Bone health and omega- fatty acids -
It is projected that at least 1 in 3 women and 1 in 5 men will suffer a fragility fracture during their lifetime 1. In addition, the worldwide rates of incidence are growing. What is interesting is that osteoporosis, sleep problems and some cancers seem to be related.
For example, not only do breast cancer and common cancer treatments increase the risk of having sleep problems, but they also increase the risk of osteoporosis 3, 4, 5. Several epidemiological studies have also shown that sleep disturbances both sleeping more than 9 hours or less than 6 increase the risk of osteoporosis 6.
Our Omega Restore vials contain three primary ingredients that may have benefits related to osteoporosis: melatonin, omega-3 fatty acids, and vitamin D3. I have written about how these ingredients impact breast cancer and sleep issues in previous articles.
In this one, I will survey the science surrounding bone health. While best known for its role in regulating the circadian rhythm, melatonin is indispensable for a multitude of cellular functions, including bone and tooth formation.
In fact, some scientists believe that reduced melatonin production could in part explain why people become more prone to bone imbalances as they get older. Researchers in Denmark looked at the effect of taking melatonin supplements in relationship to bone loss in postmenopausal women.
They found that supplementing with 3 mg of melatonin for one year increased bone mineral density BMD of the femoral neck by 2.
A American study noted similar findings. This study, which combined 5 mg of melatonin with vitamin D3 as well as vitamin K2 and strontium , found that daily use increased BMD in the spine by 4. Scientists also believe that getting enough omega-3 fatty acids could have a positive impact on bone health.
Omega-3s are known for their ability to combat chronic inflammation, which can play a significant role in the onset of osteoporosis. In fact, chronic inflammation may disturb bone metabolism and prevent bone resorption, contributing to bone loss over time 9.
In observational studies, researchers have found that people with higher intakes of omega-3s generally have better bone mineral density numbers and a reduced risk of fragility fractures Eating fish in particular seems to have a strong benefit for reducing the risk of fractures. However, researchers note that these benefits depend on dose and source.
For instance, in one study, the researchers found a positive correlation between the consumption of fish and bone mineral density in Koreans, but not in Americans.
The researchers reasoned that this could be explained by the fact that the Koreans ate 4 to 5 as much fish as their American counterparts, and that the results highlighted the importance of meeting a minimum intake level in order to achieve benefits This explanation is supported by another study showing that there is a clear relationship between the amount of omega-3s in the blood and bone mineral density Studies indicate that increased omega-3 intake, particularly from eating fish, may reduce the risk of fractures.
Of the three nutrient types, vitamin D is the best known for its role in promoting and maintaining healthy bones. Researchers originally made the connection between vitamin D and bone health thanks to cod liver oil, a common remedy for preventing rickets in the early 20th century Since then, vitamin D has been extensively studied in order to determine its impact on bone fractures While vitamin D3 is widely used and recommended for people at risk of osteoporosis, clinical trials supplementing with vitamin D alone have found somewhat mixed results.
Researchers note that this could be because of the low dose or form of vitamin D used Interestingly enough, until recently, the recommended dietary allowance of vitamin D3 was only IUs. The scientific basis for this dose was that it approximated the amount of vitamin D in one teaspoon 5 mL of unrefined cod liver oil, which had long been considered a safe and effective dose for preventing rickets In their recommendation of vitamin D, however, scientists may have ignored an important point: Raw cod liver oil is a nutrient-rich liquid containing not just vitamin D, but a multitude of substances, including omega-3 fatty acids and other vitamins.
These ingredients synergistically interact together. In addition, they also impact the gut bacteria, which in turn influence vitamin D absorption and functionality Melatonin, fish oil and vitamin D3 all seem to have a strong and positive effect on the gut microbiota, much like pre and probiotics 18, 19, 20, 21, Researchers consistently find that these nutrients increase microbial diversity and reduce the types of bacteria that manufacture inflammation-driving substances.
This is an extremely important point, since research also shows that most chronic diseases, including osteoporosis and many kinds of cancers, are accompanied by altered gut flora and diminished bacterial diversity 23, The lack of ingredient synergy could perhaps explain why clinical trials show that vitamin D3 supplementation alone has a limited or inconsistent effect on osteoporosis.
