Curcumin and bone density

Relation

Riva A, Togni S, Giacomelli L, et al. Effects of curcumin-based nutritional supplementation in asymptomatic subjects with low bone density: a preliminary 24-week nutritional supplement study.Eur. Rev. Med. Pharmacol. Sci. 2017;21:1684-1689.

Study design

A 24-week, open-label human supplementation pilot study [Editor’s note: The study’s authors clarify, “Supplement studies define the field of activity of pharma-standard supplements and their possible preventive, pre-therapeutic applications. ‘Supplement human studies’ produce supplementary data to be compared with those from the best available management plan.”]

Learning objectives

Comparison of the efficacy and safety of curcumin phytosome supplementation plus standard treatment of osteopenia with standard treatment alone

Participant

Fifty-seven elderly men (mean age 71 years) who were otherwise healthy (BMI <25 kg/m2) and diagnosed with osteopenia by DXA. Study participants self-selected to participate in one of standard treatment (i.e., a nutritional assessment followed by a diet containing sufficient vitamin D, vitamin C, and calcium, and a regular exercise program consisting of resistance training, walking, or running 4 times per week; n=28) or standard management with the addition of “a supplement” (n=29).

Exclusion criteria were a diagnosis of hypertension or hypercholesterolemia. All subjects also had normal erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels. No placebo was given in this open study.

intervention

The supplement consisted of 1,000 mg of curcumin phytosome (Meriva) administered as a single dose daily.

Target parameters

Bone densitometry was assessed using ultrasound. Specifically, calcaneal densiometry was performed using a Sahara clinical bone sonometer (Hologic Inc., Marlborough, MA, USA), and the fifth digit and jaw were performed using a semi-quantitative, high-resolution ultrasound scanner (Preirus, Hitachi, Tokyo, Japan).

Bone density was determined after 4, 12 and 24 weeks and compared with the baseline values ​​of one group and the results of the other group.

Key insights

At the 12-week and 24-week follow-up, bone density was significantly improved (P<0.05) compared to baseline on the calcaneus, maxilla and fifth finger. Ultrasound translucency of the calcaneus decreased (corresponding to the increase in bone density) by 18.4% and 21% at weeks 12 and 24, respectively (P≤0.05). Parameters of the fifth digit and maxilla also had statistically significant (P≤0.05) improvements at week 12 (6.9% and 2.3%) and week 24 (7.1% and 4.8%). Those who received only standard care had no significant changes in bone density parameters. No side effects or tolerability problems were noted.

Practice implications

Doctors considering treatments to improve bone density in patients with osteopenia are likely to include nutrients such as calcium, magnesium, vitamin D, vitamin K and omega-3 fatty acids.

Curcumin may not come to mind as a standard addition to this regimen, but this study of older men with reduced bone density suggests that perhaps it should be. It should be noted that Meriva's Curcumin phytosome supplement contains 20 percent curcumin extract, 40 percent phosphatidylcholine, and 40 percent cellulose. Thus, the daily dose of curcumin delivered was 200 mg.

However, the phytosome formulation may have unique absorption properties. In a study comparing curcumin with (Meriva) and without phytosome in 9 healthy volunteers, Cuomo and colleagues found that 200 mg of Meriva had circulating curcuminoid levels equivalent to 5.8 grams of comparable dry powder. This represents 29 times higher values, suggesting that the phytosome greatly increased the absorption and/or restricted metabolism of the curcumin.¹

The significantly improved bone density in the curcumin group found at the 12- and 24-week assessments compared to the control group suggests that curcumin may be a valuable adjunct to standard treatment for reduced bone density. While curcumin extracts have shown effectiveness in preventing bone density loss in laboratory animals,^2-5This is the first human study to show improved bone density after curcumin supplementation. A plausible mechanism could be the activity of curcumin in inhibiting osteoclastic bone resorption, possibly through its known interference with nuclear factor kappa B (NF-κB) signaling, which is also the main mechanism of curcumin's anti-inflammatory effects.^4.6

The formulation of this product is of interest because the Hordaland Health study found that dietary choline is directly related to bone mineral density.^7.8A follow-up study with a similar structure but with a placebo consisting of cellulose and phosphatidylcholine would help strengthen the evidence.

This was a preliminary study that should be repeated in a larger group, but it appears that we can add osteopenia to the list of clinical conditions.⁹delayed onset of muscle soreness after training,¹⁰osteoarthritis,¹¹benign prostatic hyperplasia,¹²sarcopenia,¹³uveitis,¹⁴non-alcoholic fatty liver disease,^fifteenand quality of life in cancer treatment.¹⁶

Declaration of Conflicts of Interest

It should be noted that three of the authors of the article discussed here are employed by Meriva's manufacturer, Indena Corporation. A fourth author works as a consultant to the company. In addition, one of the authors, F. Franceschi, MD, is associate editor of the journal in which this article was published. I am also employed by a company, Thorne Research, that benefits from the sale of Meriva.