Omega 3 good for bones as well as joints

Dr Paul Clayton 2012


The old story about fish oil being good for joints is proven; we know that if you take
enough Omega 3s, inflammation and joint pain is reduced in rheumatoid arthritis
(James et al ‘10) and, possibly, osteoarthritis; via a mechanism which prevents or reduces the destruction of cartilage in the affected joints (Wann et al ‘10).

Now there is evidence that fish oil also protects bone. Specifically, a daily dose of 300 ml of
Omega 3 appears to prevent bone loss and indeed promote bone re-growth in postmenopausal
women, when combined with aerobic, weight-bearing exercise (Tartibian et al ‘11).

This was an Iran/USA collaboration, and a fine example of how scientists can
work together even while their idiot political masters bicker and strut. The researchers
found that the fish oil – exercise combination reduced blood levels of the important inflammatory
markers IL-6 and TNF-alpha by 40% and 80% respectively; and increased bone mineral density
(BMD) by up to 15% in the lumbar vertebrae, and 19% at the femoral neck.

Fish oil alone cannot do these things, and neither can exercise. As the scientists themselves
pointed out, “The combination of PUFA supplementation with aerobic exercise provided
benefits on inflammation and bone density over exercise alone or supplementation alone.”

I was initially very sceptical about these hugely positive results, as the increases in
BMD were achieved within a mere 6 months. This is very short time as far as bone is concerned;
it is a very slowly metabolising tissue, which is why most trials of this sort run for a
minimum of 1 year, and preferably longer. But when I thought about the mechanisms of action
of the combined fish oil and exercise, it began to seem rather more plausible.

BMD (roughly, the amount of calcified tissue in the bone), is a dynamic entity. It is continually
being broken down and replaced, and the main reason why we tend to lose bone as we
move inexorably towards old age is that we move into a metabolic and lifestyle pattern that
favours breakdown, or catabolism.

We become progressively more depleted in anabolic factors such as vitamins D, K2, C, B6
and a handful of minerals, and we take less exercise. At the same time we become more
depleted in factors which slow breakdown, such as the anti-inflammatory flavonoids and
Omega 3s. This is crucial, as the breakdown of bone involves inflammatory processes.

The Iran/USA team was inadvertently targeting both sides of the equation. The fish oils
were, via their anti-inflammatory actions, reducing bone breakdown. The exercise, by directing bone-forming cells to the affected areas of bone, was driving regeneration, and may also have up-regulated the body’s own anti-oxidant and anti-inflammatory enzymes.

As the exercise involved walking and jogging three times a week, it was increasing appetite
(you may have noticed that exercise does this), and therefore increasing intakes of a range of
vitamins and minerals. Sadly, the scientists did not record dietary changes in their subjects, but
these will have occurred and will also have contributed to the positive outcomes.

I shall wait to see if other groups are able to reproduce these findings, and would recommend
to any scientists interested in developing this provocative work that they consider adding
the other key anabolic inputs to the mix. I would add that the Iranian group have been
studying (and publishing) the anti-inflammatory effects of fish oils in various exercise
models for a few years (Tartibian et al ’09, ’10, ‘11b), and appear to know what they are doing!

REFERENCES

James M, Proudman S, Cleland L. Fish oil and rheumatoid arthritis: past, present and future.
Proc Nutr Soc. 2010 Aug;69(3):316-23.

Wann AK, Mistry J, Blain EJ, Michael-Titus AT, Knight MM. Eicosapentaenoic acid and docosahexaenoic acid reduce interleukin-1ß-mediated cartilage degradation. Arthritis Res Ther. 2010;12(6):R207.

Tartibian B, Maleki BH, Kanaley J, Sadeghi K. Long-term aerobic exercise and omega-3 supplementation modulate osteoporosis through inflammatory mechanisms in post-menopausal women: a randomized, repeated
measures study. Nutrition & Metabolism 2011, 8:71 doi:10.1186/17437075-8-71

Tartibian B, Maleki BH, Abbasi A. The effects of ingestion of omega-3 fatty acids on perceived pain and external symptoms of delayed onset muscle soreness … Clin J Sport Med. 2009 Mar;19(2):115-9.

Tartibian B, Maleki BH, Abbasi A. The effects of omega-3 supplementation on pulmonary function of young wrestlers during intensive training. J Sci Med Sport. 2010 Mar;13(2):281-6.

Tartibian B, Maleki BH, Abbasi A. Omega-3 fatty acids supplementation attenuates inflammatory markers after eccentric exercise in untrained men. Clin J Sport Med. 2011 Mar;21(2):131-7.