Vegan Diet and Fracture Risk (I’m confused too)

If you’ve been anywhere near the internet I’m sure the headlines caught your eye. But a 43% higher risk of fractures just seemed really high to me with a meat free diet as the cause. I found the following article online. Since most people nowadays can’t get past the headlines you’ll find the second paragraph completely ignored by the media.

Compared with people who ate meat, vegans with lower calcium and protein intakes on average, had a 43% higher risk of fractures anywhere in the body (total fractures), as well as higher risks of site-specific fractures of the hips, legs and vertebrae, according to a study published in the open access journal BMC Medicine. Vegetarians and people who ate fish but not meat had a higher risk of hip fractures, compared to people who ate meat. However, the risk of fractures was partly reduced once body mass index (BMI), dietary calcium and dietary protein intake were taken into account.

The authors caution that they were unable to differentiate between fractures that were caused by poorer bone health (such as fractures due to a fall from standing height or less) and those that were caused by accidents because data on the causes of the fractures were not available. No data were available on differences in calcium supplement use between the different diet groups, and as in all dietary studies the estimates of nutrients such as dietary calcium or dietary protein are subject to measurement error. As the study predominantly included white European participants, generalisability to other populations or ethnicities may be limited, which could be important considering previously observed differences in bone mineral density and fracture risks by ethnicity, according to the authors.

Vegans, vegetarians and pescetarians may be at higher risk of bone fractures — https://www.eurekalert.org/pub_releases/2020-11/bc-vva111820.php

As I was gathering my thoughts the algorithms started doing what they do and this popped up in YouTube.

Let’s discuss the latest paper from the EPIC database. Excuse me eating while working. Not enough hours in day. Short version: this is a database from 90’s. Average fiber intake is 20 gm so not healthiest plant based eaters. Meat eaters got more vitamin D. Also (forgot to mention in video) used hormone replacement therapy up to 50% more. Both associated with stronger bones. Other studies have shown that plant based eaters have great bone health BUT you have to be healthy. Get dark greens. Drink or eat soy (studies show as good dairy for bones). Exercise and use resistance training. And take supplements if needed. I like multivitamins that have K2 as that may be a nutrient vegans are deficient in unless you eat natto 🤮. Definitely vitamin D if deficient. The EPIC Oxford cohort are not the healthiest vegans and vegetarians BUT have less ischemic stroke, weight less, generally better heart and less of certain cancers despite poor supplementation and diet habits.

Dr. Garth Davis YouTube post 11.23.20

I love it when someone else does the work for me. If you have eleven minutes listen to Dr. Davis’ analysis. I am now less confused.

Lower fracture risk with higher BMI because you have more padding when you fall!

Up To A Third Of Knee Replacements Pack Pain And Regret — Kaiser Health News

Danette Lake thought surgery would relieve the pain in her knees. The arthritis pain began as a dull ache in her early 40s, brought on largely by the pressure of unwanted weight. Lake managed to lose 200 pounds through dieting and exercise, but the pain in her knees persisted. A sexual assault two years ago…

via Up To A Third Of Knee Replacements Pack Pain And Regret — Kaiser Health News

OA is a Pain in the Hands (try exercises)

The source article is here.

For many people, hand strength declines with age, especially if arthritis sets in, making it hard to go about daily tasks. A study published in 2017 in Arthritis & Rheumatology estimated that the overall lifetime risk of hand osteoarthritis is close to 40 percent, with twice as many women as men developing it. People who are obese are also more susceptible—possibly because obesity increases chronic low-level inflammation, which contributes to joint damage.

All of a sudden I’m paying more attention to those infomercials that are selling electric jar openers.  An older friend recommended naproxen sodium.  I’m thinking exercise, thus the link to this short informative article.

 

Johns Hopkins Health Alert – Updated Guidelines for Knee OA

Updated Guidelines for Knee Osteoarthritis

Many nonsurgical treatments are touted as being able to ease the symptoms of knee osteoarthritis, but which ones really work? Last year, the American Academy of Orthopaedic Surgeons (AAOS) issued revised recommendations, updating its 2009 guidelines. The group made two important changes that may affect the way you manage knee osteoarthritis.

  • First, if you use acetaminophen (Tylenol) for osteoarthritis pain relief, take no more than 3,000 mg per day. The AAOS formerly advised not exceeding 4,000 mg daily. The change was made to reflect the Food and Drug Administration’s current guidelines for safe use of acetaminophen.
  • Second, the AAOS found insufficient evidence that intra-articular hyaluronic acid provides significant symptom relief for knee osteoarthritis so the organization no longer recommends the therapy.

The AAOS continues to give a thumbs-up to some familiar commonsense strategies, such as exercising and a minimum 5 percent weight loss for people whose body mass index (BMI) is greater than 25.

Other highlights: The AAOS is unable to recommend for or against the use of bracing, growth factor injections and/or platelet-rich plasma knee osteoarthritis. In addition, although acupuncture continues to grow in popularity, there is not sufficient scientific evidence to support its use in patients with knee osteoarthritis.

Published online in Treatment of Osteoarthritis of the Knee. Evidence-Based Guideline, 2nd Edition, May 18, 2013

Click to access TreatmentofOsteoarthritisoftheKneeGuideline.pdf

Here’s the link if you want to download the entire set of guidelines in pdf format.

50-Year-Olds Get New Knees in Record Numbers

During the past three decades there has been a dramatic, 130-fold increase in knee replacement surgeries, particularly among individuals in their 50s, a Finnish study found.

via Medical News: 50-Year-Olds Get New Knees in Record Numbers – in Surgery, Orthopedics from MedPage Today.

Knee replacement cost – cost of knee replacement surgery.

After reading about the dramatic increase in the number of knee replacements I did a Google search for “average cost knee replacement” without the quotation marks in the search string.  At the top of page one was the second link above.

Taiwan anyone?

Older Women Have 2X Mortality Risk First Year Post Hip Fx

Medical News: Mortality High in Year After Hip Fracture – in Orthopedics, Orthopedics from MedPage Today

Older women who experience a hip fracture have a twofold increase in mortality risk in the first year after the fracture, researchers found.

During the 12 months following the fracture, 16.9% of the women died, compared with 8.4% of controls, for an odds ratio of 2.3 (95% CI 1.9 to 2.8), according to Erin S. LeBlanc, MD, of Kaiser Permanente Northwest in Portland, Ore., and colleagues. They researchers adjusted for potential confounders such as age, bone mineral density (BMD), and coexisting conditions such as diabetes, hypertension, and stroke.

And the increased mortality risk during the first year remained after further adjustment for specific hip fracture risk factors such as total hip BMD (OR 2.4, 95% CI 1.9 to 3.1), the researchers reported online in Archives of Internal Medicine.