This same logic could also clarify why traditional omega-3 capsules have not been significantly linked to improved bone health. Low dosages delivered via gel caps ensure that the contact surface with the bacteria is too small to significantly change gut flora.
I suspect this can also explain why melatonin appears to be more powerful when it is dissolved directly into our Omega Cure oil. Compared to taking melatonin in a pill, swallowing a liquid version would likely increase the contact with the gut bacteria 25, How do liquid versus pill supplements compare?
Some studies examining the gut bacteria find that the two deliver different results. There are several treatment options and many medications that may help prevent bone mineral density loss and reduce fracture risk. Patients often reject the medications because of gastrointestinal problems and other side effects, or because they are inconvenient to take.
The researchers suspected that it was the inclusion of melatonin that made the difference for patient compliance. Because the patients noticed day-to-day benefits for their sleep, they likely felt more motivated to take their supplements as directed 8.
In talking with many of our customers who have been using our products for years, I notice a similar trend. Many customers take Omega Cure to help stave off joint discomfort or lower lipid levels. But, as life changing as Omega Cure can be, customers sometimes have trouble measuring or taking the appropriate dose daily.
While not for everyone, the Omega Restore vials seem to encourage compliance because they are pre-measured and also contain melatonin. If you have questions about Omega Restore or what you have read here, leave us a comment below or give us a call at We are always happy to talk with you and hear your feedback.
Facts and Statistics. International Osteoporosis Foundation, Chow, L. A Survey of Osteoporosis and Breast Cancer Risk Perception among Menopausal and Postmenopausal Women in Hong Kong. Journal of Menopausal Medicine , 23 2 , — Otte, J.
and Champion, V. Prevalence, Severity, and Correlates of Sleep-Wake Disturbances in Long-Term Breast Cancer Survivors. Journal of Pain and Symptom Management , 39 3 , Drake, M. Osteoporosis and Cancer. Current Osteoporosis Reports , 11 3 , — Bruyère, O.
et al. Skeletal Health in Breast Cancer Survivors. Maturitas , , Saint Martin, M. Does Subjective Sleep Affect Bone Mineral Density in Older People with Minimal Health Disorders?
The PROOF Cohort. Amstrup, A. Melatonin Improves Bone Mineral Density at the Femoral Neck in Postmenopausal Women with Osteopenia: A Randomized Controlled Trial. Journal of Pineal Research , 59 2 , Maria, S. Melatonin-Micronutrients Osteopenia Treatment Study MOTS : A Translational Study Assessing Melatonin, Strontium Citrate , Vitamin D3 and Vitamin K2 MK7 on Bone Density, Bone Marker Turnover and Health Related Quality of Life in Postmenopausal Osteopenic Women Following a One-Year Double-Blind RCT and on Osteoblast-Osteoclast Co-Cultures.
Aging , 9 1 , — Redlich, K. and Smolen, J. Inflammatory Bone Loss: Pathogenesis and Therapeutic Intervention. Nature Review Drug Discovery , 11 3 , Longo, A.
and Ward, W. PUFAs, Bone Mineral Density, and Fragility Fracture: Findings from Human Studies. Advances in Nutrition , 7 2 , Eunjin Choi, E. and Youngsoon, P. Nutrients, 8 3 , Orchard, T. and Jackson, R. and Bijvoet, O. Rickets Before the Discovery of Vitamin D. BoneKEy Reports , 3, Martineau, A.
In subgroup analyses that were stratified by gender and race, this association was still shown to be significant. Based on the smooth curve and saturation effect analysis, we found no saturation effect for the three fatty acids and total BMD. However, there was a turning point Conclusion: We found that fatty acid intake is beneficial for bone density in adults.
Therefore, according to our findings, it is recommended that adults consume moderate amounts of fatty acids to ensure adequate bone mass but not metabolic diseases.
Osteoporosis OP is a degenerative disease of the bones that results in weakened bones, weakened microarchitecture, increased fragility, and increased fracture risk 1. The prevalence of OP has been increasing in recent years.
According to a study done by the International Society for Clinical Densitometry and the International Foundation for Osteoporosis, more than 70 million Americans will have osteoporosis or bone loss by 2.
