Is a Plant-Based Diet Good for Bone Health?

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Following a plant-based diet has many health benefits, but is it good for your bones? Here's what you need to know about plant-based diets and bone health.

Disclaimer: If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Well Guide contain information from peer-reviewed research, medical societies and governmental agencies; however, these articles are not a substitute for professional medical advice, diagnosis, or treatment.

Nutrition trends come and go, but any diet that promotes eating more plants is a good thing. Plant-based diets have been shown to have numerous health benefits, including significantly reducing the risk of heart disease (Kim, 2019).

But can a plant-based diet provide all the nutrients needed for strong bones? The answer is yes, but it requires some specific considerations. If you are a vegan or vegetarian, you will want to look at the research and plan ahead to make sure a diet without animal protein is still rich in the nutrients you need for bone health.

In this article, we will discuss what you need to know about following a plant-based diet for bone health.

What is a plant-based diet?

There are multiple versions of a plant-based diet, but they all have one common goal: to improve your health by eating more plant foods. But the exact foods included in each pattern (or diet) can differ:

  • A vegan diet avoids all animal products, including dairy and sometimes honey.
  • A lacto vegetarian diet includes dairy but avoids all other animal products.
  • A lacto-ovo vegetarian diet includes eggs and dairy but avoids meat, poultry, and fish.
  • A pescatarian diet is a vegetarian pattern that includes fish.

Some people also follow a plant-focused diet, which means they still eat small amounts of meat, poultry, eggs, fish and dairy, but the primary focus is whole plant-based foods.

Your daily diet is personal. Some people follow a plant-based diet for health reasons, while others follow it for ethical purposes. There is no right or wrong way to follow a plant-based diet; it's all about what works best for you and your lifestyle.

How might a plant-based diet support healthy bones?

It can feel a little complex to sort through all the information (and misinformation) about diets and bone health. The truth is that there is no one perfect diet for bone health, just like there's no ideal diet for every person.

A plant-based diet can support strong bones, as long as you are getting the vitamins and minerals you need (you can learn more about essential nutrients for bones here).

Here's what we know about plant-based foods and bones: eating more fruits and vegetables is linked to stronger bones (Qiu, 2017). Replacing foods that may not be as great for your health—sugar, meat, and processed foods—with plant-based foods could help your bones and reduce the risk of osteoporosis (Muñoz-Garach, 2020). This is likely because many nutrients needed for bone health, like magnesium and potassium, are found in these foods.

Diets high in fresh fruits and vegetables, whole grains, legumes, low-fat dairy, fish, and nuts, such as the Mediterranean diet, are associated with higher bone mineral density (BMD) (Denova-Gutiérrez, 2018). BMD is a measure of bone strength. On the other hand, eating a lot of fast food, meat, sugar and refined products is linked to lower bone mineral density (BMD) (Denova-Gutiérrez, 2018, Sahni, 2015).

In other words, as long as you eat a nutrient-dense diet that includes all the nutrients needed for bone health, plant-based diets can support healthy bones.

Do plant-based diets have any limitations for bone health?

The major limitation of a plant-based diet is that certain critical nutrients for bone health may be lacking if not carefully followed.

For example, a study comparing people who ate meat or fish, vegetarians, and vegans found no differences in fracture risk for most groups (Appleby, 2007). The only group with a higher risk was the vegan diet. The authors concluded that compared to other groups, vegans took in less calcium (dairy is a primary calcium source for many people), which could be part of the reason.

Another recent study found that vegetarians had a higher risk of hip fractures than meat-eaters. Those who only occasionally ate meat or followed a pescatarian diet didn't have the same increased risk (Webster, 2022).

It's possible to get bone nutrients from a plant-based diet, but the more restrictive the diet, the more you may need to consider and plan ahead (we'll give you a few tips below).

