Plasma phospholipid fatty acids and fish-oil consumption in relation to osteoporotic fracture risk in older adults: the Age, Gene/Environment Susceptibility Study

Abstract

Background: Polyunsaturated fatty acids (PUFAs) may play a role in fracture, but studies have been largely confined to estimates of dietary intake. Objective: We aimed to examine associations between fatty acids measured in late life and fish-oil consumption in early life, midlife, and late life with osteoporotic fracture risk. Design: Osteoporotic fractures were determined from medical records over 5-9 y of follow-up in men and women aged 66-96 y. Data were analyzed from 1438 participants including 898 participants who were randomly selected from the Age, Gene/Environment Susceptibility Study, which is an observational study, and 540 participants with incident fracture. Plasma phospholipid fatty acids were assessed by using gas chromatography. Fish-oil consumption was assessed by using validated questionnaires as never (referent), less than daily, or daily. HRs and 95% CIs adjusted for age, education, height, weight, diabetes, physical activity, and medications were estimated by using Cox regression. Results: In men, the highest tertile of PUFAs, n-3 (v-3), and eicosapentaenoic acid were associated with decreased fracture risk [HRs (95% CIs): 0.60 (95% CI: 0.41, 0.89), 0.66 (0.45, 0.95), and 0.59 (0.41, 0.86), respectively]. In women, PUFAs tended to be inversely associated with fracture risk (P-trend = 0.06), but tertiles 2 and 3 were not independently associated with risk. Tertile 2 of n-6 and arachidonic acid was associated with fracture risk in women [HRs (95% CIs): 1.43 (1.10, 1.85) and 1.42 (1.09, 1.85), respectively]. Daily fish-oil consumption in late life was associated with lower fracture risk in men (HR: 0.64; 95% CI: 0.45, 0.91). Daily fish-oil consumption in midlife was associated with lower fracture risk in women (HR: 0.75; 95% CI: 0.58, 0.98). Conclusions: Greater PUFA concentrations may be associated with lower osteoporotic fracture risk in older adults, particularly in men. Critical time periods for n-3 fatty acid consumption may differ by sex.Am J Clin Nutr 2015;101:947-55.

Early Life Residence, Fish Consumption, and Risk of Breast Cancer

“…Consequently, the high consumption of fish rather than fish liver oil may have promoted better absorption and utilization of vitamin D. Icelandic fish liver oil also contains n-3 PUFA. However, the Icelandic population has high levels of EPA and DHA in both diet and plasma (42). It might therefore be possible that the study population has already reached a beneficial threshold level of marine derived n-3 PUFA for breast cancer risk.…”

Forearm bone density is not elevated in Inuit women with impaired fasting glucose or type 2 diabetes mellitus

“…Frequency of marine mammal intakes was positively associated with FaBMD. Fish intake is protective from T2D in other populations [30], and based on our results, marine mammals may confer protection to bone as well [15]. The intake of traditional foods should be encouraged among Inuit women.…”

“…Fish was a commonly consumed traditional food in the overall survey (median (IQR) of 0.11 (0.02, 0.30)), with a younger mean age of 42 ± 15 y [28]. Similar to fish, marine mammals are rich in omega-3 polyunsaturated FA [26] and vitamin D [10] that are beneficial to bone health [15,16]. Interestingly, neither serum 25(OH)D or RBC-Omega-3 were related to FaBMD in the current study population, although RBC-Omega-3 approached significance (p = 0.086) in the regression model (data not shown).…”

“…Other factors that accompany the rise in IFG and T2D among Inuit include the nutrition transition, characterised by reduced traditional food consumption, n-3 fatty acid intakes [13] and vitamin D status [10]. Traditional food patterns including an abundance of fish and seafood associate with lower HbA1c [14] and both vitamin D and n-3 fatty acids are, in part, considered protective against fracture risk [15,16]. In addition, elevated leptin and reduced adiponectin are observed in First Nations adults with T2D relative to normoglycemic adults [17].…”

Adverse plasma fatty acid composition in patients with femoral neck fracture1

“…In addition to n-6 PUFA, the level of all n-3 PUFA is severely lower in the patients than in the control group after the fracture and even lower 7 days after the surgery. Plasma levels of n-3 PUFA positively correlated with the bone mineralization in both mice and humans and higher n-3 PUFA intake reduces the fracture risk (Harris et al 2015). It has been found that n-3 PUFA reduce PGE2 synthesis, suppress inflammation, and promote bone repair by enhancing production of insulin-like growth factors, which are potent growth stimulators for bone remodeling (Weitzmann and Pacifici 2006).…”