The Role of Prunes in Modulating Inflammatory Pathways to Improve Bone Health in Postmenopausal Women

Abstract

The prevalence of osteoporosis among women aged 50 years and older is expected to reach 13.6 million by 2030. Alternative non-pharmaceutical agents for osteoporosis including nutritional interventions are becoming increasingly popular. Prunes (dried plums) (Prunus domestica L.) have been studied as a potential whole food dietary intervention to mitigate bone loss in preclinical models of osteoporosis and in osteopenic postmenopausal women. Sixteen preclinical studies using in vivo rodent models of osteopenia or osteoporosis have established that dietary supplementation with prunes confers osteoprotective effects both by preventing and reversing bone loss. Increasing evidence from ten studies suggests that in addition to anti-resorptive effects, prunes exert anti-inflammatory and antioxidant effects. Ten preclinical studies have found that prunes and/or their polyphenol extracts decrease malondialdehyde and nitric oxide secretion, increase antioxidant enzyme expression, or suppress NF-κB activation and pro-inflammatory cytokine production. Two clinical trials have investigated the impact of dried plum consumption (50–100g/day for 6–12 months) on bone health in postmenopausal women and demonstrate promising effects on bone mineral density and bone biomarkers. However, less is known about the impact of prune consumption on oxidative stress and inflammatory mediators in humans and their possible role in modulating bone outcomes. In this review, the current state of knowledge on the relationship between inflammation and bone health is outlined. Findings from preclinical and clinical studies that have assessed the effect of prunes on oxidative stress, inflammatory mediators, and bone outcomes are summarized, and evidence supporting a potential role of prunes in modulating inflammatory and immune pathways is highlighted. Key future directions to bridge the knowledge gap in the field are proposed.

Rationale and study design of Randomized Controlled Trial of Dietary Supplementation with prune (dried plums) on bone density, geometry, and estimated bone strength in postmenopausal women: The Prune study

“…Flow cytometric analysis: Phenolic compounds in prunes are reported to have numerous anti-inflammatory and anti-oxidative effects [ 35 ]. We chose to assess the effect of prunes on the number and activation status of monocytes as they are one of the main producers of inflammatory cytokines.…”

Changes in the composition of gut and vaginal microbiota in patients with postmenopausal osteoporosis

“…Previous studies have shown GM and VM regulates inflammation (9,23,(33)(34)(35), which is related to osteoporosis, so we hypothesized that osteoporosis may be associated with an increase in systemic inflammation by GM and VM. The results in this study showed that the level of the anti-inflammatory factor IL-10 was significantly lower in the osteoporosis group than in the control and osteopenia groups (Figure 5A).…”

New Advances in Improving Bone Health Based on Specific Gut Microbiota

“…In addition to prunes, other polyphenol-rich foods exhibit similar biological activity in the prevention of bone loss (Lucas et al, 2020). Future research should aim to investigate whether this protective effect is associated with alterations in gut microbes (Damani et al, 2022). Foods rich in anthocyanins, calcium, unsaturated fatty acids, bioactive peptides, and polyphenols regulate the diversity and composition of the intestinal microbiota to a certain extent and thus have a beneficial effect on the bone.…”

“…In addition to prunes, other polyphenol-rich foods exhibit similar biological activity in the prevention of bone loss ( Lucas et al., 2020 ). Future research should aim to investigate whether this protective effect is associated with alterations in gut microbes ( Damani et al., 2022 ).…”