With the expansion of human life expectancy and population aging, OP will become a more severe public health problem worldwide 3 , 4. Therefore, early detection and intervention of osteoporosis have attracted more and more attention.
As a controllable factor, lifestyle seems to play an important role. Numerous nutrients, especially dietary fatty acid intake, have been shown to potentially effect on bone health 5 — Studies have shown that the type of fatty acid is critical 8 , 10 , Saturated fatty acids SFAs improve bone health by enhancing osteoclast survival 12 , decreasing mesenchymal stem cell differentiation 13 , promoting calcium absorption or excretion 14 , and suppressing inflammatory gene expression Polyunsaturated fatty acids PUFAs affect bone metabolism by combining with PPARγ to induce bone marrow adipocyte differentiation 16 , regulate inflammatory response 17 , and improve bone marrow microcirculation Additionally, monounsaturated fatty acids MUFAs may have possible impacts on prostaglandin activity, influencing bone production and bone resorption 19 , However, after reviewing a lot of literature, we discovered that the effects of PUFAs on bone health have received considerable attention; nevertheless, large-scale clinical investigations are absent.
At the same time, we find it interesting that no researcher has focused on the connection between the different types of fatty acids and bone mineral density BMD.
Therefore, we decided to conduct a large-scale cross-sectional study using the National Health and Nutrition Examination Survey NHANES Database to investigate the connection between the different types of fatty acids and BMD.
This was done to help guide therapeutic efforts. Data collected by NHANES from to was used for this cross-sectional analysis.
NHANES adopts an innovative survey mode that combines face-to-face interviews and physical examinations to comprehensively assess the health and nutritional status of residents in the United States.
Questions about demographics, socioeconomics, diet, and health were included in the interviews. The medical section addresses medical, dentistry, and physiological examinations as well as laboratory testing performed by qualified medical specialists. In general, these statistics are used to assess the prevalence of diseases and the related risk factors, formulate guidelines for the implementation of practical public health policy, devise health initiatives and services, cultivate fundamental health awareness, and improve the quality of life.
Our analysis comprised 39, participants from NHENAS to , excluding participants under 20 16, individuals and those beyond 59 7, individuals. Simultaneously, missing data on fatty acids intake 1, individuals and total BMD 4, individuals were excluded.
Following the screening mentioned above, we included a total of 8, individuals Figure 1. The National Center for Health Statistics Ethics Review Board assessed and authorized the informed consent. Following the completion of official anonymization, all of the data is then made available to the public in order to make the most effective use of these resources.
Anyone may access these statistics as long as they adhere to the NHENAS database regulations and are used exclusively for statistical analysis. All studies based on these data should adhere to applicable laws and legislation. The independent variable in our study was daily fatty acids consumption, which was determined through two h food recall interviews.
Interviews were conducted in person and over the phone, respectively. In the Mobile Examination Center MEC , a small room was used to perform the first h recall interviews. Each MEC dietary interview room had a set of uniform measuring parameters.
These methods assist respondents in reporting the quantity and variety of food they consume. After the participants had finished the in-person interviews, they were provided with measuring glasses, teaspoons, a ruler, and a food model guide to equip them with the tools necessary to record meal portions accurately during the phone interviews.
All study participants were required to complete two in-person interviews, each performed by a professional dietary interviewer who spoke Spanish and English fluently. Some categorical variables, such as gender, education level, and moderate exercise, were also included in our study, as well as some continuous variables, including age, body mass index BMI , the ratio of family income to poverty, alkaline phosphatase, blood calcium, blood phosphorus, blood uric acids, total cholesterol, triglyceride, glycohemoglobin, blood urea nitrogen, serum creatinine, urinary albumin creatinine ratio, total albumin, vitamin D intake, alcohol intake, total SFAs intake, total MUFAs intake, total PUFAs intake, and total BMD.
For further details on gathering covariate data and h dietary recall interviews, go to. Dual-energy X-ray absorptiometry DXA is a clinically recognized method for measuring BMD. Its results can be used for osteoporosis fracture, fracture risk prediction, and drug efficacy evaluation Total BMD, as determined by DXA whole-body scans, served as the outcome variable in our study.
