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The Influence of Dietary Supplements on Exercise-Induced Gut Damage and Gastrointestinal Symptoms: A Systematic Review and Meta-Analysis

Robyn Aitkenhead, Mark Waldron Orcid Logo, Gill Conway Orcid Logo, Katy Horner Orcid Logo, Shane Heffernan Orcid Logo

Nutrients, Volume: 17, Issue: 3, Start page: 443

Swansea University Authors: Robyn Aitkenhead, Mark Waldron Orcid Logo, Gill Conway Orcid Logo, Shane Heffernan Orcid Logo

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DOI (Published version): 10.3390/nu17030443

Abstract

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 me...

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Published in: Nutrients
ISSN: 2072-6643
Published: MDPI AG 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa68741
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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&#x2019; g = 0.42, 95% CI &#x2212;0.17: 1.02, p = 0.15), and probiotics had a moderate significant effect for gastrointestinal symptoms (Hedges&#x2019; g = &#x2212;0.62, 95% CI &#x2212;1.01; 1.01, p = 0.05). There was a significant increase in i-FABP concentrations pre- to post exercise (&#x2206;106%; Hedges&#x2019; g = 1.01, 95% CI 0.63; 1.38, p = 0.01). There were no pooled or sub-group differences for exercise performance for any supplements (p = 0.53). Moderate-to-large heterogeneity was observed across studies (I2 &#x2265; 58.6%), and candidate moderators (exercise duration, modality, and environmental temperature) had no significant effect on any outcomes (p &gt; 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. 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spelling 2025-02-26T15:52:52.5384028 v2 68741 2025-01-27 The Influence of Dietary Supplements on Exercise-Induced Gut Damage and Gastrointestinal Symptoms: A Systematic Review and Meta-Analysis 3e157b6e7d9802d5be3c8dd790c71679 Robyn Aitkenhead Robyn Aitkenhead true false 70db7c6c54d46f5e70b39e5ae0a056fa 0000-0002-2720-4615 Mark Waldron Mark Waldron true false e33e0ee5a076ad91fe6615117caa1800 0000-0002-5991-0960 Gill Conway Gill Conway true false 72c0b36891dfbec0378c0d0f7916e807 0000-0002-3297-9335 Shane Heffernan Shane Heffernan true false 2025-01-27 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, p = 0.15), and probiotics had a moderate significant effect for gastrointestinal symptoms (Hedges’ g = −0.62, 95% CI −1.01; 1.01, p = 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, p = 0.01). There were no pooled or sub-group differences for exercise performance for any supplements (p = 0.53). Moderate-to-large heterogeneity was observed across studies (I2 ≥ 58.6%), and candidate moderators (exercise duration, modality, and environmental temperature) had no significant effect on any outcomes (p > 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. Journal Article Nutrients 17 3 443 MDPI AG 2072-6643 gut damage; exercise; supplements; heat 25 1 2025 2025-01-25 10.3390/nu17030443 COLLEGE NANME COLLEGE CODE Swansea University Other This research received no external funding. 2025-02-26T15:52:52.5384028 2025-01-27T09:09:15.0175812 Faculty of Science and Engineering School of Engineering and Applied Sciences - Sport and Exercise Sciences Robyn Aitkenhead 1 Mark Waldron 0000-0002-2720-4615 2 Gill Conway 0000-0002-5991-0960 3 Katy Horner 0000-0002-5046-3658 4 Shane Heffernan 0000-0002-3297-9335 5 68741__33415__adb15f98e72f4a64922311f0db77646c.pdf 68741.pdf 2025-01-27T09:13:45.1967995 Output 3966444 application/pdf Version of Record true © 2025 by the authors. This is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. true eng https://creativecommons.org/ licenses/by/4.0/
title The Influence of Dietary Supplements on Exercise-Induced Gut Damage and Gastrointestinal Symptoms: A Systematic Review and Meta-Analysis
spellingShingle The Influence of Dietary Supplements on Exercise-Induced Gut Damage and Gastrointestinal Symptoms: A Systematic Review and Meta-Analysis
Robyn Aitkenhead
Mark Waldron
Gill Conway
Shane Heffernan
title_short The Influence of Dietary Supplements on Exercise-Induced Gut Damage and Gastrointestinal Symptoms: A Systematic Review and Meta-Analysis
title_full The Influence of Dietary Supplements on Exercise-Induced Gut Damage and Gastrointestinal Symptoms: A Systematic Review and Meta-Analysis
title_fullStr The Influence of Dietary Supplements on Exercise-Induced Gut Damage and Gastrointestinal Symptoms: A Systematic Review and Meta-Analysis
title_full_unstemmed The Influence of Dietary Supplements on Exercise-Induced Gut Damage and Gastrointestinal Symptoms: A Systematic Review and Meta-Analysis
title_sort The Influence of Dietary Supplements on Exercise-Induced Gut Damage and Gastrointestinal Symptoms: A Systematic Review and Meta-Analysis
author_id_str_mv 3e157b6e7d9802d5be3c8dd790c71679
70db7c6c54d46f5e70b39e5ae0a056fa
e33e0ee5a076ad91fe6615117caa1800
72c0b36891dfbec0378c0d0f7916e807
author_id_fullname_str_mv 3e157b6e7d9802d5be3c8dd790c71679_***_Robyn Aitkenhead
70db7c6c54d46f5e70b39e5ae0a056fa_***_Mark Waldron
e33e0ee5a076ad91fe6615117caa1800_***_Gill Conway
72c0b36891dfbec0378c0d0f7916e807_***_Shane Heffernan
author Robyn Aitkenhead
Mark Waldron
Gill Conway
Shane Heffernan
author2 Robyn Aitkenhead
Mark Waldron
Gill Conway
Katy Horner
Shane Heffernan
format Journal article
container_title Nutrients
container_volume 17
container_issue 3
container_start_page 443
publishDate 2025
institution Swansea University
issn 2072-6643
doi_str_mv 10.3390/nu17030443
publisher MDPI AG
college_str Faculty of Science and Engineering
hierarchytype
hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Engineering and Applied Sciences - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Sport and Exercise Sciences
document_store_str 1
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description 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, p = 0.15), and probiotics had a moderate significant effect for gastrointestinal symptoms (Hedges’ g = −0.62, 95% CI −1.01; 1.01, p = 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, p = 0.01). There were no pooled or sub-group differences for exercise performance for any supplements (p = 0.53). Moderate-to-large heterogeneity was observed across studies (I2 ≥ 58.6%), and candidate moderators (exercise duration, modality, and environmental temperature) had no significant effect on any outcomes (p > 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.
published_date 2025-01-25T09:39:29Z
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