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Table 2 Risks of total and site-specific fractures by diet group in EPIC-Oxford, with varying levels of adjustments

From: Vegetarian and vegan diets and risks of total and site-specific fractures: results from the prospective EPIC-Oxford study

Fracture site/diet group

N cases

Person-years

Age at eventa

Hazard ratios (95% confidence intervals)

Model 1b

Model 2c

Model 3d

Model 4e

Model 5f

Total fractures (N = 54,898)

 Meat eaters

2468

511,459

68.5 (13.1)

Reference

Reference

Reference

Reference

Reference

 Fish eaters

464

138,851

64.3 (14.5)

0.97 (0.87, 1.07)

0.95 (0.86, 1.05)

0.95 (0.85, 1.05)

0.94 (0.84, 1.04)

0.94 (0.84, 1.05)

 Vegetarians

862

260,112

60.7 (16.4)

1.11 (1.02, 1.21)

1.09 (1.00, 1.19)

1.08 (1.00, 1.18)

1.07 (0.97, 1.17)

1.07 (0.97, 1.18)

 Vegans

147

33,510

59.9 (17.4)

1.50 (1.26, 1.78)

1.43 (1.20, 1.70)

1.31 (1.10, 1.57)

1.39 (1.16, 1.67)

1.30 (1.08, 1.56)

 p-heterogeneityg

   

< 0.001

< 0.001

0.003

0.001

0.009

Arm fractures (N = 55,014)

 Meat eaters

352

525,955

69.9 (12.4)

Reference

Reference

Reference

Reference

Reference

 Fish eaters

62

141,853

66.1 (13.0)

0.93 (0.71, 1.24)

0.92 (0.69, 1.22)

0.92 (0.69, 1.22)

0.85 (0.64, 1.13)

0.85 (0.64, 1.13)

 Vegetarians

130

265,518

63.7 (15.4)

1.28 (1.03, 1.60)

1.25 (1.00, 1.56)

1.25 (1.00, 1.56)

1.12 (0.87, 1.43)

1.12 (0.87, 1.43)

 Vegans

22

34,503

58.0 (16.1)

1.67 (1.07, 2.61)

1.56 (0.99, 2.44)

1.54 (0.96, 2.46)

1.39 (0.87, 2.22)

1.39 (0.86, 2.25)

 p-heterogeneityg

   

0.020

0.049

0.056

0.19

0.20

Wrist fractures (N = 55,013)

 Meat eaters

565

523,913

67.3 (11.4)

Reference

Reference

Reference

Reference

Reference

 Fish eaters

110

141,606

64.4 (13.6)

0.93 (0.75, 1.15)

0.90 (0.73, 1.11)

0.90 (0.73, 1.12)

0.92 (0.74, 1.15)

0.94 (0.75, 1.17)

 Vegetarians

185

265,177

60.2 (14.4)

1.03 (0.86, 1.24)

1.00 (0.83, 1.19)

1.00 (0.83, 1.20)

1.03 (0.84, 1.26)

1.05 (0.86, 1.29)

 Vegans

29

34,431

58.8 (16.2)

1.33 (0.91, 1.96)

1.24 (0.84, 1.82)

1.14 (0.76, 1.70)

1.28 (0.86, 1.90)

1.19 (0.79, 1.79)

 p-heterogeneityg

   

0.39

0.49

0.70

0.49

0.67

Hip fractures (N = 55,026)

 Meat eaters

610

525,706

76.8 (9.5)

Reference

Reference

Reference

Reference

Reference

 Fish eaters

122

141,856

74.6 (11.4)

1.33 (1.08, 1.62)

1.26 (1.02, 1.54)

1.26 (1.03, 1.54)

1.24 (1.01, 1.53)

1.25 (1.01, 1.55)

 Vegetarians

172

265,548

74.5 (11.9)

1.34 (1.12, 1.61)

1.25 (1.04, 1.50)

1.24 (1.03, 1.49)

1.20 (0.98, 1.47)

1.21 (0.99, 1.49)

 Vegans

41

34,489

74.1 (13.3)

2.64 (1.90, 3.67)

2.31 (1.66, 3.22)

1.97 (1.39, 2.79)

2.21 (1.56, 3.12)

1.94 (1.35, 2.77)

 p-heterogeneityg

   

< 0.001

< 0.001

< 0.001

< 0.001

0.002

Leg fractures (N = 55,019)

 Meat eaters

227

526,617

68.7 (12.3)

Reference

Reference

Reference

Reference

Reference

 Fish eaters

48

141,993

62.8 (13.8)

1.06 (0.77, 1.47)

