Gut Health, Strong Bones: The Hidden Connection You Need to Know

What is the Gut Microbiome? "Gut" roughly refers to the entire gastrointestinal tract, but discussions typically focus on the colon (large intestine), where most gut microbiota are found. The gut is colonized by trillions of diverse microorganisms (bacteria, viruses, fungi, parasites) forming the gut microbiome. "Microbiota" refers to all the microbes in a community; "microbiome" refers to their collective genes.

Using the Body's Microbes to Treat Disease. Researchers have explored the symbiotic relationship these microorganisms have with the human host and their role across many organ systems — the gut-brain axis, gut-lung axis, gut-skin axis. A growing number of researchers postulate that inflammation is the common denominator of many of our most common chronic diseases (diabetes, cardiovascular disease, some cancers); detecting microbial imbalances (dysbiosis) is thought to be the future of treating hundreds of diseases. A highly successful example: fecal transplants for patients with C. diff (Clostridioides difficile) infection, transferring stool from a healthy donor to restore the gut microbiome balance.

Possible Causes of Dysbiosis (interference with beneficial microbiome function): antibiotics and antimicrobial agents; other drugs and medications (e.g., proton pump inhibitors, metformin); environmental toxins; chronic diseases; physical and psychological stress; smoking; excessive alcohol use; food choices; overuse of probiotic supplements.

How Gut Health Influences Bone Health. A healthy gut is essential for absorbing nutrients that directly impact bone health — calcium, magnesium, vitamin K2, and vitamin D among them. If the gut isn't functioning properly, malabsorption of these nutrients can affect bone density over time. Research indicates a healthy, diverse gut microbiome is linked to increased bone mass, while dysbiosis may be associated with lower bone mineral density and osteoporosis. Chronic low-grade inflammation, a common consequence of poor gut health, can increase osteoclast activity (cells that break down bone) and decrease osteoblast activity (cells that build bone), leading to bone loss.

Tips for Supporting Gut Health to Benefit Your Bones:

• Nourish your microbiome with prebiotics (food for beneficial gut bacteria) via a fiber-rich diet — abundant in fruits, vegetables, leeks, garlic, onions, whole grains, and legumes.
• Consume fermented foods (yogurt, kefir, sauerkraut, kimchi, miso, tempeh, kombucha, some cheeses like Swiss, Jarlsberg, cheddar) rich in probiotics.
• Limit sugar and processed foods, which can contribute to dysbiosis and inflammation.
• Probiotic supplements may help if food alone isn't enough, but prolonged use can alter the body's natural microbial diversity; look for quality control seals like USP, since the supplement marketplace is largely unregulated.

Key Takeaways. The human gut microbiota may be a key mediator of osteoporosis and osteogenesis. As Hsu and colleagues state, "Prebiotics or probiotics may represent a future therapeutic avenue for ameliorating the risk of post-menopausal bone loss."

References

1. Gebrayel P, et al. Microbiota Medicine: Towards Clinical Revolution. Journal of Translational Medicine 2022;20(1):111.
2. Ye Tu, et al. The Microbiota-Gut-Bone Axis and Bone Health. Journal of Leukocyte Biology 2021; 110(3):525-537.
3. Jones RM, et al. Osteomicrobiology: The Influence of Gut Microbiota on Bone in Health and Disease. Bone 2018; 115:59-67.
4. Hsu, E, et al. From Osteoimmunology to Osteomicrobiology: How the Microbiota and the Immune System Regulate Bone. Calcified Tissue International 2018 May; 102(5):512-521.
5. Bolte LA, et al. Long-term Dietary Patterns Are Associated with Pro-inflammatory and Anti-inflammatory Features of the Gut Microbiome. Gut. 2021;70(7):1287-1298.
6. Merenstein D, et al. Emerging Issues in Probiotic Safety: 2023 Perspectives. Gut Microbes 2023;15(1):2185034.