Fracture Rates in China and Sweden
My two biggest concerns about vegan nutrition are vitamin B12 and calcium. The message about vitamin B12 has gotten through to anyone who has been paying attention and isn’t in nutrition la la land (unfortunately, this are still a lot of vegans on both accounts). But even today, calcium and bones is a particularly tough sell among people who are interested in mainstream science and have been paying some attention.
Normally when I harp on the need for calcium, explaining that animal protein does not cause osteoporosis and so vegans are not protected by virtue of not eating any, someone will point out that countries that have higher intakes of dairy (northern Europe and the USA) have higher rates of osteoporosis than do Asian and African countries where much less milk in consumed. Here is a study that helps explain this paradox for Asians.
The first prospective study measuring clinically diagnosed vertebral fractures in an Asian population, the Hong Kong Osteoporosis Study, was released in March of 2012 (1). It measured the vertebral and hip fractures in a Chinese population and compared the rates to Sweden. Data from Japan was also included, but the measurements of vertebral fracture were estimated for Japan.
Rather than typing out the numbers for the various age groups, which are tedious to read, the results can be seen in the diagram below (or you can click here for an easier version to see).
The Swedish have higher rates of hip fracture while the Chinese have higher rates of vertebral fractures (much higher after age 80).
The authors state:
“The observed ethnic differences in fracture incidences may be due to the fact that hip fracture risk was affected by fall risk, whereas the risk of vertebral fracture mostly depends on bone strength. Despite the low hip fracture rate in our population, Hong Kong women had a higher prevalence of osteoporosis (bone mineral density T- score à “2.5 at any one site in reference to ethnic-specific peak young mean according to the ISCD recommendation) than US Caucasian women (35.8% vs. 20%, respectively) and a similar prevalence of about 6% in Hong Kong and US Caucasian men.”
In other words, the Chinese don’t have lower rates of osteoporosis.
1. Bow CH, Cheung E, Cheung CL, Xiao SM, Loong C, Soong C, Tan KC, Luckey MM, Cauley JA, Fujiwara S, Kung AW. Ethnic difference of clinical vertebral fracture risk. Osteoporos Int. 2012 Mar;23(3):879-85. | link