Probiotic supplementation for respiratory and gastrointestinal illness symptoms in healthy physically active individuals

Published:October 14, 2013DOI:https://doi.org/10.1016/j.clnu.2013.10.002

      Summary

      Background & aims

      To examine the effect of supplementation with probiotics on respiratory and gastrointestinal illness in healthy active men and women.

      Methods

      A randomised double-blind placebo-controlled trial was conducted. Four hundred and sixty five participants (241 males; age 35 ± 12 y (mean ± SD) and 224 females; age 36 ± 12 y) were assigned to one of three groups: Group 1 – Bifidobacterium animalis subsp. lactis Bl-04 (Bl-04) 2.0 × 109colony forming units per day, CFU per day, Group 2 – Lactobacillus acidophilus NCFM and Bifidobacterium animalis subsp. lactis Bi-07 (NCFM & Bi-07) 5 × 109 CFU each per day) or Group 3 – placebo mixed in a drink.

      Results

      The risk of an upper respiratory illness episode was significantly lower in the Bl-04 group (hazard ratio 0.73; 95% confidence interval 0.55–0.95; P = 0.022) compared to placebo. There was no significant difference in illness risk between the NCFM & Bi-07 group (hazard ratio 0.81; 0.62–1.08; P = 0.15) and the placebo group. There was a 0.7 and 0.9 month delay in the median time to an illness episode in the Bl-04 and NCFM & Bi-07 groups respectively compared to placebo (placebo 2.5 months; Bl-04 3.2 months; NCFM & Bi-07 3.4 months). There were insufficient GI illness episodes for analysis. The NCFM & Bi-07 group but not the Bl-04 group undertook significantly more physical activity (8.5%; 6.7%–10%; P < 0.003) than the placebo group.

      Conclusion

      The probiotic Bl-04 appears to be a useful nutritional supplement in reducing the risk of URTI in healthy physically-active adults.

      Trial registration

      Australia New Zealand Clinical Trials Registry: Number ACTRN12611000130965.

      Keywords

      Abbreviations:

