The research, funded by the National Natural Science Foundation of China, puts forward data that suggests that although n-3 PUFA supplementation may have a positive impact on bone mineral density, 25(OH)D, serum calcium, and NTx-1 in elderly women from Eastern countries, findings are tentative and require further investigation.
The authors from China conclude: “There is no definitive evidence to support the significant improvement of bone health in adults through n-3 PUFA supplementation or to elucidate how n-3 PUFA affects bone metabolism.”
Osteoporosis and N-3 PUFA
Osteoporosis, a condition characterised by decreased bone mass and deterioration of bone microarchitecture, is a growing concern worldwide.
Among adult Caucasian women, the prevalence of osteoporosis is approximately 16% for those aged 50 years and older, and in Spain, the prevalence of osteoporosis among the elderly was reported to be 39.3% in 2020.
As the global population ages, the prevalence of osteoporosis is on the rise, leading to increased fracture risk and posing a burden on healthcare systems.
In response to this public health challenge, researchers are exploring potential interventions to promote bone health and mitigate the effects of osteoporosis.
Previous research has suggested that n-3 PUFA may play a role in bone metabolism, fracture risk, and musculoskeletal health.
N-3 PUFAs encompass a range of fatty acids, including α-linolenic acid (ALA), stearidonic acid (SDA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA).
A previous study found slight benefits on spine and total hip areal bone mineral density (aBMD) with omega-3 fatty acid supplements.
According to the authors, the intricate mechanisms underlying the relationship between n-3 PUFA and bone health are still being investigated, however previous research has suggested that EPA and DHA, may inhibit bone resorption and promote bone formation.
Additionally, the anti-inflammatory effects of n-3 PUFA have been proposed as a potential mechanism for improving bone quality.
The authors of the new review conducted a comprehensive search of PubMed, Web of Science, and EBSCO, updated until 1 March 2022, using applicable keywords.
The meta-analysis, which included 19 RCTs conducted within the past five years, revealed an inverse association between n-3 PUFA and fracture risk.
Furthermore, the analysis showed that supplementation with n-3 PUFA, particularly ALA, affected bone turnover markers, including bone-specific alkaline phosphatase (BAP), N-telopeptides of type I collagen (NTx-1), and C-terminal telopeptide of type I collagen (CTx-1) in postmenopausal women.
But the authors of the study note there were some limitations in the conducting of the review and meta-analysis, stating: “Moderate to high heterogeneity in trial results was found in several meta-analyses due to a few small-to-moderate-sized studies reporting positive results that were not seen in larger trials.”
The authors note that caution is advised when interpreting results from smaller studies, as they may not be replicated in larger or longer studies.
“The Effects of n-3 PUFA Supplementation on Bone Metabolism Markers and Body Bone Mineral Density in Adults: A Systematic Review and Meta-Analysis of RCTs”
Authors: Jie Gao, Chenqi Xie, Jie Yang, Chunyan Tian, Mai Zhang, Zhenquan Lu, Xiangyuan Meng, Jing Cai, Xiaofei Guo, and Tianlin Gao.