Because of their quickness, simplicity, and low radiation exposure are widely used to estimate body composition. In the NHANES, DXA scans of the participants have conducted on a Hologic Discovery Model A densitometer Hologic, Inc.
Professional technicians who have received training and certificates do the operations above. The official NHANES website has a body composition manual with more information about how the DXA exam works.
We used EmpowerStats 2 and R 3. Typically, we consider a statistical result to be meaningful if the p value is lower than 0. In this study, all sample sizes are weighted.
The chi-square test was used to figure out the p -value, and categorical variables were given as a percentage. Weighted multiple linear regression analyses were performed to assess the effect of intake of the three types of fatty acids on BMD.
We established three models of SFAs, MUFAs, and PUFAs intake and BMD, with all confounders age, gender, race, education level, the ratio of family income to poverty, moderate activity, body mass index, alkaline phosphatase, serum calcium, serum uric acid, total cholesterol, blood urea nitrogen, serum phosphorus, triglyceride, glycohemoglobin, urinary albumin creatinine ratio, and total protein, serum creatinine, vitamin D intake, total saturated fatty acids, total monounsaturated fatty acids, and total polyunsaturated fatty acids corrected for each model.
This was done to improve the reporting of epidemiological observational studies and get the most out of the data. Concurrently, fatty acids consumption was transformed into categorical group data using the quartile approach, and P for trend was computed.
Segregated according to age, gender, and race, subgroup analysis was performed to assess the association between fatty acids consumption and BMD in varying ages, gender, and race differences.
In addition, after controlling for all confounding factors, smooth curve fitting was done, and a saturation effect analysis model was constructed to assess the correlation between the consumption of different fatty acids types and BMD.
There are significant differences in age, gender, race, education level, the ratio of family income to poverty, moderate activity, body mass index, alkaline phosphatase, serum calcium, serum uric acid, total cholesterol, blood urea nitrogen, serum creatinine, vitamin D intake, total saturated fatty acids, total monounsaturated fatty acids, and total polyunsaturated fatty acids.
However, the difference was not significant in terms of serum phosphorus, triglyceride, glycohemoglobin, urinary albumin creatinine ratio, and total protein. Table 2 displays the weighted multiple linear regression model.
After controlling for all confounding variables, the association between total SFAs consumption and BMD was positive and statistically significant in subgroups stratified by age. However, in subgroups stratified by gender, total SFAs intake was statistically positively linked with BMD in male individuals but not in female subjects.
In subgroups stratified by race, there was a positive correlation between total BMD and total saturated fatty acids intake among whites, blacks, and other race. These outcomes reach statistical significance. As shown in Figures 2A , B , we found no saturation effect between SFAs and BMD when we performed smooth curve fitting on the revised model.
Table 2. Figure 2. A,C,E Each black point represents a sample. B,D,F The solid red line represents the smooth curve fit between variables. All confounding factors were adjusted.
There was a statistically significant correlation between total MUFAs intake and BMD across age groups in subgroups stratified by age and gender. BMD was linked to total MUFA intake in whites, blacks, and people of other race, these associations are statistically significant.
We found a turning point between total MUFAs intake and BMD using a smooth curve fit inside a model that controlled all covariates Figures 2C , D. According to the saturation effect analysis model, the effect value for total MUFAs consumption was Taken together, the connection between MUFAs intake and total BMD showed an inverted U-shaped curve.
Table 3. In subgroups stratified by age and gender, the positive association between total PUFAs intake and total BMD remained statistically significant.
In subgroups stratified by race, we observed this positive association only in blacks and other genders. These outcomes possess statistical significance. As shown in Figures 2E , F , we found no saturation effect between PUFAs and BMD when we performed smooth curve fitting on the revised model.
Three classes of fatty acids SFAs, PUFAs, and MUFAs were favorably linked with BMD in this cross-sectional study of 8, people. In this study, we analyzed fatty acid intake by quartile and found that higher fatty acid intake was associated with better bone health within a certain range of fatty acid intake.
Furthermore, saturation effect model analysis and smooth curve fitting showed that total MUFAs had an inverted U-shaped relationship with BMD, with a turning point of When total MUFAs were higher than Currently, PUFAs have received the most attention in bone health investigations, but the results are controversial.
