Cross-talks between osteoporosis and gut microbiome

Table 1 Summary of microbial-related therapeutics and their effects on bone health

Therapeutic type	Microbial strains	Mechanisms of action	Clinical outcomes
Probiotics	Lactobacillus reuteri, Lactobacillus paracasei, B. longum	Inhibit osteoclastogenesis, promote osteoblast activity, enhance calcium and vitamin D absorption	Increased BMD, reduced bone resorption, prevention of bone loss in clinical trials
Prebiotics	Galacto-oligosaccharides, fructo-oligosaccharides, Inulin-type fructans	Stimulate growth of Bifidobacteria and Lactobacillus, increase short-chain fatty acid production, enhance mineral absorption	Improved calcium absorption, increased bone strength, reduced markers of bone resorption
Synbiotics	Combination of prebiotics and B. longum, Bifidobacterium bifidum	Enhanced probiotic proliferation, increased calcium absorption, reduced inflammation	Greater improvement in bone mineral content and strength compared to prebiotics or probiotics alone
Fermented foods	Lactobacillus, Bifidobacterium strains in yogurt, kefir, tempeh	Natural source of probiotics and prebiotics, enhanced nutrient absorption	Improved calcium and vitamin D absorption, increased BMD in consumers

B. longum: Bifidobacterium longum; BMD: Bone mineral density.