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

Niazi S, Mazloomi M, Ostovar A, Fahimfar N, Nematy H, Rezaie M, Niazi F, Doroodgar F

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025

382,094 participants · 1 citation

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.

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 382,094 participants or records.

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