Aitkenhead Robyn, Waldron Mark, Conway Gillian E, Horner Katy, Heffernan Shane M
A-STEM Centre, Faculty of Science and Engineering, Swansea University, Swansea SA1 8EN, UK.
Welsh Institute of Performance Science, Swansea University, Swansea SA1 8EN, UK.
Nutrients. 2025 Jan 25;17(3):443. doi: 10.3390/nu17030443.
Endurance exercise, especially under heat stress, temporarily compromises the integrity of the intestinal barrier in healthy individuals. Consequently, there is growing interest in developing effective dietary strategies to alleviate exercise-induced gastrointestinal symptoms and gut damage. This meta-analysis investigated the effects of dietary supplements on mitigating these challenges. The search was performed in November 2024 following PRISMA guidelines, and 26 peer-reviewed studies were included across three meta-analyses: (1) gastrointestinal symptoms, (2) circulating intestinal fatty acid-binding protein (i-FABP), and (3) exercise performance. The moderating effect of variables was assessed via sub-group analysis and meta-regression. Overall, there was no pooled effect of supplement interventions on gastrointestinal symptoms (Hedges' g = 0.42, 95% CI -0.17: 1.02, = 0.15), and probiotics had a moderate significant effect for gastrointestinal symptoms (Hedges' g = -0.62, 95% CI -1.01; 1.01, = 0.05). There was a significant increase in i-FABP concentrations pre- to post exercise (∆ 106%; Hedges' g = 1.01, 95% CI 0.63; 1.38, = 0.01). There were no pooled or sub-group differences for exercise performance for any supplements ( = 0.53). Moderate-to-large heterogeneity was observed across studies (I ≥ 58.6%), and candidate moderators (exercise duration, modality, and environmental temperature) had no significant effect on any outcomes ( > 0.05). A significant increase in circulating i-FABP during exercise was observed. However, when examining the effects of different supplement categories, although significance was observed for a select few supplements, the changes in i-FABP, gastrointestinal symptoms, and exercise performance were outside of clinical relevance. Although probiotics showed a moderate significant effect for gastrointestinal symptoms, the conflicting findings across studies may have been due to inadequate control of confounding variables across studies. Further research is required to assess the alternative dietary supplements' effects on gastrointestinal health and exercise performance, particularly under varied environmental conditions, where more rigorous control for cofounding factors is implemented.
耐力运动，尤其是在热应激条件下，会暂时损害健康个体肠道屏障的完整性。因此，人们越来越关注制定有效的饮食策略，以缓解运动引起的胃肠道症状和肠道损伤。这项荟萃分析研究了膳食补充剂对应对这些挑战的影响。检索工作于2024年11月按照PRISMA指南进行，26项经同行评审的研究纳入了三项荟萃分析：（1）胃肠道症状，（2）循环肠道脂肪酸结合蛋白（i-FABP），以及（3）运动表现。通过亚组分析和荟萃回归评估变量的调节作用。总体而言，补充剂干预对胃肠道症状没有合并效应（Hedges' g = 0.42，95% CI -0.17: 1.02，P = 0.15），而益生菌对胃肠道症状有中度显著效应（Hedges' g = -0.62，95% CI -1.01; 1.01，P = 0.05）。运动前后i-FABP浓度显著升高（∆ 106%；Hedges' g = 1.01，95% CI 0.63; 1.38，P = 0.01）。任何补充剂对运动表现均无合并或亚组差异（P = 0.53）。各研究间观察到中度至高度异质性（I²≥ 58.6%），候选调节因素（运动持续时间、方式和环境温度）对任何结果均无显著影响（P > 0.05）。观察到运动期间循环i-FABP显著增加。然而，在研究不同补充剂类别的影响时，虽然少数几种补充剂显示出显著性，但i-FABP、胃肠道症状和运动表现的变化并不具有临床相关性。尽管益生菌对胃肠道症状显示出中度显著效应，但各研究结果相互矛盾可能是由于研究中对混杂变量的控制不足。需要进一步研究来评估替代膳食补充剂对胃肠道健康和运动表现的影响，特别是在不同环境条件下，需要对混杂因素进行更严格的控制。