Plant-based foods to include in a diet for bone health

Here are some of the top plant-based foods to support your bones:

  • Dark leafy greens like kale and spinach. These foods are high in nutrients essential for bone health.
  • Beans and legumes. Beans and legumes are excellent sources of plant-based protein and minerals for strong bones.
  • Nuts and seeds. Nuts and seeds contain protein, minerals, and healthy fats for bone (and overall) health.
  • Olive oil. According to research, the polyphenols in extra virgin olive oil may protect against fractures related to osteoporosis (García-Gavilán, 2018).
  • Prunes. A bone-health secret weapon, prunes are high in vitamins, minerals, and polyphenols, to protect the bones. One study found that eating 5 to 6 prunes daily supported healthy BMD and reduced bone loss (Hooshmand, 2016).
  • Fortified foods. If you're not getting enough vitamins and minerals from your diet alone, consider fortified foods like plant-based milk and cereals. These foods can bump up your intake of bone-building minerals like calcium or vitamin D. Just watch out for any added sugar on the nutrition label.

Plant-based diets and bone health: The takeaway

Optimizing your diet for bone health is important at any age, but it becomes increasingly crucial as we get older. A plant-based diet can be great for bones—as long as it includes all the key bone-building nutrients. But don't forget that diet is only one part of bone health. Exercise and other lifestyle habits are also important.

Including a variety of nutrient-rich foods like leafy greens, beans and legumes, nuts and seeds, and fortified foods can help you get all the nutrients you need from a plant-based diet. Still, sometimes a multivitamin or other supplements may be necessary to fill in the gaps.

If you're interested in switching to a plant-based diet of any kind, working with a registered dietitian can be a good idea to ensure you aren't missing out on any valuable bone-building nutrients.

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References

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2. Denova-Gutiérrez E, Méndez-Sánchez L, Muñoz-Aguirre P, Tucker KL, Clark P. Dietary Patterns, Bone Mineral Density, and Risk of Fractures: A Systematic Review and Meta-Analysis. Nutrients. 2018;10(12):1922. doi:10.3390/nu10121922

3. García-Gavilán JF, Bulló M, Canudas S, et al. Extra virgin olive oil consumption reduces the risk of osteoporotic fractures in the PREDIMED trial. Clin Nutr. 2018;37(1):329-335. doi:10.1016/j.clnu.2016.12.030

4. Hooshmand S, Kern M, Metti D, et al. The effect of two doses of dried plum on bone density and bone biomarkers in osteopenic postmenopausal women: a randomized, controlled trial. Osteoporos Int. 2016;27(7):2271-2279. doi:10.1007/s00198-016-3524-8

5. Kim H, Caulfield LE, Garcia-Larsen V, Steffen LM, Coresh J, Rebholz CM. Plant-Based Diets Are Associated With a Lower Risk of Incident Cardiovascular Disease, Cardiovascular Disease Mortality, and All-Cause Mortality in a General Population of Middle-Aged Adults. J Am Heart Assoc. 2019;8(16):e012865. doi:10.1161/JAHA.119.012865

6. Muñoz-Garach A, García-Fontana B, Muñoz-Torres M. Nutrients and Dietary Patterns Related to Osteoporosis. Nutrients. 2020;12(7):1986. doi:10.3390/nu12071986

7. Qiu R, Cao WT, Tian HY, He J, Chen GD, Chen YM. Greater Intake of Fruit and Vegetables Is Associated with Greater Bone Mineral Density and Lower Osteoporosis Risk in Middle-Aged and Elderly Adults. PLoS One. 2017;12(1):e0168906. doi:10.1371/journal.pone.0168906

8. Sahni S, Mangano KM, McLean RR, Hannan MT, Kiel DP. Dietary Approaches for Bone Health: Lessons from the Framingham Osteoporosis Study. Curr Osteoporos Rep. 2015;13(4):245-255. doi:10.1007/s11914-015-0272-1

9. Webster J, Greenwood DC, Cade JE. Risk of hip fracture in meat-eaters, pescatarians, and vegetarians: results from the UK Women's Cohort Study. BMC Med. 2022;20(1):275. doi:10.1186/s12916-022-02468-0

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