Probiotic found effective in preventing osteoporosis in postmenopausal women: JAMA

A recent clinical trial revealed that daily supplementation with the probiotic Limosilactobacillus reuteri (L. reuteri) does not significantly reduce bone loss or alter bone turnover in early postmenopausal women. The findings of this study published in the Journal of American Medical Association suggest that while L. reuteri showed promise in earlier animal models and initial human studies, its effectiveness in preventing osteoporosis in postmenopausal women may be limited.

The primary objective of the study was to determine if long-term treatment with L. reuteri could offer clinically relevant skeletal benefits in women experiencing postmenopausal osteoporosis. This double-blind, randomized, placebo-controlled trial was conducted from December 2019 to October 2022 and included a total of 239 women who were of 50 to 60 years. The participants were recruited through online advertisements and direct mail, with an initial pool of 10,062 women narrowed down through telephone and in-person screenings.

The participants were divided into groups receiving either a low dose (5 × 10^8 CFU) or high dose (5 × 10^9 CFU) of L. reuteri capsules twice daily, or a placebo. All capsules also contained 200 IU of cholecalciferol (vitamin D). The primary outcome measured was the relative change in tibia total volumetric bone mineral density (vBMD) over two years. The secondary outcomes included changes in areal bone mineral density (aBMD) of the lumbar spine and total hip as well as various bone turnover markers.

The results of this study found that there were no significant differences in bone loss between the groups taking L. reuteri and the participants taking the placebo. Tibia vBMD, hip and spine vBMD, and tibia cortical area and BMD decreased significantly across all groups with no notable differences between them. This was further confirmed by secondary outcomes which also showed no significant treatment effects.

A prespecified sensitivity analysis indicated a potential interaction between body mass index (BMI) and treatment effect by suggesting that BMI may influence the efficacy of L. reuteri on bone health. Also, the study found no significant adverse effects associated with L. reuteri supplementation which affirms its safety for consumption. Despite the lack of efficacy in reducing bone loss, the probiotic was well tolerated by the study group.

These findings suggest that while L. reuteri is safe, its role in preventing postmenopausal bone loss is negligible. The interaction between BMI and treatment effect observed in the study open opportunities for research that should consider individual physiological factors when assessing the benefits of probiotics for bone health.

Source:

Gregori, G., Pivodic, A., Magnusson, P., Johansson, L., Hjertonsson, U., Brättemark, E., & Lorentzon, M. (2024). Limosilactobacillus reuteri 6475 and Prevention of Early Postmenopausal Bone Loss. In JAMA Network Open (Vol. 7, Issue 6, p. e2415455). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2024.15455