Abdominal obesity and hip fracture: results from the Nurses’ Health Study and the Health Professionals Follow-up Study Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. Low-fat, increased fruit, vegetable, and grain dietary pattern, fractures, and bone mineral density: the Women's Health Initiative Dietary Modification Trial. Fruit and Vegetable Intake and Hip Fracture Incidence in Older Men and Women: The CHANCES Project. Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford Plasma phospholipid fatty acids and fish-oil consumption in relation to osteoporotic fracture risk in older adults: the Age, Gene/Environment Susceptibility Study. Diet and hip fractures among elderly Europeans in the EPIC cohort Fish Consumption, Bone Mineral Density, and Risk of Hip Fracture Among Older Adults: The Cardiovascular Health Study The effects of long (C20/22) and short (C18) chain omega-3 fatty acids on keel bone fractures, bone biomechanics, behavior, and egg production in free-range laying hens. Associations of Baltic Sea and Mediterranean dietary patterns with bone mineral density in elderly women. Calcium plus vitamin D supplementation and the risk of fractures. Impact of 3-monthly vitamin D supplementation plus exercise on survival after surgery for osteoporotic hip fracture in adult patients over 50 years: A pragmatic randomized, partially blinded, controlled trial Dietary intake of polyunsaturated fatty acids and risk of hip fracture in men and women Fatty acid consumption and risk of fracture in the Women's Health Initiative.
Summary Abdominal obesity might increase  fracture risk . We studied the prospect i ve associations between waist circumference , waist-to-hip ratio , and hip fracture . The indicators of abdominal obesity were associated with increased  hip fracture risk in women , but not in men . The increased risk was restricted to women with low physical activity . Introduction Low weight is an established risk factor for osteoporosis and hip fracture . However , the association between fat tissue , muscle , and bone is complex , and abdominal obesity might increase fracture risk . We studied the prospect i ve associations between indicators of abdominal obesity and hip fracture in two large US cohorts . Methods At baseline in 1986 and through biennial follow-up , information on hip fracture and potential risk factors was collected in 61,677 postmenopausal women and 35,488 men above age 50 . Waist and hip circumferences were reported at baseline and up date d twice . Results During follow-up , 1168 women and 483 men sustained a hip fracture . After controlling for known risk factors , there was a significant association in women between increasing waist circumference and hip fracture ( RR per 10-cm increase 1.13 ( 95 % CI 1.04–1.23 ) and between increasing waist-to-hip ratio and hip fracture ( RR per 0.1 unit increase 1.14 ( 95 % CI 1.04–1.23 ) , but these associations were not seen in men . In women , both measures interacted with physical activity . Those in the highest ( ≥0.90 ) versus lowest ( < 0.75 ) category of waist-to-hip ratio had increased risk of hip fracture if their activity was less than the population median ( RR = 1.61 , 95 % CI 1.18–2.19 ) but not if their activity was higher ( RR = 1.00 , 95 % CI 0.72–1.40 ) . A similar pattern was found for waist circumference . Conclusion Indicators of abdominal obesity were associated with increased hip fracture risk after controlling for BMI in women . The increased risk was restricted to women with low physical activity . In men , no significant associations were found BACKGROUND Short trials of calcium supplementation show that it reduces loss of bone density in postmenopausal women ; longer observational studies do not generally find a lower risk of hip fracture with higher-calcium diets . Fewer studies have focused on vitamin D in preventing postmenopausal osteoporosis or fractures . OBJECTIVE We assessed relations between postmenopausal hip fracture risk and calcium , vitamin D , and milk consumption . DESIGN In an 18-y prospect i ve analysis in 72 337 postmenopausal women , dietary intake and nutritional supplement use were assessed at baseline in 1980 and up date d several times during follow-up . We identified 603 incident hip fractures result ing from low or moderate trauma .  