The Gut-Microbiota-Bone axis

The gut-microbiota-bone axis is an exciting new concept referring to the communications between the gut microbiome and the skeletal system. The gut microbiome is understood to influence bone density health, primarily through its modulation of the immune system and systemic inflammation. A 2019 randomised controlled trial completed on 249 post-menopausal women showed that, compared to placebo, daily supplementation of three strains of Lactobacilli slowed the rate of bone density loss over 12 months. A second clinical trial is underway, examining the effect of this Lactobacilli combination on bone metabolism and bone density maintenance.

Maintaining bone density is an important therapeutic aim for practitioners working with older patients. Bone density maintenance is a key aspect of maintaining health at an older age.

Although core dietary principles are generally well-understood, rapidly-evolving nutrition science over the last two decades has significantly expanded our understanding. The coupled roles of nutrigenetics and nutrigenomics have led to a greater practical understanding of the clinical benefits bestowed by food-derived signalling molecules, especially from plants. The mainstay of nutrition therapy has, to a large extent, relied on manipulating food macronutrients supplemented by micronutrients, whereas 21st century nutrition science is now strongly focused on utilising the signalling properties of the many non-nutrient components of food. This presentation aims to build on a clinician’s current knowledge by identifying the key food-derived factors that can greatly impact cellular function. When this is implemented in childhood, such a foundation has the potential to future-proof a child’s health as he or she enters adulthood.

Learning Outcomes:

The gut-bone axis has been the missing link in addressing bone health and maintaining bone density. Healthcare practitioners are aware of the role of nutrition (calcium, vitamin D, vitamin K) in bone metabolism, alongside lifestyle interventions such as weight-bearing exercise, but the potential for specific strains of probiotic bacteria to act as a meaningful intervention is now being examined. In this presentation, delegates will hear about the scope of the healthcare challenges facing an aging population in the context of bone density loss and osteoporotic fractures. They will learn about the role played by inflammation and immune dysregulation in creating an osteoclastogenic environment, and how the gut microbiota may be an important player in this environment. Delegates will be guided through recent research into specific strains of probiotic bacteria and the potential they have exhibited as a novel agent in the maintenance of bone health in post-menopause women. They will hear about the latest trial on these specific strains, which is currently being conducted on osteopenic women. Overall, delegates will walk away from this presentation with enhanced knowledge regarding the importance of the gut-microbiota-bone axis, and an up to date understanding of the research examining the potential benefit of specific strains of probiotic to reduce the rate of bone density loss.

Delegates will: 1. Appreciate the scope of the health challenges presented by loss of bone mass in post menopausal women. 2. Understand the concept of the gut-microbiome-brain axis 3. Understand the relationship between the gut microbiome, immune dysregulation, inflammation, and osteoclastogenesis. 4. Become familiar with the research on specific strains of probiotic bacteria and their impact on bone density retention.