Fatty acid consumption and risk of fracture in the Women's Health Initiative

Am J Clin Nutr. 2010 Dec;92(6):1452-60. doi: 10.3945/ajcn.2010.29955. Epub 2010 Oct 27.


Background: Fatty acids (FAs) may be important dietary components that modulate osteoporotic fracture risk.

Objective: The objective was to examine FA intake in relation to osteoporotic fractures.

Design: The participants were postmenopausal women enrolled in the Women's Health Initiative (n = 137,486). Total fractures were identified by self-report; hip fractures were confirmed by medical record review. FA intake was estimated from baseline food-frequency questionnaires and standardized to total caloric intake. No data on omega-3 (n-3) FA supplements were available. Cox proportional hazard models were constructed to estimate risk of fracture.

Results: Higher saturated FA consumption was associated with higher hip fracture risk [quartile 4 multivariate-adjusted hazard ratio (HR): 1.31; 95% CI: 1.11, 1.55; P for trend = 0.001]. Lower total fracture risk was associated with a higher monounsaturated FA intake (quartile 3 HR: 0.94; 95% CI: 0.89, 0.98; P for trend = 0.050) and polyunsaturated FA intake (quartile 4 HR: 0.95; 95% CI: 0.90, 0.99; P for trend = 0.019). Unexpectedly, higher consumption of marine n-3 FAs was associated with greater total fracture risk (quartile 4 HR: 1.07; 95% CI: 1.02, 1.12; P for trend = 0.010), whereas a higher n-6 FA intake was associated with a lower total fracture risk (quartile 4 HR: 0.94; 95% CI: 0.89, 0.98; P for trend 0.009).

Conclusions: These results suggest that saturated FA intake may significantly increase hip fracture risk, whereas monounsaturated and polyunsaturated FA intakes may decrease total fracture risk. In postmenopausal women with a low intake of marine n-3 FAs, a higher intake of n-6 FAs may modestly decrease total fracture risk. This trial was registered at clinicaltrials.gov as NCT00000611.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Dietary Fats / administration & dosage*
  • Dietary Fats / adverse effects
  • Fatty Acids / adverse effects
  • Fatty Acids / pharmacology*
  • Fatty Acids, Monounsaturated / pharmacology*
  • Fatty Acids, Omega-3 / pharmacology*
  • Fatty Acids, Omega-6 / pharmacology*
  • Female
  • Fish Oils / adverse effects
  • Fractures, Bone / etiology*
  • Fractures, Bone / prevention & control
  • Hip
  • Humans
  • Middle Aged
  • Osteoporosis, Postmenopausal / complications*
  • Proportional Hazards Models
  • Risk Factors
  • Self Report


  • Dietary Fats
  • Fatty Acids
  • Fatty Acids, Monounsaturated
  • Fatty Acids, Omega-3
  • Fatty Acids, Omega-6
  • Fish Oils

Associated data

  • ClinicalTrials.gov/NCT00000611