Relative risks ( RRs ) from proportional hazards models were controlled for other dietary and nondietary factors . RESULTS Women consuming > or = 12.5 microg vitamin D/d from food plus supplements had a 37 % lower risk of hip fracture ( RR = 0.63 ; 95 % CI : 0.42 , 0.94 ) than did women consuming < 3.5 microg/d . Total calcium intake was not associated with hip fracture risk ( RR = 0.96 ; 95 % CI : 0.68 , 1.34 for > or = 1200 compared with < 600 mg/d ) . Milk consumption was also not associated with a lower risk of hip fracture ( P for trend = 0.21 ) . CONCLUSIONS An adequate vitamin D intake is associated with a lower risk of osteoporotic hip fractures in postmenopausal women . Neither milk nor a high-calcium diet appears to reduce risk . Because women commonly consume less than the recommended intake of vitamin D , supplement use or dark fish consumption may be prudent BACKGROUND The effects of dietary changes on  osteoporosis , low bone density , and frequent falls  are unestablished . OBJECTIVE We assessed the effect of the Women 's Health Initiative Dietary Modification low-fat and increased fruit , vegetable , and grain intervention on incident hip , total , and site-specific fractures and self-reported falls , and , in a subset , on bone mineral density ( BMD ) . DESIGN Postmenopausal women ( n = 48,835 ) aged 50 - 79 y ( 18.6 % of minority race-ethnicity ) were r and omly assigned to receive the Dietary Modification intervention ( 40 % , n = 19,541 ) ( daily goal : < or = 20 % of energy as fat , > or = 5 servings of vegetables and fruit , and > or = 6 servings of grains ) or to a comparison group that received no dietary changes ( 60 % ; n = 29,294 ) . RESULTS After a mean 8.1 y of follow-up , 215 women in the intervention group and 285 women in the comparison group ( annualized rate : 0.14 % and 0.12 % , respectively ) experienced a hip fracture ( hazard ratio : 1.12 ; 95 % CI : 0.94 , 1.34 ; P = 0.21 ) . The intervention group ( n = 5423 ; annualized rate : 3.44 % ) had a lower rate of reporting > or = 2 falls than did the comparison group ( n = 8695 ; annualized rate : 3.67 % ) ( HR : 0.92 ; 95 % CI : 0.89 , 0.96 ; P < 0.01 ) . There was a significant interaction according to hormone therapy use ; those in the comparison group receiving hormone therapy had the lowest incidence of hip fracture . In a subset of 3951 women , hip BMD at years 3 , 6 , and 9 was 0.4 - 0.5 % lower in the intervention group than in the comparison group ( P = 0.003 ) . CONCLUSIONS A low-fat and increased fruit , vegetable , and grain diet intervention modestly reduced the risk of multiple falls and slightly lowered hip BMD but did not change the risk of osteoporotic fractures . This trial was registered at clinical trials.gov as NCT00000611 The role of fruit and vegetable intake in relation to fracture prevention during adulthood and beyond is not adequately understood . We investigated the potential association between fruit and vegetable intake  and hip fracture incidence in a large sample of older adults from Europe and the United States . A total of 142,018 individuals ( 116,509 women ) aged ≥60 years , from five cohorts , were followed up prospect ively for 1,911,482 person-years , accumulating 5552 hip fractures .  Fruit and vegetable intake  was assessed by vali date d , cohort-specific , food-frequency question naires ( FFQ ) . Ηip fractures were ascertained through national patient registers or telephone interviews/ question naires . Adjusted hazard ratios ( HRs ) derived by Cox proportional hazards regression were estimated for each cohort and subsequently pooled using r and om effects meta- analysis . Intake of ≤1 serving/day of fruit and vegetables combined was associated with 39 % higher hip fracture risk ( pooled adjusted HR , 1.39 ; 95 % confidence interval [ CI ] , 1.20 to 1.58 ) in comparison with moderate intake ( > 3 and ≤5 servings/day ) ( pfor heterogeneity = 0.505 ) , whereas higher intakes ( > 5 servings/day ) were not associated with lower risk in comparison with the same reference . Associations were more evident among women . We concluded that a daily intake of 1 or < 1 servings of fruits and vegetables was associated with increased hip fracture risk in relation to moderate daily intakes . Older adults with such low fruit and vegetable consumption may benefit from raising their intakes to moderate amounts in order to reduce their hip fracture risk . © 2016 American Society for Bone and Mineral Research Objective : To compare fracture rates in four diet groups ( meat eaters , fish eaters , vegetarians and vegans ) in the Oxford cohort of the European Prospect i ve Investigation into Cancer and Nutrition ( EPIC-Oxford ) . Design : Prospect i ve cohort study of self-reported fracture risk at follow-up . Setting : The United Kingdom . Subjects : A total of 7947 men and 26 749 women aged 20–89 years , including 19 249 meat eaters , 4901 fish eaters , 9420 vegetarians and 1126 vegans , recruited by postal methods and through general practice surgeries .  