A study of more than 26,000 middle-aged women has revealed those who do not eat meat and fish have a 33 per cent higher risk of hip fractures.
This could be because they have a lower intake of nutrients that are linked with bone and muscle health, the researchers said.
And it reinforces advice that vegetarians should fortify their diets with key nutrients, they added.
A team from Leeds University investigated the risk of hip fracture in occasional meat-eaters, pescatarians – who eat fish but not meat – and vegetarians compared to regular meat-eaters.
Among 26,318 women, 822 hip fracture cases were observed over roughly 20 years – meaning around 3 per cent of women experienced them.
Analysis, published in the journal BMC Medicine, found that after adjusting for factors such as smoking and age, vegetarians were the only diet group with an elevated risk of hip fracture.
The team also discovered the average BMI among vegetarians was slightly lower than the average among the regular meat eaters.
Previous research has shown a link between low BMI and high risk of hip fracture, which could help explain the finding.
Lead author James Webster said vegetarian diets can vary, with some still being unhealthy.
‘Our study highlights potential concerns regarding risk of hip fracture in women who have a vegetarian diet,’ he said.
‘However, it is not warning people to abandon vegetarian diets. As with any diet, it is important to understand personal circumstances and what nutrients are needed for a balanced healthy lifestyle.
‘Vegetarian diets can vary widely from person to person and can be healthy or unhealthy, just like diets that include animal products.
‘However, it is concerning that vegetarian diets often have lower intakes of nutrients that are linked with bone and muscle health. These types of nutrients generally are more abundant in meat and other animal products than in plants, such as protein, calcium, and other micronutrients.
‘Low intake of these nutrients can lead to lower bone mineral density and muscle mass, which can make you more susceptible to hip fracture risk.’
Vegetarian diets have gained popularity in recent years, with a 2021 survey putting the size of the UK vegetarian population as high as 7 per cent.
It is often perceived as a healthier dietary option, with previous evidence showing it can reduce the risk of several chronic diseases including diabetes, heart disease and cancer compared to people who also eat meat.
However it has also been linked to negative effects such as poor bone health.
Co-author Professor Janet Cade said: ‘Hip fracture is a global health issue with high economic costs that causes loss of independence, reduces quality of life, and increases risk of other health issues.
‘Plant-based diets have been linked with poor bone health, but there has been a lack of evidence on the links to hip fracture risk.
‘This study is an important step in understanding the potential risk plant-based diets could present over the long-term and what can be done to mitigate those risks.’
Not being underweight, fortifying the diet with key nutrients and being physically active to strengthen bones and muscles are some of the ways vegetarian women can help maintain their bone health, the authors said.
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