Role of Probiotics in Sports Performance

Do you want to enhance your exercise performance, post-training recovery and overall well-being?

Whether you are an elite and professional athlete, a recreational athlete, or a novice trainer, improved athletic performance would be a key focus for you and this includes faster recovery from physical fatigue and achieving overall wellbeing. Growing scientific evidence suggests that optimum gut health and efficiently functioning immune systems are key for achieving high performance (Jäger et al., 2019). The emerging scientific evidence suggests that one of the key contributors to improving gut health, immune function and post-training recovery, leading to enhanced performance are gut probiotics, the healthy gut microorganisms (Jäger et al., 2019 & 2016; Maughan et al., 2018; Wakeman, 2013).

1. What are probiotics?

According to the World Health Organisation (WHO) and the International Olympic Committee (IOC), probiotics are healthy to live micro-organisms (mainly bacteria) that when administered orally inadequate amount for several days/weeks can increase the numbers of beneficial bacteria in the gut and confer several health benefits to the host (a person). These bacteria can live in the gut and in some fermented, raw and living foods. The concept of probiotics is not new; around 1900 Nobel laureate, Elie Metchnikoff, discovered that the consumption of live bacteria (example: L. bulgaricus) in yogurt or fermented milk improved some biological features of the gastrointestinal (GI) tract. Probiotics have been associated with a range of potential benefits to gut health, modulation of immune function and wellness and their benefits are especially important for endurance and/or recreational athletes (Jäger et al., 2019; Maughan et al., 2018; Wakeman, 2013). Bacteria with claimed probiotic properties are now widely available in the form of foods such as dairy products and juices, and also as capsules, drops, and powders. Scientists categorise microorganisms with genus, species and strain names. For example, for the probiotic bacterium, Lactobacillus rhamnosus GG, the genus is Lactobacillus, the species is rhamnosus and the strain is GG.

The benefits of probiotics depend on the combination of various strains and doses. Commercially, probiotics can be available as a single bacterium or a cocktail of multiple stains.

2. How do probiotics contribute to achieving optimum performance and health benefits for athletes?

A recent review published in 2019 in the Journal of International Society of Sports Nutrition reviewed 299 studies in this field. According to this review and several emerging evidence, the probiotics functions can be discussed in the following categories:

Role of probiotics in improving gastrointestinal (GI) health, GI integrity and athletic performance

GI problems often occur in endurance athletes during prolonged events (such as cycling, triathlons and marathons), especially in challenging conditions. Symptoms may include nausea, cramping, bloating and diarrhoea. Recent research indicates that probiotic supplementation, using a certain combination of probiotics strains, can promote improvements in exercise performance through various pathways in athletes and physically active individuals. A few recent studies (Vaisberg et al., 2019; Salarki et al., 2013) have demonstrated that multi-strain probiotics supplementation, a few weeks’ pre-race, lowered GI symptoms significantly and improved immune and inflammatory functions in marathon runners. A number of studies have demonstrated that multi-strain probiotics supplements in endurance trainers and resistance-trained men increased their VOmax, aerobic power, training performance and improved range of motion during acute recovery. These studies also found a decrease in inflammation (cytokines) and a reduction in the incidence of Upper Respiratory Tract infections in athletes taking probiotics supplements (Huang et al., 2019; Gapner et al., 2017; Jäger et al., 2016; Salehzadeh 2015; Salakia et al., 2013)

So let’s see how probiotics achieve the above mentioned beneficial effects?

a. By modulating metabolism, improving the availability and absorption of amino acids, vitamins and minerals

• Probiotics assist in the maintenance of appropriate gut pH and digestive function through enzyme activity and metabolism within the gut. This improves the availability of amino acids, vitamins, short chain fatty acids, micronutrients and minerals; these are then easily absorbed through from the gut to the circulation.
• Probiotics provide the favourable environment for the resident healthy microorganisms by maintaining appropriate PH, recycling nitrogen, detoxification and transformation of many substances and micronutrients (Jäger et al., 2019).

b. By improving immune functions, reducing inflammation and infections

70% of the immune system (cells) is located in the gut and probiotic supplementation has been shown to promote a healthy immune response in the host (Jäger et al, 2019).

• A number of studies have demonstrated that certain strains of probiotics improve the structural integrity of the gut by influencing a protein called Zonulin. Thereby keeping the gut lining intact and preventing the leaking of partially digested macro (big) molecules in body’s circulation. This is very important to prevent ‘leaky gut’ and certain allergic reactions (Jäger et al., 2019). It is important to note that the gut undergoes a lot of stressful event in high endurance athletes. 
• Probiotics reduce the adhesion of pathogens (harmful microorganisms) to the mucosal lining of the gut, this helps in reducing the number of pathogens in the gut.
• Probiotics also produce antimicrobial substances, thus defending against invaders and maintaining a balance of good microflora in the gut. This is important to reduce the frequency of infections and abdominal discomfort.

–  Role of probiotics in post-training recovery of fatigued muscles and systems

Fatigued and/or damaged muscles, systemic inflammation and build-up of harmful and muscle-damaging oxidative molecules (called oxidative stress) are common in athletes and these can impact post-training recovery and performance. As discussed above, supplementation of selected anti-inflammatory probiotic strains has been linked to improved recovery from muscle-damaging exercise by removing inflammatory molecules, reducing oxidative stress and improving the availability of essential amino acids and vitamins. Specific strains of probiotics can prevent frequent episodes of respiratory infections. These are crucial in the healing of damaged muscles and post-training recovery (Huang et al., 2019; Gapner et al., 2017; Jäger et al., 2016; Salehzadeh 2015; Salakia et al., 2013).

