Background: Osteoporosis, a major health problem among postmenopausal women, is influenced by dietary factors. The purpose of the present study was to evaluate the hypothesis that erythrocyte levels of n–3 polyunsaturated fatty acid (PUFA) and the dietary intake of fish are associated with risk of osteoporosis and correlate with bone mass in postmenopausal Korean women with the disease. Methods: Fifty cases and 100 controls were recruited. Osteoporosis was defined according to the International Society for Clinical Densitometry guideline as a score lower than –2.5 SD below the T-score for lumbar vertebrae L1–L4, femoral neck or femoral total. Results: The T-score of the femoral neck was positively correlated with erythrocyte levels of n–3 PUFA, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and the intake of fish, and was negatively correlated with the ratio of n–6/n–3 PUFA after adjusting for age, years after menopause and height. In addition, the risk of osteoporosis was positively associated with erythrocyte levels of saturated fatty acids but negatively associated with EPA + DHA. Conclusions: Erythrocyte levels of n–3 PUFA and the intake of fish were positively correlated with bone mass. In particular, erythrocyte levels of EPA + DHA reduced the risk of osteoporosis in postmenopausal Korean women.

Delaney MD, Miriam F: Strategies for the prevention and treatment of osteoporosis during early postmenopause. Am J Obstetrics Gynecol 2006;194:S12–S23.
Korea Institute for Health and Social Affairs, Ministry of Health and Welfare: Korean National Health and Nutrition Examination Survey, Report on 2007. Seoul, 2009.
New SA, Bolton-Smith C, Grubb DA, Reid DM: Nutritional influences on bone mineral density: a cross-sectional study in premenopausal women. Am J Clin Nutr 1997;65:1831–1839.
Cashmen KD: Diet, nutrition, and bone health. J Nutr 2007;137:2507S–2512S.
Muller-Esterl W, Kruger MC, Horrobin DF: Calcium metabolism, osteoporosis and essential fatty acids: a review. Prog Lipid Res 1997;36:131–151.
Claassen N, Coetzer H, Steinmann CML, Kruger MC: The effect of different n–6/n–3 essential fatty acid ratios on calcium balance and bone in rats. Prostaglandins Leukot Essent Fatty Acids 1995;53:13–19.
Claassen N, Potgieter HC, Seppa M, Vermaak WJ, Coetzer H, Van Papendorp DH: Supplemented gamma-linolenic acid and eicosapentaenoic acid influence bone status in young male rats: effects on free urinary collagen crosslinks, total urinary hydroxyproline, and bone calcium content. Bone 1995;16:385S–392S.
Liu D, Veit HP, Denbow DM: Effects of long-term dietary lipids on mature bone mineral content, collagen, crosslinks, and prostaglandin E2 production in Japanese quail. Poult Sci 2004;83:1876–1883.
Sun D, Krishnan A, Zaman K, Lawrence R, Bhattacharya A, Fernandes G: Dietary n–3 fatty acids decrease osteoclastogenesis and loss of bone mass in ovariectomized mice. J Bone Miner Res 2003;18:1206–1216.
Caughey GE, Mantzioris E, Gibson RA, Cleland LG, James MJ: The effect on human tumor necrosis factor alpha and interleukin 1 beta production of diets enriched in n–3 fatty acids from vegetable oil or fish oil. Am J Clin Nutr 1996;63:116–122.
Chen YM, Ho SC, Lam SS: Higher sea fish intake is associated with greater bone mass and lower osteoporosis risk in postmenopausal Chinese women. Osteoporos Int 2010;21:939–946.
Weiss LA, Barrett-Connor E, von Muhlen D: Ratio of n–6 to n–3 fatty acids and bone mineral density in older adults: the Rancho Bernardo Study. Am J Clin Nutr 2005;81:934–938.
Kruger MC, Coetzer H, de Winter R, Gericke G, van Papendorp DH: Calcium, gamma-linolenic acid and eicosapentaenoic acid supplementation in senile osteoporosis. Aging 1998;10:385–394.
Terano T: Effect of omega 3 polyunsaturated fatty acid ingestion on bone metabolism and osteoporosis. World Rev Nutr Diet 2001;88:141–147.
Hogstrom M, Nordstrom P, Nordstrom A: n–3 fatty acids are positively associated with peak bone mineral density and bone accrual in healthy men: the NO2 Study. Am J Clin Nutr 2007;85:803–807.
Virtanen JK, Mozaffarian D, Cauley JA, Mukamel KJ, Robbins J, Siscovick DS: Fish consumption, bone mineral density, and risk of hip fracture among older adults: the Cardiovascular Health Study. J Bone Miner Res 2010;25:1972–1979.
Fujiwara S, Kasagi F, Yamada M, Kodama K: Risk factors for hip fracture in a Japanese cohort. J Bone Miner Res 1997;12:998–1004.