Methods : Cox regression . Results : Over an average of 5.2 years of follow-up , 343 men and 1555 women reported one or more fractures . Compared with meat eaters , fracture incidence rate ratios in men and women combined adjusted for sex , age and non-dietary factors were 1.01 ( 95 % CI 0.88–1.17 ) for fish eaters , 1.00 ( 0.89–1.13 ) for vegetarians and 1.30 ( 1.02–1.66 ) for vegans . After further adjustment for dietary energy and calcium intake the incidence rate ratio among vegans compared with meat eaters was 1.15 ( 0.89–1.49 ) . Among subjects consuming at least 525 mg/day calcium the corresponding incidence rate ratios were 1.05 ( 0.90–1.21 ) for fish eaters , 1.02 ( 0.90–1.15 ) for vegetarians and 1.00 ( 0.69–1.44 ) for vegans . Conclusions : In this population , fracture risk was similar for meat eaters , fish eaters and vegetarians . The higher fracture risk in the vegans appeared to be a consequence of their considerably lower mean calcium intake . An adequate calcium intake is essential for bone health , irrespective of dietary preferences . Sponsorship : The EPIC-Oxford study is supported by The Medical Research Council and Cancer Research UK BACKGROUND Polyunsaturated fatty acids ( PUFAs ) may play a role in fracture , but studies have been largely confined to estimates of dietary intake . OBJECTIVE We aim ed to examine associations between fatty acids measured in late life and fish-oil consumption in early life , midlife , and late life with  osteoporotic fracture risk .  DESIGN Osteoporotic fractures were determined from medical records over 5 - 9 y of follow-up in men and women aged 66 - 96 y. Data were analyzed from 1438 participants including 898 participants who were r and omly selected from the Age , Gene/Environment Susceptibility Study , which is an observational study , and 540 participants with incident fracture . Plasma phospholipid fatty acids were assessed by using gas chromatography .  Fish-oil consumption was assessed by using vali date d question naires as never ( referent ) , less than daily , or daily . HRs and 95 % CIs adjusted for age , education , height , weight , diabetes , physical activity , and medications were estimated by using Cox regression . RESULTS In men , the highest tertile of PUFAs , n-3 ( ω-3 ) , and eicosapentaenoic acid were associated with decreased fracture risk [ HRs ( 95 % CIs ) : 0.60 ( 95 % CI : 0.41 , 0.89 ) , 0.66 ( 0.45 , 0.95 ) , and 0.59 ( 0.41 , 0.86 ) , respectively ] . In women , PUFAs tended to be inversely associated with fracture risk ( P-trend = 0.06 ) , but tertiles 2 and 3 were not independently associated with risk . Tertile 2 of n-6 and arachidonic acid was associated with fracture risk in women [ HRs ( 95 % CIs ) : 1.43 ( 1.10 , 1.85 ) and 1.42 ( 1.09 , 1.85 ) , respectively ] . Daily  fish-oil consumption in late life was associated with lower fracture risk in men ( HR : 0.64 ; 95 % CI : 0.45 , 0.91 ) . Daily fish-oil consumption in midlife was associated with lower fracture risk in women ( HR : 0.75 ; 95 % CI : 0.58 , 0.98 ) . CONCLUSIONS Greater PUFA concentrations may be associated with lower osteoporotic fracture risk in older adults , particularly in men . Critical time periods for n-3 fatty acid consumption may differ by sex Background / Objectives : Evidence on the role of diet during adulthood and beyond on fracture occurrence is limited . We investigated diet and hip fracture incidence in a population of elderly Europeans , participants in the European Prospect i ve Investigation into Cancer and nutrition study .Subjects/ Methods : 29 122 volunteers ( 10 538 men , 18 584 women ) aged 60 years and above ( mean age : 64.3 ) from five countries were followed up for a median of 8 years and 275 incident hip fractures ( 222 women and 53 men ) were recorded .  