Osteoporosis
In this newsletter, I am going to describe osteoporosis in some detail. It is commonly understood that osteoporosis is a condition where the bone loses density, and exercise can help prevent or stabilise the condition. What is commonly not known is that the gut microbiome plays a big part in aggravating or improving osteoporosis. This newsletter will cover that in detail and what further actions can be taken to help the condition.
Osteoporosis is a major health problem that occurs with advancing age, particularly in post-menopausal women, but also affects men. It is characterised by low bone mineral density, which makes the bones weak and fragile. It occurs when the body loses too much bone, doesn’t make enough bone, or a combination of both.
In healthy bones, there is a balance between new bone formation and old bone removal.
Bone is constantly being remodelled by this process. It keeps the bone alive and somewhat flexible, which prevents fracturing with minor falls. It is important to understand the 2 processes in some detail before we talk about how to prevent osteoporosis.
There are specialised cells that build bone and that remove bone.
The bone builders are called osteoblasts (b for building), and the bone removers are called osteoclasts (c for clawing). In healthy balance, as mentioned, the bone is strong. With increasing age in both men and women, osteoclasts become more active compared with the osteoblasts. To understand how these 2 cell types function, we need to talk about the gut microbiome.
A healthy gut microbiome is crucial for bone health.
It is made up of trillions of microorganisms that, if balanced with predominantly beneficial bacteria, can be called a healthy microbiome. If unbalanced, with more unfriendly bacteria, we have a state called dysbiosis. If this persists, then the intestinal lining can get damaged by the unfriendly bacteria developing what is called a leaky gut. I will cover dysbiosis in depth in another newsletter, but let me cover some basics to help you understand what will follow.
A healthy microbiome produces a range of helpful products for your body.
It produces vitamins, amino acids, and a group of chemicals called Short Chain Fatty Acids (SCFAs). These chemicals play a beneficial role in many different organs. Today we will confine our discussions to bone, skeletal muscle, and also brain. I have to introduce another concept before I tie them all together, and that is Leaky Gut.
Leaky gut is the start of further health problems.
It will allow bacterial toxins and even bacteria to go through the leaking gut and interact with the immune system, which lies just on the inside of the intestinal lining. The interaction can induce a state of inflammation, which then can affect almost all organs in the body. For our discussion now, inflammation can cause cognitive dysfunction; at the skeletal muscle level, it causes breakdown of muscle protein and also difficulty or resistance by the body to build more muscle.
Short Chain Fatty Acids stimulate osteoblasts and inhibit osteoclasts.
The net effect is an enhancement of bone formation and a reduction in bone resorption. To emphasize, this only occurs when the gut microbiome is in a healthy state of balance. If the microbiome is in a state of dysbiosis, there will be a shortage of SCFAs, and the unfriendly bacteria can produce chemicals or toxins that can cause an excessive activation of osteoclasts that results in more bone loss.
Summary of what’s been discussed
Bone is constantly being remodelled.
Two types of bone cells are involved in the remodelling.
Osteoblasts: build bone
Osteoclasts: remove bone
If these 2 cells are in balance, with building and removal, we have strong bones.
If there is more osteoclast activity, we head to osteoporosis.
A healthy gut microbiome produces SCFAs that stimulate osteoblasts to build bone and inhibit osteoclasts.
A gut that is in dysbiosis (unhealthy) will not produce enough SCFAs.
A dysbiotic gut also produces chemicals that can cause osteoclasts to be more active, leading to osteoporosis.
Actions we can take to prevent osteoporosis or aggravate its progress
Increase the production of SCFAs.
These helpful chemicals are produced by the friendly bacteria from fiber. Your diet needs to be high in vegetables to get more fiber. I recommend you increase your vegetable intake to get 30 different types per week. Different friendly bacteria live on different types of fiber. So the bigger the variety, the more varieties of bacteria you feed. The 30 include herbs, and I am not talking about quantity, just variety. If you are not used to a high intake, slowly increase over time. A big pot of soup can easily contain 15 different types. Look up vegetarian recipes and add your preferred protein to them.
Polyphenols
These are a very large family of chemical compounds that plants produce to protect themselves from damage from insects and other threats. They act as powerful antioxidants in our bodies. They fight inflammation, protect our cells from damage, support brain health, and can lower the risk of some chronic diseases. However, we cannot absorb or utilise them in their raw state. The gut microbiome must first transform them into active metabolites. Polyphenols also modulate the composition of the microbiome, improving the growth of beneficial bacteria.
For osteoporosis, there are some specific polyphenols that help with the disease. The most abundant source are pomegranates. Lesser amounts are found in nuts (especially hazelnuts and pecans) and berries.
Curcumin, resveratrol, and quercetin also have bone-protective properties.
Foods
Both the following, FOS and GOS, are special fibers that help our digestive health.
Fructooligosaccharides (FOS) Sources
Vegetables: Jerusalem artichoke, chicory root, onions, garlic, leeks, and asparagus
Fruit: Bananas
Grains: wheat and barley
Galactooligosaccharides (GOS) Sources
Dairy products: especially milk
Legumes: beans and lentils
This newsletter has introduced what osteoporosis is and the interaction of the microbiome with the bone.
Future newsletters on osteoporosis will cover:
The role of supplements especially calcium, vitamin K2 and protein.
Diet—what helps and what aggravates osteoporosis
The role of muscle
Exercise
The role of hormones
The effect of environmental toxins
References:
1. Gut microbiome and bone health PMID: 39643654
2. From gut to bone PMID: 39386168
3. Polyphenol supplementation benefits human health via gut microbiota https://doi.org/10.1016/j.jff.2020.103829
4. FOS/GOS attenuates high-fat diet-induced bone loss PMID: 33753088
Medical Disclaimer:
This newsletter is for general informational purposes only and does not constitute medical advice. The content should not replace professional medical advice, diagnosis, or treatment. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read in this newsletter. Reliance on any information provided here is solely at your own risk.
