Craig A. Suckling

An Exploratory Investigation of Endotoxin Levels in Novice Long Distance Triathletes, and the Effects of a Multi-Strain Probiotic/Prebiotic, Antioxidant Intervention

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·day−1 containing 10 billion CFU·day−1 Lactobacillus acidophilus CUL-60 (NCIMB 30157), 10 billion CFU·day−1 Lactobacillus acidophillus CUL-21 (NCIMB 30156), 9.5 billion CFU·day−1 Bifidobacterium bifidum CUL-20 (NCIMB 30172) and 0.5 billion CFU·day−1 Bifidobacterium animalis subspecies lactis CUL-34 (NCIMB 30153)/55.8 mg·day−1 fructooligosaccharides/ 400 mg·day−1 α-lipoic acid, 600 mg·day−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 h urinary lactulose (L): mannitol (M) recovery) were assessed at baseline, pre-race and six 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 six days post-race (5.18 ± 0.57 pg·mL−1; p = 0.03, ηp2 = 0.35), but only six 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 (h:min:s) were not statistically different between groups despite faster times with both pro/prebiotoic groups (LAB4ANTI: 13:17:07 ± 0:34:48; LAB4: 12:47:13 ± 0:25:06; PL: 14:12:51 ± 0:29:54; 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.

Chronic probiotic supplementation with or without glutamine does not influence the eHsp72 response to a multi-day ultra-endurance exercise event

Probiotic and glutamine supplementation increases tissue Hsp72, but their influence on extracellular Hsp72 (eHsp72) has not been investigated. The aim of this study was to investigate the effect of chronic probiotic supplementation, with or without glutamine, on eHsp72 concentration before and after an ultramarathon. Thirty-two participants were split into 3 independent groups, where they ingested probiotic capsules (PRO; n = 11), probiotic + glutamine powder (PGLn; n = 10), or no supplementation (CON; n = 11), over a 12-week period prior to commencement of the Marathon des Sables (MDS). eHsp72 concentration in the plasma was measured at baseline, 7 days pre-race, 6-8 h post-race, and 7 days post-race. The MDS increased eHsp72 concentrations by 124% (F[1,3] = 22.716, p < 0.001), but there was no difference in the response between groups. Additionally, PRO or PGLn supplementation did not modify pre- or post-MDS eHsp72 concentrations compared with CON (p > 0.05). In conclusion, the MDS caused a substantial increase in eHsp72 concentration, indicating high levels of systemic stress. However, chronic PRO or PGLn supplementation did not affect eHsp72 compared with control pre- or post-MDS. Given the role of eHsp72 in immune activation, the commercially available supplements used in this study are unlikely to influence this cascade.

Probiotic Supplementation and Gastrointestinal Endotoxemia Before and After the Marathon Des Sables.: 888 Board #204 June 1, 2: 00 PM - 3: 30 PM.

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: 874 Board #190 June 1, 2: 00 PM - 3: 30 PM.

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.