Compared to meat eaters, vegans / vegetarian / pescatarians have higher risk of fractures

haidut

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The study just hit major news outlets and is generating a lot of "controversy". Why putting that word in quotes? Because, as I mentioned in several other posts, that word has become a euphemism for "embarrassing truth" that mainstream medicine (and often society at large) will do just about anything to suppress. While the negative effects of veganism and vegetarianism on bone health have been known for some time (mostly due to the state of protein deficiency they induce), the fact that pescatarians also had increased risk of bone fracture is somewhat surprising. That is, until one considers the fact that fish is full of PUFA that, while that PUFA is of the less-inflammatory omega-3 variety, has known detrimental effects on bone morphology and growth. There are safer types of fish, such as cod as well as most tropical fish (due to having more saturated fats in its tissues), however most pescatarians do not really care to make such selections and, in fact, tend to stick with the cold-water fish (abundant in PUFA) such as salmon, sardines, herring, mackerel, etc. The study actually did confirm the deficiency of protein and calcium as a mechanism of action in the vegan and vegetarian groups fractures. It also added this gem - higher BMI was protective against bone fractures. Yes, "obesity paradox" strikes again! Yet another "controversy" for medicine to reckon with. I actually propose that this study title be changed to "Malnourished people have a much higher risk of fractures", because that is what the findings amount to considering the diets of the vegans, vegetarians and pescatarians, as well as the findings that eating more protein and calcium reversed the increased risks of fractures. However, a study to implying that eating mostly vegan, vegetarian and pescatarian diets amounts to malnourishment would be so..."controversial"...and it probably would not have gotten published :):

Vegetarian and vegan diets and risks of total and site-specific fractures: results from the prospective EPIC-Oxford study
Vegans 43% more likely to suffer broken bones than meat eaters, study finds
Vegans, Vegetarians and Pescatarians May Have an Increased Risk of Bone Fractures

"...New results from the EPIC-Oxford study suggest that vegans, vegetarians and pescatarians (people who eat fish but no other meat) may be at higher risk of bone fractures, compared with meat eaters. In particular, the results showed that vegans had a higher risk of fractures anywhere in the body (total fractures), as well as fractures of the legs and vertebrae, compared with meat eaters. In addition, vegans, vegetarians and pescatarians had a significantly greater risk of hip fractures. In all cases, however, the increased fracture risk was reduced if participants had a higher body mass index (BMI) and higher calcium and protein intake. There were no differences in the risks of wrist or ankle fractures by diet group with or without BMI adjustment, nor for arm fractures after BMI adjustment. Dr Tammy Tong, Nutritional Epidemiologist at NDPH’s Cancer Epidemiology Unit and the lead author said: ‘This is the first comprehensive study on the risks of both total and site-specific fractures in people of different diet groups. We found that vegans had a higher risk of total fractures which resulted in close to 20 more cases per 1000 people over a 10-year period compared to people who ate meat. The biggest differences were for hip fractures, where the risk in vegans was 2.3 times higher than in people who ate meat, equivalent to 15 more cases per 1000 people over 10 years.’
 

AndrogenicJB

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The study just hit major news outlets and is generating a lot of "controversy". Why putting that word in quotes? Because, as I mentioned in several other posts, that word has become a euphemism for "embarrassing truth" that mainstream medicine (and often society at large) will do just about anything to suppress. While the negative effects of veganism and vegetarianism on bone health have been known for some time (mostly due to the state of protein deficiency they induce), the fact that pescatarians also had increased risk of bone fracture is somewhat surprising. That is, until one considers the fact that fish is full of PUFA that, while that PUFA is of the less-inflammatory omega-3 variety, has known detrimental effects on bone morphology and growth. There are safer types of fish, such as cod as well as most tropical fish (due to having more saturated fats in its tissues), however most pescatarians do not really care to make such selections and, in fact, tend to stick with the cold-water fish (abundant in PUFA) such as salmon, sardines, herring, mackerel, etc. The study actually did confirm the deficiency of protein and calcium as a mechanism of action in the vegan and vegetarian groups fractures. It also added this gem - higher BMI was protective against bone fractures. Yes, "obesity paradox" strikes again! Yet another "controversy" for medicine to reckon with. I actually propose that this study title be changed to "Malnourished people have a much higher risk of fractures", because that is what the findings amount to considering the diets of the vegans, vegetarians and pescatarians, as well as the findings that eating more protein and calcium reversed the increased risks of fractures. However, a study to implying that eating mostly vegan, vegetarian and pescatarian diets amounts to malnourishment would be so..."controversial"...and it probably would not have gotten published :):

