Fatty acid dietary intakes and blood concentrations in relation to hip fracture risk in adults: a systematic review and meta-analysis of prospective cohort studies

Osteoporos Int. 2025 Nov;36(11):2053-2069. doi: 10.1007/s00198-025-07587-x. Epub 2025 Jul 27.

Abstract

Previous research suggests that dietary intake and blood levels of fatty acids may influence the risk of osteoporosis and hip fractures, although findings have been inconsistent. We conducted a meta-analysis of nine prospective cohort studies involving 382,094 participants and 12,392 hip fractures to investigate these associations. Follow-ups ranged from 7 to 24 years in duration. A hazard ratio (HR) of 1.20 (95% CI: 1.08-1.33) indicated that a higher intake of saturated fatty acids (SFAs) was associated with an increased risk of hip fractures. In contrast, polyunsaturated fatty acids (PUFAs) (HR: 0.93; 95% CI: 0.85-1.00) and linoleic acid (LA) (HR: 0.89; 95% CI: 0.82-0.96) were associated with a lower risk, though the PUFA association was marginal. The inverse relationship for LA was observed only at intakes of 9-16 g per day. Higher amounts of PUFAs (HR: 0.75; 95% CI: 0.61-0.92), total omega-3 fatty acids (HR: 0.79; 95% CI: 0.64-0.97), and eicosapentaenoic acid (EPA) (HR: 0.76; 95% CI: 0.62-0.94) in the blood were linked to a lower risk. No significant associations were found for other fatty acids. These findings suggest that consuming 9-16 g of linoleic acid (LA) daily (equivalent to 2-3 tablespoons of corn oil or 30-60 g of walnuts) and maintaining elevated blood levels of omega-3 fatty acids, especially eicosapentaenoic acid (EPA), may help reduce the risk of hip fractures.

Keywords: Diet; Fatty acids; Hip fracture; Linoleic acid.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Diet* / statistics & numerical data
  • Dietary Fats* / administration & dosage
  • Dietary Fats* / adverse effects
  • Dietary Fats* / blood
  • Fatty Acids* / administration & dosage
  • Fatty Acids* / blood
  • Fatty Acids, Unsaturated / administration & dosage
  • Fatty Acids, Unsaturated / blood
  • Hip Fractures* / blood
  • Hip Fractures* / epidemiology
  • Hip Fractures* / etiology
  • Hip Fractures* / prevention & control
  • Humans
  • Osteoporotic Fractures* / blood
  • Osteoporotic Fractures* / epidemiology
  • Osteoporotic Fractures* / etiology
  • Osteoporotic Fractures* / prevention & control
  • Prospective Studies
  • Risk Assessment / methods
  • Risk Factors

Substances

  • Dietary Fats
  • Fatty Acids
  • Fatty Acids, Unsaturated