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

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

  • The study was carried out at Anglia Ruskin University in Cambridge and University of Hertfordshire in Hatfield.
  • 30 recreationally active volunteers (average age 35) were divided into three groups of 10.
  • All volunteers went through a 9-month standardized training programme.
  • In the final 12 weeks of their training programme:
    • Group 1 – took 30 billion Lab4 probiotics with prebiotic fibre daily
    • Group 2 – took 30 billion Lab4 probiotics with prebiotic fibre and antioxidants daily
    • Group 3 – took a daily placebo
  • After 12 weeks, the volunteers undertook the Barcelona Challenge Triathlon (3.8km sea swim, 180km road cycle and 42.2km marathon).
  • Volunteers provided samples at baseline (Week 0), pre-race (Week 12) and post-race (6 days post triathlon) and completed a monthly gut symptoms questionnaire.

    • Results

    Gut disturbance
  • Gut symptom severity scores during training were significantly lower in both Lab4 probiotic groups compared to the placebo group (*P<0.001).
  • Gut symptoms include bloating, nausea, stomach/intestinal pain or discomfort, cramping, headaches, dizziness, constipation and diarrhoea.
    • Endotoxin
  • Endotoxin levels were significantly reduced in group 1 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 2 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 the placebo group.
    • Plasma endotoxin levels (pg/ml)
    Plasma endotoxin levels (pg/ml)
    Intestinal permeability
  • Lactulose:Mannitol ratio was measured as an assessment of intestinal permeability.
  • Altered intestinal permeability was only observed in the placebo group, 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 Lab4 probiotics group and a 0.7 fold increase for Lab4 probiotics plus antioxidant group.
    • Placebo group L:M Ratio
    Lactulose: Mannitol Ratio
    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 placebo group.
  • A significantly faster time was reported for Lab4 probiotics group during the cycle stage of the triathlon (*P = 0.046).
  • Both Lab4 probiotics and Lab4 probiotics plus antioxidants groups completed the marathon faster than the placebo group.
    • Overall race times (mins)
    Overall race times (mins)

    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.

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