Vegetarian and vegan diets and risks of total and site-specific fractures: results from the prospective EPIC-Oxford study
Vegans 43% more likely to suffer broken bones than meat eaters, study finds
Vegans, Vegetarians and Pescatarians May Have an Increased Risk of Bone Fractures

"...New results from the EPIC-Oxford study suggest that vegans, vegetarians and pescatarians (people who eat fish but no other meat) may be at higher risk of bone fractures, compared with meat eaters. In particular, the results showed that vegans had a higher risk of fractures anywhere in the body (total fractures), as well as fractures of the legs and vertebrae, compared with meat eaters. In addition, vegans, vegetarians and pescatarians had a significantly greater risk of hip fractures. In all cases, however, the increased fracture risk was reduced if participants had a higher body mass index (BMI) and higher calcium and protein intake. There were no differences in the risks of wrist or ankle fractures by diet group with or without BMI adjustment, nor for arm fractures after BMI adjustment. Dr Tammy Tong, Nutritional Epidemiologist at NDPH’s Cancer Epidemiology Unit and the lead author said: ‘This is the first comprehensive study on the risks of both total and site-specific fractures in people of different diet groups. We found that vegans had a higher risk of total fractures which resulted in close to 20 more cases per 1000 people over a 10-year period compared to people who ate meat. The biggest differences were for hip fractures, where the risk in vegans was 2.3 times higher than in people who ate meat, equivalent to 15 more cases per 1000 people over 10 years.’
The tinned sardines that I eat have very little PUFA. It is tinned in olive oil and has 2g pufa, the rest is mono and sat
 
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Ray peat is for the most part a vegetarian
But he drinks a ton of milk. I doubt most vegetarians are drinking a gallon of milk a day. Some vegetarians don't even drink milk at all.

Ray said he doesn't feel right until he gets 150 grams of protein a day, some of the time reaching 170 grams( don't remember if it was in an email response to someone, although I think it was). Getting that much from just dairy is hard. A gallon of milk is close to 120 grams. Orange juice and eggs add maybe some extra 10 or 20 grams depending on how much he's eating of these. I wonder if he eats some kind of flesh( from beef or from seafood, which he's fond of) everyday for that extra 30 to 50 grams of protein.

Also important to say that eating liver just once a week gives you a huge boost on multiple fronts: b12, selenium, zinc, molybdenum, vitamin A, vitamin K2, riboflavin, etc. Vegans and vegetarians aren't getting this boost.
 

AndrogenicJB

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But he drinks a ton of milk. I doubt most vegetarians are drinking a gallon of milk a day. Some vegetarians don't even drink milk at all.

Ray said he doesn't feel right until he gets 150 grams of protein a day, some of the time reaching 170 grams( don't remember if it was in an email response to someone, although I think it was). Getting that much from just dairy is hard. A gallon of milk is close to 120 grams. Orange juice and eggs add maybe some extra 10 or 20 grams depending on how much he's eating of these. I wonder if he eats some kind of flesh( from beef or from seafood, which he's fond of) everyday for that extra 30 to 50 grams of protein.

Also important to say that eating liver just once a week gives you a huge boost on multiple fronts: b12, selenium, zinc, molybdenum, vitamin A, vitamin K2, riboflavin, etc. Vegans and vegetarians aren't getting this boost.
Do you think taking high doses of d3 will deplete other fat soluble vitamins. Also if I'm getting a lot of vitamin a from sweet potatoes do i need to supplement with retinol vit a
 
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Do you think taking high doses of d3 will deplete other fat soluble vitamins. Also if I'm getting a lot of vitamin a from sweet potatoes do i need to supplement with retinol vit a
High doses of D3 can cause unwanted calcifications without vitamin A and K2. I think much more than 10.000 IU per day of d3 would require some added vitamin K2 especially, since vitamin A is easier to get.

If you can convert beta- carotene into retinol well( depends on things like b12, thyroid function and heredity), then I would say it's not necessary to supplement retinol.
 

AndrogenicJB

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High doses of D3 can cause unwanted calcifications without vitamin A and K2. I think much more than 10.000 IU per day of d3 would require some added vitamin K2 especially, since vitamin A is easier to get.

If you can convert beta- carotene into retinol well( depends on things like b12, thyroid function and heredity), then I would say it's not necessary to supplement retinol.
How much k2 is needed, does it need to be mk7 or can i take kuinone? Also how much A should I aim for when taking d3? I feel like d3 provides very powerful effects when taken in high doses, I am wary of depleting other vitamins by taking such high doses.
 
