British Journal of Nutrition

Full Papers

A systematic review of omega-3 fatty acids and osteoporosis

Tonya S. Orcharda1, Xueliang Pana2, Fern Cheeka3, Steven W. Inga4 and Rebecca D. Jacksona4 c1

a1 The Ohio State University, College of Education and Human Ecology, Department of Human Nutrition, Columbus, OH, USA

a2 The Ohio State University, Center for Biostatistics, Columbus, OH, USA

a3 The Ohio State University, Prior Health Sciences Library and Center for Knowledge Management, Columbus, OH, USA

a4 The Ohio State University, College of Medicine, Division of Endocrinology, Diabetes, and Metabolism, Columbus, OH, USA


Some epidemiological evidence suggests that diets high in omega 3 fatty acids (n-3 FAs) may be beneficial for skeletal health. The aim of this systematic review was to determine if randomized controlled trials (RCTs) support a positive effect of n-3 FAs on osteoporosis. A systematic search was performed in PubMed and EMBASE databases. We included RCTs with skeletal outcomes conducted in adults or children (> = 1 year old) using n-3 FA fortified foods, diets or supplements alone or in combination with other vitamins/minerals, versus placebo. Primary outcomes were incident fracture at any site and bone mineral density (BMD) in g/cm2. Secondary outcomes included bone formation or resorption markers and bone turnover regulators. A total of 10 RCTs met inclusion criteria. Effect sizes with 95 % confidence intervals were estimated to compare studies across various treatments and outcome measures. No pooled analysis was completed due to heterogeneity of studies and small sample sizes. No RCTs included fracture as an outcome. Four studies reported significant favorable effects of n-3 FA on BMD or bone turnover markers. Of these, three delivered n-3 FA in combination with high calcium foods or supplements. Five studies reported no differences in outcomes between n-3 FA intervention and control groups; one study included insufficient data for effect size estimation. Strong conclusions regarding n-3 FAs and bone disease are limited due to the small number and modest sample sizes of RCTs, however, it appears that any potential benefit of n-3 FA on skeletal health may be enhanced by concurrent administration of calcium.


c1 Corresponding author: Rebecca D. Jackson, email