Vegetarian women have a higher risk of hip fracture compared to regular meat-eaters, according to a study published in BMCMedicine.
], and included : ethnicity ; socio-economic status ; marital status ; menopausal status ; number of children ; prevalence of cardiovascular disease, cancer, or diabetes at recruitment ; physical activity in hours per day ; smoking status ; alcohol consumption ; BMI ; and any nutritional supplement use . The DAG and definitions of confounders are given in Additional file: Supplementary methods, Table S3, and Fig. S2.
To determine the role of BMI as a potential effect modifier, we added dichotomized BMI level , SES , smoking status , and use of any nutritional supplements . In each exploratory subgroup analysis, the potential effect modifier was omitted from the relevant adjustment set. We explored the effect of potential mediators by further adjusting the adjusted model for each mediator independently. Potential mediators were total energy intake and intake of protein, calcium, vitamin D, vitamin B12, monounsaturated fatty acids , polyunsaturated fatty acids , and zinc from dietary sources only . An adjusted model with BMI removed from the adjustment set is also presented to determine its influence on any associations.
As a sensitivity analysis, we explored the risk of hip fracture in vegans compared to meat-eaters by fitting the adjusted model with vegetarians and vegans separated.
]. Participants with missing data for a variable required in a given analysis were excluded from that analysis. We did not impute missing covariate data. All statistical analyses were performed using Stata .Of the 30,244 women potentially eligible at recruitment, those with missing covariate data for body weight (
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