Diet  was assessed at baseline through vali date d dietary question naires . Data were analyzed through Cox proportional-hazards regression with adjustment for potential confounders . Results : No food group or nutrient was significantly associated with hip fracture occurrence . There were suggestive inverse associations , however , with vegetable consumption ( hazard ratio ( HR ) per increasing sex-specific quintile : 0.93 , 95 % confidence interval ( CI ) : 0.85–1.01 ) , fish consumption ( HR per increasing sex-specific quintile : 0.93 , 95 % CI : 0.85–1.02 ) and polyunsaturated lipid intake ( HR per increasing sex-specific quintile : 0.92 , 95 % CI : 0.82–1.02 ) , whereas saturated lipid intake was positively associated with hip fracture risk ( HR per increasing sex-specific quintile : 1.13 , 95 % CI : 0.99–1.29 ) . Consumption of dairy products did not appear to influence the risk ( HR per increasing sex-specific quintile : 1.02 , 95 % CI : 0.93–1.12 ) . Conclusions : In a prospect i ve study of the elderly , diet , including consumption of dairy products , alcohol and vitamin D , did not appear to play a major role in hip fracture incidence . There is however , weak and statistically non-significant evidence that vegetable and fish consumption and intake of polyunsaturated lipids may have a beneficial , whereas saturated lipid intake a detrimental effect Marine n-3 polyunsaturated fatty acids ( PUFAs ) eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) may be beneficial for bone health , but few studies have investigated the association with fish consumption . Our aim was to study associations of fish and EPA + DHA consumption with bone mineral density ( BMD ) and hip fracture risk and determine whether high linoleic acid ( LA ) intake , the major dietary n-6 PUFA , modifies the associations . The study population consisted of 5045 participants aged 65 years and older from the Cardiovascular Health Study . Data on BMD were available for 1305 participants . Food-frequency question naire was used to assess dietary intake , and hip fracture incidence was assessed prospect ively by review of hospitalization records . After multivariable adjustment , femoral neck BMD was 0.01 g/cm2 lower in the highest versus lowest tuna/other-fish intake category ( p = .05 for trend ) .  EPA + DHA intake ( higher versus lower median of 0.32 g/day ) was associated with lower femoral neck BMD ( 0.66 versus 0.71 g/cm2 , p < .001 ) among those with LA intake greater than the median 12.1 g/day ( p = .03 for interaction ) . No significant associations were found with total-hip BMD . During mean follow-up of 11.1 years , 505 hip fractures occurred . Fish or EPA + DHA  consumption was not significantly associated with fracture incidence [ hazard ratio ( HR ) for extreme categories : HR = 1.23 , 95 % confidence interval ( CI ) 0.83–1.84 for tuna/other fish ; HR = 1.16 , 95 % CI 0.91–1.49 for fried fish ; and HR = 0.98 , 95 % CI 0.71–1.36 for EPA + DHA ] . High LA intake did not modify these associations . In this large prospect i ve cohort of older adults , fish consumption was associated with very small differences in BMD and had no association with hip fracture risk . © 2010 American Society for Bone and Mineral Research Keel fractures in the laying hen are the most critical animal welfare issue facing the egg production industry , particularly with the increased use of extensive systems in response to the 2012 EU directive banning conventional battery cages . The current study is aim ed at assessing the effects of 2 omega-3 ( n3 ) enhanced diets on bone health , production endpoints , and behavior in free-range laying hens . Data was collected from 2 experiments over 2 laying cycles , each of which compared a ( n3 ) supplemented diet with a control diet . Experiment 1 employed a diet supplemented with a 60:40 fish oil-linseed mixture ( n3:n6 to 1.35 ) compared with a control diet ( n3:n6 to 0.11 ) , whereas the n3 diet in Experiment 2 was supplemented with a 40:60 fish oil-linseed ( n3:n6 to 0.77 ) compared to the control diet ( n3:n6 to 0.11 ) . The n3 enhanced diet of Experiment 1 had a higher n3:n6 ratio , and a greater proportion of n3 in the long chain ( C20/22 ) form ( 0.41 LC : SC ) than that of Experiment 2 ( 0.12 LC : SC ) . Although dietary treatment was successful