Osteoporosis: Could a healthy gut microbiome prevent bone loss?

  • The health of the gut microbiome affects a person’s overall health.
  • Previous research has linked gut microbiome health to the body’s bone density and improving osteoporosis.
  • Researchers from the Marcus Institute for Aging Research have identified specific bacteria in the gut microbiome linked to skeletal health.

The gut microbiome comprises trillions of microorganisms, including bacteria, fungi, and viruses.

Over the past few years, researchers have focused on the gut microbiome and how it affects the body’s overall health.

Previous studies have linked the health of the gut microbiome to:

  • obesity
  • irritable bowel syndrome (IBS)
  • type 2 diabetes (T2D)
  • depression
  • autoimmune diseases

Additionally, past studies show a healthy gut microbiome plays an important role in regulating the body’s bone density and can improve osteoporosis.

Now, researchers from the Marcus Institute for Aging Research at Harvard Medical School and Beth Israel Deaconess Medical Center add to this body of knowledge with a new study that has identified specific bacteria in the gut microbiome linked to skeletal health.

This study was recently published in the journal Frontiers in Endocrinology.

What is the gut-bone axis?

Diet gut profoundly impacts bone health.

For example, eating fruits and vegetables high in vitamin C will both stimulate the production of bone-making cells and protect bone cells from damage. And consuming high protein and high-calcium foods also helps your bones stay strong and healthy.

Scientists have also found a connection between the gut microbiome and the body’s bones, called the gut-bone axis.

A 2019 review notes that changes in the gut microbiome can contribute to bone loss, and taking nutritional supplements with prebiotics and probiotics may help prevent or even reverse bone loss.

For example, a bacteria in the gut microbiome called Faecalibacterium prausnitziihas been linked to helping with bone formation and produces butyric acid, which can assist with regulating bone metabolism.

Additionally, a review published in 2022 states that gut microbiota may be a novel therapeutic target for treating osteoporosis, as well as bone fracture prevention.

Which gut bacteria are associated with bone density?

For the present research, scientists conducted an observational study using high-resolution imaging of the arms and legs of male and female participants of the Framingham Third Generation Study and male participants of the Osteoporotic Fractures in Men (MrOS) study.

Researchers found two specific types of bacteria in the gut microbiome — Akkermansia and Clostridiales bacterium DTU089 — linked to negative associations with bone health for older adults.

Previous research has found that levels of the DTU089 bacteria are higher in people with lower physical activity and lower protein intake.

“We do not precisely know why these bacteria would be connected to skeletal health, but we do know that Akkermansia abundance in the intestine is linked to obesity and that obesity may be related to compromises in skeletal integrity,” Dr. Douglas P. Kiel, professor of medicine at the Marcus Institute for Aging Research at Harvard Medical School and Beth Israel Deaconess Medical Center, and principal investigator of this study told Medical News Today.

“The same reasoning applies to the Clostridiales bacterium called DTU089 that is associated with lower physical activity. We know that low physical activity is related to bones that are less dense and strong. Also, the bacteria in the intestine can produce other factors that may adversely affect the bone, namely factors that increase general low-level inflammation, which can have deleterious effects on bone cells.”

— Dr. Douglas P. Kiel, lead study author

Could prebiotics and probiotics support bone health?

The researchers of this study believe their findings may eventually provide a modifiable factor that can contribute to bone health.

“Right now, the only treatments for osteoporosis are the drugs that are given to women with the disease,” Dr. Kiel explained.

“If there were approaches to preserving skeletal strength with aging, then less women would get osteoporosis and need drug treatment. Right now, there are few if any, ways to achieve this.”

“At this current stage of our research, we cannot specifically recommend anything that a physician could do to preserve bone through the microbiome, but we are now starting a study to test if probiotics combined with prebiotics can modify bone metabolism in a favorable way,” he added.

“If our study supports a prevention approach by using synbiotics — probiotics combined with prebiotics — physicians may be able to recommend synbiotics as a dietary approach to the preservation of bone health.”

Do healthy bones lead to a longer life?

Your bones are actually a type of living tissue that is always changing. There are 206 to 213 bones in a human adult.

Having healthy bones helps:

  • hold the body’s muscles
  • support the body and allow it to stand up straight
  • provide the ability to move
  • protect the body’s vital organs
  • store minerals like calcium and release them into the body when needed

Your skeletal bones primarily comprise collagen, protein, calcium, and other minerals. Both collagen and calcium are what make bones strong to give you a healthy bone density.

If you do not have enough calcium to keep your bones strong, they can become fragile and weak, causing them to break easily, a condition called osteoporosis. Frail bones can also lead to poor posture and back pain.

And keeping your bones healthy may help you live longer.

A 2021 study found that people who lived 90 years or older in rural Arkansas had a low percentage of osteoporosis and bone fractures, potentially contributing to their longevity.

Other research published in 2015 discovered osteoporosis can lower a person’s lifespan.

Targeting gut health to improve bone health

After reviewing this study, Dr. Rosario Ligresti, chief of gastroenterology at Hackensack University Medical Center in New Jersey, told MNT he found the results fascinating.

“For a long time, we have speculated that there was a connection between bone health and a healthy microbiome,” he explained. “This is the first well-done study that firmly links certain types of bacterial profiles in the microbiome with a more healthy bone structure.”

Dr. Ligresti said the theory of how the gut microbiome might affect bone health centers around the immune system.

“The microbiome — especially certain microbiome profiles — might trigger a certain type of immune system inflammatory response that directly affects how the cells that remodel bone function,” he continued. “This can be either a positive, or more worrisome, a negative effect leading to bone loss.”

“Now that this research has more conclusively linked certain microbiome profiles with bone health, we have to get more precise. Which species of bacteria in the microbiome are most responsible for this link? If we can gain some insight into this particular question, it opens the door to potentially more targeted therapy for bone health.”

— Dr. Rosario Ligresti, gastroenterologist

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