Vegan Diet and Bone Health-Results from the Cross-Sectional RBVD Study

Nutrients. 2021 Feb 21;13(2):685. doi: 10.3390/nu13020685.


Scientific evidence suggests that a vegan diet might be associated with impaired bone health. Therefore, a cross-sectional study (n = 36 vegans, n = 36 omnivores) was used to investigate the associations of veganism with calcaneal quantitative ultrasound (QUS) measurements, along with the investigation of differences in the concentrations of nutrition- and bone-related biomarkers between vegans and omnivores. This study revealed lower levels in the QUS parameters in vegans compared to omnivores, e.g., broadband ultrasound attenuation (vegans: 111.8 ± 10.7 dB/MHz, omnivores: 118.0 ± 10.8 dB/MHz, p = 0.02). Vegans had lower levels of vitamin A, B2, lysine, zinc, selenoprotein P, n-3 fatty acids, urinary iodine, and calcium levels, while the concentrations of vitamin K1, folate, and glutamine were higher in vegans compared to omnivores. Applying a reduced rank regression, 12 out of the 28 biomarkers were identified to contribute most to bone health, i.e., lysine, urinary iodine, thyroid-stimulating hormone, selenoprotein P, vitamin A, leucine, α-klotho, n-3 fatty acids, urinary calcium/magnesium, vitamin B6, and FGF23. All QUS parameters increased across the tertiles of the pattern score. The study provides evidence of lower bone health in vegans compared to omnivores, additionally revealing a combination of nutrition-related biomarkers, which may contribute to bone health. Further studies are needed to confirm these findings.

Keywords: BUA; QUS; RRR; SOS; biomarker; bone health; diet; reduced rank regression; vegan.

MeSH terms

  • Adult
  • Biomarkers / analysis
  • Body Mass Index
  • Bone Density*
  • Calcaneus / diagnostic imaging
  • Cross-Sectional Studies
  • Diet, Vegan / adverse effects*
  • Female
  • Fibroblast Growth Factor-23
  • Humans
  • Male
  • Middle Aged
  • Nutritional Status / physiology*
  • Ultrasonography


  • Biomarkers
  • FGF23 protein, human
  • Fibroblast Growth Factor-23