Current Osteoporosis Reports

, Volume 16, Issue 1, pp 65–75 | Cite as

Linking the Gut Microbiota to Bone Health in Anorexia Nervosa

  • Nicole C. Aurigemma
  • Kristen J. Koltun
  • Hannah VanEvery
  • Connie J. Rogers
  • Mary Jane De Souza
Secondary Causes of Osteoporosis (S Warden, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Secondary Causes of Osteoporosis


Purpose of Review

The purpose of this review is to examine the anorexia nervosa-microbiota-bone relationship, offering a compilation of the relevant human and animal studies that may contribute to a more comprehensive understanding of potential mechanisms involved.

Recent Findings

Recent studies have implicated fermentation by-products of the gut microbiota in bone metabolism.


Compromised bone health often accompanies anorexia nervosa due to energy deficiency and hypoestrogenism. The gut microbiome has been implicated as a link between these conditions and impaired bone growth phenotypes. Current research supports decrements in Firmicutes and short-chain fatty acids with increases in Methanobrevibacter smithii and Proteobacteria in anorexia nervosa. A potential mechanism for microbiome-regulated bone growth is through modulation of insulin-like growth factor-1. Future research should aim to examine short-chain fatty acids, probiotics, and prebiotics as alternative therapies to treat low bone density in anorexia nervosa.


Anorexia nervosa Gut microbiota Bone metabolism Osteoporosis Insulin-like growth factor-1 Short-chain fatty acids 


Compliance with Ethical Standards

Conflict of Interest

Nicole Aurigemma, Kristen Koltun, Hannah VanEvery, Connie Rogers, and Mary Jane De Souza declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of Importance •• Of Major Importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Nicole C. Aurigemma
    • 1
  • Kristen J. Koltun
    • 1
  • Hannah VanEvery
    • 2
  • Connie J. Rogers
    • 3
  • Mary Jane De Souza
    • 4
  1. 1.Women’s Health and Exercise Lab, Department of KinesiologyThe Pennsylvania State UniversityUniversity ParkUSA
  2. 2.Departments of Nutritional Sciences and Clinical and Translational SciencesThe Pennsylvania State UniversityUniversity ParkUSA
  3. 3.Department of Nutritional SciencesThe Pennsylvania State UniversityUniversity ParkUSA
  4. 4.Women’s Health and Exercise Lab, Department of Kinesiology and PhysiologyThe Pennsylvania State UniversityUniversity ParkUSA

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