Systemic inflammation is the root cause of chronic disease. Heart disease, diabetes, Alzheimer’s, and yes, osteoporosis, have their underlying basis in inflammation. Chronic inflammation messes with the delicate balance of bone formation and resorption during the remodeling process and leads to bone loss.

You have probably heard that supplementing with fish oil for their omega-3 fatty acids can help reduce the aches and pains of inflamed arthritic joints, but can omega-3s also help reduce the chronic systemic inflammation linked to bone loss? Can adding fish to your diet and supplementing with fish oil help prevent the progression of osteoporosis?

Dr. Tonya Orchard from the Department of Human Nutrition at The Ohio State University researched this question. Dr. Orchard and her colleagues analyzed the omega-6:3 fatty acid ratio of postmenopausal women through a completely unique approach and sought to determine whether this ratio could predict fracture risk.
The relationship of omega-6 and omega-3 fatty acids to bone density has been studied before but never through the assessment of red blood cell fatty acids. Earlier studies have looked at the impact of omega-3s on bone health but their results are conflicting. Some report that omega-3 oils can benefit bone health while others show no benefit at all. As it turns out, it is fairly difficult to accurately determine the amount of dietary fatty acids a person takes in and absorbs and then assess the impact of these fatty acids on fracture risk. But Dr. Orchard decided to use a unique approach. Instead of studying the fatty acid content of fat cells, or that found in the plasma or serum of blood, Dr. Orchard looked at the fatty acid content of red blood cells. Scientists have now determined that the amount of fatty acids found in red blood cells is a better reflection of long-term dietary intake of omega-3 fatty acids than any other component of blood or even of fatty tissue itself. By studying red blood cell fatty acids and their link to fracture risk, Dr. Orchard’s novel approach seems to have laid to rest the long-standing question of whether omega-3s should be included in the armamentarium of individuals with bone loss.
The authors of this study which was published in the Journal of Bone and Mineral Research concluded that omega-3 fatty acids “were significantly inversely associated with risk of hip fracture in these WHI [Women’s Health Initiative] participants.” “Conversely, women with an n6/n-3 FA ratio in the highest tertile had nearly twice the risk of hip fracture compared to those in the lowest tertile.” “Women with highest RBC EPA [*] in this case-control study had a 54% lower risk of hip fracture.
While this study confirms that supplementing with omega-3s can benefit bone health, it is important to remember that reducing omega-6 intake is equally important if it is too high. That doesn’t mean that you cut out all omega-6s from your diet. Omega-6s are important for health but too much of anything is not good. I remember when I used to eat loads of pasta while training for triathlons. I thought a plate full of spaghetti would be better than a plate of fish and vegetables any day! Argggg…. that’s one of the reasons that I developed osteoporosis. Omega-6s–bread, pasta, cereal–cause inflammation when eaten in excess. It is the ratio between the omega-3s and 6s that is important and the typical American diet is higher in omega-6 fatty acids than in omega-3s. Not only are grains high in omega-6s but they are also acidic. Salmon, mackerel, herring, and tuna, on the other hand, are loaded with omega-3s to help reduce inflammation, plus they are a great source of protein. Krill oil, hemp seed oil and flaxseed are also excellent sources of omega-3s.
 * Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are the fatty acids found in fish oil.
Orchard TS et al. 2013. The association of red blood cell n-3 and n-6 fatty acids with bone mineral density and hip fracture risk in the Women’s Health Initiative. JBMR 28(3):505-515.