Probiotics may improve selected GI symptoms in distance runners

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Probiotic supplements may improve general health and reduce the incidence of selected gastrointestinal (GI) disturbances in long-distance runners, researchers say.

Daily consumption of a multi-strain probiotic by endurance runners for three months revealed self-reported improvements in general health in 71% of women and 60% of men taking part in a Polish study. The formulation also reduced constipation among female participants.

Endurance runners are much more susceptible to gastric regurgitation, intestinal gurgling, diarrhoea, and abdominal pain brought on by prolonged and intense training sessions. Microbiome differences, stress and excessive consumption of hypertonic fluids and dietary fibre may also influence the frequency of GI disorders.

Probiotics like Lactobacillus acidophilus, L. acidophilus, and Bifidobacterium bifidum, for example, have shown promising results in alleviating symptoms, but studies on the influence of probiotic strains on the incidence of GI symptoms are inconsistent, according to the study authors.

“There is a dearth of research on the use of probiotics in sport and, therefore, a change in methodology is needed so that specific probiotic strains for specific intensities of physical activity are identified,” explained researchers from the Medical University of Bialystok in the International Journal of Environmental Research and Public Health.

Study protocol

The study aimed to evaluate the effect of a multi-strain probiotic containing B. lactis, Levilactobacillus brevis, L. casei, Lactococcus lactis, Lc. lactis, L. acidophilus, F. bifidum, and Ligilactobacillus salivarius on the incidence of gastrointestinal and selected biochemical parameters in blood serum.

Seventy long-distance runners aged between 20 and 60 and actively involved in race events were randomised to one of two groups, according to gender, with supplement was consumed daily for three months. The multi-strain probiotic was supplied by Polish biotech, Sanprobi, and provided a dose of 2.5 x 109 CFU/g (one capsule).

During the intervention, participants engaged in an exercise programme comprising endurance training and long-distance running (5km or more per day, 5–7 days per week), as well as 45-minute strength training workouts once or twice a week for three months.

Food diaries were completed with mealtimes, quantities, dishes, and fluid intake per day, as well as multiple-choice questionnaires indicating frequency and severity of GI symptoms at baseline and study end. Blood analyses determined changes in serum composition.

Results

There was no significant difference in nutrient intake at baseline among participants, which indicates diet did not have an impact on the GI symptoms in the examined athletes, the authors write.

After three months of intervention, concentrations of sodium, potassium, iron, and HDL cholesterol and triglycerides increased in probiotic women, although fasting serum glucose decreased in both female groups (probiotic and placebo). Iron concentrations also decreased significantly in the placebo and increases in unfavourable LDL cholesterol were noted. Incidence of constipation also fell in the female probiotic group.

Serum calcium concentrations and HDL cholesterol decreased in both male groups. Researchers observed positive reductions in fasting glucose concentrations in the probiotic group, but increased potassium and decreased magnesium and iron concentrations.

At the initial assessment, the majority of participants indicated they suffer from diarrhoea, but at the study end only the placebo groups observed significant reductions.

Meanwhile, all probiotic study participants demonstrated decreased white and red blood cells, haemoglobin, and platelets.

Tailored probiotics

The intestinal barrier plays a crucial role in exercise-induced GI symptoms and probiotics “undoubtedly have a beneficial effect”, demonstrated both by prior and current study results, wrote the authors.

However, further trials will help determine the mechanism of probiotic actions in physically active people and could lead to personalised solutions based on individual parameters, they added.

“In order to elucidate the mechanism of action on the bodies of physically active people, it would be necessary to analyse the intestinal microbiome of a particular athlete and, based on the findings, offer sportsperson tailored probiotics therapy.”

Source: International Journal of Environmental Research and Public Health

Published online July 30th, 2022: https://doi.org/10.3390/ijerph19159363

“Effect of a Multi-Strain Probiotic Supplement on Gastrointestinal Symptoms and Serum Biochemical Parameters of Long-Distance Runners: A Randomized Controlled Trial”

Authors: J. Smarkusz-Zarzecka, et al