Harris WS, Von Schacky C: The Omega-3 Index: a new risk factor for death from coronary heart disease? Prev Med 2004;39:212–220.
Park Y, Oh SH, Rhee MY: Association between 24-h ambulatory blood pressure and erythrocyte n–3 polyunsaturated fatty acid in Korean subjects with hypertension. Nutr Res 2010;30:807–814.
Lewiecki EM, Baim S, Langman CB, Bilezikian JP: The official positions of the International Society for Clinical Densitometry: perceptions and commentary. J Clin Densitom 2009;12:267–271.
Gregory JS, Aspden RM: Femoral geometry as a risk factor for osteoporotic hip fracture in men and women. Med Eng Phys 2008;30:1275–1286.
Zalloua PA, Hsu YH, Terwedow H, Zang T, Wu D, Tang G, Li Z, Hong X, Azar ST, Wang B, Bouxsein ML, Brain J, Cummings SR, Rosen CJ, Xu X: Impact of seafood and fruit consumption on bone mineral density. Maturitas 2007;56:1–11.
Feskanich D, Willett WC, Colditz GA: Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. Am J Clin Nutr 2003;77:504–511.
Suzuki T, Yoshida H, Hashimoto T, Yoshimura N, Fujiwara S, Fukunaga M, Nakamura T, Yoh K, Inoue T, Hosoi T, Orimo H: Case-control study of risk factors for hip fractures in the Japanese elderly by a Mediterranean Osteoporosis Study (MEDOS) questionnaire. Bone 1997;21:461–467.
Farina EK, Kiel DP, Roubenoff R, Schaefer EJ, Cupples LA, Tucker KL: Protective effects of fish intake and interactive effects of long-chain polyunsaturated fatty acid intakes on hip bone mineral density in older adults: the Framingham Osteoporosis Study. Am J Clin Nutr 2011;93:1142–1151.
Tartibian B, Hajizadeh Maleki B, Kanaley J, Sadeghi K: Long-term aerobic exercise and omega-3 supplementation modulate osteoporosis through inflammatory mechanisms in post-menopausal women: a randomized, repeated measures study. Nutr Metab (Lond) 2011;8:71.
Manson JE, Bassuk SS, Lee IM, Cook NR, Albert MA, Gordon D, Zaharris E, Macfadyen JG, Danielson E, Lin J, Zhang SM, Buring JE: The VITamin D and OmegA-3 TriaL (VITAL): rationale and design of a large randomized controlled trial of vitamin D and marine omega-3 fatty acid supplements for the primary prevention of cancer and cardiovascular disease. Contemp Clin Trials 2012;33:159–171.
Orchard TS, Cauley JA, Frank GC, Neuhouser ML, Robinson JG, Snetselaar L, Tylavsky F, Wactawski-Wende J, Young AM, Lu B, Jackson RD: Fatty acid consumption and risk of fracture in the Women’s Health Initiative. Am J Clin Nutr 2010;92:1452–1460.
Fan YY, Chapkin RS: Mouse peritoneal macrophage prostaglandin E1 synthesis is altered by dietary gamma-linolenic acid. J Nutr 1992;122:1600–1606.
Corwin RL, Hartman TJ, Maczuga SA, Graubard BI: Dietary saturated fat intake is inversely associated with bone density in humans: analysis of NHANES III. J Nutr 2006;136:159–165.
Brasitus TA, Davidson NO, Schachter D: Variations in dietary triacylglycerol saturation alter the lipid composition and fluidity of rat intestinal plasma membranes. Biochim Biophys Acta 1985;812:460–472.
Coetzer H, Claassen N, van Papendorp DH, Kruger MC: Calcium transport by isolated brush border and basolateral membrane vesicles: role of essential fatty acid supplementation. Prostaglandins Leukot Essent Fatty Acids 1994;50:257–266.
Barzel US, Massey LK: Excess dietary protein can adversely affect bone. J Nutr 1998;128:1051–1053.
Meyer HE, Pedersen JI, Loken EB, Tverdal A: Dietary factors and the incidence of hip fracture in middle-aged Norwegians: a prospective study. Am J Epidemiol 1997;145:117–123.
Abelow BJ, Holford TR, Insogna KL: Cross-cultural association between dietary animal protein and hip fracture: a hypothesis. Calcif Tissue Int 1992;50:14–18.
Kerstetter JE, O’Brien KO, Insogna KL: Low protein intake: the impact on calcium and bone homeostasis in humans. J Nutr 2003;133:855S–861S.
Promislow J, Goodman-Gruen D, Slymen DJ, Barrett-Connor E: Protein consumption and bone mineral density in the elderly: the Rancho Bernardo study. Am J Epidemiol 2002;155:636–644.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.