Probiotics and Isoflavones as a Promising Therapeutic for Calcium Status and Bone Health: A Narrative Review

Abstract

Probiotics have potential clinical effects for treating and preventing osteoporosis. Meanwhile, isoflavones have attracted much attention due to their ability to prevent postmenopausal symptoms. Research has established that probiotics and isoflavones can regulate hormones, immune cells, and the gastrointestinal system, acting as links in the gut–bone axis. However, combining the effects of probiotics and isoflavones on calcium status and bone health is a more novel and a still-evolving research area. Lactobacillus and Bifidobacterium are the foremost strains that influence bone health to a significant extent. Among the isoflavones, daidzein, genistein, and the metabolites of genistein (such as equol) stimulate bone formation. It can be concluded that probiotics and isoflavones promote bone health by regulating calcium uptake, gut microbiota, and various metabolic pathways that are associated with osteoblast activity and bone formation. Nevertheless, further experiments of probiotics and isoflavones are still necessary to confirm the association between calcium bioavailability and bone health.

Impact of isoflavones and Lactobacillus acidophilus on the fecal microbiology status in healthy female rats

“…Recent research suggests that the gut microbiota could be a possible therapeutic target for treating osteoporosis after menopause (Xu et al, 2017). The gastrointestinal system can regulate the balance between osteoclast-mediated bone resorption and osteoblast--mediated bone formation (Harahap and Suliburska, 2021). It appears that the gut microbiome influences bone morphology, which in turn may have an impact on bone strength and fracture risk (Medina-Gomez, 2018).…”

Gut Microbiota Modulation of Moderate Undernutrition in Infants through Gummy Lactobacillus plantarum Dad-13 Consumption: A Randomized Double-Blind Controlled Trial

“…A review by Harahap and Suliburska [ 34 ] suggested that probiotic intervention may improve bone health, even though the paradoxical results and the mechanisms remain unclear. Besides that, the placebo group had a decrement intake of vitamin K. Vitamin K is essential for growth and mainly helps bone development (ossification), maintains bone density, and prevents the occurrence of osteoporosis.…”

Nutrition, Physical Activity, and Dietary Supplementation to Prevent Bone Mineral Density Loss: A Food Pyramid

“…The correlation between fiber intake and BMD could be meditated by the composition of the microbiota: a recent narrative review summarized the findings from preclinical studies that support that gut microbes positively impact bone mineral density and strength parameters [ 45 ]. Moreover, an even more recent narrative review reported that both the in-vitro and in-vivo studies show that the probiotics that positively affect bone health are Lactobacillus and Bifidobacterium through calcium regulation either on the transcellular pathway or on the paracellular pathway [ 46 ].…”

“…A recent narrative review [ 46 ] showed that isoflavones may play a significant role in preventing BMD loss: isoflavones (in particular daidzein) have showed direct effect in promoting osteoblast differentiation [ 285 ] and in suppressing the cellular expression of RANK-L [ 286 ] in in-vitro studies; also, a variety of human clinical trials assessed the potential benefit of the intake of flavonoids in osteopenia/osteoporosis and found possible positive correlation between flavonoid supplementation and attenuation of BMD loss [ 287 , 288 , 289 ].…”