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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