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Osteoporosis , Nutrition and Gut Microbiome

What is osteoporosis?

Osteoporosis is a bone disease that is characterized by reduced bone mineral density and bone mass, leading to an increased risk of fractures. It is more prevalent in women than in men and is caused by aging and changes in hormone levels that affect bone health. Osteoporosis is a common and serious health condition that affects millions of people worldwide, but can be effectively treated and prevented with early detection and intervention.

In the life of a person, bones are subjected to various stresses and strains, which may cause various bone injuries In order to maintain the integrity of the bone, the human body constantly remodels the bone, and in adults, 5-10% of the bone is renewed every year. The bone renewal is a process involving co-coupled activation of a group of cells called bone remodeling units. The bone remodeling cell unit contains four types of cells: osteoblast, osteoclasts ,osteocytes ,and endosteal cells .The bone remodeling cycle consists of four distinct phases: initiation, resorption, reversal, and formation ,he dynamic balance of osteoblasts and osteoclasts runs through these four phases Gut microbiome refers to the microbes that live in human digestive tract and are symbiotic with the human body.

They participate in the regulation of various physiological and pathological processes of the human body and are associated with various diseases. The pathological process of osteoporosis is affected by gut microbes.

The molecular mechanisms of osteoporosis mainly include:

1) Intestinal barrier and nutrient absorption (involving SCFAs)

2) Immunoregulation

3) Regulation of intestinal-brain axis

Gut microbes can increase bone mass and improve osteoporosis by inhibiting osteoclast proliferation and differentiation, inducing apoptosis, reducing bone resorption, or promoting osteoblast proliferation and maturation. Researches have analyzed the microflora in feces of female osteoporosis patients and the correlation between the gut microflora and estrogen levels in patients, and found that changes in gut microbial species are associated with estrogen level changes in patients which may create a new approach to prevent osteoporosis 

There is some evidence that a modified and alternative Mediterranean diet may reduce the risk of hip fracture, and DASH may improve lumbar spine BMD.

The study findings provide important insights into how healthy diets, besides the well-known Mediterranean diet, can prevent bone density loss and osteoporotic fractures. Nevertheless, further studies are needed to create holistic health guidelines.

Likewise, future observational studies should follow study participants from many races, ethnicities, and geographies over more extended periods of time. Future studies should also aim to be consistent regarding sample sizes and age limits so that findings can be compared. Regional diets should also be included.

A healthy diet alone is insufficient for preventing osteoporosis, as several studies have emphasized the important role of exercise in preventing osteoporosis. Thus, combining diet and exercise could decrease the risk of fractures and improve osteoporosis outcomes.

Study shows that lactic bacteria also promote bone health by modulating calcium and vitamin D metabolism. On one hand, administration of  Lactobacillus acidophilusLactobacillus casei, and Bifidobacterium significantly increased the level of serum clacium. On the other hand, the level of serum 1,25-(OH)2-vitamin D significantly increases in response to oral supplementation of L. casei, Bacillus coagulans and Lactobacillus reuteri and protects bone loss in ovariectomized rats. Oral supplementation with L. reuteri, also increases the serum level of 25-hydroxyvitamin D in humans..

Journal reference:

Chen, H. & Avgerinou, C. (2023). Association of Alternative Dietary Patterns with Osteoporosis and Fracture Risk in Older People: A Scoping Review. Nutrients (2023).

Kai Ding , Fei Huan and Wenge Ding (2020) Gut Microbiome and Osteoporosis.Published online 2020 Mar 9.

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