A two-decade cohort study has found women who follow one particular diet have a higher risk of breaking a hip.

The study, from the University of Leeds in the United Kingdom, compared vegetarians, pescatarians and meat eaters, and found vegetarian women ages 35 to 69 were 33% more likely to experience a hip fracture than those who regularly ate meat.

Pescatarians and women who only occasionally ate meat did see the same fracture risk, the study, published in BMC Medicine, found.

According to researcher James Webster, the link between lower intake of protein, calcium and other micronutrients with bone and muscle health is often concerning with vegetarians.

“This makes it especially important for further research to better understand factors driving the increased risk in vegetarians,” he said, “whether it be particular nutrient deficiencies or weight management, so that we can help people to make healthy choices.”

Webster and his colleagues said the study isn’t a condemnation of the vegetarian diet, according to MedPage Today.

“Vegetarian diets can vary widely from person to person and can be healthy or unhealthy, just like diets that include animal products,” Webster said. He advised women to weigh the pros and cons of the various diets to ensure they’re getting proper nutrition for their bodies.

“Hip fracture is a global health issue with high economic costs that causes loss of independence, reduces quality of life, and increases risk of other health issues,” study co-author Janet Cade, PhD, said in the statement.

“Plant-based diets have been linked with poor bone health, but there has been a lack of evidence on the links to hip fracture risk,” she added. “This study is an important step in understanding the potential risk plant-based diets could present over the long-term and what can be done to mitigate those risks.”

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