Effect of Probiotic Consumption on Immune Response in Athletes: A Meta-analysis

Rahele Tavakoly; Amir Hadi; Nahid Rafie; Behrouz Talaei; Wolfgang Marx; Arman Arab

doi:10.1055/a-1463-3303

International Journal of Sports Medicine, Table of Contents

Int J Sports Med 2021; 42(09): 769-781
DOI: 10.1055/a-1463-3303

Review

Effect of Probiotic Consumption on Immune Response in Athletes: A Meta-analysis

Rahele Tavakoly

¹Student Research Committee, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran (the Islamic Republic of)

²Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran (the Islamic Republic of)

,

Amir Hadi

³Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)

,

Nahid Rafie

³Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)

,

Behrouz Talaei

¹Student Research Committee, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran (the Islamic Republic of)

⁴Department of Nutrition, school of Public Health, Kerman University of Medical Sciences, Kerman, Iran (the Islamic Republic of)

,

Wolfgang Marx

⁵Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia

,

Arman Arab

⁶Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)

› Author Affiliations

Abstract

The possible effect of probiotic interventions on immunological markers in athletes is inconclusive. Therefore, to synthesize and quantitatively analyze the existing evidence on this topic, systematic literature searches of online databases PubMed, Scopus, Cochrane Library, and ISI Web of Sciences was carried out up to February 2021 to find all randomized controlled trials (RCTs) concerning the immunological effects of probiotics in athletes. In the random-effects model, weighted mean difference (WMD) and 95% confidence interval (CI) explained the net effect. The authors assessed the likelihood of publication bias via Egger’s and Begg’s statistics. A total of 13 RCTs (836 participants) were retrieved. Probiotic consumption reduced lymphocyte T cytotoxic count significantly (WMD=−0.08 cells×10⁹/L; 95% CI: −0.15 to −0.01; p=0.022) with evidence of moderate heterogeneity (I ²⁼59.1%, p=0.044) and monocyte count when intervention duration was ≤ 4 weeks (WMD=−0.08 cells×10⁹/L; 95% CI: −0.16 to −0.001; I ²⁼0.0%). Furthermore, leukocyte count was significantly elevated (WMD=0.48 cells×10⁹/L; 95% CI: 0.02 to 0.93; I ²⁼0.0%) when multi-strain probiotics were used. Probiotic supplements may improve immunological markers, including lymphocyte T cytotoxic, monocyte, and leukocyte in athletes. Further randomized controlled trials using diverse strains of probiotics and consistent outcome measures are necessary to allow for evidence-based recommendations.

Key words

probiotics - immunological markers - athletes - systematic review - meta-analysis

Full Text

References

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Supplementary Material