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 (LAB(ANTI)(4); 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) alpha-lipoic acid, 600 mg.day(-1) N-acetyl-carnitine); matched pro/prebiotic (LAB(4)) 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 (LAB(ANTI)(4):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 LAB4 ANTI 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, +/- eta p(2) = 0.35), but only six days post-race with LAB(4) (5.01 +/- 0.28 pg.mL(-1); p = 0.01, eta p(2) = 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, +/- eta(2) = 0.51). Mean race times (h:min:s) were not statistically different between groups despite faster times with both pro/prebiotoic groups (LAB(ANTI)(4):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 LAB(ANTI)(4) potentially conferring an additive effect via combined GI modulation and antioxidant protection.