Probiotics for athletes – probiotics are live microorganisms which have been shown to have a beneficial effect on human health. Essentially, they are the opposite of antibiotics which are designed to kill bacteria and fungi. If you type in the term “probiotics” into the PubMed search box you will observe the exponential increase in studies researching or referencing probiotics over the past two decades. Many of these studies are looking at gut conditions, which makes sense given that there are billions of microbes in our gut, known as the microbiome. The other major area of probiotic research is related to the immune system. The microbiome and the immune system appear to have bidirectional interactions that can have widespread effects on the immune system, as well as other body systems. Many studies have found positive results for probiotic supplementation on both gastrointestinal and immune conditions in the general population. Therefore, given that athletes often suffer from gut issues during intense exercise, and increased upper respiratory tract infections (URTI), probiotics may be worthwhile trialing. There isn’t a lot of research on probiotics specific to athletes, but I will discuss some of the research in this article.
Much of the literature relating to gut symptoms (cramps, vomiting, nausea, abdominal pain, altered bowel movements) in athletes indicate that these issues occur mainly due to either:
Lamprecht et al 2012 suggest that increased intestinal permeability and decreased gut barrier function contribute to gut issues in athletes. The common term for this is “leaky gut”, but the authors used the more technical term of exercise-induced intestinal barrier dysfunction. Essentially, the authors are saying that intense exercise damages the lining of the gut and this can lead to the gut symptoms experienced by athletes. Many other studies have also shown that leaky gut can cause gut and immune issues. In athletes it seems logical that this effect is due to the physical strain that is placed on the gut during intense exercise. However, many factors can contribute to a leaky gut, including changes in the microbiome. Therefore, there could be other contributing factors that lead to a leaky gut in athletes. The authors concluded that probiotics may play a part in reducing these symptoms, along with other benefits. In another study carried out by Lamprecht et al 2012, they found that a multi-strain probiotic supplement decreased markers for intestinal permeability, oxidation and inflammation in well trained men. Therefore, athletes suffering from gastrointestinal issues may benefit from strategies aimed at reducing intestinal permeability, which includes probiotics.
Pyne et al 2015 looked at studies examining probiotic supplementation by athletes and concluded that there were modest clinical benefits for athletes. This was due to reduced severity, frequency and/or duration of respiratory and gastrointestinal illness.
Shing et al 2014 found that supplementation by male athletes of a multi-strain probiotic for 4 weeks significantly increased run time to fatigue in heat. However, the exact mechanisms for improvement were not identified.
Probiotics have also been shown to reduce the risk of traveller’s diarrhoea (TD). This is very relevant for athletes who are travelling to developing countries where the risk of TD is high e.g. Asia, Africa and the Middle East.
What is becoming clear from the research is that the benefits of probiotics are strain specific. Therefore, not every strain is going to be effective for every condition and some strains may actually have a negative effect. There also seems to be differences between how probiotics effect different population groups. For example, West et al 2011 found that supplementing with Lactobacillus fermentum (PCC®) was beneficial for male athletes, but not so good for female athletes who had increased URTI when taking the probiotic. Therefore, athletes need to look at the evidence and choose a probiotic that may benefit their particular health condition. Therefore, it’s not advisable to buy any product off the shelf and athletes should consult a trained health practitioner before taking any nutritional supplement.
There is currently relatively limited evidence for the benefits of probiotics specific to athletes. However, results from studies carried out on athletes and the general population show that probiotics are generally safe and effective for treating a range of conditions. It appears that exercise-induced intestinal dysfunction could be a contributing factor to athletes suffering acute and/or chronic gastrointestinal issues and strategies to minimise this could prove beneficial. Therefore, I believe that well researched strains of probiotics are likely worthwhile trialing for athletes with gut or immune issues.
A lot more studies are needed to fill in the large data gaps that currently exist for probiotic supplementation. We are just at the beginning of understanding the effects of probiotics on human health. Given the prevalence of gut and immune issues in athletes, probiotics could become the next big thing in sports nutrition.
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Rick Hallion is a nutritionist who takes a holistic approach to sports nutrition. Rick combines the science of sports nutrition with the principles of naturopathic medicine to treat the whole athlete.
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