New week, new diet study, new online battle
According to the headlines, vegans are more likely to break bones
any study touching on vegans or keto, the media are gona milk it for views and its gona be
an ideological battle on social media
just last week we saw another new study, low carb diet supposedly gives u heart disease,
but then we looked at the actual facts and they told a very different story
so now its vegans breaking bones
so let's take an objective look at this. this was a population study. They look
for connections between what people eat and their health
these statistical correlations can't prove that one factor causes the other, just like we
said last week with the low carb case, that's always true of this type of study
So this creates 2 types of misconceptions. Some
people give these studies too much weight and jump to a conclusion, and others just dismiss them
as useless. Neither is very rigorous
you even see some people hopping from one to the other, one week celebrating this type
of study, the next week dismissing it, depending on whether they like the result or not
so let's not do that. let's forget the
nutrition 'camps' here for a sec and take a look at the actual facts
they found vegans were more likely to experience
bone fractures than meat-eaters. Pescatarians and vegetarians had slightly
higher risk for some specific fractures, like hip, but not most other sites
vegans had the highest risks, especially for the lower body, hip and leg. when it came to wrist and rib fractures
vegans did not have a higher risk than meat-eaters. We'll come back to why this could be relevant
so the investigators set out to try and figure out why
the vegans seemed more brittle. Are all vegans doomed to crumble to dust
or is it specific to some? Is it something about the food inherently, or is it something else they're
doing?
Right off the bat, the #1 suspect is calcium. vegans don't consume dairy of course
so if they don't make sure they get calcium from their food, they could end up with
too little. And we know from previous work by these same investigators
that there's a big difference in bone health between vegans who get enough calcium and those who
don't
So in this new study they asked what if we looked only at vegans who got enough calcium? does
the risk of fracture go away? But it didn't, it was still higher than the meat-eaters, so there had to be something
else
so they looked at protein as another common suspect since
protein may affect calcium absorption and some vegans might get less protein. But
even among vegans who ate enough protein, the higher risk of fractures was still there
So they kept following the clues. What else
could it be? Well, we know body weight or BMI has a strong impact on bone health
fractures are more common in people with very
low BMI, especially in the hip, and that's the site where vegans were showing the highest
risk
and in fact they found the vegans had a lower average BMI than the meat-eaters,
especially among women where 27% had a BMI under 20
according to the CDC between 18.5 and 25 is normal,
under that you're underweight and over that... you guessed it, you're overweight
So to test if BMI was to blame they did something called stratified analysis. now half
the people just went back to cat videos because the nerd alert went off. Bear with me, it's
actually not that complicated. For the 3 people left watching, it just means they split
the subjects into groups and compared those with higher BMI to those with lower.
And voila. The higher fracture risk was only seen in the lower BMI vegans
why would low BMI cause bones to break? Shouldn't it be the opposite?
Well more weight naturally stimulates your body to increase bone density to support
that weight, so being underweight can result in lower bone density. Also, there's a
cushioning effect of fat and muscle that can protect your bones from impacts
They also found the risk was mostly seen in
women, and in people who had no or low levels of physical activity
So it all seems to make sense and come together. More fractures were seen at low BMI, in women where there
was a higher % of underweight people, and in individuals who were inactive,
and we know
physical activity helps increase bone density
It also makes sense that the risk was specific to certain sites. If the problem
was something general, like low calcium, you'd expect any fracture to
be more likely, arm, wrist, leg, hip, anything. But that's not what they saw
The sites more likely to break were areas
where higher BMI can be protective, like the leg which supports body weight
so bone density will increase with BMI, and the hip where having some fat around it can
provide that cushioning effect
Interestingly, the ankles are usually more likely to break
in heavier people and ankle fractures were not increased
in vegans, so this again points to a specific problem like excessively low BMI in some vegans
as opposed to a general issue that would affect all bones
so the study itself is saying the problem is not a vegan diet, it's having an excessively low BMI
of course these nuances are always lost in the media headlines and the online diet wars
ok some of you may be wondering about the elephant in the room. We're talking about bone health,
we've mentioned calcium, and protein and BMI, but what about Vitamin D?? pretty crucial, right?
well this study didn't measure vitamin D, and
we know vegans can have lower levels, especially in places without a lot of sunlight, and this
study looked at a population in England!! Not exactly known for its great
weather and sunshine
bearing in mind that we need to be cautious with a study like this, bc it's correlations
and some sample sizes were small and there's ongoing debate about the statistics, bearing
all of that in mind what can we learn from this?
Asking if vegans have weak bones is like asking if vegans have low b12. depends how it's
done. If u ignore b12, yeah you'll risk deficiency.
Just like I can eat a low carb diet that raises
my cardiovascular risk or not. Depends how I design it
Same with bones. This study is saying you can eat
a vegan diet and have good bone health, if you cover the basics
So bottomline, here's 5 key takeaways to optimize your bone health. these are important in any diet, but
especially if you're going 100% plants
#1 get your Calcium. If you don't consume dairy, keep in mind the best kept secret of nutrition:
low oxalate leafy greens like kale and collard greens not only have more calcium
than milk, it's actually more absorbable
some types of fish like sardines are also high in calcium, and for people who
prefer not to eat fish, sesame seeds and beans are high in calcium too
2) get your b12 AND your vitamin D. both can help with bone health. and both be found in
animal products, fortified foods and supplements. but for vitamin D there's a 4th
option that's even cheaper: sunlight!
take-away #3: Make sure you eat enough calories to maintain a healthy BMI
Especially for women who in general have lower BMIs and less muscle
Of course you don't want to be overweight but excessively underweight isn't healthy either. You don't
need to obsess over numbers, most of us know just by looking in the mirror if we have a
few extra pounds to lose or if we need to put some meat on those bones
Track your calories for a couple days to get the hang of it if you need
#4: Stay active. Resistance training is a great stimulus for building bone density
and #5: get adequate protein which may help with calcium absorption and maintaining a healthy
BMI. Here are my top 7 sources of plant protein and here's more on how to get enough
calories from whole plants and that crucial vitamin D. thanks for watching, stay healthy, see you next week