1.07 (0.77, 1.48)

1.06 (0.77, 1.47)

1.06 (0.76, 1.49)

1.05 (0.75, 1.47)

 Vegetarians

73

265,842

61.3 (16.0)

1.00 (0.75, 1.33)

1.01 (0.76, 1.34)

1.00 (0.75, 1.33)

0.99 (0.72, 1.37)

0.99 (0.72, 1.36)

 Vegans

18

34,533

59.1 (19.3)

2.04 (1.23, 3.38)

2.05 (1.23, 3.41)

1.83 (1.07, 3.14)

2.02 (1.19, 3.44)

1.81 (1.04, 3.15)

 p-heterogeneityg

   

0.044

0.045

0.16

0.053

0.17

Ankle fractures (N = 55,021)

 Meat eaters

332

525,449

63.0 (12.1)

Reference

Reference

Reference

Reference

Reference

 Fish eaters

58

141,898

56.0 (10.2)

0.79 (0.59, 1.05)

0.84 (0.63, 1.12)

0.84 (0.63, 1.12)

0.88 (0.65, 1.19)

0.89 (0.66, 1.20)

 Vegetarians

117

265,486

54.7 (14.4)

0.94 (0.75, 1.19)

1.01 (0.80, 1.27)

1.01 (0.80, 1.27)

1.10 (0.85, 1.43)

1.11 (0.85, 1.44)

 Vegans

13

34,566

51.1 (14.8)

0.90 (0.51, 1.58)

1.03 (0.58, 1.82)

0.91 (0.50, 1.63)

1.13 (0.63, 2.03)

1.00 (0.55, 1.82)

 p-heterogeneityg

   

0.44

0.65

0.65

0.59

0.60

Other main site fracturesh (N = 55,016)

 Meat eaters

287

526,576

69.1 (14.1)

Reference

Reference

Reference

Reference

Reference

 Fish eaters

57

142,051

63.1 (15.1)

1.01 (0.75, 1.36)

0.98 (0.73, 1.33)

0.98 (0.72, 1.32)

0.98 (0.72, 1.33)

0.96 (0.71, 1.31)

 Vegetarians

100

265,768

59.4 (16.7)

1.03 (0.80, 1.32)

0.99 (0.77, 1.27)

0.98 (0.76, 1.26)

0.97 (0.73, 1.28)

0.95 (0.72, 1.26)

 Vegans

23

34,526

58.2 (16.2)

1.73 (1.11, 2.70)

1.59 (1.02, 2.50)

1.66 (1.03, 2.67)

1.55 (0.97, 2.48)

1.61 (0.98, 2.62)

 p-heterogeneityg

   

0.11

0.20

0.18

0.23

0.20

  1. aIn cases only, as mean years (SD)
  2. bModel 1 was stratified by sex, method of recruitment (general practice or postal), and region (7 categories), and adjusted for year of recruitment (per year from ≤ 1994 to ≥ 1999), ethnicity (white, other, unknown), Townsend deprivation index (quartiles, unknown), education level (no qualifications, basic secondary (e.g. O level), higher secondary (e.g. A level), degree, unknown), physical activity (inactive, low activity, moderately active, very active, unknown), smoking (never, former, light, heavy, unknown), alcohol consumption (< 1 g, 1–7 g, 8–15 g, 16+ g/day), dietary supplement use (no, yes, unknown), height (5 cm categories from < 155 to ≥ 185 cm, unknown), and in women menopausal status (premenopausal, perimenopausal, postmenopausal, unknown), hormone replacement therapy use (never, ever, unknown), and parity (none, 1–2, ≥ 3, unknown)
  3. cModel 2 was model 1 plus BMI (< 18.5, 18.5–19.9, 20–22.4, 22.5–24.9, 25–27.4, 27.5–29.9, 30–32.4, ≥ 32.5 kg/m2, unknown)
  4. dModel 3 was model 2 plus dietary calcium intake (< 525, 525–699, 700–899, 900–1199, ≥ 1200 mg)
  5. eModel 4 was model 2 plus protein intake (< 13, 13–14.4, 14.5–15.9, 16–18.0, ≥ 18.1 of % energy)
  6. fModel 5 was model 2 plus dietary calcium intake (< 525, 525–699, 700–899, 900–1199, ≥ 1200 mg) and protein intake (< 13, 13–14.4, 14.5–15.9, 16–18.0, ≥ 18.1 of % energy)
  7. gp-heterogeneity represents heterogeneity in risk between diet group based on Wald’s tests
  8. hDefined as fractures of the clavicle, rib, or vertebra