A recent presentation at the 2013 Institute of Food Technologists (IFT) Annual Meeting & Expo in Chicago focused on the health benefits of short-chain fructooliogosaccharides (scFOS), which are low-calorie, non-digestible carbohydrates that just might help improve bone health and the growth and balance of important bacteria in the digestive track. Fructooliogosaccharides are naturally found in chicory, onions, asparagus, wheat, tomatoes and other fruits, vegetables and grains. Not only are they considered to be prebiotics, but they also increase calcium absorption in the body.
Carbs That Promote Bone Health

The regular addition of scFOS to the diet is “ideal for maintaining mineral density and (bone) strength, ” said Phillip Allsopp, Ph.D., research associate at the University of Ulster in Coleraine, Ireland.
Dr. Allsopp told OTW, “This study demonstrated that a multimineral seaweed extract rich in calcium (Aquamin) does not appear to have a beneficial effect on BMD [bone mineral density] in the group of healthy post-menopausal population tested, however significant reductions in bone turnover markers following 12 months supplementation would indicate a positive impact on bone health, however this effect appeared to diminish after 24 months. Interestingly, when the Aquamin was combined with the prebiotic short chain FOS (Nutraflora) the favourable change in bone health markers was maintained following 12 and 24 months supplementation albeit no change in BMD was observed in the whole cohort. However, exploratory analysis of the post-menopausal participants that were identified as osteopenic, showed that the combined supplementation of Aquamin and Nutraflora significantly reduced vertebral BMD loss alongside a non-significant reduction in hip BMD loss. The accumulation of evidence on the role of dietary components on bone health, such as the multi-mineral and prebiotic supplement used in this study, could assist in the prevention of age related osteoporosis through long-term supplementation, particularly in the first five years following the menopause.”
“Future studies would benefit from restricting the intervention study to those within the first five years following the menopause where the most drastic BMD loss has been shown to occur. Supplementation at this early stage may enable a more dramatic beneficial effect to be apparent and maximize the prevention of BMD loss at this most critical stage. Despite a need to verify a reduction of fracture incidence in such studies, the task of investigating the role of such dietary components on fracture risk are extremely difficult to undertake with financial, logistical and time restraints, however such a study would be needed to conclusive implicate a definite causal role for any selected dietary component or supplement on reducing the risk of osteoporosis related fracture risk.”

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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