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Effects of Probiotics Supplementation on Gastrointestinal Symptoms in Athletes: A Systematic Review of Randomized Controlled Trials.

ABSTRACT: This study examines the effectiveness of probiotic supplementation on gastrointestinal (GI) symptoms, the gut barrier function, and inflammatory markers in athletes based on data from randomised controlled trials. Searches were conducted in PubMed, the Cochrane Library, and the Web of Science up to October 2021. The protocol for this review was registered with PROSPERO (CRD42021284938). Two reviewers independently screened the titles, abstracts, and full texts to identify articles on the influence of probiotics or symbiotics on GI symptoms, gut barrier function, and cytokines, and the quality of the studies was assessed using RoB2. Ten articles involving 822 athletes were included in this review. A single strain Lactobacillus bacteria was used in three studies, seven studies used a Lactobacillus and Bifidobacterium multi-strain cocktail, and one study used this cocktail with a prebiotic. Only slight evidence was found for a positive effect of probiotics on GI symptoms in athletes during training, exercise, and competition, so it was not possible to identify the best product for managing GI symptoms in athletes. Due to the small number of studies, it was also difficult to find a direct association between the reduced exercise-induced perturbations in cytokines, gut barrier function, and GI symptoms after probiotic supplementation.

SUBMITTER: Lagowska K

PROVIDER: S-EPMC9268154 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundGestational diabetes mellitus (GDM) is a health challenge during pregnancy and is associated with adverse effects. Dysbiosis of the gut microbiota may play a role in developing inflammation and insulin resistance observed in GDM. Probiotics are supposed to be influential in preventing GDM since they can alter the composition of microbiota in the intestine. Despite the existing studies on the therapeutic effects of probiotics in women with GDM, in this study we aim to systematically review and meta-analyze the results of randomized control trials (RCTs) on the beneficial effects of probiotics supplements on the prevention of GDM in healthy pregnant women.MethodsWeb of science, Scopus and PubMed databases were searched via a precise strategy to gather RCTs related to our study. Duplication removal, screening and data extraction were conducted by two researchers, independently. Quality assessment of eligible studies was conducted by Cochrane risk of bias tool. Meta-analysis was conducted using the random effects model due to substantial heterogeneity among studies.ResultsTen articles met our eligibility criteria from our initial search of 451 articles. Two thousand nine hundred and twenty-one participants without previously diagnosed glucose disturbance were included in our analysis. Probiotics reduced GDM incidence by 33% (RR = 0.67, 95% CI: 0.47, 0.95), while greater effect was detected in trials using multiple-strains probiotics (RR = 0.65, 95% CI: 0.42, 0.99). We did not detect any significant benefits or harms related to probiotics supplements on secondary outcomes including GDM related infantile and maternal complications including preeclampsia, caesarian section, mothers' weight gain during pregnancy, prematurity, macrosomia, hypoglycemia, NICU admission, and birth weight.ConclusionProbiotics supplementation may reduce the incidence of GDM and help control glucose parameters in pregnant women. Further studies are warranted regarding the GDM-related maternal and infantile complications.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022315550, identifier: CRD42022315550.

Project description:BackgroundProbiotics, prebiotics, and synbiotics are three different supplements to treat end stage renal disease (ESRD) patients by targeting gut bacteria. The comprehensive comparison of the effectiveness of different supplements are lacking.ObjectivesThe purpose of this network meta-analysis (NMA) is to assess and rank the efficacy of probiotics, prebiotics, and synbiotics on inflammatory factors, uremic toxins, and gastrointestinal symptoms (GI symptoms) in ESRD patients undergoing dialysis.MethodsRandomized clinical trials were searched from the PubMed, Embase, and Cochrane Register of Controlled Trials databases, from their inception until 4 September 2021. Random-effect model were used to obtain all estimated outcomes in network meta-analysis (NMA). Effect estimates were presented as mean differences (Mean ± SD) with 95% confidence interval (CI). The comprehensive effects of all treatments were ranked by the surface under the cumulative ranking (SUCRA) probabilities.ResultsTwenty-five studies involved 1,106 participants were included. Prebiotics were superior in decreasing Interleukin-6 (IL-6; SMD -0.74, 95% CI [-1.32, -0.16]) and tumor-necrosis factor-α (TNF-α; SMD -0.59, 95% CI [-1.09, -0.08]), synbiotics were more effective in declining C-reactive protein (CRP; SMD -0.69, 95% CI [-1.14, -0.24]) and endotoxin (SMD -0.83, 95% CI [-1.38, -0.27]). Regarding uremic toxins, prebiotics ranked highest in reducing indoxyl sulfate (IS; SMD -0.43, 95% CI [-0.81, -0.05]), blood urea nitrogen (BUN; SMD -0.42, 95% CI [-0.78, -0.06]), and malondialdehyde (MDA; SMD -1.88, 95% CI [-3.02, -0.75]). Probiotics were rated as best in alleviating GI symptoms (SMD: -0.52, 95% CI [-0.93, -0.1]).ConclusionOur research indicated prebiotics were more effective in declining IL-6, TNF-α, IS, MDA, and BUN, synbiotics lowering CRP and endotoxin significantly, and probiotics were beneficial for alleviating GI symptoms, which may contribute to better clinical decisions. This study was registered in PROSPERO (Number: CRD42021277056).Systematic review registration[http://www.crd.york.ac.uk/PROSPERO], identifier [CRD42021277056].

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Effects of Probiotics Supplementation on Gastrointestinal Symptoms in Athletes: A Systematic Review of Randomized Controlled Trials.

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