Paul Appleby is not only a veg activist in Oxford - www.ivu.org/oxveg - he’s also a researcher in a major study of the links between food and health: EPIC (European Prospective Investigation into Cancer and Nutrition) - epic.iarc.fr

Here’s a summary of a recent report on which Paul served as first author.

One of the health concerns relating to lactose intolerance appears to be the fear that persons who, for whatever reason, avoid dairy products (a major source of dietary calcium) will be at greater risk of bone loss and fracture.

Our study of fracture risk by diet group showed that "among subjects consuming at least 525 mg/day calcium" (an amount equal to the Estimated Average Requirement in the UK - considered sufficient for 97.5% of the population) there was no difference in self-reported fracture incident rates between meat eaters and vegans. However, it did also emphasize the fact that "an adequate calcium intake is essential for bone health, irrespective of dietary preferences".

European Journal of Clinical Nutrition (2007) 61, 1400–1406

Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford

P Appleby, A Roddam, N Allen and T Key

Objective: To compare fracture rates in four diet groups (meat eaters, fish eaters, vegetarians and vegans) in the Oxford cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford).
Design: Prospective cohort study of self-reported fracture risk at follow-up.
Setting: The United Kingdom.

Subjects: A total of 7947 men and 26 749 women aged 20–89 years, including 19 249 meat eaters, 4901 fish eaters, 9420 vegetarians and 1126 vegans, recruited by postal methods and through general practice surgeries.
Methods: Cox regression.

Results: Over an average of 5.2 years of follow-up, 343 men and 1555 women reported one or more fractures. Compared with meat eaters, fracture incidence rate ratios in men and women combined adjusted for sex, age and non-dietary factors were 1.01 (95% CI 0.88–1.17) for fish eaters, 1.00 (0.89–1.13) for vegetarians and
1.30 (1.02–1.66) for vegans. After further adjustment for dietary energy and calcium intake the incidence rate ratio among vegans compared with meat eaters was 1.15 (0.89–1.49).

Among subjects consuming at least 525 mg/day calcium the corresponding incidence rate ratios were 1.05 (0.90–1.21) for fish eaters, 1.02 (0.90–1.15) for vegetarians and 1.00 (0.69–1.44) for vegans.

Conclusions: In this population, fracture risk was similar for meat eaters, fish eaters and vegetarians. The higher fracture risk in the vegans appeared to be a consequence of their considerably lower mean calcium intake. An adequate calcium intake is essential for bone health, irrespective of dietary preferences.

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