You’ve probably heard it before: “You can’t get enough calcium on a vegan diet, so you’ll get osteoporosis.”
This statement is so common that it feels like a given. But is it true?
Busting the Myth: Vegan Diets and Bone Health
While it’s true that vegan diets can be low in certain nutrients that are important for bone health, such as calcium, vitamin D, vitamin B12, and omega-3s, studies show that well-planned vegan diets can support optimal bone health.
In fact, there’s evidence that vegans have lower rates of hip fracture and total fracture compared to non-vegans.
A study of 56,000 adults in the United Kingdom found that vegans had a 10% lower risk of hip fracture and a 15% lower risk of total fracture compared to meat-eaters. And a study of more than 250,000 adults in the United States found that vegans had a 12% lower risk of fracture at any site in the body compared to non-vegetarians.
So, what gives? How can a vegan diet support bone health when it lacks certain nutrients that are important for bones? Let’s take a closer look.
Understanding Bone Composition and Metabolism
Bones are living structures that are constantly being remodeled. They are made up of a protein called collagen and a mineral called calcium phosphate. Bones are constantly being broken down and rebuilt, which requires a balance between bone formation and bone resorption.
Calcium and vitamin D are two of the most well-known nutrients for bone health, and they are important for both bone formation and bone resorption. But other nutrients, such as protein, magnesium, zinc, and vitamin K, are also important for bone health.
Calcium is the most abundant mineral in the body and is essential for the proper functioning of nerves and muscles. It is also important for blood clotting and the regulation of heart rhythms. About 99% of the body’s calcium is stored in the bones and teeth, and the remaining 1% is circulating in the blood.
Vitamin D is important for calcium absorption and also has other important functions in the body, such as regulating immune system function and supporting muscle growth.
Protein is important for bone health because it provides the structure for new bone growth. When bones are broken down, the body needs protein to build new bone tissue. Protein also helps to regulate the body’s acid-base balance, which is important for bone health.
Magnesium is a mineral that plays a role in more than 300 enzyme reactions in the body, including those involved in bone health. It helps to regulate the amount of calcium in the blood and is also involved in the formation of new bone tissue.
Zinc is a mineral that is important for immune function and wound healing. It is also important for bone health because it helps to regulate bone growth and development.
Vitamin K is a fat-soluble vitamin that is important for blood clotting and bone health. It helps to regulate the amount of calcium in the blood and is also involved in the formation of new bone tissue.
Vegan-Friendly Calcium Sources
Calcium is found in many plant-based foods, including:
- Leafy green vegetables, such as kale, spinach, and bok choy
- Broccoli and other cruciferous vegetables
- Beans and lentils
- Nuts and seeds, such as almonds, sesame seeds, and chia seeds
- Fortified foods, such as plant-based milks, orange juice, and tofu
Most Americans don’t get enough calcium from their diets, regardless of whether they eat animal products or not. According to the National Institutes of Health, adults need about 1,000 milligrams (mg) of calcium per day, and women over age 50 and men over age 70 need about 1,200 mg per day.
If you are having trouble getting enough calcium from your diet, talk to your doctor or a registered dietitian about taking a calcium supplement. Calcium supplements can increase the risk of stomach bleeding, so it’s important to talk to your doctor before taking one.
Ensuring Adequate Vitamin D Intake on a Vegan Diet
Vitamin D is important for bone health because it helps the body to absorb calcium. It is also important for immune function and mood regulation.
Most people don’t get enough vitamin D from their diets, and vegans are at higher risk because the most common sources of vitamin D are animal products, such as fish, eggs, and milk.
Fortified foods, such as plant-based milks and orange juice, and some mushrooms, are good sources of vitamin D, but they don’t provide as much as animal products.
Vitamin D is made in the body when the skin is exposed to sunlight, but most people don’t get enough sun exposure to meet their needs.
Adults need about 600 international units (IU) of vitamin D per day, and older adults and people with darker skin tones need more. Some doctors recommend taking a vitamin D supplement, especially in the winter when the sun is not as strong.
Optimizing Protein Intake for Bone Strength
Protein is important for bone health because it provides the structure for new bone growth and helps to regulate the body’s acid-base balance.
There is a common myth that vegans are deficient in protein, but this is not true. Beans, lentils, nuts, seeds, and whole grains are all good sources of protein.
