PUFAs, Bone Mineral Density, and Fragility Fracture: Findings from Human Studies

Adv Nutr. 2016 Mar 15;7(2):299-312. doi: 10.3945/an.115.009472. Print 2016 Mar.


Osteoporosis is a global health problem that leads to an increased incidence of fragility fracture. Recent dietary patterns of Western populations include higher than recommended intakes of n-6 (ω-6) polyunsaturated fatty acids (PUFAs) relative to n-3 (ω-3) PUFAs that may result in a chronic state of sterile whole body inflammation. Findings from human bone cell culture experiments have revealed both benefits and detriments to bone-related outcomes depending on the quantity and source of PUFAs. Findings from observational and randomized controlled trials suggest that higher fatty fish intake is strongly linked with reduced risk of fragility fracture. Moreover, human studies largely support a greater intake of total PUFAs, total n-6 (ω-6) fatty acid, and total n-3 (ω-3) fatty acid for higher bone mineral density and reduced risk of fragility fracture. Less consistent evidence has been observed when investigating the role of long chain n-3 (ω-3) PUFAs or the ratio of n-6 (ω-6) PUFAs to n-3 (ω-3) PUFAs. Aspects to consider when interpreting the current literature involve participant characteristics, study duration, diet assessment tools, and the primary outcome measure.

Keywords: arachidonic acid; bone health; bone mineral density; docosahexaenoic acid; eicosapentaenoic acid; fatty acids; fracture; osteoporosis; women's health; α-linolenic acid.

Publication types

  • Review

MeSH terms

  • Animals
  • Bone Density
  • Evidence-Based Medicine*
  • Fatty Acids, Omega-3 / administration & dosage
  • Fatty Acids, Omega-3 / adverse effects
  • Fatty Acids, Omega-3 / therapeutic use*
  • Fatty Acids, Omega-6 / administration & dosage
  • Fatty Acids, Omega-6 / adverse effects
  • Fatty Acids, Omega-6 / therapeutic use
  • Female
  • Fishes*
  • Global Health*
  • Humans
  • Male
  • Observational Studies as Topic
  • Osteoporosis / diet therapy
  • Osteoporosis / physiopathology
  • Osteoporosis / prevention & control
  • Osteoporosis, Postmenopausal / diet therapy
  • Osteoporosis, Postmenopausal / physiopathology
  • Osteoporosis, Postmenopausal / prevention & control*
  • Osteoporotic Fractures / etiology
  • Osteoporotic Fractures / prevention & control*
  • Randomized Controlled Trials as Topic
  • Recommended Dietary Allowances / trends
  • Seafood* / adverse effects


  • Fatty Acids, Omega-3
  • Fatty Acids, Omega-6