The short version
This is the page where being on veganism's side means leading with the finding that cuts against it. In the largest study to look, vegans broke more bones than meat-eaters, and the gap at the hip was not small. EPIC-Oxford tracked about 55,000 people for an average of 18 years and linked them to hospital records, which makes it the strongest evidence we have on this question. Here is what it found.
Primary source 01 / 04
the risks of hip fracture were higher in fish eaters (hazard ratio 1.26; 95% CI 1.02–1.54), vegetarians (1.25; 1.04–1.50), and vegans (2.31; 1.66–3.22)
A hazard ratio of 2.31 means vegans had more than double the rate of hip fractures, which the authors put at roughly 15 extra hip fractures for every 1000 vegans over 10 years. And it was not only hips.
Primary source 02 / 04
The vegans also had higher risks of total (1.43; 1.20–1.70), leg (2.05; 1.23–3.41), and other main site fractures (1.59; 1.02–2.50) than meat eaters.
So the headline is real: total fractures ran about 43% higher in vegans, driven hardest by the hip. Vegetarians and fish-eaters were closer to meat-eaters overall, with their clearest excess also at the hip.
Why, and why it still counts
The reasons are not mysterious. Vegans in this cohort were lighter on average, which raises hip-fracture risk, and they took in less calcium and less protein than meat-eaters. The important part for honesty is what happened when the researchers adjusted for those factors: the risk shrank but did not disappear.
Primary source 03 / 04
Overall, we found that compared with meat eaters, vegans had higher risks of total, hip, leg, and vertebral fractures, while fish eaters and vegetarians had higher risk of hip fractures. These risk differences were likely partly due to their lower BMI, and possibly to lower intakes of calcium and protein.
Partly explained is not fully explained, and the authors were candid that the question is still open.
Primary source 04 / 04
the findings suggest that bone health in vegans requires further research.
We publish this rather than bury it because a case that only survives on flattering evidence is not worth much. This one is the strongest trust signal on the whole shelf: the diet we cover comes with a real, measured downside at the skeleton.
The fixable part
The good news is that the risk tracks levers you can pull rather than veganism as an unchangeable fate. Vegans in the study averaged about 590 mg of calcium a day against roughly 1000 mg in meat-eaters, and that gap is the single most actionable lever. Getting enough calcium and vitamin D, eating enough protein, staying in a healthy weight range rather than underweight, and doing regular weight-bearing exercise all pull in the protective direction. Our pages on calcium and bone health, vitamin D, and protein cover each lever. The grade here is Strong evidence that the higher fracture risk is real, paired with good reason to think a well-built vegan diet closes most of the gap.