---
title: Recent Systematic Review and Meta-analysis Investigated Relationship Between n-3 PUFA Supplementation and Bone Integrity
description: A meta-analysis of 19 trials found no significant effect of n-3 PUFA supplementation on bone markers, though women showed higher femoral bone density.
---

[Evidence-based Wellness Education](https://www.casi.org/articles)

# [Recent Systematic Review and Meta-analysis Investigated Relationship Between n-3 PUFA Supplementation and Bone Integrity](https://www.casi.org/articles/relationship-between-n-3-pufa-supplementation-bone-integrity)

 Written by [Cory Ambrose, ND, MAT](https://www.casi.org/articles/author/cory-ambrose-nd-mat) | Sep 15, 2023, 4:00:00 AM

The challenges of maintaining bone integrity can increase as we age. Bone health can be affected by hormonal changes, [nutritional status](https://www.dynamed.com/condition/osteoporosis-in-postmenopausal-women), and lifestyle factors such as physical activity. Unbalanced inflammatory states have also been shown to negatively influence [bone metabolism](https://pubmed.ncbi.nlm.nih.gov/37375709/). 

States of decreased bone formation and increased bone resorption have been associated in research with elevated levels of certain [inflammatory markers](https://pubmed.ncbi.nlm.nih.gov/37375709/) including C-reactive protein (CRP) and interleukin-6 (IL)-6. Omega-3 polyunsaturated fatty acids (n-3 PUFAs) have been well-researched for their potential to support a normal inflammatory response alongside many other body systems. Recent studies have investigated if n-3 PUFAs may also play a supportive role in bone health. 

Evidence suggests that n-3 PUFAs may influence certain biochemical pathways related to bone metabolism. A [randomized controlled trial](https://pubmed.ncbi.nlm.nih.gov/37375709/) (RCT) reported 17% reductions in N-telopeptides of type I collagen (NTx-1). NTx-1 is an indicator of [osteoclast activity](https://pubmed.ncbi.nlm.nih.gov/37375709/), suggesting states of bone resorption. In addition, n-3 PUFAs are thought to influence bone health through their role in supporting a healthy inflammatory response. Laboratory studies indicate that n-3 PUFAs may help reduce inflammatory cytokine activity including [nuclear factor-κB](https://pubmed.ncbi.nlm.nih.gov/37226250/) and IL-1β. [Systematic reviews](https://pubmed.ncbi.nlm.nih.gov/37375709/) of clinical studies have suggested an inverse association between fracture risk and n-3 PUFA status. 

A recently published systematic review and meta-analysis by [Gao and colleagues](https://pubmed.ncbi.nlm.nih.gov/37375709/) explored the potential efficacy of n-3 PUFAs on bone metabolism and integrity. This study aggregated data from 19 RCTs involving over 2,500 individuals. Overall, statistically significant increases in blood n-3 PUFAs were found. In addition, upon [subgroup analysis](https://pubmed.ncbi.nlm.nih.gov/37375709/), significant increases in parameters related to bone health, as measured by bone density in the femoral neck, were observed in females. Decreases in [NTx-1](https://pubmed.ncbi.nlm.nih.gov/37375709/) were reported in all genders. Of note, 25(OH)D, a measure of vitamin D status, was observed to increase in studies involving only n-3 PUFA supplementation; however, more information is needed before clinical conclusions can be made. 

Overall, the meta-analysis concluded that n-3 PUFA supplementation did not significantly influence biomarkers related to bone health. However, [subgroup analyses](https://pubmed.ncbi.nlm.nih.gov/37375709/) suggest that certain qualities of bone health may have improved in the presence of n-3 PUFA supplementation. This may indicate that more clinical research with standardized amounts of n-3 PUFAs, more participants, a snapshot of the nutritional status of participants at baseline and study terminus, and longer trials are warranted. 

While more research is needed to understand the scope of the influence of n-3 PUFAs on bone health, evidence suggests that they may help support a healthy inflammatory response, brain health, skin integrity, and many other body systems. Dietary sources of n-3 PUFAs include fatty fish such as salmon, sardines, and mackerel. Vegan sources include flaxseeds, chia seeds, walnuts, and edamame.

[View full post](https://www.casi.org/articles/relationship-between-n-3-pufa-supplementation-bone-integrity)

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