Best Practices for Probiotic Research in Athletic and Physically Active Populations: Guidance for Future Randomized Controlled Trials

Abstract

Probiotic supplementation, traditionally used for the prevention or treatment of a variety of disease indications, is now recognized in a variety of population groups including athletes and those physically active for improving general health and performance. However, experimental and clinical trials with probiotics commonly suffer from design flaws and different outcome measures, making comparison and synthesis of conclusions difficult. Here we review current randomized controlled trials (RCTs) using probiotics for performance improvement, prevention of common illnesses, or general health, in a specific target population (athletes and those physically active). Future RCTs should address the key elements of (1) properly defining and characterizing a probiotic intervention, (2) study design factors, (3) study population characteristics, and (4) outcome measures, that will allow valid conclusions to be drawn. Careful evaluation and implementation of these elements should yield improved trials, which will better facilitate the generation of evidence-based probiotic supplementation recommendations for athletes and physically active individuals.

Orally Ingested Probiotic, Prebiotic, and Synbiotic Interventions as Countermeasures for Gastrointestinal Tract Infections in Nonelderly Adults: A Systematic Review and Meta-Analysis

“…To address these issues, more high-quality, large, randomized controlled trials are needed. These studies should incorporate best practice methodologies [ [72] , [73] , [74] ], include diagnosis of GTI, and (when possible) identify specific pathogens causing infection. Within that context, confirmatory studies of specific probiotic strains and mixtures, prebiotic types, and synbiotic formulations will be especially critical to generate the evidence needed to tailor recommendations for particular interventions (i.e., specific probiotic strains or mixtures or prebiotic types) to specific populations and environmental exposures.…”

Resistance Exercise Increases Gastrointestinal Symptoms, Markers of Gut Permeability, and Damage in Resistance-Trained Adults

“…Additionally, participants were excluded if they had a history of antibiotics or consumed probiotics in the 2 months before enrollment in the study. If a participant had recently consumed probiotics, an 8-wk washout period (22) was required before enrollment in the study to ensure the potential effects of the probiotics were eliminated. However, no participant reported consuming probiotics within the previous 3 months of their participation in the study.…”

Recommendations to Improve Quality of Probiotic Systematic Reviews With Meta-Analyses

“…Sources of information on probiotic use have included practical guides, online applications, or systematic reviews (SRs) with or without a meta-analysis (MA) component, but these sources often disagree on which probiotics should be recommended for different uses . Guidelines published by large organizations have also provided conflicting recommendations for probiotics because of differences in methods .…”