Higher dietary fish consumption is associated with a lower risk of osteoporosis: A meta-analysis of observational studies.

While numerous epidemiological studies have investigated the relationship between fish consumption and osteoporosis risk, findings remain inconclusive. This meta-analysis hypothesizes that higher fish intake is associated with a lower risk of osteoporosis. A systematic search of PubMed, Web of Science, and Wan Fang was conducted for relevant studies published up to October 2024. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using fixed or random effects models based on heterogeneity. Fourteen studies comprising 26,145 participants were included. The pooled OR for osteoporosis comparing the highest to lowest fish consumption levels was 0.62 (95% CI, 0.49-0.79; I² = 79.4). Among perimenopausal women, higher fish intake was associated with a lower risk of osteoporosis (OR, 0.54; 95% CI, 0.32-0.90; I² = 83.5). Significant associations were observed in both case-control studies (OR, 0.28; 95% CI, 0.16-0.50; I² = 0.0) and cross-sectional studies (OR, 0.70; 95% CI, 0.55-0.87; I² = 79.6%). Subgroup analysis indicated an inverse association in the lumbar and/or femoral regions (OR, 0.59; 95% CI, 0.42-0.85; I² = 85.4%) and the calcaneus region (OR, 0.73; 95% CI, 0.54-0.97; I² = 0.0%). These findings suggest that may reduce osteoporosis risk, supporting the potential role of a fish-rich diet in bone health maintenance. Further prospective and interventional studies are needed to verify the causal relationship.