In the ORENTRA experiment, Jørgensen et al. The researchers believe that it may be due to the threshold effect of n-3 PUFAs on BMD. In a retrospective study of healthy women from Japan, Kuroda et al. used multiple linear regression analysis to show that omega-3 fatty acid intake contributes to hip BMD.
Results from this study showed that the connection between PUFAs intake and BMD was stronger in the 3rd and 4th quartiles of the distribution, but not in the 2nd quartile.
We believe that PUFAs intake is positively correlated with BMD only when PUFAs intake reaches a certain threshold, which seems to be consistent with previous research.
Notably, a 5-year longitudinal study 25 found that a higher intake of PUFAs and MUFAs was linked to lower BMD in the femoral neck, even after controlling for possible confounding factors, these associations are statistically significant.
This contradictory conclusion may be owing to the limited sample size of the population included in this study. Similarly, in animal study 26 , BMD was significantly reduced in rats fed an atherogenic diet, and monounsaturated fatty acids ameliorated these changes but remained lower than in controls.
Little research has been conducted on the correlation between saturated fatty acid consumption and BMD to date, and there has been a dearth of large-scale investigations into the topic. Because of this, we conducted this extensive retrospective study and found that consuming saturated fatty acids actually improves BMD.
In addition to the regulation of bone metabolism, fatty acids have other biological effects, such as omega-3 PUFAs to protect cardiovascular 27 and nerve 28 , anti-tumor 29 , possibly by inhibiting inflammation, reducing oxidative stress, regulating cell apoptosis and other mechanisms.
Data from the literature indicates that diabetes is a high risk factor for osteoporosis According to a number of studies, those who suffer from diabetes have lower bone mineral density than those who do not suffer from the condition 32 , In addition, the ratio of PUFAs e.
Obesity is also a protective factor for bone density, which partially explain why PUFAs are good for BMD 34 , In addition, BMD has been shown to be higher in those with adequate fat intake than in those with insufficient fat intake We performed weighted multiple linear regression analysis and smooth curve fitting analysis with data from 8, participants and found that fatty acid intake in adults aged 20—59 was beneficial to bone mineral density, which is also associated with osteoporosis.
Prevention provides dietary guidance. However, our study also has some flaws. Because this is a cross-sectional study, it cannot show that the association between fatty acid consumption and BMD is caused by one or the other.
More prospective clinical studies and basic research are needed to back up these results. We have studied a sizable amount of literature.
However, to our knowledge, the saturation effect and threshold between MUFAs and BMD are not supported by any pertinent data.
The exact mechanism is yet unknown, and more studies are needed to confirm it. There is no literature on the saturation effect between SFAs, PUFAs, and BMD. Therefore, in the future, we suggest carrying out a larger prospective study on SFAs, PUFAs, and BMD to further understand the causal relationship between fatty acids and BMD.
Since there are only total SFAs, PUFAs, and MUFAs intakes in the NHANES database, but no specific fatty acid intakes, such as the specific intakes of n-3 and n-6 PUFAs, we suggest that future studies should focus on the association between specific fatty acids and BMD.
In conclusion, SFAs, MUFAs, and PUFAs intake were positively associated with BMD, and the associations persisted in subgroups stratified by age, gender, and race in this study. Notably, when fatty acid intake was quartiled, MUFAs in the 2nd quartile were negatively correlated with BMD and those in the 4th quartile were positively correlated.
Meanwhile, this research found that MUFAs were positively correlated with BMD, but there was a threshold. Publicly available datasets were analyzed in this study. Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.
Z-BF and G-XW contributed equally to this study and made contributions to data collection, curation, statistical analysis, and manuscript writing and revision. G-ZC and P-XZ contributed to the statistical analysis. D-LL, S-FC, and H-XZ supervised the study and contributed to the polishing and reviewing of the manuscript.
S-FC provided financial assistance for this research. H-LL supervised, wrote the review, and edited this study. All authors contributed to the article and approved the submitted version. H-LL was supported by the Shenzhen Municipal Science and Technology Innovation Council JCYJ S-FC was supported by the Natural Science Foundation of Guangdong Provincial No.
The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors thank the staff and the participants of the NHANES study for their valuable contributions.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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