Lactobacillus fermentum (PCC®) supplementation and gastrointestinal and respiratory-tract illness symptoms: a randomised control trial in athletes
Open accessAbstract
Background: Probiotics purportedly reduce symptoms of gastrointestinal and upper respiratory-tract illness by modulating commensal microflora. Preventing and reducing symptoms of respiratory and gastrointestinal illness are the primary reason that dietary supplementation with probiotics are becoming increasingly popular with healthy active individuals. There is a paucity of data regarding the effectiveness of probiotics in this cohort. The aim of this study was to evaluate the effectiveness of a probiotic on faecal microbiology, self-reported illness symptoms and immunity in healthy well trained individuals. Methods: Competitive cyclists (64 males and 35 females; age 35 ± 9 and 36 ± 9 y, VO 2 max 56 ± 6 and 52 ± 6 ml.kg-1.min-1, mean ± SD) were randomised to either probiotic (minimum 1 × 10 9 Lactobacillus fermentum (PCC®) per day) or placebo treatment for 11 weeks in a double-blind, randomised, controlled trial. The outcome measures were faecal L. fermentum counts, self-reported symptoms of illness and serum cytokines. Results: Lactobacillus numbers increased 7.7-fold (90% confidence limits 2.1- to 28-fold) more in males on the probiotic, while there was an unclear 2.2-fold (0.2- to 18-fold) increase in females taking the probiotic. The number and duration of mild gastrointestinal symptoms were ~2-fold greater in the probiotic group. However, there was a substantial 0.7 (0.2 to 1.2) of a scale step reduction in the severity of gastrointestinal illness at the mean training load in males, which became more pronounced as training load increased. The load (duration×severity) of lower respiratory illness symptoms was less by a factor of 0.31 (99%CI; 0.07 to 0.96) in males taking the probiotic compared with placebo but increased by a factor of 2.2 (0.41 to 27) in females. Differences in use of cold and flu medication mirrored these symptoms. The observed effects on URTI had too much uncertainty for a decisive outcome. There were clear reductions in the magnitude of acute exercise-induced changes in some cytokines. Conclusion: L. fermentum may be a useful nutritional adjunct for healthy exercising males. However, uncertainty in the effects of supplementation on URTI and on symptoms in females needs to be resolved. Trial registration: The trial was registered in the Australia and New Zealand Clinical Trials Registry (ACTRN12611000006943).
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In 80 competitive cyclists, 11 weeks of supplementation with L. fermentum (PCC®) had no effect on peak power or VO2 max.
“Similarly, in 80 competitive cyclists, 11 weeks of supplementation with L. fermentum (PCC®) had no effect on peak power or VO2 max [61].”
From International Society of Sports Nutrition Position Stand: Probiotics (2019) · cites this paper as [61]
The single strain interventions used in five studies did not produce an aerobic performance benefit.
“The single strain interventions used in these five studies did not produce an aerobic performance benefit.”
From International Society of Sports Nutrition Position Stand: Probiotics (2019) · cites this paper as [61]
In an athletic population, specific probiotic strains can reduce the number of episodes, severity and duration of upper respiratory tract infections.
“In an athletic population, specific probiotic strains can reduce the number of episodes, severity and duration of upper respiratory tract infections.”
From International Society of Sports Nutrition Position Stand: Probiotics (2019) · cites this paper as [61]
In competitive cyclists, L. fermentum (PCC®) over an 11-week winter training period reduced severity of self-reported symptoms of lower respiratory illness and use of cold and flu medication compared to placebo, but this effect was only noted in males and not females.
“In competitive cyclists, West et al. [61] reported reduced severity of self-reported symptoms of lower respiratory illness and use of cold and flu medication over an 11-week winter training period with L. fermentum (PCC®) compared to placebo. Interestingly, this effect was only noted in males and not females.”
From International Society of Sports Nutrition Position Stand: Probiotics (2019) · cites this paper as [61]
There is some limited evidence that discrepancies exist between males and females, even after supplementation of probiotics with the same dose.
“Finally, there is some limited evidence that discrepancies exist between males and females, even after supplementation of probiotics with the same dose [61].”
From International Society of Sports Nutrition Position Stand: Probiotics (2019) · cites this paper as [61]
Discrepancies between men and women in response to probiotic supplementation at the same dose are evident.
“For example, discrepancies between men and women, even after supplementation of probiotics with the same dose, are evident [61].”
From International Society of Sports Nutrition Position Stand: Probiotics (2019) · cites this paper as [61]
Probiotic bacteria, particularly Lactobacillus and Bifidobacterium species, are known to modify GI microbiota and reduce GI episode severity and respiratory tract infections associated with training.
“Probiotic bacteria, particularly the gram-positive genera Lactobacillus and Bifidobacterium species, are known to modify GI microbiota [17,18,19], and have been shown to reduce GI episode severity [20] and respiratory tract infections commonly associated with training [21].”
Probiotic administration is associated with reduced GI symptom prevalence and severity.
“There is evidence of reduced GI symptom prevalence and severity following the administration of probiotics [145, 146] although benefits may be individualized and strain-specific.”
From International Society of Sports Nutrition Position Stand: nutritional considerations for single-stage ultra-marathon training and racing (2019) · cites this paper as [145]
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- Authors
- West, N. P., Pyne, D. B., Cripps, A. W., Hopkins, W. G., Eskesen, D. C., Jairath, A., Christophersen, C. T., Conlon, M. A., & Fricker, P. A.
- Affiliations
- Griffith University (AU)
- Australian National University (AU)
- Chr. Hansen (Denmark) (DK)
- Procomcure Biotech (Austria) (AT)
- Commonwealth Scientific and Industrial Research Organisation (AU)
- Corresponding author
- Cripps, Allan W
- Venue
- Nutrition Journal
- Published
- 2011-04-11
- Volume
- 10
- Issue
- 1
- Pages
- 30-30
- ISSN
- 1475-2891 (ISSN-L)
- PMC
- PMC3083335
- OpenAlex
- W2104181007
- Cited by
- 180
- References
- 45
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 11 · 2023: 6 · 2022: 19 · 2021: 24 · 2020: 9 · 2019: 16 · 2018: 16 · 2017: 12 · 2016: 11 · 2015: 8 · 2014: 5 · 2013: 14 · 2012: 11
- FWCI
- 14.49
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Nutrition Journal (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Victoria University Research Repository (Victoria University) (submittedVersion, cc-by)
- Griffith Research Online (submittedVersion, cc-by)
- University of Canberra Research Portal (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- eSpace (Curtin University) (submittedVersion, cc-by)
- ANU Open Research (Australian National University) (submittedVersion)
- Funders
- Australian Institute of Sport
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- Lactobacillus fermentum, probiotics, athletes, cyclists, gastrointestinal diseases, upper respiratory tract infection, fecal microbiota, serum cytokines, sex differences, training load, dietary supplementation, gut microbiota modulation, gastrointestinal symptoms, cold and flu
- MeSH terms
- Adult, Double-Blind Method, Feces, Female, Gastrointestinal Diseases, Humans, Immunity, Male, Middle Aged, New Zealand, Respiratory Tract Infections, Exercise, Cytokines, Probiotics, Gastrointestinal Tract, Limosilactobacillus fermentum, Young Adult, Athletes, Self Report
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