in reducing the frequency of fractures by approximately 27 % in Experiment 2 , data from Experiment 1 indicated the diet actually induced a greater likelihood of fracture ( odds ratio : 1.2 ) and had substantial production detriment . Reduced keel breakage during Experiment 2 could be related to changes in bone health as n3-supplemented birds demonstrated greater load at failure of the keel , and tibiae and humeri that were more flexible . These results support previous findings that n3-supplemented diets can reduce fracture likely by increasing bone strength , and that this can be achieved without detriment to production . However , our findings suggest diets with excessive quantities of n3 , or very high levels of C20/22 , may experience health and production detriments . Further research is needed to optimize the quantity and type of n3 in terms of bone health and production variables and investigate the potential associated mechanisms OBJECTIVE Dietary quality in relation to bone health has been analysed in relatively few studies . The current study aim ed to assess the association of the Baltic Sea diet ( BSD ) and the Mediterranean diet ( MD ) with  bone mineral density ( BMD ) among elderly women . DESIGN Lumbar , femoral and total body BMD were measured by dual-energy X-ray absorptiometry at baseline and year 3 . Dietary intake was measured by 3 d food record at baseline . BSD and MD scores were calculated from food and alcohol consumption and nutrient intake . Information on lifestyle , diseases and medications was collected by question naires . Longitudinal associations of BSD and MD scores with BMD were analysed using linear mixed models . SETTING Interventional prospect i ve Kuopio Osteoporosis Risk Factor and Fracture Prevention study including women aged 65 - 71 years and residing in Kuopio province , Finl and . SUBJECTS Women ( n 554 ) with mean age of 67·9 ( sd 1·9 ) years and mean BMI of 28·8 ( sd 4·7 ) kg/m2 . RESULTS Higher BSD scores were associated with higher intakes of fruit and berries , vegetables , fish and low-fat dairy products , and lower intake of sausage . Higher MD scores were associated with higher consumption of fruit and berries and vegetables . BSD and MD scores were associated with higher PUFA : SFA and higher fibre intake . Femoral , lumbar or total body BMD was not significantly different among the quartiles of BSD or MD score . CONCLUSION The lack of associations suggest that Baltic Sea and Mediterranean dietary patterns may not adequately reflect dietary factors relevant to bone health BACKGROUND The efficacy of calcium with vitamin D supplementation for preventing hip and other fractures in healthy postmenopausal women remains equivocal . METHODS We recruited 36,282 postmenopausal women , 50 to 79 years of age , who were already enrolled in a Women 's Health Initiative ( WHI ) clinical trial . We r and omly assigned participants to receive 1000 mg of elemental [ corrected ] calcium as calcium carbonate with 400 IU of vitamin D3 daily or placebo .  Fractures were ascertained for an average follow-up period of 7.0 years . Bone density was measured at three WHI centers . RESULTS Hip bone density was 1.06 percent higher in the calcium plus vitamin D group than in the placebo group ( P<0.01 ) . Intention-to-treat analysis indicated that participants receiving calcium plus vitamin D supplementation had a hazard ratio of 0.88 for hip fracture ( 95 percent confidence interval , 0.72 to 1.08 ) , 0.90 for clinical spine fracture ( 0.74 to 1.10 ) , and 0.96 for total fractures ( 0.91 to 1.02 ) . The risk of renal calculi increased with calcium plus vitamin D ( hazard ratio , 1.17 ; 95 percent confidence interval , 1.02 to 1.34 ) . Censoring data from women when they ceased to adhere to the study medication reduced the hazard ratio for hip fracture to 0.71 ( 95 percent confidence interval , 0.52 to 0.97 ) . Effects did not vary significantly according to prer and omization serum vitamin D levels . CONCLUSIONS Among healthy postmenopausal women , calcium with vitamin D supplementation result ed in a small but significant improvement in hip bone density , did not significantly reduce hip fracture , and increased the risk of kidney stones . ( Clinical Trials.gov number , NCT00000611 . ) Objective To determine whether 3-monthly supplementation of an oral vitamin D widely