Altered bone metabolism in inflammatory disease: role for nutrition

Abstract

Osteoporosis is a major public health problem, and as life expectancy and the world's population continue to increase will become even more important. Thus, there is an urgent need to develop and implement nutritional approaches and policies for the prevention and treatment of osteoporosis. Patients with some chronic inflammatory diseases appear to be more likely to develop osteopenia, and in some cases earlier in life, which is of particular concern as the incidence of inflammatory diseases in the Western world is increasing. While the cause of bone loss in patients with inflammatory disease is multifactorial, nutrition may have a role. Many of these patients may have one or more nutritional deficiencies, which can lead to altered rates of bone metabolism. On the other hand, some nutritional factors may attenuate the inflammatory process itself, and thus may indirectly benefit bone metabolism and bone health in patients with inflammatory disease. The present review will consider these issues, particularly in the context of inflammatory bowel disease, coeliac diease and atherosclerosis.

Preservation of Bone Structure and Function by Lithothamnion sp. Derived Minerals

“…An attractive (alternative) hypothesis is that the combination of minerals functions to help control systemic inflammation, a known risk factor for bone mineral loss [44]. In support of this, we observed in the same animal model that mice on the mineral-supplemented diets had fewer colonic polyps than control mice [21,22], and that liver tumor formation was almost completely absent in these animals [23].…”

A Mineral-Rich Extract from the Red Marine Algae Lithothamnion calcareum Preserves Bone Structure and Function in Female Mice on a Western-Style Diet

“…An attractive (alternative) hypothesis involves a role for the mineral-rich supplement in control of systemic inflammation. Chronic systemic inflammation is well accepted as a risk factor in bone mineral loss [48-50]. We hypothesize that in the high-fat, low-Ca 2+ diet, epithelial differentiation in the gastrointestinal tract is impaired, leading to a defective or “leaky” barrier, with a higher level of proinflammatory moieties (bacteria, bacterial toxins, food allergens, etc.)…”

Osteoporosis and inflammation

“…Over 75% of untreated patients with this disease present with low BMD. Therefore, it is considered one of the most frequent predisposing conditions to osteoporosis (26). Bone turnover markers are altered in patients with untreated celiac disease, reflecting reduction of bone formation and increase of resorption (10).…”

“…Malabsorption leads to general malnutrition, decreased bioavailability of calcium and vitamin D, lower body mass index (BMI) and reduced muscle mass (10,26). Vitamin D deficiency and low calcium concentrations are presented in 30%-60% of these patients (26).…”