Probiotic Supplementation and Gastrointestinal Endotoxemia Before and After the Marathon Des Sables.

Whilst evidence of increased gastrointestinal endotoxemia (GE) has been previously demonstrated during single-day ultra-endurance events, less is known on the prevalence of GE following extreme ultra-events such as the Marathon Des Sables (MDS). The potential benefit of probiotic formulas on gut integrity during ultra-endurance events also requires further investigation. PURPOSE: To assess the impact of probiotic supplementation with or without glutamine on GE prevalence in runners competing in a multi-day ultra-run (MDS). METHODS: Thirty four healthy participants from the 2015 MDS UK cohort volunteered for a 12 week pre-race intervention and were randomly assigned to either: probiotic (PRO; 100mg.d-1 lactobacillus acidophilus) (age 40 ±3 yrs., weight 79.4 ±2.0kg, VO2max 4.2 ±0.1 L.min-1), probiotic with glutamine (PROglut; 40.5mg.d-1 lactobacillus acidophilus and 900mg.d-1L-glutamine) (age 39 ±2 yrs., weight 70.6 ±4.8 kg, VO2max 4.0 ±0.2 L.min-1) and control (CON) (age 42±3 yrs., weight 79.2 ±3.8 kg, VO2max 4.0 ±0.3 L.min-1). Plasma lipopolysaccharides (LPS) (via Limulus Amebocyte Lysate chromogenic endotoxin quantification) were assessed at weeks 0, 12, post-race and 7 days post-race. Performance data was collated from official timing chips. Data presented as mean ±SE. RESULTS: Mild to moderate GE was prevalent in all groups at baseline (PRO 9.71 ±0.85pg.ml-1, PROglut 9.89 ±1.43 pg.ml-1, CON 9.40 ±0.57 pg.ml-1; P>0.05). Whilst LPS, post intervention, was lower in PROglut there was no significance between groups (9.81 ±1.47pg.ml-1 vs 12.80 ±0.93pg.ml-1 (PRO) vs 11.72 ±1.08 pg.mol-1 (CON); P>0.05). LPS were evidently reduced 6hrs post-race, but not different between groups (PRO: 7.29 ±1.41 pg.ml-1, PROglut: 6.95 ±0.94 pg.ml-1, CON: 9.73 ±1.39 pg.ml-1; P>0.05).Plasma LPS returned to baseline levels 7 days post-race (PRO 7.60 ±0.95 pg.ml-1, PROglut 10.41 ±1.04 pg.ml-1, CON 8.57 ±0.75 pg.ml-1; P>0.05). Race performance (hrs:mins) was not significant between groups, despite PRO and PROglut being ~9hrs faster than CON (41:28±2:31 vs 41:58±4:02 vs 50:43±4:38; P>0.05). CONCLUSION: Moderate GE was prevalent in all groups pre-race and fell significantly during the short-term recovery period. Despite promising results neither probiotic formula had a significant impact on GE or race performance

Assessing the Impact of Probiotic Supplementation and Caloric Periodization on Ultra-endurance Performance and Gastrointestinal Symptoms

