The effects of marine fatty acid omega-3 supplements on incident fractures and bone mineral density in generally healthy adults.

Omega-3 supplementation had no effect on total fracture risk compared to placebo.

• HR 1.02; 95% CI, 0.92-1.13; p = .73
• Study included 25,871 U.S. men (aged ≥50) and women (aged ≥55) without baseline cancer or cardiovascular disease
• Median follow-up was 5.3 years
• Fractures were adjudicated incident outcomes

Omega-3 supplementation had no effect on nonvertebral fracture risk compared to placebo.

• HR 1.01; 95% CI, 0.91-1.12; p = .80
• Nonvertebral fractures were a primary outcome in the overall cohort of 25,871 participants
• Intervention took place from November 2011 through December 2017

Omega-3 supplementation had no significant effect on hip fracture risk compared to placebo.

• HR 0.89; 95% CI, 0.61-1.30; p = .55
• Hip fracture was a primary outcome adjudicated in the overall cohort
• The wide confidence interval reflects relatively low hip fracture event rates in this generally healthy population

Omega-3 supplementation resulted in a small but statistically significant increase in whole body areal BMD compared to placebo.

• Whole body aBMD change: +0.03% in omega-3 group vs -0.41% in placebo group; p = .006
• Measured by DXA over 2 years in a subcohort of 771 individuals
• The difference was described as 'small'

Omega-3 supplementation had no effect on spine or hip areal BMD, or on volumetric BMD or bone strength indices at the radius or tibia.

• Measured in a subcohort of 771 individuals
• Volumetric BMD (vBMD), cortical thickness, and bone strength indices were assessed at the radius and tibia by peripheral QCT
• 2-year changes in aBMD at the spine and hip showed no significant differences between groups

The VITAL trial was a large 2×2 factorial randomized placebo-controlled trial studying marine omega-3 fatty acids (1 g/d; EPA+DHA in a 1.2:1 ratio) and/or vitamin D3 versus placebo.

• Primary outcomes for VITAL were cancer and cardiovascular events; bone outcomes were ancillary
• 25,871 U.S. men aged ≥50 and women aged ≥55 were enrolled, not selected for low bone density or fracture history
• Average participant age was 67.1 years
• Intervention period: November 2011 through December 2017; median follow-up 5.3 years

No serious adverse effects of omega-3 supplementation were observed.

• Safety was assessed across the full trial cohort
• No serious adverse effects were reported in relation to omega-3 supplementation