      URTI (upper respiratory tract illness), GI (gastrointestinal), BMI (body mass index), CFU (colony forming units)
      To read this article in full you will need to make a payment
      Subscribe to Clinical Nutrition
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Britt H.
        • Miller G.C.
        • Charles J.
        • Henderson J.
        • Bayram C.
        • Pan Y.
        • et al.
        General practice activity in Australia 2009–10.
        (General practice series no. 27)2010
        • Moyad M.A.
        Conventional and alternative medical advice for cold and flu prevention: what should be recommended and what should be avoided?.
        Urol Nurs. 2009 Nov–Dec; 29: 455-458
      1. (Online article)
        • Davis G.
        Social and economic costs of influenza.
        2010 ([accessed 11.08.11])
        • Newman L.
        • Stirzaker S.
        • Knuckey D.
        • Robinson K.
        • Hood J.
        • Knope K.
        • et al.
        Australia's notifiable disease status, 2008: annual report of the national notifiable diseases surveillance system.
        Commun Dis Intell Q Rep. 2010 Sep; 34: 157-224
        • Hao Q.
        • Lu Z.
        • Dong B.R.
        • Huang C.Q.
        • Wu T.
        Probiotics for preventing acute upper respiratory tract infections.
        Cochrane Database Syst Rev. 2011; 9: CD006895
        • West N.P.
        • Pyne D.B.
        • Peake J.M.
        • Cripps A.W.
        Probiotics, immunity and exercise: a review.
        Exerc Immunol Rev. 2009; 15: 107-126
        • Timmerman H.M.
        • Koning C.J.
        • Mulder L.
        • Rombouts F.M.
        • Beynen A.C.
        Monostrain, multistrain and multispecies probiotics–A comparison of functionality and efficacy.
        Int J Food Microbiol. 2004 Nov 15; 96: 219-233
        • Leyer G.J.
        • Li S.
        • Mubasher M.E.
        • Reifer C.
        • Ouwehand A.C.
        Probiotic effects on cold and influenza-like symptom incidence and duration in children.
        Pediatrics. 2009 Aug; 124: e172-e179
        • Makino S.
        • Ikegami S.
        • Kume A.
        • Horiuchi H.
        • Sasaki H.
        • Orii N.
        Reducing the risk of infection in the elderly by dietary intake of yoghurt fermented with Lactobacillus delbrueckii ssp. bulgaricus OLL1073R-1.
        Br J Nutr. 2010 Oct; 104: 998-1006
        • Berggren A.
        • Lazou Ahren I.
        • Larsson N.
        • Onning G.
        Randomised, double-blind and placebo-controlled study using new probiotic lactobacilli for strengthening the body immune defence against viral infections.
        Eur J Nutr. 2011 Apr; 50: 203-210
        • Gleeson M.
        • Bishop N.C.
        • Oliveira M.
        • Tauler P.
        Daily probiotic's (Lactobacillus casei Shirota) reduction of infection incidence in athletes.
        Int J Sport Nutr Exerc Metab. 2011 Feb; 21: 55-64
        • Garber C.E.
        • Blissmer B.
        • Deschenes M.R.
        • Franklin B.A.
        • Lamonte M.J.
        • Lee I.M.
        • et al.
        American college of sports medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise.
        Med Sci Sports Exerc. 2011 Jul; 43: 1334-1359
        • Gleeson M.
        • Bishop N.C.
        • Stensel D.J.
        • Lindley M.R.
        • Mastana S.S.
        • Nimmo M.A.
        The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease.
        Nat Rev Immunol. 2011 Sep; 11: 607-615
        • Szakaly Z.
        • Szente V.
        • Kover G.
        • Polereczki Z.
        • Szigeti O.
        The influence of lifestyle on health behavior and preference for functional foods.
        Appetite. 2011 Nov 15; 58: 406-413
        • Paineau D.
        • Carcano D.
        • Leyer G.
        • Darquy S.
        • Alyanakian M.A.
        • Simoneau G.
        • et al.
        Effects of seven potential probiotic strains on specific immune responses in healthy adults: a double-blind, randomized, controlled trial.
        FEMS Immunol Med Microbiol. 2008 Jun; 53: 107-113
        • Larsen C.N.
        • Nielsen S.
        • Kaestel P.
        • Brockmann E.
        • Bennedsen M.
        • Christensen H.R.
        • et al.
        Dose-response study of probiotic bacteria Bifidobacterium animalis subsp lactis BB-12 and Lactobacillus paracasei subsp paracasei CRL-341 in healthy young adults.
        Eur J Clin Nutr. 2006 Nov; 60: 1284-1293
        • Campbell-Sills L.
        • Stein M.B.
        Psychometric analysis and refinement of the connor-davidson resilience scale (CD-RISC): validation of a 10-item measure of resilience.
        J Trauma Stress. 2007 Dec; 20: 1019-1028
        • West N.P.
        • Pyne D.B.
        • Cripps A.W.
        • Hopkins W.G.
        • Eskesen D.C.
        • Jairath A.
        • et al.
        Lactobacillus fermentum (PCC(R)) supplementation and gastrointestinal and respiratory-tract illness symptoms: a randomised control trial in athletes.
        Nutr J. 2011; 10: 30
        • Gwaltney J.M.
        Viral respiratory infection therapy: historical perspectives and current trials.
        Am J Med. 2002 Apr 22; 112: 33S-41S
        • Heritier S.
        • Gebski V.
        • Pillai A.
        Dynamic balancing randomization in controlled clinical trials.
        Stat Med. 2005 Dec 30; 24: 3729-3741
        • Falsey A.R.
        Respiratory syncytial virus infection in adults.
        Semin Respir Crit Care Med. 2007 Apr; 28: 171-181
        • Abd ElHafeez S.
        • Torino C.
        • D'Arrigo G.
        • Bolignano D.
        • Provenzano F.
        • Mattace-Raso F.
        • et al.
        An overview on standard statistical methods for assessing exposure-outcome link in survival analysis (Part II): the Kaplan-Meier analysis and the cox regression method.
        Aging Clin Exp Res. 2012 Jun; 24: 203-206
        • Wei L.J.
        • Lin D.Y.
        • Weissfield L.
        Regressionanalysis of multivariate incomplete failure time data.
        J Am Stat Assoc. 1989; 84: 1065-1073
        • Wei L.J.
        • Johnson W.E.
        Combining dependent tests with incomplete repeated measurements.
        Biometrika. 1985; 72: 359-364
        • Stel V.S.
        • Dekker F.W.
        • Tripepi G.
        • Zoccali C.
        • Jager K.J.
        Survival analysis I: the Kaplan-Meier method.
        Nephron Clin Pract. 2011; 119: c83-c88
        • Gleeson M.
        • Walsh N.P.
        The BASES expert statement on exercise, immunity, and infection.
        J Sports Sci. 2012; 30: 321-324
        • Walsh N.P.
        • Gleeson M.
        • Shephard R.J.
        • Woods J.A.
        • Bishop N.C.
        • Fleshner M.
        • et al.
        Position statement. Part one: immune function and exercise.
        Exerc Immunol Rev. 2011; 17: 6-63
        • Walsh N.P.
        • Gleeson M.
        • Pyne D.B.
        • Nieman D.C.
        • Dhabhar F.S.
        • Shephard R.J.
        • et al.
        Position statement. Part two: maintaining immune health.
        Exerc Immunol Rev. 2011; 17: 64-103
        • Besselink M.G.
        • Timmerman H.M.
        • Buskens E.
        • Nieuwenhuijs V.B.
        • Akkermans L.M.
        • Gooszen H.G.
        Probiotic prophylaxis in patients with predicted severe acute pancreatitis (PROPATRIA): design and rationale of a double-blind, placebo-controlled randomised multicenter trial [ISRCTN38327949].
        BMC Surg. 2004; 4: 12
        • de Vrese M.
        • Winkler P.
        • Rautenberg P.
        • Harder T.
        • Noah C.
        • Laue C.
        • et al.
        Effect of Lactobacillus gasseri PA 16/8, Bifidobacterium longum SP 07/3, B. bifidum MF 20/5 on common cold episodes: a double blind, randomized, controlled trial.
        Clin Nutr. 2005 Aug; 24: 481-491
        • Hemila H.
        • Chalker E.
        Vitamin C for preventing and treating the common cold.
        Cochrane Database Syst Rev. 2013; 1: CD000980