Beneficial use of probiotic (PRO) interventions on gastrointestinal endotoxemia (GE) prior to an ultra-endurance triathlon has been previously demonstrated. The prevalence of GE (and whether PRO strategies minimise gastrointestinal (GI) symptoms) relating to multi-day ultra-events is less known. Understanding if nutritional periodization strategies confer similar GI benefits also warrants investigation. PURPOSE: To assess the impact of probiotic supplementation and caloric periodization prior to an extreme ultra-marathon on GI symptoms and race performance. METHODS: Thirty-eight healthy participants were recruited from entrants of the 2015 Marathon Des Sables (age: 42±9yrs; weight: 77.71±10.31kg; VO2max: 52.58±8.66 mL·kg·min-1), and randomly assigned to either: PRO (100mg.d-1 capsulated Lactobacillus acidophilus); CP (caloric periodization of 500kcal above habitual intake on alternate days) or control (CON) for 12 weeks pre-race. Plasma lipopolysaccharides (LPS) via Limulus Amebocyte Lysate chromogenic endotoxin quantification were determined at baseline, pre and post-race. Participants graded duration and severity of GI symptoms through daily questionnaires. Performance times were obtained from accumulated race tracking. Data presented as mean ±SE. RESULTS: Race times (hrs:mins) were 41:28±2:31, 45:12±2:05 and 50:43 ±4:38 for PRO, CP and CON respectively (p>0.05). Overall LPS significantly increased from baseline (10.08±0.53pg.ml-1) to pre-race (13.12±0.74pg.ml-1; p=0.001). Delta LPS pre-race was not different between groups (PRO: 2.94±1.11pg.ml-1; CP: 3.71±1.28pg.ml-1; CON: 2.32±1.26pg.ml-1; p>0.05). Similarly, delta LPS post-race was not different, despite greater reductions in both intervention groups (PRO: -4.57±1.93pg.ml-1; CP: -6.95±1.84pg.ml-1; CON: -2.16±2.21pg.ml-1; p>0.05). GI symptom count favoured PRO (21.8%) compared with CP (41.6%) and CON (36.6%) respectively (p=0.001), although no differences for GI symptom index were reported between groups (p>0.05). CONCLUSIONS: Moderate GE was evident in a UK cohort undertaking a multi-day ultra-marathon. PRO use did not significantly impact on GE prevalence, despite evidence of reduced GI symptoms. Caloric periodization appeared to favour GE recovery post-race, but was not deemed significant

An exploratory investigation of endotoxin levels in novice long distance triathletes, and the effects of a multi-strain probiotic/prebiotic, antioxidant intervention.

Abstract: Gastrointestinal (GI) ischemia during exercise is associated with luminal permeability and increased systemic lipopolysaccharides (LPS). This study aimed to assess the impact of a multistrain pro/prebiotic/ antioxidant intervention on endotoxin unit levels and GI permeability in recreational athletes. Thirty healthy participants (25 males, 5 females) were randomly assigned either a multistrain pro/prebiotic/ antioxidant (LAB4ANTI; 30 billion CFU.d-1 containing 10 billion CFU.d-1 Lactobacillus acidophilus CUL-60 [NCIMB 30157], 10 billion CFU.d-1 Lactobacillus acidophillus CUL-21 [NCIMB 30156], 9.5 billion CFU.d-1 Bifidobacterium bifidum CUL-20 [NCIMB 30172] and 0.5 billion CFU.d-1 Bifidobacterium animalis subspecies lactis CUL-34 [NCIMB 30153]/ 55.8 mg.d-1 fructooligosaccharides/ 400 mg.d-1 α-lipoic acid, 600 mg.d-1 N-acetyl-carnitine); matched pro/prebiotic (LAB4) or placebo (PL) for 12 weeks preceding a long-distance triathlon. Plasma endotoxin units (via Limulus amebocyte lysate chromogenic quantification) and GI permeability (via 5 hour urinary lactulose (L): mannitol (M) recovery) were assessed at baseline, pre-race and 6 days post-race. Endotoxin unit levels were not significantly different between groups at baseline (LAB4ANTI: 8.20±1.60 pg.ml-1; LAB4: 8.92±1.20 pg.ml-1; PL: 9.72± 2.42 pg.ml-1). The use of a 12 week LAB4ANTI intervention significantly reduced endotoxin units both pre-race (4.37± 0.51 pg.ml-1) and 6 days post-race (5.18±0.57 pg.ml-1; p=0.03, ηp2 = 0.35), but only 6 days post-race with LAB4 (5.01± 0.28 pg.ml-1; p=0.01, ηp2 = 0.43). In contrast, endotoxin units remained unchanged with PL. L:M significantly increased from 0.01±0.01 at baseline to 0.06± 0.01 with PL only (p=0.004, ηp2 = 0.51). Mean race times (hr:min:sec) were not statistically different between groups despite faster times with both pro/prebiotoic groups (LAB4ANTI:13:17:07±34:48; LAB4: 12:47:13±25:06; PL: 14:12:51±29:54; p>0.05). Combined multistrain pro/prebiotic use may reduce endotoxin unit levels, with LAB4ANTI potentially conferring an additive effect via combined GI modulation and antioxidant protection