What is the link between gut health and bone health?

The relationship between gut health and bone health — known as the gut-bone axis — is an emerging area of research.^[1] There are a number of potential ways in which the two may be connected. For one, gut dysbiosis impairs the absorption of calcium in the intestines. Additionally, several gut-derived metabolites exert control over cells that are responsible for bone turnover. Finally, gut-dysbiosis-induced intestinal permeability causes the release of inflammatory cytokines into the bloodstream, which can negatively affect BMD and other bone-health-related factors.

Prebiotics and probiotics have been investigated for their ability to improve bone health via their effects on the gut microbiome. While more research is needed, some evidence suggests that probiotic supplementation may protect against the loss of BMD and improve markers of bone turnover in postmenopausal women.^[1]

Modulation of the gut microbiota through other means, such as diet, synbiotics, postbiotics, antibiotics, and fecal microbiota transplantation, is another avenue through which the gut-bone axis can be targeted to improve bone health. The Mediterranean diet may exert favorable effects on reducing fracture risk due to its high content of fiber, fermented dairy, and polyphenols, which favorably alter the composition of the gut microbiome.^[2]