Fatty Acids and Bone

Nutritional status is an important determinant of skeletal health. Increased fat mass favorably influences bone mineral density and reduces fracture risk. The mechanisms by which adiposity influences skeletal health include mechanical skeletal loading, the effects of adipocyte and pancreatic β-cell-derived hormones that act on bone, and neuroendocrine outputs from the hypothalamus that respond to peripheral nutritional signals. A growing body of evidence, including the recognition that specific fatty acid receptors are expressed in skeletal tissue, also suggests that fatty acids affect skeletal health. These effects include indirect actions of dietary and circulating fatty acids, mediated by hormonal signals derived from the intestine and pancreas, and direct effects of some fatty acid species on bone cells. Emerging evidence suggests that marrow adipocyte-derived fatty acids might affect skeletal health via paracrine mechanisms. The existing evidence suggests that there is potential for both positive and negative effects of fatty acids on the skeleton, such that the net effect may be context-specific. Careful laboratory and clinical investigation is required to increase our understanding of a potentially important area of skeletal health.