of data: NDN, LTH-P, TQL and TVN. Drafting the manuscript: LTH-P, NDN and TVN. Critical revision of the manuscript: LTH-P, NDN, TVN, BQV and TQL. Statistical expertise: NDN and TVN.

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Ho-Pham, L., Vu, B., Lai, T. et al. Vegetarianism, bone loss, fracture and vitamin D: a longitudinal study in Asian vegans and non-vegans. Eur J Clin Nutr 66, 75–82 (2012).

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  • veganism
  • vitamin D
  • parathyroid hormone
  • bone loss
  • Asian
  • Vietnamese

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