The Hertfordshire Study

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

SUMMARY

This study aimed to assess the impact of a multi-strain probiotic/prebiotic/antioxidant intervention on endotoxin levels and gastrointestinal permeability in recreational athletes.
The triathlon athletes taking Lab4 probiotics with prebiotic fibre alone or in combination with antioxidants experienced fewer and less severe exercise-related gut symptoms during their training period.
Reductions in plasma endotoxin levels were observed with Lab4 probiotic/fibre/antioxidant supplementation.
Supplementation of Lab4 probiotics with fibre led to faster race finishing times.

Aim

This randomised, double-blind, placebo-controlled study aimed to assess the effect of a 12-week Lab4 probiotic/prebiotic/antioxidant intervention on gut symptoms, endotoxin levels, intestinal permeability and race time in recreational athletes.

Method

Results

Gut disturbance

Gut symptom severity scores during training were significantly lower in both Groups 2 and 3 compared to Group 1 (*P<0.001).
Gut symptoms include bloating, nausea, stomach/intestinal pain or discomfort, cramping, headaches, dizziness, constipation, diarrhoea, belching, urge to urinate & defecate.

Endotoxin

Endotoxin levels were significantly reduced in Group 2 who took Lab4 probiotics six days post-race compared to the start levels (*P<0.05). This represented an overall 43.9% reduction in endotoxin levels.

Endotoxin levels were significantly reduced in Group 3 who took Lab4 probiotics plus antioxidants for both pre-race and six days post-race compared to the start levels (*P<0.05). This represented an overall 36.8% reduction in endotoxin levels.

No changes in endotoxin levels were observed in Group 1.

Intestinal permeability

Lactulose:Mannitol ratio was measured as an assessment of intestinal permeability.

Altered intestinal permeability was only observed in Group 1, where L:M ratio significantly increased from baseline to pre-race and six days post-race (*P<0.05). This represents a 4.2 fold increase compared to a 0.6 fold increase for Group 2 and a 0.7 fold increase for Group 3.

Race times

Faster race times were observed with Lab4 probiotics (10.0% reduction, P= 0.058) and Lab4 probiotics plus antioxidants (6.5% reduction) compared to Group 1.
A significantly faster time was reported for Group 2 during the cycle stage of the triathlon (*P = 0.046).
Both Group 2 and Group 3 completed the marathon faster than Group 1.

Conclusion

Lab4 probiotics with fibre alone or in combination with antioxidants protect athletes from gut disturbances during endurance training and improve their race finishing times.

Reference

Roberts JD et al 2016. An exploratory investigation of endotoxin levels in novice long distance triathletes, and the effects of a multi-strain probiotic/prebiotic/antioxidant intervention.
Nutrients 8:733.