Effect of a Short-term Multi-strain Probiotic Supplementation in Endurance Athletes

Effect of a Short-term Multi-strain Probiotic Supplementation on the Exercise- Associated Gastrointestinal Disturbances in Trained Female Athletes Under Controlled Conditions During Professional Training Cycle

The aim of this project is to evaluate and identify the effect of a short-term 2-week multi-strain probiotic (MPRO) supplementation on the exercise-associated gastrointestinal (GI) symptoms and perturbations in high level female athletes of the Polish national team during strictly controlled conditions of a training camp, based on recommendations for best practices for probiotic (PRO) research in athletes and assessment of EX-associated GI perturbations.

Objective of the study: GI health is crucial for the maintenance of general health and high performance in athletes. It is well known that GI symptoms are common in endurance athletes and that women are more likely to experience moderate or severe levels of symptoms. Exercise stress and external factors have an impact on GI health, leading to perturbations of GI integrity and functions negatively affecting performance outcomes. It is therefore necessary to develop treatment strategies capable of strengthening the GI health. Among the various preparations, PRO seem to induce improvements in intestinal diseases. There is a possible direct association between the reduced exercise-induced perturbations and cytokines, gut barrier function, and GI symptoms after PRO supplementation, but it has not been fully clarified yet. Moreover, it is stated that PRO benefits are strain-specific and dose-dependent, and include improved gut-barrier function, nutrient absorption, recovery and performance in athletes. Nevertheless, there is lack of well-designed studies on athletes population. Therefore, the main goal of the project is to evaluate and identify the effect of a short-term 2-week MPRO supplementation on the exercise- associated GI symptoms and perturbations in high level female rowers (particularly exposed to GI disturbances) of the Polish national team during completely controlled conditions of a training camp, based on recommendations for best practices for probiotic research in athletes and assessment of exercise-associated GI perturbations. The primary outcome is to recognize the MPRO supplementation effect on GI mechanisms, responsible for the occurrence of exercise-induced GI symptoms negatively affecting exercise performance. The following research hypotheses were adopted: A) considerable physical stress induced by high intensity exercises during national training camp contribute to the occurrence of GI disturbances; B) MPRO during high intensity training schedule may have a significant impact on specific key markers of GI perturbations; C) MPRO may have a positive effect on GI integrity; D) MPRO may have a beneficial effect on the systemic immune responses; E) MPRO may alter the fecal bacterial composition; F) MPRO may positively affect psychological stress and mood during high intensity training camp; G) MPRO may positively affect exercise performance outcomes.

Research project methodology: The study will be conducted in the standard of randomized, triple-blind, PLA-controlled crossover studies. A number of 30 high level female rowers will be enrolled. Specific MPRO strategy will be implemented. The assessment of body composition, exercise performance, baseline stool and baseline/post-exercise blood collection, GI and stress and mood status and nutrition will be performed. Samples will be analysed for: A) GI integrity markers permeability, bacterial endotoxin translocation, B) immune/stress responses' markers [inflammatory cytokine profile, immune cell response, C) exercise adaptation and intensity markers, D) stool GI integrity markers, E) fecal bacterial composition.

Expected impact of the research project on the development of science, practice and society: This completely innovative MPRO project will be conducted according to recently released recommendations for best practices for probiotic research in athletes and assessment of exercise-associated GI perturbations. Furthermore, recognizing the impact of MPRO on GI health could have beneficial implications for athletes, and people from the general population. An indisputable strength of our project is the fact that obtained data may be extrapolated into a real-world. Information on whether MPRO administration promotes proper GI health and physical training adaptation could be important for developing recommendations for PRO usage. Finally, the indisputable necessity of conducting research in the area of PRO is proved, in particular, by the abundance of GI disturbances, in terms of investigating natural methods in the prevention of GI symptoms.

Inclusion Criteria:

• belonging to the national rowing team;
• training experience ≥5 years;
• a currently issued medical certificate confirming
• good health and capacity to practice sports;
• good health without chronic health disorders;
• written informed consent to participate.

Exclusion Criteria:

• injury, any health contraindication or failure to perform exercise procedures;
• gastrointestinal infections, diseases, disorders;
• past history of gastrointestinal surgery, and
• other self-reported gastrointestinal issues;
• reporting symptoms of infection or taking any medication (e.g. antibiotics) for 4 weeks before the study protocol;
• current supplementation of prebiotics,
• probiotics, synbiotics (last 4 weeks);
• current intake of pharmaceutical agents (e.g., nonsteroidal anti-inflammatory drugs, laxatives, antidiarrhea agents, antacids, and/or antiemetics) (last 4 weeks);
• failure to follow the study protocol;
• declared general feeling of being unwell;
• pregnancy or current pregnancy planning.