A review of studies published in the journal Nutrients found that people who eat plant-based diets can get enough protein for bone health as long as they are eating enough calories. The review also found that eating soy foods, such as tofu and soy milk, is associated with better bone health.
There is some evidence that a high protein intake, especially from animal sources, can be hard on the kidneys and may be associated with bone loss. But more research is needed to understand the relationship between protein intake and bone health.
Addressing Other Bone-Supportive Nutrients
Magnesium, zinc, and vitamin K are also important for bone health.
Magnesium is found in:
- Leafy green vegetables
- Nuts and seeds
- Whole grains
- Avocados
- Dried fruit
Adults need about 310 mg of magnesium per day.
Zinc is found in:
- Beans and lentils
- Nuts and seeds
- Whole grains
- Fortified cereals
Adults need about 8 mg of zinc per day.
Vitamin K is found in:
- Leafy green vegetables
- Broccoli
- Brussels sprouts
- Cruciferous vegetables
Adults need about 90 micrograms (mcg) of vitamin K per day.
Lifestyle Factors for Stronger Bones
In addition to getting enough of the nutrients we’ve talked about, there are other lifestyle factors that can help support bone health:
- Weight-bearing exercise, such as walking, running, and resistance training, can help to strengthen bones.
- Maintaining a healthy body weight is important for bone health. Being underweight or overweight can increase the risk of bone loss.
If you are concerned about bone health and you are thinking about making dietary changes, it’s a good idea to talk to your doctor or a registered dietitian before making any big changes.
While it’s true that vegan diets can be low in certain nutrients that are important for bone health, such as calcium, vitamin D, vitamin B12, and omega-3s, well-planned vegan diets can support optimal bone health. And there is evidence that vegans have lower rates of hip fracture and total fracture compared to non-vegans.
Transitioning to a Vegan Diet: Strategies for Bone Health
If you are thinking about transitioning to a vegan diet, there are some things you can do to make sure you are getting enough of the nutrients you need for bone health:
- Make sure you are eating a variety of plant-based foods each day, including plenty of fruits and vegetables, beans and lentils, nuts and seeds, and whole grains.
- Eat fortified foods, such as plant-based milks, orange juice, and tofu, to help boost your calcium intake.
- Talk to your doctor or a registered dietitian about taking a calcium and vitamin D supplement if you are not getting enough of these nutrients from your diet.
- Eat vitamin D-rich foods, such as fortified plant-based milks and orange juice, and consider taking a vitamin D supplement, especially in the winter when the sun is not as strong.
- Eat foods that are high in protein, such as beans, lentils, nuts, seeds, and whole grains.
- Consider taking a multivitamin that contains magnesium, zinc, and vitamin K.
If you have a history of bone fractures or you are concerned about your bone health, it’s a good idea to talk to your doctor before making any dietary changes.
Debunking Common Concerns: Vegan Diets and Osteoporosis Risk
Some people worry that vegan diets increase the risk of osteoporosis and fractures. But the evidence does not support this.
A large study of more than 59,000 adults in the United Kingdom found that vegans had a lower risk of hip fracture and a lower risk of any fracture compared to non-vegans. And a study of more than 250,000 adults in the United States found that vegans had a lower risk of fracture at any site in the body compared to non-vegetarians.
There are some reasons why vegans might have a lower risk of fracture. For example, plant-based diets are typically high in fiber, which can help to prevent falls by keeping you regular and improving digestion. Vegan diets are also lower in saturated fat and cholesterol, which can help to reduce the risk of heart disease and stroke.
It’s important to make sure you are getting enough of the nutrients that are important for bone health, such as calcium, vitamin D, vitamin B12, and omega-3s. But if you are eating a well-planned vegan diet, you should be able to get all of the nutrients you need.
One study found that vegans were more likely to have lower bone density in their hips and spine compared to non-vegans. But the study also found that vegans had a lower risk of fractures, which suggests that the lower bone density does not translate into more fractures.
It’s important to note that bone density is just one marker of bone health. Other factors, such as bone strength and elasticity, are also important.
There are many reasons why people choose to eat a vegan diet, and bone health is not typically a concern. But if you are worried about bone health, rest assured that a well-planned vegan diet can support optimal bone health. And there is evidence that vegans have lower rates of hip fracture and total fracture compared to non-vegans.
If you are thinking about transitioning to a vegan diet, talk to your doctor or a registered dietitian about how to make sure you are getting all of the nutrients you need for bone health.