–  Maintaining hydration

Probiotics have been demonstrated to maintain ion transporters in the gut lining, helping to maintain optimum cellular hydration and preventing gastric upset (Jäger et al., 2019).

– Modulating neurotransmitters, hormones and stress

Preclinical and early human research has shown that probiotics have potential benefits relevant to an athletic population. These include improved hormonal functions related to body composition and lean body mass, normalizing age-related declines in some hormones (example: testosterone levels), reductions in stress hormone (cortisol) levels, improved responses to a physical or mental stressor, reduction of exercise-induced lactate, and increased neurotransmitter synthesis (related to cognition and mood). However, these potential benefits require validation in more rigorous human studies and in a diverse athletic population (Jäger et al., 2019).

3. Do probiotics affect professional athletes and novice athletes differently?

–  High performing professional/elite athletes

The main benefit for elite or high performing athletes are expected to be in achieving the faster post-training recovery, reduced incidents of infections and overall wellbeing. These athletes may already be performing to their optimum levels and hence may not notice the changes in their performance as a result of probiotic supplements (Jäger et al., 2019).

–  Novice trainers

Novice trainers taking regular probiotics supplements are expected to notice differences in their performance, post-training recovery and overall well-being (Jäger et al., 2019).

4. Complementary effects of good nutrition and activities on the effects of probiotics

The endurance training and physical activities put additional demand on the physiological and immunological processes. Probiotics alone are not sufficient to achieve your overall fitness and performance goals. Research evidence suggests that a balanced diet of healthy protein (for example whey protein, salmon fish), fibre, carbohydrates and some forms of fatty acids enhance the functions of probiotics. Some food types which promote probiotic functions are called prebiotics, examples include fermented food (examples: yogurt, whey, buttermilk, pickles, fermented soybean food, kimchi), garlic, onions, oats, barley, cocoa, flaxseed, banana, apple, greens and salmon fish.  In addition, physical activity has been shown to positively promote probiotics growth and functions (Jäger et al., 2019).

5. Health and Safety related to Probiotics

Common probiotic species in commercial use are mainly derived from fermented foods with a long history of human consumption. These are considered safe for the general population by the European Food Safety Authority (EFSA, Jäger et al., 2019). People with specific medical conditions should seek medical advice.

6. What are the key characteristics of probiotics supplements recommended by International Olympic Committee (IOC) and WHO (Jäger et al. 2019)?

• Only reputable sources of commercially available supplements should be used by athletes. This is important to reduce the risk of contaminants that might be considered as doping in sport regulations. Athletes should be educated on the likely risks of contamination given that the World Anti-Doping Agency enforces a strict regulation for banned substances. 
• The effect of probiotics is dependent on the dose and types of stains used. A good product should have a cocktail (mixture) of probiotics strains and provide the details of the names including species and genus names of each of the live organisms included.
• The doses (total estimated quantity) of each probiotic strain at the end of the product’s shelf life, as measured by colony forming units (CFU) of live cells should be provided.

7. Key features of PowerAMP Everyday Sports Probiotics:

• PowerAMP products are tested for all banned substance so these can be used by competitive professional athletes.
• PowerAMP’s Everyday Sports probiotics supplement is a mixture of adequate doses of 12 strains of two very well researched and approved genera (Lactobacillus and Bifidobacterium). The product label clearly provides the detailed names and doses of each of these strains used, as recommended by the IOC.

Summary:

Considering the growing scientific evidence related to benefits and favourable safety profile of probiotic supplementation reported in sports and medical journals, probiotics are generally used to optimize the performance, recovery and overall health of athletes. Regular consumption of specific probiotic strains especially a product with a multi-strain combination, may improve immune functions, reduce the number of respiratory infections and GI discomfort an athlete may experience during endurance training in challenging conditions. In addition, probiotics improve gut integrity and hence improve nutrient absorption, reduce allergies and improve post-training recovery ad performance. The benefits of probiotics are specific to strains when consumed at adequate doses. It is therefore important that athletes must choose the product with clinically researched strains with health validated benefits and products should be clean from any banned substances.

References:

1. Jäger et al. International Society of Sports Nutrition Position Stand: Probiotics. Journal of the International Society of Sports Nutrition. 2019; 16:62. https://doi.org/10.1186/s12970-019-0329-0
2. Huang et al. Nutrients. 2019;11(2). https://doi.org/10.3390/nu11020353.
3. Maughan et al. IOC consensus statement: Dietary supplements and the high-performance athlete. Br J Sports Med. 2018;52:439–55.
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5. Jäger et al. Probiotic Streptococcus thermophilus FP4 and Bifidobacterium breve BR03 supplementation attenuates performance and range-of-motion decrements following muscle damaging exercise. Nutrients. 2016;8. https://doi.org/10.3390/nu8100642.
6. Salehzadeh K. The effects of probiotic yogurt drink on lipid profile, CRP, and record changes in aerobic athletes. Life Sci. 2015;9:32–7.
7. David et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature. 2014;505:559–63. https://doi.org/10.1038/nature12820.
8. Didari et al. A systematic review of the safety of probiotics. Expert Opin Drug Saf. 2014;13:227–39. https://doi.org/10.1517/14740338.2014.872627.
9. Wakeman M. (2013). A review of the role of probiotics in sport. ISSSMCconference abstract 031 2013. http://dx.doi.org/10.1136/bjsports-2013-093073.31
10. Salarkia et al. Effects of probiotic yogurt on performance, respiratory and digestive systems of young adult female endurance swimmers: a randomized controlled trial. Med J Islam Repub Iran. 2013;27:141–6.