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

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 II 1 55 P for trend = 0 001] Lower total fracture risk was associated with a higher monounsaturated FA in take (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 094 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 high er intake of n-6 FAs may modestly decrease total fracture risk This trial was registered at clinicaltrials gov as NCT00000611 Am J Clin Nutr 2010 92 1452-60