Intestinal Microbiota and Bone Health: The Role of Prebiotics, Probiotics, and Diet

In recent years, the intestinal microbiota has emerged as a crucial regulator of health with dysbiosis linked to a number of pathological states such as inflammatory bowel disease. In addition to a local intestinal effect, emerging evidence has demonstrated the potential for the microbiota to modulate systemic bone health via a gut-bone axis. In the present chapter, we discuss how diet can affect the composition of the intestinal microbiota, through the intake of prebiotics, and how these are utilized by the bacteria to influence the immune system and bone. In addition, we detail the recent murine studies that investigate how probiotic supplementation can increase bone mineral density in “healthy” individuals and protect against the pathological bone loss associated with menopausal estrogen deficiency. Finally, we highlight the advances made in unearthing the mechanisms that potentially lead to these observed beneficial effects.