Probiotics as a New Regulator for Bone Health: A Systematic Review and Meta-Analysis

Abstract

Despite the proposed role of the gut microbiota-bone axis, findings on the association between probiotic consumption and bone health are conflicting. This systematic review aimed to assess the effect of probiotic consumption on bone health parameters. A systematic literature search of relevant reports published in PubMed/Medline, Web of Science, SCOPUS, EMBASE, and Google scholar before December 2020 was conducted. All clinical trials or experimental studies, which examined the relationship between probiotic consumption and bone health parameters, were included. No limitation was applied during the search. After screening articles based on inclusion criteria, 44 studies remained. In clinical trials, probiotic consumption affects bone health parameters such as serum calcium levels (3.82; 95% CI: 1.05, 6.59 mmol/l), urinary calcium levels (4.85; 95% CI: 1.16, 8.53 mmol/l), and parathyroid hormone (PTH) levels (−5.53; 95% CI: −9.83, −0.86 ng/l). In most studies, Lactobacillus species such as L. helveticus, L. reuteri, and L. casei were consumed and women aged 50 years or older were assessed. Spinal and total hip bone mineral density (BMD) was not affected significantly by probiotic consumption. In 37 animal experiments, probiotic or symbiotic feeding mostly had effects on bone health parameters. Some strains of Bifidobacterium and Lactobacillus including L. reuteri, L. casei, L. paracasei, L. bulgaricus, and L. acidophilus have indicated beneficial effects on bone health parameters. In conclusion, this systematic review and meta-analysis indicate that probiotic supplementation might improve bone health. Further studies are needed to decide on the best probiotic species and appropriate dosages.

Obesity and Bone: A Complex Relationship

“…[174][175][176]. Similar results are reported by other RCTs [168,170,172,173]. If diet-induced weight loss is combined with exercise training, there is an attenuation of the loss of total hip BMD in older obese patients [168,169,173].…”

“…Gut microbiota (GM) dysbiosis has been identified in various diseases, such as hypertension, Alzheimer disease, type 2 diabetes, depression, and also in obesity [164][165][166][167][168][169]. Several studies have also shown a relationship of GM dysbiosis with bone health [170]. It can be inferred that the relationship between obesity and bone can also be conditioned by GM.…”

Long-term intake of Lacticaseibacillus helveticus enhances bioavailability of omega-3 fatty acids in the mouse retina

“…Several hypotheses could be explored to characterize the origin of this L. helveticus VEL12193-related phenotype. The firstone would be a loss of muscle and/or bone mass, but such an hypothesis is unlikely since lactobacilli have been shown to instead have the opposite effect [37][38][39][40] . A second possibility would be a modulation by L. helveticus VEL12193 of the gut microbiota capacities on nutrient absorption, energy expenditure and/or fat oxidation 41,42 .…”

Extracellular Proteins Isolated from L. acidophilus as an Osteomicrobiological Therapeutic Agent to Reduce Pathogenic Biofilm Formation, Regulate Chronic Inflammation, and Augment Bone Formation In Vitro

“…Further, the strong and dose-dependent anti-inflammatory properties of L. acidophilus spp. has been reported [122][123][124][125][126] , where combined probiotics showed the most efficacious antiinflammatory activity, [121,127] potentially via NF-𝜅B signaling. [128] Lipopolysaccharide stimulates the synthesis of substantial levels of NO, ROS, and cyclooxygenase-2 (COX-2) in macrophages resulting in cellular oxidative stress, [129][130][131] and DNA damage.…”