used in Spain ( calcifediol ) plus daily exercise could influence survival at one and four years after surgery for osteoporotic hip fracture . Design A pragmatic , r and omized , partially single-blind placebo-controlled study . Setting Patients admitted to a tertiary university hospital for acute hip fracture . Participants 675 healthy adult patients undergoing surgery for osteoporotic hip fracture were recruited from January 2004 to December 2007.Intervention Patients were r and omized to receive either 3-monthly oral doses of 3 mg calcifediol ( Hidroferol Choque ® ) or placebo in the 12 months postsurgery . Patients who received calcifediol were also given an exercise programme . The placebo group received st and ard health recommendations only . Measurements The primary endpoint was survival at 1 year and at 4 year follow-up . We also recorded new fractures , medical complications and anti-osteoporotic treatment compliance . Results We included a total of 88 patients , aged 62 to 99 years . Mean age was 82 years and 88.6 % were women . At 12 months , 10 ( 11.3 % ) patients had died , 9 of them , from the non-intervention group . At 4 years after surgery , 20 ( 22.7 % ) had died , 3 ( 3.4 % ) from the intervention group and 17 ( 19.3 % ) from the non-intervention group . At this time , survival curve analysis showed 93 % survival in the intervention group and 62 % in the non-intervention group ( p=0.001 ) . At 12-month follow up , there were 18 new fractures , 9 in each group . The non-intervention group had more medical complications , with significant differences at visit 2 ( p = 0.04 ) and 3 ( p = 0.02 ) but not at visit 4 ( p = 0.18 ) . No significant differences between groups were found regarding treatment compliance . Conclusion 3-monthly , oral supplements of 3 mg calcifediol plus daily exercise  improved survival at one-year and four-year follow up after surgery for an osteoporotic hip fracture Summary Data on the impact of polyunsaturated fatty acid intake on hip fracture risk are inconsistent . We investigated this association in 75,878 women and 46,476 men and did not find a significant role for polyunsaturated fatty acid intake in the prevention of hip fractures . Introduction Polyunsaturated fatty acids ( PUFA ) are important in the prevention of chronic diseases , but studies of bone health report inconsistent results . Our aim was to investigate the association between dietary PUFA  intake and risk of hip fracture in two large prospect i ve cohorts of men and women with long follow-up times and frequently up date d dietary data . Methods The study population included 75,878 women and 46,476 men free of osteoporosis at baseline .  Dietary intakes  were assessed by a food frequency question naire at baseline and several times during the follow-up . Multivariable-adjusted Cox proportional hazards models were used to estimate relative risks ( RR ) . Results During 24 years of follow-up , we identified 1,051 hip fracture cases due to low or moderate trauma among the women and 529 cases among the men . In the pooled analyses , no statistically significant associations were found between intakes of total PUFA [ RR in the highest vs. lowest quintile : 0.99 , 95 % confidence interval ( CI ) 0.69 , 1.43 ; p value for trend is = 0.83 ] , total n-3 PUFA ( RR 0.89 , 95 % CI 0.75 , 1.06 ; p value for trend is = 0.26 ) , total n-6 PUFA ( RR 0.99 , 95 % CI 0.71 , 1.38 ; p value for trend is = 0.82 ) , n-6/n-3 PUFA ratio or individual PUFAs , and hip fracture risk . However , in women low intakes of total PUFA , total n-6 PUFA , and linoleic acid were associated with higher risk . Conclusions This study does not support a significant role for PUFA intake in the prevention of hip fractures , although low total PUFA , n-6 PUFA , or linoleic acid intakes may increase the risk in women 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 question naires and st and ardized 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 clinical trials.gov as NCT00000611
ABSTRACT Previous studies have shown that fish consumption and dietary intake of n-3 polyunsaturated fatty acids ( n-3 PUFAs ) are associated with hip fracture ; however , findings were conflicting .
The present review aim ed to summarize the current evidence on the association of fish consumption and dietary intake of n-3 PUFAs with hip fracture .