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How much k2 is needed, does it need to be mk7 or can i take kuinone? Also how much A should I aim for when taking d3? I feel like d3 provides very powerful effects when taken in high doses, I am wary of depleting other vitamins by taking such high doses.
As K2, especifically the MK-4 version, is very safe, I would err on the side of a little more than a little less. How much d3 are you taking? People who do the coimbra protocol take very high dosages of it, and even k2 can't prevent all of the hamful calcifications. They even recommend the patients to reduce their calcium intake. You could try 1 or 2 mg of kuinone for each 10.000 IU, although higher doses of K2 are beneficial. I've heard of people having benefits from MK-7, and I myself used to use a couple of years ago, but it shouldn't replace the MK-4. You could use both, but I think MK-4 is more effective.

Also, be careful with potassium, as vitamin D3 uses it up. Some extra magnesium would be useful too.
 
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Oh yeah, I had forgotten about gelatin. Thanks for reminding me. That certainly jacks up the protein intake a little.
 

AndrogenicJB

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As K2, especifically the MK-4 version, is very safe, I would err on the side of a little more than a little less. How much d3 are you taking? People who do the coimbra protocol take very high dosages of it, and even k2 can't prevent all of the hamful calcifications. They even recommend the patients to reduce their calcium intake. You could try 1 or 2 mg of kuinone for each 10.000 IU, although higher doses of K2 are beneficial. I've heard of people having benefits from MK-7, and I myself used to use a couple of years ago, but it shouldn't replace the MK-4. You could use both, but I think MK-4 is more effective.

Also, be careful with potassium, as vitamin D3 uses it up. Some extra magnesium would be usef
As K2, especifically the MK-4 version, is very safe, I would err on the side of a little more than a little less. How much d3 are you taking? People who do the coimbra protocol take very high dosages of it, and even k2 can't prevent all of the hamful calcifications. They even recommend the patients to reduce their calcium intake. You could try 1 or 2 mg of kuinone for each 10.000 IU, although higher doses of K2 are beneficial. I've heard of people having benefits from MK-7, and I myself used to use a couple of years ago, but it shouldn't replace the MK-4. You could use both, but I think MK-4 is more effective.

Also, be careful with potassium, as vitamin D3 uses it up. Some extra magnesium would be useful too.
My training days are Monday wednesday friday. How does this sound, on training days 10,000 IU D3, 200Iu vitamin E(for inhibiting aromatase), 2mg Kuinone. Non training days, 2000-5000IU D3, 1mg Kuinone, 100IU E?
 
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That seems good. I think that you don't even need to lower k2 to 1mg on non- training days. Just keep at 2 mg everyday( unless you feel better taking less on those days).

The vitamin E will also have the benefit of preventing vitamin A from getting oxidized, aside from inhibiting aromatase as you said.
 

AndrogenicJB

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That seems good. I think that you don't even need to lower k2 to 1mg on non- training days. Just keep at 2 mg everyday( unless you feel better taking less on those days).

The vitamin E will also have the benefit of preventing vitamin A from getting oxidized, aside from inhibiting aromatase as you said.
Thanks for the reply, are tinctures better than capsules for vitamin d3 and vitamin e.? What supplementation is the most bio-available? Transdermal maybe?
 
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Thanks for the reply, are tinctures better than capsules for vitamin d3 and vitamin e.? What supplementation is the most bio-available? Transdermal maybe?
The d3 capsules that I use are made of gelatin, and they dissolve quite easily, so I think it doesn't make much difference.

Transdermal absorption is much lower than oral: between 10% and 20%, so you would have to use a lot more. Haidut has talked about putting d3 on the bellybutton for increased absorption. I tried this and it does seem to have a stronger effect than putting it on the legs or arms. For d3 I just use it orally for convenience and economy, but on the skin is safer.
 

AndrogenicJB

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The d3 capsules that I use are made of gelatin, and they dissolve quite easily, so I think it doesn't make much difference.

Transdermal absorption is much lower than oral: between 10% and 20%, so you would have to use a lot more. Haidut has talked about putting d3 on the bellybutton for increased absorption. I tried this and it does seem to have a stronger effect than putting it on the legs or arms. For d3 I just use it orally for convenience and economy, but on the skin is safer.
Thanks. Should the calcirol from idealabs for vitamin d be taken orally?
 
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Thanks. Should the calcirol from idealabs for vitamin d be taken orally?
The composition is just SFA esters and ethanol, so it can be taken orally too( haidut cannot recommend it to be consumed like that due to legal reasons, I believe).
 
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