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.


METHODS
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.
Orchard
Tonya S
TS
Department of Human Nutrition, College of Education and Human Ecology, The Ohio State University, Columbus, OH, USA.
Cauley
Jane A
JA
Frank
Gail C
GC
Neuhouser
Marian L
ML
Robinson
Jennifer G
JG
Snetselaar
Linda
L
Tylavsky
Fran
F
Wactawski-Wende
Jean
J
Young
Alicia M
AM
Lu
Bo
B
Jackson
Rebecca D
RD
D000368:Aged; D004041:Dietary Fats / Q000008:administration & dosage* / Q000009:adverse effects; D005227:Fatty Acids / Q000009:adverse effects / Q000494:pharmacology*; D005229:Fatty Acids, Monounsaturated / Q000494:pharmacology*; D015525:Fatty Acids, Omega-3 / Q000494:pharmacology*; D043371:Fatty Acids, Omega-6 / Q000494:pharmacology*; D005260:Female; D005395:Fish Oils / Q000009:adverse effects; D050723:Fractures, Bone / Q000209:etiology* / Q000517:prevention & control; D006615:Hip; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications*; D016016:Proportional Hazards Models; D012307:Risk Factors; D057566:Self Report
D004041:Dietary Fats; D005227:Fatty Acids; D005229:Fatty Acids, Monounsaturated; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D005395:Fish Oils